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MedCity News · Jul 16, 2026

What Happens to Independent Medicine When Private Equity Shows Up With a Checkbook

This is not an argument against capital in independent medicine. Practices need infrastructure, and physicians have legitimate reasons to seek liquidity. It is an argument that the exit stage carries a risk this market has not yet priced. The post What Happens to Independent Medicine When Private Equity Shows Up With a Checkbook appeared first on MedCity News .

BMJ Open · Jul 16, 2026

Strengthening the reporting of observational studies in drowning epidemiology (STROBE-D): a protocol for an extension to the STROBE statement

Introduction Drowning remains a substantial global health challenge, and research in this area predominantly relies on observational study designs due to ethical, practical and administrative limitations. Although the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement is available, adherence within the drowning research community has been inconsistent and frequently incomplete. Consequently, essential methodological components and drowning-specific factors are often under-reported or inconsistently described, impeding quality, reproducibility, critical…

BMJ Open · Jul 16, 2026

Development and psychometric evaluation of a compassion perception instrument for patients with cancer receiving nursing care: a mixed-methods study protocol

Introduction Compassion is a core value in person-centred nursing and is essential in the care of patients with cancer. However, existing measurement instruments often fail to capture the cultural, ethical and relational dimensions of compassion as perceived by patients within specific sociocultural contexts. This study aims to develop and psychometrically evaluate the compassion perception in nursing care (CPNC) instrument for patients with cancer, reflecting the local sociocultural context of cancer care in Iran. Methods and analysis A sequential exploratory mixed-methods design…

BMJ Open · Jul 16, 2026

Awareness, knowledge and attitudes towards artificial intelligence among nursing students: a systematic review protocol

Introduction Internationally, nursing students’ awareness and familiarity with artificial intelligence (AI) remain a challenge as evidenced by the current literature. Interestingly, the Gulf Cooperation Council (GCC) region has earned a strong standing for driving national digital transformation; however, this ambition has not been translated into research. Despite growing interest in AI-driven healthcare, empirical studies examining nursing students’ readiness in these countries to operate in healthcare environments remain limited, representing a critical gap in the literature. Our initial…

BMJ Open · Jul 16, 2026

Early-life body mass index and adult fat distribution: a life-course Mendelian randomisation study

Objectives Body mass index (BMI) changes dynamically during early life, but whether BMI at specific developmental stages is associated with adult regional fat distribution remains uncertain. We evaluated age-specific associations of genetically predicted childhood BMI with adult MRI-derived BMI-adjusted fat depots and examined whether these associations were independent of adolescent BMI. Design Two-sample Mendelian randomisation study using univariable Mendelian randomisation (UVMR) and multivariable Mendelian randomisation (MVMR). Data sources Publicly available genome-wide association study…

BMJ Open · Jul 16, 2026

Implementing and evaluating Adaptive Mentorship Networks to strengthen primary care in Canada: protocol for a mixed-methods implementation science study

Introduction Canada’s health workforce crisis is placing sustained pressure on primary care, particularly in the management of chronic pain, mental health conditions and substance use disorders. Mentoring is a compelling response to workforce, educational and well-being challenges in healthcare, and Adaptive Mentorship Networks (AMNs) have emerged in Canada as an interprofessional model to strengthen provider capacity, psychological safety and compassionate care. Despite widespread interest and demonstrable effectiveness, the determinants that influence successful implementation, spread…

BMJ Open · Jul 16, 2026

Current evidence on radiofrequency denervation for chronic low back pain: a systematic review and meta-analysis

Objective To assess the effects of radiofrequency (RF) denervation for chronic low back pain (LBP) from facet joint, sacroiliac joint, discogenic and non-specific pain. Design Systematic review and meta-analysis. Data sources We searched Medline, Embase, Cochrane Library, CINAHL, PsycINFO, ClinicalTrials.gov and WHO ICTRP up to 18 February 2025 for randomised controlled trials (RCTs). Study selection, data extraction and synthesis Pairs of reviewers independently selected studies, extracted data and assessed risk of bias (Cochrane RoB 2). Meta-analyses with clinically homogeneous studies were…

BMJ Open · Jul 16, 2026

Peer advocacy and access to hospital care for people who are homeless in London, UK, 2019-2023: a cohort study

Objectives To measure differences in hospital use between homeless adults using the homeless health peer advocacy (HHPA) service (clients) and non-clients in London. Design We conducted a cohort study with linkage to Hospital Episode Statistics (HES) 1 year prior and postenrolment. Setting London, UK. Population People who are homeless in London aged over 18 years residing in a hostel, attending a day centre or being referred by a homelessness service; experiencing difficulties accessing healthcare; and speaking either English or Polish. Participants were required to provide consent for…

BMJ Open · Jul 16, 2026

Implementation of a learning health system for the management of non-communicable diseases in Thailand: a realist evaluation protocol

Introduction Learning health systems (LHS) are an approach to translate patient data into actionable clinical insights, empower healthcare teams to drive quality improvement and reduce health inequalities. Here we present a protocol for a realist evaluation to explore what works to implement a learning health system approach in primary care settings in Thailand, for whom does it work, how, why and in what circumstances. Methods and analysis A mixed-methods realist evaluation will run in parallel with an interventional trial [Reg No: NCT06873243] in Northern Thailand which aims to improve the…

BMJ Open · Jul 16, 2026

Mapping narratives on mental health to facilitate collaboration, communication and alignment of care: a systematic scoping review and interview study

Objectives We aimed to examine existing and emerging master narratives on mental health and to capture the changing emphasis in these narratives over time. Making these shifts explicit can facilitate alignment of actors and practices that must collaborate to support those seeking help. Design We gathered data via a scoping review, semistructured interviews and podcast episodes. Data analysis consisted of a thematic analysis to identify narratives and a content analysis to map shifts in emphasis over time. Setting Semistructured interviews and included podcast episodes were all Dutch. The…

BMJ Open · Jul 16, 2026

Effect of low-dose naltrexone for long COVID: a systematic review and meta-analysis

Objective Long covid is a debilitating chronic condition, and the effect of low-dose naltrexone (LDN) on its symptoms is unclear. We aimed to determine the effectiveness of LDN on symptoms of long covid. Design Systematic review and meta-analysis. Data sources PubMed, Embase and Cochrane Library for published studies; ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) for registered ongoing studies were searched through 5 May 2026. Eligibility criteria We included randomised controlled trials and pre–post studies of patients with long covid reporting on fatigue…

BMJ Open · Jul 16, 2026

Perspectives of clinicians caring for people experiencing homelessness on point of care tests: an online survey

Objectives People experiencing homelessness (PEH) face multiple barriers to seeking healthcare and have poorer health outcomes. Point of care tests (POCTs) provide a potential solution to improving access to diagnostics for this population. This survey aimed to understand if these technologies could address unmet needs in primary care for PEH. Design and setting An online survey was circulated via dedicated inclusion healthcare newsletters to professionals providing community-based care for PEH in England. The survey focused on experiences of diagnostics and opinions on the use of POCTs for…

BMJ Open · Jul 16, 2026

Machine learning evaluation of clinical, social and behavioural factors influencing progression from pre-diabetes to type 2 diabetes: a retrospective cohort study in southeast Michigan

Objective We aimed to use machine learning (ML) models to investigate the impact of clinical, social and behavioural factors on 1-year progression from pre-diabetes to type 2 diabetes mellitus (DM). Design A retrospective cohort study. Setting A large health system including eight sites in southeast Michigan. Participants Adults with haemoglobin A1c (HbA1c) between 5.7% and 6.4% for two consecutive years between 1 January 2008 and 31 December 2023, and no prior history of type 2 DM or metformin use. Primary outcome measure New-onset type 2 DM (HbA1c ≥6.5%) in 1 year. Results Among 11 809…

BMJ Open · Jul 16, 2026

Optimising Health Literacy and Access (Ophelia) in Florence, Italy: a cluster analysis to guide cardiovascular prevention among perimenopausal and postmenopausal women in a vulnerable urban setting

Background Cardiovascular risk increases markedly in perimenopausal and postmenopausal women and social disadvantage can intensify barriers to prevention. In these settings, limited health literacy may further restrict women’s ability to understand cardiovascular risk, access appropriate services and translate advice into daily behaviours—potentially widening inequalities. Objectives This study investigated health literacy profiles among perimenopausal and postmenopausal women living in a socioeconomically vulnerable urban area of Florence, Italy, and examined how these profiles may guide…

BMJ Open · Jul 16, 2026

Personalised approach to hypertension treatment: protocol for the HYPERMARKER randomised controlled trial

Introduction Blood pressure treatment response is variable in individual patients, and the choice of medical therapy is often dependent on clinician experience. Treatment choices could be personalised by patient empowerment and metabolomic profiles, and augmented by machine learning, but robust evaluation is lacking on how these can be combined to enhance clinical effectiveness. The HYPERMARKER trial will evaluate how an individualised choice of medication class can address the avoidable global health and economic burdens of hypertension. Methods and analysis The HYPERMARKER trial is a…

BMJ Open · Jul 16, 2026

Who complains? A nationwide register-based cross-sectional study of socioeconomic differences in patient complaints and complaint case outcomes in Denmark

Objective To examine socioeconomic and demographic differences in who complains about healthcare and whether these factors are associated with the outcomes of complaint cases. Design Nationwide cross-sectional study in Denmark using linked national health, complaint and administrative registers. Setting The Danish healthcare system provides universal coverage and has a centralised system for handling complaints with linked patient-level data to sociodemographic variables. Participants All healthcare contacts in 2022 in general practice (GP), non-psychiatric hospitals and psychiatric hospitals…

BMJ Open · Jul 16, 2026

Implementation and economic analysis of a perioperative brain healthcare bundle: a mixed-methods study

Study type Mixed-methods observational implementation and economic evaluation study. Background Perioperative care bundles have the potential to improve patient outcomes but their successful implementation depends on staff engagement and the resources required. Data on implementation costs and staff perceptions are limited for perioperative brain health initiatives. Objectives To estimate the resource use and costs of implementing a perioperative brain healthcare bundle in a Swiss hospital and to explore staff perceptions relevant to sustainable adoption. Design Retrospective mixed-methods…

BMJ Open · Jul 16, 2026

Nationwide, multicentre, prospective periprosthetic joint infection cohort study: study protocol of the Swiss Revision Cohort (REVCO)

Introduction Diagnostic and therapeutic management of patients with periprosthetic joint infections (PJIs) remains challenging. This national cohort aims to describe the epidemiology, clinical phenotypes, management strategies and outcomes of patients with PJI. Methods and analysis This is a national, multicentre, prospective, longitudinal, observational cohort study of patients who underwent revision for PJI of the hip, knee, shoulder, elbow or ankle. Participating centres are university or non-university tertiary healthcare facilities located in Switzerland. Episodes include likely and…

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