Medical Bulletin 01/ February/ 2025
Here are the top medical news for the day:
TB or Not TB: Study Highlights Role of TB Risk Scoring Tool in Diagnosis
Researchers have developed a TB risk scoring tool by reviewing past patient data to improve the ability to assess patients for potential TB infections. This tool was then integrated into the electronic health record with the label “TB or Not TB.” The findings are published in infection control and hospital epidemiology.
The tool helps clinicians assess, once their TB workup is complete and apparently negative, whether infection control precautions can be discontinued, ensuring accurate decisions for TB isolation, alleviating workload and improving patient experience.
The tool has been validated and is now in use at all Mass General Brigham. The research team joined with developers in clinical informatics and digital health to program the scoring model into the electronic health record in the form of a tool called “TB or Not TB.”
If a patient is identified as needing evaluation for TB, they are labeled as “TB-Risk,” prompting the correct isolation in the specialized hospital room and use of personal protective equipment. Once the healthcare provider believes, given the patient’s symptoms, test results and/or risk factors, that TB is no longer a possibility, they can use the TB or Not TB tool to determine if it is safe to discontinue isolation precautions.
In a rigorous analysis of TB evaluations across the Mass General Brigham system over six years, the tool correctly identified all instances in which TB infection was present and ensured that all those patients would remain safely isolated during their work up.
At the same time, the tool was able to identify about a quarter of cases where TB was highly unlikely.
Paper Cited:
Dugdale, C. M., Zachary, K. C., Craig, R. L., Doms, A., Germaine, L., Green, C. V., Gulbas, E., Hurtado, R. M., Hyle, E. P., Jerry, M. S., Lazarus, J. E., Maxfield, S., Paras, M., Swanson, K., & Shenoy, E. S. (2025). TB or not TB? Development and validation of a clinical decision support system to inform airborne isolation requirements in the evaluation of suspected tuberculosis. Infection control and hospital epidemiology, 1–9. Advance online publication. https://doi.org/10.1017/ice.2024.214
Scale Goes Up, Happiness Doesn’t Go Down: Study Finds
A recent study shows gaining weight generally does not reduce happiness. A decade’s worth of data analyzed by a researcher in Germany found that weight gain does not negatively affect life satisfaction. In some instances, individuals who gained weight even reported small increases in happiness, regardless of gender or age, indicating that the psychological impact of weight may be less pronounced than previously assumed. Findings are published in the international Journal of Applied Positive Psychology.
The study investigated the impact of overweight and obesity on happiness, utilizing large-scale German panel data of 8815 individuals collected across ten survey waves. The participants were aged between 25 and 60 and the data was collected from 2011 to 2021. The study excluded individuals who were underweight or extremely obese to ensure results were not biased by outliers. Body mass index (BMI), calculated from self-reported weight and height, served as the measure of overweight and obesity. Happiness was assessed using a single-item question about life satisfaction, rated on a scale from 0 (completely dissatisfied) to 10 (completely satisfied). Control variables included age, health, employment status, relationship status, and geographic region.
Although descriptive analyses initially showed a slight negative correlation between BMI and happiness, this relationship disappeared—or even reversed—when examining causal effects. Specifically, weight gain was not linked to a decrease in happiness. For both men and women, an increase in BMI was either unrelated to happiness or had a slight positive impact. These findings were consistent across all age groups and BMI categories, including those who were overweight or moderately obese.
“Not being able to detect any negative effects of overweight or obesity on happiness was very surprising to me, but the results are very robust and not a single analysis or model could find any negative effect in a longitudinal setting,” said Felix Bittmann, author of the study.
“Perhaps being overweight has a negative impact on satisfaction, but then possibly only for a short time, until people have become accustomed to the weight,” Bittmann said. “To measure these small and short-term effects, you would have to survey people much more often, which is costly.”
Reference: Bittmann, F. The Scale Goes Up, the Joy Goes Down? Investigating the Causal Effect of Body Weight on Happiness. Int J Appl Posit Psychol 10, 7 (2025). https://doi.org/10.1007/s41042-024-00203-z
Cochrane Review Shows Antidepressants Reduce Anxiety, But Long-Term Effects Remain Unclear
A new Cochrane review confirms that antidepressants effectively reduce symptoms of generalized anxiety disorder (GAD) under trial conditions, although there is limited data on long-term usage.
The review analyzed 37 randomized controlled trials with over 12,000 participants, comparing antidepressants to a placebo. Most trials recruited adults of both sexes. In most cases, there were slightly more female participants (~60%) which reflects the clinical prevalence of generalized anxiety disorder.
Results showed that antidepressants were more effective than placebo in reducing anxiety symptoms, with a 41% higher response rate among those taking the medication compared to those taking a placebo. The review found no significant difference in dropout rates between those taking antidepressants and those taking a placebo, indicating that these medications are generally well-tolerated.
The review also highlights the lack of data on the long-term effects of antidepressants. Most included trials lasted between 4 to 12 weeks, with no long-term follow-up.
"The research shows that antidepressants are highly effective at treating GAD, at least in the specific circumstances seen in trials,” says senior author Dr Giuseppe Guaiana, Associate Professor of Psychiatry at the Schulich School of Medicine & Dentistry, Western University, and Chief of Psychiatry at St Thomas Elgin General Hospital. “For people with Generalized Anxiety Disorder and no other conditions, we have good evidence that antidepressants lead to clinically meaningful improvements over a one- to three-month period compared to placebo.
“We don’t have enough evidence to say how effective they may be in patients with GAD alongside other mental health conditions, which is much more common in clinical practice. Most of the patients I see with GAD also have other mental health conditions, so future trials should investigate the effects of different treatment strategies on patients with multiple conditions."
Reference: Kopcalic K, Arcaro J, Pinto A, Ali S, Barbui C, Curatoli C, Martin J, Guaiana G. Antidepressants versus placebo for generalised anxiety disorder (GAD). Cochrane Database of Systematic Reviews 2025, Issue 1. Art. No.: CD012942. DOI: 10.1002/14651858.CD012942.pub2. Accessed 30 January 2025.
Lancet Study Pinpoints Prenatal Vitamins That May Reduce Infant Death Risk
A new study has identified prenatal supplements that reduce health risks to small and vulnerable babies. This research was published in The Lancet Global Health journal
Researchers found that compared to folic acid and iron alone, a multiple micronutrient supplement led to a 27% lower risk of giving birth to “small vulnerable newborn types,” or babies who suffered from preterm birth, low birthweight, and small-for-gestational-age birth—the three groups most likely to result in infant death.
Researchers combined 16 different studies and analyzed how prenatal nutrition correlates to the occurrence of small vulnerable newborns. They explored the effects of two additional types of prenatal supplements on women in low- and middle-income countries: prenatal multiple micronutrient supplements (MMS), similar to a common multivitamin, and small-quantity lipid-based nutrient supplements (SQ-LNS), which provide caloric nutrition and fatty acids in addition to vitamins.
He found that nearly all of these vitamins conferred some type of benefit—and some of them were hugely beneficial.
“This study underscores the important promise of nutritional supplements in prenatal care in low- and middle-income countries,” says Dongqing Wang, an assistant professor of Global and Community Health at George Mason’s College of Public Health. “In particular, the protective effects of prenatal multiple micronutrients on smallest vulnerable newborn types, particularly those with the greatest mortality risk, strongly supports switching from iron and folic acid supplements to multiple micronutrient supplements as the standard care.”
Reference: The effects of prenatal multiple micronutrient supplementation and small-quantity lipid-based nutrient supplementation on small vulnerable newborn types in low-income and middle-income countries: a meta-analysis of individual participant data, Wang, DongqingAdu-Afarwuah, Seth et al. The Lancet Global Health, Volume 13, Issue 2, e298 - e308
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