Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 3 appraisals
Journal of the American College of Cardiology
Cardiovascular Science, Medicine, and Society: The Brave New World: The ACC Braunwald Lecture 2025
Recent scientific and technological advances have dramatically expanded the possibilities in cardiovascular medicine. Landmark clinical trials have introduced transformative therapies for lipid disorders, heart failure, and obesity, offering clinicians powerful new tools to manage increasingly complex patient populations. Discoveries in molecular medicine, including gene therapies and RNA therapeutics, have ushered in new biopharmaceutical platforms and promise the potential for curative or infrequent dosing regimens. Minimally invasive, percutaneous, and robotic surgical techniques, along with next-generation devices and interventional procedures, are enhancing patient outcomes and broadening access to advanced care. The rapid rise of artificial intelligence and digital health technologies is reshaping how we gather, interpret, and act on data across the care continuum. Together, these developments mark the arrival of a brave new world in cardiovascular medicine. Yet the promise of this new era is tempered by unequal access, ethical dilemmas, and potential unintended consequences at both the patient and societal levels. This review is written in honor of Dr Eugene Braunwald, who has been a pioneer in cardiovascular science and technological innovation. The paper summarizes recent milestones in cardiovascular medicine and offers a forward-looking perspective on how to realize the full potential of innovation by translating scientific progress into equitable, responsible care and improved health outcomes.
25 Apr 2026
Read appraisal →JMIR nursing
Nurses' Evaluation of a Service Robot for Inpatient Care: Technology Acceptance Study
BACKGROUND: The integration of robotic systems into nursing practice is increasingly discussed as a potential strategy to alleviate workload and support care processes in response to demographic changes and staffing shortages. However, the acceptance of nursing staff as primary end users remains a critical determinant for successful implementation. Despite technological advances, the practical requirements and perspectives of nursing staff have not been adequately considered in research and development efforts to date. OBJECTIVE: Building on the user-centered development approach applied, this study aimed to examine nursing staff's evaluation of a service robot designed to assist with routine tasks in inpatient care, as well as their intention to use it, while accounting for technology-specific and psychological determinants of acceptance. METHODS: A total of 30 nurses tested the robot across 3 application scenarios (information service, item delivery, and beverage delivery) in a simulated care setting, alternating between the roles of nurse and care recipient. Acceptance-related constructs, including intention to use, were measured using the Technology Usage Inventory. General attitudes toward robots were assessed via the General Attitudes Towards Robots Scale. Participants' prior experience with robotics was also documented. Spearman rank correlations and Mann-Whitney U tests were used for analysis. RESULTS: The robot was rated positively across all dimensions. Usability was high (median 20, IQR 18-21; scale range 3-21), as was perceived usefulness (median 21, IQR 16-24; range 4-28). Skepticism was low (median 10.5, IQR 7-12; scale range 4-28), and accessibility was moderate (median 10, IQR 8-13; scale range: 3-21). Intention to use was strong (median 224.5, IQR 157-248; scale range 0-300) and correlated positively with usability (rs(28)=0.505; P=.004), perceived usefulness (rs(28)=0.74; P<.001), and accessibility (rs(28)=0.628; P<.001), and negatively with skepticism (rs(28)=-0.516; P=.004). More positive personal attitudes toward robots were also associated with higher perceived usefulness (rs(28)=0.549; P=.002) and greater intention to use (rs(28)=0.483; P=.007). No significant differences in intention to use were found between participants with and without prior robotics experience (U=83.5; P=.62). CONCLUSIONS: The findings indicate a high level of acceptance among the participating nursing staff for the developed service robot within the tested scenarios. Considering the chosen user-centered development approach, they further underscore the need for strategies that combine participatory design, transparent communication of system capabilities and limitations, and structured opportunities for hands-on experience. Such measures, together with proactive knowledge transfer and skills development, are essential to sustainably leverage the practical potential of service robotics in nursing practice.
15 Apr 2026
Read appraisal →Eur Heart J
Coronary revascularization: a long-term perspective.
This paper will forecast advancements in coronary revascularization by 2040, drawing on historical trends and recent breakthroughs. Having forecasted in 2000 the impact of innovations like drug-eluting stents, coronary computed tomography angiography, and bioresorbable scaffolds, the authors examine the evolving landscape of coronary artery disease treatment emphasizing artificial intelligence and omics sciences. Imagenomics-the integration of imaging and omics-will be a transformative tool with artificial intelligence enabling more personalized decisions between pharmacological and mechanical revascularization. The shift towards minimally invasive, image-guided procedures is discussed along with the potential obsolescence of current antiplatelet and anticoagulant therapies with novel biomimetic peptides like CD31-covalently bound to metallic or polymeric devices. Advances in photon-counting computed tomography and Fibre Optic Real Shape promise high-resolution imaging with lower radiation, enhancing procedural safety and diagnostic accuracy. It is anticipated that robotics and 3D holograms in percutaneous and surgical revascularization will improve precision and the resulting outcomes. Additionally, the need for mechanical revascularization for younger patients may decline due to effective plaque regression therapies and novel potent anti-atherogenic biologics. However, the aging population will drive demand for mechanical interventions, with advancements in atherectomy and lithotripsy techniques improving outcomes in complex, calcified lesions. This comprehensive analysis outlines a future where myocardial revascularization becomes increasingly personalized, with technology-driven interventions redefining cardiovascular medicine.
1 Feb 2026
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