Good morning! It's the middle of the week, so it's time for another SmartBrief Reader Poll, below. What are your thoughts on adult patients bringing a companion into the exam room during an appointment?

Also, check out the results of last week's poll on primary care staffing shortages.

American College of Physicians President Dr. Jason Goldman discusses challenges faced by private practice physicians, including reimbursement rates, government regulations and administrative tasks. Goldman says advocacy is needed to address these issues and advance the health care system.

A study in the Journal of the American Medical Association found the rate of parents refusing vitamin K shots for newborns increased from less than 3% in 2017 to more than 5% in 2024. Researchers found that about 4% of babies did not receive the shots from 2017 to 2024. The CDC has said that compared with infants who get the shot, those who do not get vitamin K shortly after birth have a more than 80 times higher risk of developing bleeding from vitamin K deficiency.

A study published in the journal Hypertension found that adolescents with migraines may be at a higher risk of hypertension. The study, which included more than 2 million young patients in Israel, found that those with migraines had a much higher risk of hypertension compared to those without, and the association was stronger among those with severe migraines. The study suggests that identifying migraines as a hypertension risk marker could lead to earlier detection and prevention.

Researchers have developed an AI model to identify patients with congenital heart disease who are at risk of experiencing gaps in continuous care, as presented at the American Heart Association Scientific Sessions. The model, which utilizes data from 1,746 patients, takes into account factors such as social determinants of health and disease complexity. While the model shows strong performance in identifying patients maintaining follow-up, it needs refinement to better predict those with care gaps.

A study in JAMA Network Open found distinct postpartum prediabetes rates among gestational diabetes subtypes, with the fasting hyperglycemia and mixed defect subtypes having higher rates of prediabetes than the postload intolerance subtype. The findings suggest that women with certain subtypes may benefit from immediate lifestyle interventions and early postpartum testing.

Health care organizations are adopting AI technologies rapidly, but it's important to take a step back and assess whether the tools align with community needs, especially for mental health, writes physician and public health leader Dr. Oni Blackstock. Few published studies on health AI involve patient or community input, and randomized, controlled trials were used to evaluate less than 3% of FDA-cleared AI health devices. Blackstock suggests using tools like the Organizational Readiness to Engage in Community-Led Health AI Partnership framework to foster community-led partnerships and ensure that digital health tools, whether AI-based or not, align with community priorities.

Nearly 40% of adults over age 50 brought a companion with them to health care appointments, and more than 90% said it was helpful, according to a University of Michigan poll. Companions help with transportation and communication, and are often a spouse, partner or adult child.