Internal medicine journal
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Internal medicine journal · May 2024
A minority of women of childbearing potential are tested for pregnancy before chemoimmunotherapy: An Australian Cancer Centre Experience.
Chemotherapy is potentially harmful to a developing foetus, and there are limited data on the foetal impact of chemoimmunotherapy (CIT). Therefore, determining pregnancy status prior to initiation of CIT should be standard of care. ⋯ Our results highlight a concerningly low rate of pregnancy screening in women of childbearing age receiving CIT. The implication of missing a positive pregnancy test in this group of women could result in foetal complications, accidental miscarriage, potential bleeding risks and avoidable psychosocial stress. This highlights the urgent need for guidelines to mandate pregnancy testing in women of childbearing age receiving CIT and evidence-based implementation tools.
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Internal medicine journal · May 2024
ReviewThe new paradigm in machine learning - foundation models, large language models and beyond: a primer for physicians.
Foundation machine learning models are deep learning models capable of performing many different tasks using different data modalities such as text, audio, images and video. They represent a major shift from traditional task-specific machine learning prediction models. ⋯ However, such models are not without risk and can potentially cause harm if their development, evaluation and use are devoid of proper scrutiny. This narrative review describes the different types of LLM, their emerging applications and potential limitations and bias and likely future translation into clinical practice.
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Internal medicine journal · May 2024
Multicenter StudyClinician perspectives on voluntary assisted dying and willingness to be involved: a multisite, cross-sectional survey during implementation in New South Wales, Australia.
In the context of nationwide law reform, New South Wales (NSW) became the last state in Australia to legalise voluntary assisted dying (VAD) - commencing 28 November 2023. Clinicians have divergent views regarding VAD, with varying levels of understanding, support, and willingness to be involved, and these may have a significant impact on the successful implementation. ⋯ The majority of clinical staff surveyed across NSW supported VAD legislation. While many eligible clinicians were reluctant to be actively involved, sufficient numbers appear willing to provide VAD services, indicating that successful implementation should be possible.
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Internal medicine journal · May 2024
Demographics, comorbidities and risk factors for severe disease from the early SARS-CoV-2 infection cases in Queensland, Australia.
Demographics and comorbidities associated with coronavirus disease 2019 (COVID-19) severity differs between subpopulations and should be determined to aid future pandemic planning and preparedness. ⋯ Comorbidities associated with the highest level of COVID-19 disease severity were morbid obesity, chronic respiratory disease and cardiac disease. These data can assist with identifying high-risk patients susceptible to severe COVID-19 and can be used to facilitate preparations for future pandemics.