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Background: On June 24th, 2022, the United States (US) Supreme Court's ruling in Dobbs v. Jackson, et al. (hereafter, the Dobbs decision) removed federal‐level protections for induced abortion, sparking concerns about reproductive rights and health privacy. Although other pregnancy outcomes (e.g. spontaneous abortion, ectopic pregnancy) are not explicit targets of post‐Dobbs abortion bans, study participants may be worried about how their reproductive health data are used by researchers in the post‐Dobbs era. Objective: To evaluate the extent to which the Dobbs decision influenced participant's engagement in a preconception cohort study. Methods: We leveraged data spanning 20 weeks before and after the Dobbs decision (4 February 2022, to 11 November 2022) from US participants in Pregnancy Study Online (PRESTO), an internet‐based prospective preconception cohort study of couples attempting conception. We categorised participants' state‐level abortion access by residential location: banned or restricted rights; limited access; and protected rights. We evaluated three participant engagement outcomes: follow‐up questionnaire completion; report of a pregnancy; and clicking on the invitation link for a fertility‐tracking app. We fit separate linear regression models and restricted cubic splines to compare outcome prevalence before and after the Dobbs decision by state‐level abortion category. Results: A total of 585 newly enrolled participants and 1247 already‐enrolled participants received 2802 invitations to complete a follow‐up questionnaire. In states with limited or protected abortion rights, we observed little change in participant engagement. In states with banned or restricted abortion rights, however, we observed a 27.12 percentage point reduction (95% confidence interval −43.68, −10.51) in the prevalence of clicking on the invitation link for the fertility‐tracking app comparing the post‐ versus pre‐Dobbs periods. Conclusions: There was some evidence of reduced participant engagement after the Dobbs decision in states with banned or restricted abortion rights, indicating potentially deleterious effects on the conduct of reproductive health studies. [ABSTRACT FROM AUTHOR]

Several years ago, the US News and World Report changed their risk-adjustment methodology, now relying almost exclusively on chronic conditions for risk adjustment. The impacts of adding selected acute conditions like pneumonia, sepsis, and electrolyte disorders ("augmented") to their current risk models ("base") for 4 specialties--cardiology, neurology, oncology, and pulmonology--on estimates of hospital performance are reported here. In the augmented models, many acute conditions were associated with substantial risks of mortality. Compared to the base models, the discrimination and calibration of the augmented models for all specialties were improved. While estimated hospital performance was highly correlated between the 2 models, the inclusion of acute conditions in risk-adjustment models meaningfully improved the predictive ability of those models and had noticeable effects on hospital performance estimates. Measures or conditions that address disease severity should always be included when risk-adjusting hospitalization outcomes, especially if the goal is provider profiling. [ABSTRACT FROM AUTHOR]