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At least 19 recordsLinked to original sources
PubMed1977

How well recommended are the recommended dietary allowances?

The Recommended Dietary Allowances serve two basic uses: As guidelines for planning diets and food supplies and as a tool for evaluating nutritional adequacy of food consumed. Establishing standards to serve these functions is not simple. Differences in individuals in different population groups dictate allowances with relatively high margins of safety to prevent deficiencies. Even so, anomalies arise. Surveys have shown that intakes of vitamin A and protein are likely to exceed their respective allowances. On the other hand, calcium and thiamin intakes of older women and iron in teenage boys and women in the reproductive years are difficult to meet in terms of nutrient density ratios. In addition, insufficient data make it impossible to set allowances for some essential trace elements--and, other essential elements may yet be discovered. Thus the allowances are not guaranteed to represent the totality of nutritional needs.

Adolescent↗
PubMed2026

Sustainable dietary recommendations for the Spanish population.

BACKGROUND/OBJECTIVES: The 2030 Agenda for Sustainable Development highlights the urgent need for a profound transformation in food production and consumption to enhance both sustainability and human health. The aim of this study is to provide both the general population and food system stakeholders with the most comprehensive and current information available on healthy and sustainable dietary patterns, in the form of culturally adapted food-based guidelines. METHODS: We performed a systematic review of the scientific evidence published since 2019 on the association between main food groups consumption and the risk of developing chronic diseases and premature mortality to update the information provided by the Dietary Guidelines for Americans 2020-2025, which summarized previous evidence. With this information, we updated the servings recommended in the former dietary guidelines for Spain. Then, we considered the recommendations of the EAT-Lancet Commission for healthy diets within planetary boundaries, specific dietary habits and food production in Spain, and adjusted the servings per each group to consider these characteristics. RESULTS: A minimum intake of 5 servings of vegetables and fruits per day is recommended, which may be distributed in at least 3 servings of vegetables per day, and 2-3 servings of fruits per day. Cereal consumption is set at 3-6 servings per day, adjusted to individual energy needs and prioritizing whole grains, no more than 4 servings per day are advised in cases of caloric restriction. Plant-based foods are recommended as the primary protein source, with legumes incorporated into at least one main daily meal and consumed at a frequency of at least 4 servings per week, ideally up to daily. Nut consumption should reach at least 3 servings per week, up to one serving per day, choosing those without added salt, fats or sugar. The remaining protein portions may include fish (≥3 servings/week, prioritizing oily fish and low-impact species), eggs (up to 4/week), dairy (up to 3/day, with low-sugar and low-salt options), and meat (up to 3/week, emphasizing poultry and rabbit, and minimizing processed meats). Daily consumption of olive oil at main meals is recommended. CONCLUSIONS: The proposed Sustainable Dietary Recommendations can help improve the health and well-being of the Spanish population, while reducing the environmental impact.

Humans↗
PubMed2026

Artificial Intelligence Cannot Replace Peer Reviewers but May Help Editors Triage: A Comparative Analysis of a Large Language Model and Human Reviewer Recommendations at the American Journal of Sports Medicine.

BACKGROUND: The peer review system faces increasing strain from rising manuscript volumes, reviewer fatigue, and well-documented interreviewer disagreement. Large language models (LLMs) have shown potential to support the peer review process, but their ability to replicate editorial decisions at high-impact medical journals and their utility as manuscript screening tools remain unknown. PURPOSE: To compare the agreement between an LLM and the final editorial decision on manuscripts submitted to the American Journal of Sports Medicine and to evaluate the potential of LLMs as a manuscript screening tool. STUDY DESIGN: Cross-sectional agreement study. METHODS: Fifty-four manuscripts randomly selected from submissions to the American Journal of Sports Medicine (September 2024-October 2024) were reviewed by a locally deployed LLM (Ministral 3 14B; Mistral AI) using a standardized prompt. The artificial intelligence (AI) produced a categorical recommendation (reject, cascade, revision, or accept) and a numerical score (0-100) for each manuscript. Agreement with the final editorial decision was assessed by Cohen kappa (4-category model) for pooled human reviewers (n = 139 reviews) and the AI (n = 54). Screening performance was evaluated by positive predictive value (PPV), sensitivity, and specificity. RESULTS: Pooled human reviewers demonstrated fair agreement with the final decision (&#x3ba; = 0.181 [P < .001]; 42.4% agreement), while the AI demonstrated slight, nonsignificant agreement (&#x3ba; = 0.126 [P = .099]; 37.0% agreement). The AI recommended revision for 61.1% of manuscripts, of which 72.7% were ultimately rejected or cascaded, demonstrating systematic "revision bias." When the AI recommended rejection, 54.5% of those manuscripts were ultimately rejected and 27.3% were cascaded; when the AI recommended cascade, 50% were rejected and 50% were cascaded. However, when the AI recommended rejection or cascade (n = 21), 90.5% received a final decision of rejection or cascade (PPV, 90.5%; specificity, 81.8%). Manuscripts with an AI score <70 were rejected or cascaded 88.0% of the time (PPV, 88.0%). CONCLUSION: AI cannot replicate the nuanced judgment of human peer reviewers at a high-impact sports medicine journal. When AI recommended rejection or cascade, 90.5% of manuscripts received that final decision (descriptive PPV, 90.5%; 95% CI, 71.1%-97.3%), suggesting potential utility as an exploratory first-pass screening tool warranting further validation in larger cohorts. However, AI could not reliably distinguish manuscripts destined for outright rejection from those that would be cascaded to a sister journal-an important limitation for editorial triage applications.

Sports Medicine↗
PubMedDate not supplied

Are psychiatric consultants' recommendations followed?

The extent of adherence to psychiatric consultants' recommendations was calculated through a review of charts. All charts of patients seen in Psychiatric consultation from May 1976 to April 1977 were reviewed and a total of 273 charts contained scoreable consultant recommendations. Recommendations were scored as either actively followed, passively followed or not followed. Results are reported for the extent of adherence 1) between different types of recommendations (medications, disposition, etc.), 2) between medical, surgical and obstetrical-gynecological services and 3) between consultants, two psychiatrists and one psychologist. The results suggest that recommendations more likely to be followed are those easily performed by a consultee and leading to direct, tangible results. Adherence to consultants' recommendations is discussed in the context of resistance to psychiatric consultation.

Hospital Departments↗
PubMed2026

A Scoping Review of Direct-to-Consumer Nutrigenetic Testing: Mapping Genes and Associated Nutrition Recommendations.

Consumer demand for autonomy in their own health care is fueling the rise of personal genetic testing. Nutrigenetics tests promise tailored dietary recommendations to help consumers achieve their health and well-being goals. To support informed decision-making by both practitioners and consumers, there is a need for a comprehensive evaluation of the current market landscape and the specific nutrition claims being made. A scoping review was completed via an internet search. Companies that provided direct-to-consumer tests with nutritional recommendations were included. Nonhuman, or pediatric tests, and tests requiring a health practitioner to order were excluded. Genes and nutrition recommendations used in the testing panels were mapped, and company characteristics were summarized. The review was prospectively registered with Open Science Framework (DOI: 10.17605/OSF.IO/A4K2R). There were 104 companies providing 204 nutrition-related testing panels that were included. The mean cost was US$234, with North America the most common continent of company registration. Only 56 (54%) companies publicly disclosed the genes used to make nutritional recommendations, with 3309 unique genes identified across testing panels. Micronutrients (n = 1593 genes), cardiovascular health (n = 1446 genes), and weight loss (n = 1383 genes) were the most commonly reported nutrition categories. Posttest support was provided by 55 (53%) companies, but this was often at additional cost (n = 33), and the qualifications of those providing support varied greatly. The expanding nutrigenetics market continues to be unregulated, with high variability in offerings. With thousands of unique genes linked with nutrition recommendations, it is challenging for healthcare practitioners and consumers to keep pace with this dynamic market. Evidence analysis and resources are required to support healthcare practitioners to provide consumers with evidence-based guidance and ensure their best interests are protected.

Humans↗
PubMed2026

Mapping and measuring addiction recovery: Recommended protocols through the PHENX toolkit.

BACKGROUND: Addiction "recovery" has served as a positive conceptual basis for major public health frameworks, communication strategies, and policies. With greater research interest and increasing explication of the recovery construct a multitude of measures have emerged, prompting a need to reach consensus on recommendations to enable better data harmonization and cross-study syntheses. The PhenX (consensus measures for Phenotypes and eXposures) Toolkit (www.phenxtoolkit.org) is a freely accessible catalog of validated protocols designed to promote data comparability across clinical, epidemiological, and genomic research, yet contained no recovery-specific measures. METHOD: In 2024, a Substance Use and Recovery Working Group (SURWG) followed a well-established and detailed PhenX consensus process to identify and recommend protocols suitable for recovery research. Protocols were chosen based on criteria including recovery specificity, brevity, psychometrics, scoring simplicity, and non-proprietary access. The broader scientific community (12 national/regional organizations) provided feedback (respondent N&#x2009;=&#x2009;86) on the SURWG's preliminary recommendation which was incorporated into final decisions. RESULTS: In 2025, the PhenX Toolkit released 15 new recommended protocols across three broad recovery elements: 1. Biopsychological (post-acute withdrawal; craving), 2. Socio-ecological (social relationships;social network characteristics; substance use goal; recovery identity; recovery capital), 3. Treatment and recovery services (Treatment and Recovery Services Use; Satisfaction; and Happiness in Recovery; Mutual-Help). CONCLUSIONS: This PhenX Toolkit SURWG process resulted in a new Substance Use Recovery Specialty Collection of recommended protocols with specific multidimensional applicability. As such, they provide the field with pre-vetted tools that researchers can employ with some confidence to enhance empirical efficiency and return on national research investment.

Humans↗
PubMed2026

Simultaneous Administration of Human Papillomavirus (HPV) Vaccine With Other Recommended Vaccines Among Adolescents Aged 13-17 years, National Immunization Survey-Teen (NIS-Teen), United States, 2023.

PURPOSE: To investigate the percent of adolescents who receive human papillomavirus (HPV) vaccine with one or more other vaccines recommended for adolescents in a single medical visit. METHODS: Data from the 2023 National Immunization Survey-Teen were analyzed. Timing of receipt of HPV vaccine, tetanus, diphtheria, and acellular pertussis vaccine (Tdap), quadrivalent meningococcal conjugate vaccine (MenACWY), and influenza vaccine was assessed using provider-reported vaccination histories. RESULTS: In 2023, among adolescents aged 13-17 years, 69.5% received HPV vaccine with one or more other vaccines recommended for adolescents in a single medical visit. In addition, 47.8% received specifically HPV vaccine, Tdap, and MenACWY together in a single medical visit. DISCUSSION: The HPV vaccine is commonly given with other vaccines recommended for adolescents in a single medical visit. These findings demonstrate variation in simultaneous vaccination patterns, suggesting that flexibility in the recommended adolescent vaccination schedule allows for different approaches to vaccination across clinical settings and family preferences while maintaining adherence to the recommended schedule.

Humans↗
PubMed2026

'Truthsets' for clinical validation of large-scale functional assays: Practice recommendations from Cancer Variant Interpretation Group UK (CanVIG-UK).

BACKGROUND: Large-scale functional assays, including multiplex assays of variant effect, have substantial potential to resolve variants of uncertain significance (VUS), particularly for rare missense variants where clinical and population evidence are limited. The ClinGen assay-level clinical validation framework described by Brnich et al provided baseline guidance for the use of functional data for variant classification. However, clear consensus regarding construction of variant 'truthsets' by which to clinically validate functional data remains lacking. METHODS: CanVIG-UK developed consensus recommendations for truthset construction through an iterative national consultation process involving the CanVIG Steering Advisory Group (CStAG), wider CanVIG-UK membership, and engagement with international functional genomics experts. Consultation was based on previous analyses of 2,120 truthset constructions examining the impact of truthset composition on evidence point allocation within the ClinGen assay-level clinical validation framework. RESULTS: Across several consultations, CanVIG-UK established nine guiding principles and seven best-practice recommendations for assay-level clinical validation, using the assumed context of an assay for a cancer susceptibility gene where loss-of-function is the mechanism of pathogenicity. The principal recommendation stipulates, where assays are intended for use in interpretation of largely missense variants, the truthset used to validate should comprise only missense variants. Rather than mixtures of different variant types which may serve to over-estimate assay performance. Additional recommendations support option for relaxation of truthset stringency to improve power, augmentation of benign missense truthsets with systematically derived 'proxy-clinical' benign variants, independent clinical validation separate from assayist-defined validation, and careful evaluation of missense score distributions against that of protein-truncating and synonymous variants. Guidance is also provided for scenarios with limited pathogenic truthset availability and for assays reporting multiple deleterious zones or readouts. CONCLUSIONS: The CanVIG-UK principles and recommendations for truthset construction upon the ClinGen assay-level clinical validation framework, while aiming to form a baseline for future discussion regarding other functional and disease contexts and helping to address the gap between publication of new data and routine clinical implementation.

Journal Article↗
PubMed1979

Physicians' concordance with consultants' recommendations for psychotropic medication.

Physicians' concordance with the recommendations of psychiatric consultants regarding the use of psychotropic medications in a general hospital was retrospectively examined in an outcome study. Using medical records in a series of 200 consecutive consultations, the authors found 68% of all psychotropic recommendations resulted in physician responses rated concordant and 24% nonconcordant. Resultant concordance ratings are presented according to category of recommendation (that is, start, adjust, continue, or discontinue) and drug groupings. The data suggest that drug group is not a critical variable in physician concordance. Responses did differ by category of recommendation. Further study of physician concordance is desirable. The work suggests both the potential of and need for outcome studies in consultation work.

Humans↗
PubMed2026

A systematic review of international/national guidelines for the management of nasopharyngeal carcinoma: Convergence and divergence of recommendations.

Increasing numbers of clinical practice guidelines have been published by international/national groups for nasopharyngeal carcinoma (NPC), providing valuable references for clinicians in making evidence-based decisions on treatment. However, there are substantial discrepancies in various recommendations, leading to uncertainties in choosing the optimal strategies. The authors systematically searched databases and organizational websites for NPC guidelines published between January 2000 and November 2025. All identified guidelines underwent quality appraisal; in total, 26 clinical practice guidelines rated recommended for use were included. The recommendations covering all management aspects (diagnosis, staging, radiotherapy, systemic therapy, follow-up surveillance, biomarkers, and salvage of recurrent/metastatic diseases) were summarized and comparatively analyzed for consistency and disparities. Strong consensus exists for diagnostic workup, staging systems, and induction chemotherapy plus concurrent chemoradiotherapy for advanced disease, whereas marked disparities exist on radiotherapy details, particularly target volume delineation, elective coverage extent, and dose specifications. Although systemic therapy strategies for different stage groups were mostly consistent, substantial disparities exist in alternative options and treatment details. This first comprehensive systematic synthesis of international NPC guidelines provides a practical reference for clinicians to understand all recommendations and select optimal options based on local resources and expertise while identifying current controversies that demand future research for further standardization and harmonization.

Humans↗
PubMed2026

From standardization to precision medicine: Evolution of European Leukemianet recommendations in Philadelphia-negative myeloproliferative neoplasms.

The European LeukemiaNet (ELN) recommendations have been instrumental in shaping the diagnosis, risk stratification, and management of Philadelphia-negative myeloproliferative neoplasms (MPNs), including polycythemia vera, essential thrombocythemia, and primary myelofibrosis. Over the past two decades, these recommendations have evolved from consensus-based frameworks focused on response standardization to increasingly sophisticated, evidence-based and biologically informed approaches. Early efforts primarily aimed to harmonize response criteria across clinical studies, establishing a foundation for consistent therapeutic evaluation. Subsequent updates introduced risk-adapted treatment strategies centered on thrombotic risk, reflecting the major determinants of morbidity and mortality in these disorders. However, the limitations of surrogate endpoints prompted a shift toward clinically meaningful outcomes, including symptom burden, vascular events, and disease progression. More recent advances have been driven by the integration of molecular genetics and the adoption of structured evidence-based methodologies, enabling refined diagnostic classification and more accurate prognostic assessment. Contemporary ELN frameworks increasingly incorporate dynamic clinical parameters, genomic profiling, and emerging biomarkers, supporting a transition toward individualized, risk-adapted therapeutic strategies. Beyond their role in standardizing MPN management, ELN recommendations have also influenced clinical trial design, endpoint selection, risk stratification, and therapeutic decision-making. Evidence from prospective studies and real-world cohorts supports the clinical applicability of these frameworks, although their implementation remains heterogeneous across healthcare settings. This review provides a comprehensive and critical overview of the evolution and implementation of ELN recommendations, highlighting their impact on clinical research and routine practice, current limitations, and future directions toward precision medicine in Philadelphia-negative MPNs.

Essential thrombocythemia↗
PubMed2025

Relapsed rhabdomyosarcoma: treatment recommendations from the European pediatric soft tissue sarcoma study group (EpSSG).

At least one-third of patients with localized rhabdomyosarcoma (RMS) and 60-70% of patients with metastatic RMS experience progressive disease or relapse. Following relapse, outcomes generally remain poor with limited treatment options and a high risk of subsequent recurrence. Optimal treatment requires a multidisciplinary approach incorporating chemotherapy with local control. Given the complexity of managing relapsed RMS and the challenges in developing effective treatment strategies, we aim to present clear and practical recommendations on the management of these patients across Europe. These recommendations were developed collaboratively by a group of pediatric and adolescent sarcoma experts from the European paediatric Soft Tissue Sarcoma Study Group. A careful review of the literature was performed to ensure that wherever possible recommendations are supported by the results of clinical trials or substantive retrospective reports. Such recommendations provide a standardized approach to managing relapsed cases, improving patient outcomes and offering a framework for clinicians to make informed decisions.

Humans↗