In an international, randomized trial involving patients with acute venous thromboembolism, the risk of clinically relevant bleeding was significantly lower with apixaban than with rivaroxaban during the 3-month treatment period.
Read the full COBRRA trial results and accompanying editorial at NEJM.org (link in bio).
#Cardiology #CriticalCare #NEJM
In a meta-analysis involving 17,801 patients with myocardial infarction and preserved LVEF (≥50%), beta-blockers did not reduce death, MI, or heart failure over a median 3.6 years of follow-up.
Read the full trial results and Research Summary at NEJM.org (link in bio).
#Cardiology #ClinicalTrials #NEJM
In patients with shock, whether noninvasive blood-pressure monitoring is an effective alternative to the recommended use of an arterial catheter is uncertain.
This video in our partnership with @docglauc summarizes the results of a trial that evaluated whether management of shock without early arterial catheterization is noninferior to the practice of early catheter insertion with regard to death from any cause at day 28.
View the Original Article for free: https://nej.md/DrG33 (link in bio)
#criticalcare #medicaleducation #NEJM
From a new Perspective by Andrea Sikora, PharmD, MSCR, Leo A. Celi, MD, MPH, and Raja-Elie E. Abdulnour, MD:
A first-year resident is asked, “What explains the patient’s rising creatinine?” She pauses. “I don’t know ….” The team reviews the patient’s medications and risk factors and chooses a cautious plan involving checking drug levels and consulting the nephrology department.
A clinical #ArtificialIntelligence (AI) system is presented with the same case. It retrieves relevant articles, but despite conflicting evidence, it produces a confident answer, without flagging the uncertainty involved in applying the selected studies to the patient in question.
There are few clinical scenarios more problematic than a practitioner being confidently wrong. Clinicians are rightly expected to disclose their gaps in knowledge or their inability to forecast an outcome. Yet emerging AI tools often cannot — or will not — do the same. In an analysis of large language models (LLMs) that were presented with 300 physician-designed vignettes, each including one fabricated detail, the LLMs accepted and amplified the falsehood 50 to 82% of the time. In short, most models didn’t say, “I don’t know.”
Continue reading the Perspective “Can AI Say ‘I Don’t Know’?” by Andrea Sikora, PharmD, MSCR, Leo A. Celi, MD, MPH, and Raja-Elie E. Abdulnour, MD, from University of Colorado School of Medicine (@cumedschool ), Harvard T.H. Chan School of Public Health (@harvardchansph ), @brighamandwomens , and @harvardmed , at NEJM.org (link in bio).
#MedicalEducation #MedicalEthics
The history of race-based correction of lung-capacity measures can be traced to a pre–Civil War belief among slave owners that slaves had naturally inferior lung capacity. Despite work to show that race-corrected spirometers mask lung-disease severity in Black patients, the majority of U.S. hospitals still use them.
Tap the link in our bio to listen to the latest episode of Intention to Treat.
#MedicalEducation #MedicalPractice #NEJM
A 57-year-old woman with a history of osteopenia presented to the emergency department with left wrist pain after slipping on ice and landing on her palm. Physical examination and a lateral radiograph of the left wrist are shown. What is the most likely diagnosis? Submit your answer at NEJM.org (link in bio).
Inflammatory myopathies are a heterogeneous group of autoimmune diseases characterized by immune-mediated damage to skeletal muscle. They are classified into five major subtypes: inclusion-body myositis, immune-mediated necrotizing myopathies, antisynthetase syndrome, overlapping myositis, and dermatomyositis, each with distinct clinical features and outcomes. Inclusion-body myositis and immune-mediated necrotizing myopathies primarily affect muscle, with prognosis largely determined by functional impairment, whereas antisynthetase syndrome, overlapping myositis, and dermatomyositis are systemic diseases that can involve the skin, joints, and lungs and may be life-threatening. The majority of inflammatory myopathies are associated with myositis-specific autoantibodies, which inform diagnosis, subtype classification, and prognosis. Advances in understanding the distinct pathomechanisms underlying each subgroup now enable increasingly targeted therapeutic approaches.
Learn more in the Review Article “Inflammatory Myopathies” by Yves Allenbach, MD, PhD, and Olivier Benveniste, MD, PhD, at NEJM.org (link in bio).
#Neurology #Rheumatology #NEJM
A 64-year-old woman presented with fatigue, memory changes, and falls. MRI of the head revealed numerous hyperintense foci in the white matter on fluid-attenuated inversion recovery images. What is the most likely diagnosis in this case?
Read the case details and vote at NEJM.org (link in bio).
#ClinicalMedicine #NEJM
The incidence of Lyme disease has steadily increased since the discovery of the causative agent, 𝘉𝘰𝘳𝘳𝘦𝘭𝘪𝘢 𝘣𝘶𝘳𝘨𝘥𝘰𝘳𝘧𝘦𝘳𝘪, in 1982, writes Durland Fish, PhD, in a new Perspective. In recent years, an estimated 500,000 cases have been diagnosed each year in the United States, resulting in nearly $1 billion in annual health care costs. Cases of other tickborne diseases, including anaplasmosis, babesiosis, and Powassan virus infection, have also increased (swipe left to see graphs). Despite 40 years of research aimed at controlling Lyme disease, there are currently no available prevention methods that significantly reduce disease incidence in humans. Failure to address this epidemic is in part a result of the misdirection of research efforts, which have emphasized clinical disease and pathogen microbiology rather than the root cause of Lyme disease: the infected tick vectors in the environment, which remain uncontrolled.
Continue reading the Perspective “Getting Serious about Tickborne Diseases — Shifting Research Priorities” by Durland Fish, PhD, from Yale School of Public Health (@yalesph ), at NEJM.org (link in bio).
#InfectiousDisease
Dr. Aaron Baugh, a Black pulmonologist in California, believed that using race-correction in lung-function tests was a way to reduce health inequities. That was until he ran the numbers himself. Shocked by the results, he began to study the harmful effects of race correction on Black patients with lung disease.
Part two of 𝙏𝙝𝙚 𝙍𝙖𝙘𝙚 𝙀𝙦𝙪𝙖𝙩𝙞𝙤𝙣 uncovers the racist myths that led to today’s lung-function testing with Harvard historian of science Evelynn Hammonds and Brown professor Lundy Braun. Why is the race-corrected interpretation of spirometer test results still used by a majority of U.S. hospitals, when scientists have documented that the practice is harming patients?
Explore this topic in the latest episode of the Intention to Treat podcast: https://nej.md/3RsGBLv (link in bio)
The hantavirus outbreak has raised two major concerns for Dr. Paul Sax — and neither is directly related to the outbreak itself.
Tap the link in our bio to read the latest from Dr. Sax in NEJM Voices, a new clinician blog featuring short, personal essays grounded in real-world practice.
New in the May 14, 2026, issue of NEJM:
A Phase 3 Trial of Brepocitinib in Dermatomyositis (phase 3 VALOR trial)
Treatment of Medium-Vessel-Occlusion Stroke (ORIENTAL-MeVO trial)
Ensitrelvir for Covid-19 Postexposure Prophylaxis (phase 3 SCORPIO-PEP trial)
Telitacicept for IgA Nephropathy (phase 3 TELIGAN trial)
Visit NEJM.org for the latest medical research and tap the link in our bio to subscribe.
#ClinicalTrials #MedEd #NEJM
