Stepped reminders lifted annual lung screening adherence; an ACP review ranks menopausal vasomotor drugs; whole-body MRI screening yields findings but no known benefit

The edition in brief

In a 2 x 2 factorial pragmatic trial of 1,837 people who had a normal low-dose CT screen, stepped reminders (pended orders for primary care physicians plus patient outreach) raised annual screening completion to 75.5% from 47.4% (RR 1.59, 95% CI 1.47 to 1.72), while a health communication intervention slightly lowered it (59.2% vs 63.3%; RR 0.93, 0.86 to 1.00). A systematic review for the American College of Physicians of 90 trials found estrogens, estrogen with bazedoxifene and oxybutynin reduced both frequency and severity of menopausal vasomotor symptoms, while neurokinin receptor antagonists, SNRIs, SSRIs, gabapentin and progestogens reduced frequency only; certainty was mostly low to moderate. A meta-analysis of 17 low-quality studies (18,043 people) of whole-body MRI without an evidence-based indication found a malignancy prevalence of 1.4%, clinically actionable non-malignant findings in 14.8%, and unknown clinical outcomes. A non-randomised pilot of hospital-level care at home for 144 frail older adults in Taiwan found similar remission and mortality and a shorter stay (9.72 vs 11.85 days). A retrospective cohort found two weeks of post-discharge meals associated with lower 14-day readmission (aOR 0.31), attenuating by 30 days. A pearl on pending orders as a system fix closes the edition.