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Ebby CG, Tse G, Bethel J, Zhao Q, Gerber DM, Kelly MM. Large Language Models to Summarize Pediatric Admission Notes Into Plain Language. Pediatrics 2025; 155:e2024069515. [PMID: 40374185 DOI: 10.1542/peds.2024-069515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 03/12/2025] [Indexed: 05/17/2025] Open
Affiliation(s)
- Cris G Ebby
- Division of Hospital Medicine and Complex Care, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Gabriel Tse
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University, Palo Alto, California
| | - Jessica Bethel
- Division of Hospital Medicine and Complex Care, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Qianqian Zhao
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Danielle M Gerber
- Division of Hospital Medicine and Complex Care, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Michelle M Kelly
- Division of Hospital Medicine and Complex Care, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Dewidar O, Sayfi S, Pardo JP, Welch V, Wright GC, Akl EA, Khabsa J, Lin JS, Wang X, Darzi AJ, Lotfi T, Pottie K, Khawandi J, Morgan RL, Pereira Nunes Pinto AC, Tufte J, Brennan SE, Motilall A, Oloyede O, Mustafa RA, Petkovic J, Nieuwlaat R, Xia J, Yao X, Chi Y, Schünemann HJ, Tugwell P. Enhancing health equity considerations in guidelines: health equity extension of the GIN-McMaster Guideline Development Checklist. EClinicalMedicine 2025; 82:103135. [PMID: 40224676 PMCID: PMC11992520 DOI: 10.1016/j.eclinm.2025.103135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 02/11/2025] [Accepted: 02/12/2025] [Indexed: 04/15/2025] Open
Abstract
Background Practice guidelines may reduce health inequities by addressing preventable and unjust differences in health. However, health equity considerations are often inadequately integrated into the guideline planning and development process. This article describes a pragmatic approach to enhancing health equity considerations within guidelines by introducing an extension to the GIN-McMaster Guideline Development Checklist (GDC). Methods We reviewed the latest guidance on enhancing health equity considerations in guideline development to draft the checklist and deployed a global online survey from March 27th, 2024, to May 13th, 2024 to gather consensus. We conducted a methodological review of guideline development handbooks to identify best practices in health equity considerations. An advisory board comprised of diverse interest-holders informed the development of the checklist. We made revisions based on the survey feedback and review findings. Findings We present 21 extension items spanning 16 of the 18 guideline development topics from the GIN-McMaster GDC. Key additions include planning for engagement with individuals experiencing inequities in guideline development activities, applying an equity lens, and considering health equity in recommendation formulation, dissemination and implementation strategies. This checklist gives value to lived experiences to enrich health equity assessments, complementing empirical evidence to inform guideline recommendations. Guideline developers should assess guideline sensitivity to health equity to determine resource prioritization for optimal implementation of the extension items. Interpretation The GIN-McMaster health equity extension provides guidance for the streamlined integration of health equity considerations throughout the guideline development process. Using this tool alongside the original GIN-McMaster GDC may lead to more equitable and impactful guidelines. Funding This project was partially funded by Public Health Agency of Canada. The funder was not involved in the conceptualization or design or the conduct of the project.
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Affiliation(s)
- Omar Dewidar
- Temerty School of Medicine, University of Toronto, Toronto, Ontario, Canada
- Bruyère Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Shahab Sayfi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jordi Pardo Pardo
- Ottawa Centre for Health Equity, University of Ottawa, Ottawa, Ontario, Canada
| | - Vivian Welch
- Bruyère Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Grace C. Wright
- Association of Women in Rheumatology, USA
- Grace C Wright MD PC Inc, New York, NY, USA
| | - Elie A. Akl
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Joanne Khabsa
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jennifer S. Lin
- Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - Xiaoqin Wang
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Andrea J. Darzi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, Ontario, Canada
| | - Tamara Lotfi
- Cochrane Canada & GRADE McMaster, Health Research Methods, Evidence & Impact (HEI), McMaster University, Hamilton, Ontario, Canada
| | - Kevin Pottie
- CT Lamont Centre for Primary Care, Bruyère Health Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, Western University, London, Ontario, Canada
| | - Jana Khawandi
- Evidence-Based Practice and Impact Center, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Rebecca L. Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | | | - Janice Tufte
- Cochrane Consumer, COVID-END Equity group, Seattle, WA, USA
| | - Sue E. Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ashley Motilall
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Cochrane Canada, MacGRADE Centres, McMaster University, Hamilton, Ontario, Canada
| | | | - Reem A. Mustafa
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Internal Medicine, University of Kansas Health System, Kansas City, KS, USA
| | - Jennifer Petkovic
- Bruyère Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Robby Nieuwlaat
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Cochrane Canada, MacGRADE Centres, McMaster University, Hamilton, Ontario, Canada
| | - Jun Xia
- Nottingham Ningbo GRADE Centre, University of Nottingham Ningbo, China
- School of Economics, University of Nottingham Ningbo, China
| | - Xiaomei Yao
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Yuan Chi
- Yealth Network, Beijing Yealth Technology Co., Ltd, China
| | - Holger J. Schünemann
- Clinical Epidemiology and Research Center (CERC), Humanitas University & Humanitas Research Hospital, Milan, Italy
- WHO Collaborating Center for Evidence-Based Decision-Making in Health, Humanitas University, Milan, Italy
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Health Research Institute, Ottawa, Ontario, Canada
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Brown SI, Dhagat P, Aatresh AV, Bodnar S, Madad S. Streamlining Preparedness: A Practical Pathway to Special Pathogens Management. Trop Med Infect Dis 2025; 10:72. [PMID: 40137826 PMCID: PMC11945489 DOI: 10.3390/tropicalmed10030072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2025] [Revised: 02/26/2025] [Accepted: 03/04/2025] [Indexed: 03/29/2025] Open
Abstract
Managing special pathogens cases, also known as high consequence infectious diseases, presents unique challenges for healthcare systems. It requires thorough planning and comprehensive operational protocols, as well as an appreciation of how human and organizational factors influence readiness. Based on the outcomes from a full-scale Ebola Virus Disease exercise at New York City Health and Hospitals (NYC Health + Hospitals), this paper presents a checklist of considerations to promote healthcare facility preparedness for special pathogens and to minimize gaps between protocol design and real-world implementation. This approach not only strengthens compliance with the new Joint Commission requirements but also provides a replicable framework for enhancing special pathogens preparedness within other healthcare systems.
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Affiliation(s)
- Sarah Irene Brown
- System-Wide Special Pathogens Program, New York City Health and Hospitals, New York, NY 10004, USA; (P.D.); (A.V.A.); (S.B.); (S.M.)
- Department of Global Health, Princeton University, Princeton, NJ 08544, USA
| | - Priya Dhagat
- System-Wide Special Pathogens Program, New York City Health and Hospitals, New York, NY 10004, USA; (P.D.); (A.V.A.); (S.B.); (S.M.)
| | - Aishani V. Aatresh
- System-Wide Special Pathogens Program, New York City Health and Hospitals, New York, NY 10004, USA; (P.D.); (A.V.A.); (S.B.); (S.M.)
- Program on Science, Technology, and Society, Harvard University, Cambridge, MA 02138, USA
| | - Saoirse Bodnar
- System-Wide Special Pathogens Program, New York City Health and Hospitals, New York, NY 10004, USA; (P.D.); (A.V.A.); (S.B.); (S.M.)
- Department of Global Health, Princeton University, Princeton, NJ 08544, USA
| | - Syra Madad
- System-Wide Special Pathogens Program, New York City Health and Hospitals, New York, NY 10004, USA; (P.D.); (A.V.A.); (S.B.); (S.M.)
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