An abrupt policy change in 2022 — allowing patients to choose between peritoneal dialysis or hemodialysis — created severe unintended consequences for the Thai health system. A multidisciplinary commission found that interacting factors in the system were overlooked and that future dialysis policies must integrate more-diverse evidence and stakeholder views, prioritizing care quality and ethics while balancing equity and sustainability.

This multicenter study demonstrates use of dried and capillary blood as a minimally invasive, scalable approach for Alzheimer’s biomarker testing in research, with potential as a widely scalable population-based research approach, especially in resource-limited settings.

Analyzing data of the Mexican Biobank project, a new study finds regional differences in clinically relevant genetic frequencies and presents MexVar, a publicly accessible resource designed to support ancestry-informed genetic testing.

MedHELM, an extensible evaluation framework including a new taxonomy for classifying medical tasks and a benchmark of many datasets across these categories, enables the evaluation of large language models on real-world clinical tasks.

Long-term follow-up of participants in the ADVENT trial, which compared pulsed field to conventional thermal ablation in patients with paroxysmal atrial ablation, shows preserved effectiveness of pulsed field ablation over the course of four years.

In a phase 2 randomized, controlled, dose–response trial, the live-attenuated chikungunya vaccine (VLA1553) was given in full and half doses to children under the age of 12 in Honduras and the Dominican Republic and was found to be safe and immunogenic, with the results supporting selection of the full-dose VLA1553 in future clinical trials in this population.

In a randomized study involving 9 general cardiologists and 107 real-world patient cases, assistance from a specifically tailored large language model resulted in preferable responses on complex case management compared to physicians alone, as rated by specialist cardiologists using a multidimensional scoring rubric.

In a case series of eight pediatric patients with systemic lupus erythematosus, dermatomyositis or systemic sclerosis, autologous anti-CD19 CAR T cell therapy was feasible, safe and effective in reducing disease activity.

In the phase 1/2 TRIDENT-1 trial, treatment of patients with NTRK fusion–positive advanced solid tumors with the tyrosine kinase inhibitor repotrectinib—selective for ROS1, TRKA−C and ALK—was safe and resulted in durable systemic and intracranial clinical response.

The phase 2/3 DEVOTE trial demonstrated that high-dose nusinersen significantly improved motor function and was safe in patients with spinal muscular atrophy, compared with a matched sham control.

Regulatory approval of blood-based biomarkers for Alzheimer’s disease could change diagnosis, trial design and therapeutic development. As these tests move into the clinic, physicians must assess how best to deploy them in real-world care.

Designing a fit-for-purpose global health architecture requires regional coordination and global alignment.