2 Minute Medicine Rewind Aug 24th, 2026
Out-of-State Travel for Abortion Care Before and After the Dobbs v Jackson Decision
1. In a large cohort study, population-level data prior and after the Dobbs v Jackson decision was assessed to evaluate changes in abortion care patterns following implementation of abortion restrictions.
Evidence Rating Level: 1 (Excellent)
Following the 2022 Dobbs v Jackson Women’s Health Organization decision, abortion restrictions have significantly altered access to reproductive health care across the United States. This cohort study analyzed 79,433 abortions in North Carolina during the year before and after Dobbs to evaluate changes in out-of-state abortion travel. Following Dobbs, abortions obtained by out-of-state patients increased by 37.5 cases per day (95% CI, 34.5–40.4), while there was no significant increase among North Carolina residents (2.6 cases/day; 95% CI, −3.6 to 8.8). Mean travel distance among out-of-state patients increased from 156 to 258 miles, and median gestational age at abortion increased from 7 to 8 weeks (P<0.001). The largest increases in patients traveling to North Carolina came from Georgia (+5,028%) and Alabama (+24,060%). The increase in travel was particularly concentrated among first-trimester patients and non-Hispanic Black individuals; the ratio of travelers of other racial/ethnic groups to White travelers increased from 2.64 to 3.24. Overall, the findings demonstrate that abortion restrictions following Dobbs substantially shifted abortion care across state borders, increasing both the number and distance traveled by patients and delaying the gestational age at which out-of-state patients obtained care, highlighting the growing logistical burden of accessing abortion services.
Patient Viewing and Comprehension of Immediately Released Test Results
1. In a large cross-sectional study, patients who viewed laboratory/test results immediately through patient portals were assessed on how well they understood those results before discussing them with a healthcare professional.
Evidence Rating Level: 2 (Good)
Immediate release of laboratory and diagnostic results through electronic patient portals allows patients to access health information before discussing it with their clinician, but may create challenges for patients with limited health or digital literacy. This cross-sectional study analyzed 4,982 adults from the 2024 Health Information National Trends Survey to evaluate test-result viewing and comprehension. Overall, 68.6% (95% CI, 66.4%–70.9%) of patients reported viewing their results before hearing from a clinician, while 6.6% (95% CI, 5.1%–8.1%) reported poor understanding of their results. Greater digital literacy was associated with increased likelihood of viewing results (adjusted PR, 1.24; 95% CI, 1.17–1.32; P<0.001) but decreased likelihood of poor comprehension (PR, 0.63; 95% CI, 0.46–0.85; P=0.003). Patient-centered communication was also associated with better comprehension (PR, 0.50; 95% CI, 0.37–0.67; P<0.001). Overall, the study suggests that although immediate electronic access to test results is being widely used, a meaningful subset of patients may not fully understand their results, emphasizing the importance of patient-centered communication and digital health literacy when implementing immediate-result-release systems.
1. This retrospective matched case-control study examined clinical characteristics and risk factors associated with PPH to develop an antepartum prediction model for PPH among preterm deliveries.
Evidence Rating Level: 1 (Excellent)
Postpartum hemorrhage (PPH) is an important cause of maternal morbidity, particularly among patients delivering preterm, yet tools to identify patients at increased risk before delivery remain limited. This retrospective matched case-control study included 728 women with preterm delivery, including 219 with PPH and 509 controls, to identify antepartum predictors of hemorrhage. Multivariable analysis identified ≥2 previous induced abortions (OR, 2.07; P=0.010), gestational diabetes (OR, 1.70; P=0.015), placenta accreta (OR, 7.44; P<0.001), placenta increta (OR, 60.17; P<0.001), anemia (OR, 1.94; P<0.001), and polyhydramnios (OR, 3.54; P=0.022) as independent predictors of PPH. The resulting prediction model demonstrated moderate discrimination with an AUC of 0.770 and good calibration (Hosmer-Lemeshow P=0.789). Overall, the study suggests that a combination of antepartum clinical factors can provide moderate prediction of PPH among patients delivering preterm and may help clinicians identify patients requiring heightened hemorrhage preparedness, although external validation is needed before clinical implementation.
1. At least one in four National Football League (NFL) players who died between 2016-2021 had evidence of chronic traumatic encephalopathy (CTE) at death, with a potential maximum prevalence at death of 97.7%.
2. Stage IV CTE was associated with a significantly increased risk of dementia among donors.
Evidence Rating Level: 2 (Good)
CTE is a neurodegenerative disease common among people with history of repetitive head trauma. Diagnosis of CTE can only be reliably done after death on the basis of a neuropathological evaluation. Many studies have identified increased rates of dementia on NFL players. This retrospective cohort study therefore sought to investigate the prevalence of CTE among NFL players at death. Samples from brain donors were obtained from various institutions in the United States. Death certificates from the former NFL players were obtained from the Centers for Disease Control and Prevention National Death Index and classified into different causes by two clinicians. Samples were examined using neuropathological processing and microscopic evaluation. Between 2008 and 2021, 1712 NFL players died of which 338 brains were studied. Among these 338 brains, 315 (93.2%) had CTE. When considering the time interval between 2016-2021 during which donation frequency was highest, 878 players died of which 235 brains were studied. Among these 235 brains, CTE was diagnosed in 215 (91.4%). Stage IV CTE was associated with an increased risk of dementia (risk ratio 1.44, 95% CI: 1.16-1.78, p < 0.001). Overall, this study found that among NFL players who died, a significant portion had CTE at death. Notably, advanced CTE was associated with increased risk of dementia, highlighting the importance of better characterizing CTE prevalence and risk.
1. This retrospective cohort study found that necessary fracture surgery during pregnancy can be performed with favorable short-term maternal and obstetric outcomes when appropriate anesthesia regimens are utilized.
Evidence Rating Level: 2 (Good)
Fracture management during pregnancy requires balancing maternal recovery with fetal considerations related to anesthesia and radiation exposure. This retrospective cohort study evaluated 19 pregnant patients who underwent surgical fracture treatment, examining anesthesia type, fluoroscopy exposure, fracture healing, and maternal and obstetric outcomes. Regional anesthesia was used in 63% of patients, with a mean fluoroscopy exposure of 17.8 ± 6.2 seconds. All patients achieved fracture union, with a mean healing time of 11.1 ± 2.0 weeks, while postoperative complications occurred in 4/19 patients (21.1%). No anesthesia-related complications, fetal losses, congenital anomalies, or preterm deliveries were reported, and the mean gestational age at delivery was 38.9 ± 1.2 weeks. Overall, the findings suggest that necessary fracture surgery during pregnancy can be performed with favorable short-term maternal and obstetric outcomes when individualized anesthesia, multidisciplinary management, and strict radiation-minimization strategies are used; however, the very small sample size and lack of standardized neonatal or long-term neurodevelopmental follow-up substantially limit the ability to draw definitive conclusions about fetal safety.
Image: PD
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