Canadian healthcare, particularly family medicine, is experiencing a capacity crisis. To address this challenge, systems-level reform is required. Specific to medical education, there is an urgency for educational institutions to prepare the next generation of physicians to meet Canadians' healthcare needs. This will require not only the expansion of the number of physicians trained, but consideration of the specialty mix and types of practice those physicians are prepared to undertake. Building on an existing collaborative partnership, the Queen's-Lakeridge Health Doctor of Medicine - Family Medicine Program (QLH MD FM) launched in 2023. This initiative is designed to address the needs of Canadians through purposeful recruitment and the development of learners interested in, and committed to, careers in family medicine. This paper shares the experiences of the QLH MD FM team, and the steps taken in conceptualizing and implementing this educational initiative. A program description is provided, focusing on the six program pillars: (a) admissions, (b) curriculum, (c) faculty and staff engagement, (d) community engagement, (e) infrastructure and supports, and (f) learner experience. The QLH MD FM Program is an innovative approach to medical education that emphasizes an authentic focus on addressing the complex healthcare needs of individuals and their communities. Le système de santé canadien, en particulier la médecine familiale, est confronté à une crise de capacité. Pour relever ce défi, une réforme à l’échelle du système s’impose. En ce qui concerne plus particulièrement la formation médicale, il est urgent que les établissements d’enseignement préparent la prochaine génération de médecins à répondre aux besoins des Canadiens en matière de soins de santé. Cela nécessitera non seulement d’augmenter le nombre de médecins formés, mais aussi de prendre en compte la répartition entre les spécialités et les types de pratique auxquels ces médecins seront préparés. S’appuyant sur un partenariat collaboratif existant, le programme de doctorat en médecine – médecine familiale de Queen’s-Lakeridge Health (QLH MD FM) a été lancé en 2023. Cette initiative vise à répondre aux besoins des Canadiens grâce à un recrutement ciblé et à la formation d’apprenants intéressés par une carrière en médecine familiale et déterminés à s’y consacrer. Cet article présente les expériences de l’équipe du programme QLH MD FM, ainsi que les étapes suivies pour conceptualiser et mettre en œuvre cette initiative éducative. Une description du programme est fournie, mettant l’accent sur ses six piliers : (a) les admissions, (b) le programme d’études, (c) l’engagement du corps enseignant et du personnel, (d) l’engagement communautaire, (e) les infrastructures et les services de soutien, et (f) l’expérience des apprenants. Le programme QLH MD FM constitue une approche innovante de la formation médicale qui met l’accent sur une approche authentique visant à répondre aux besoins complexes en matière de soins de santé des individus et de leurs communautés.
Despite societal change, women and men still differ in the extent to which they prioritize work and family. Women more often reduce work hours or adjust careers to prioritize family needs, whereas men more often work overtime or decline family responsibilities to advance their careers. This study tested two possible explanations, that women and men differ in (1) how they perceive the costs and benefits of prioritizing work versus family; and (2) how they weigh these costs and benefits when deciding which domain to prioritize. We presented 625 employed participants (309 women, 316 men) with six scenarios involving work-family trade-offs. Analyses confirmed that women were more willing than men to prioritize family over work and less willing to prioritize work over family, even though both women and men were generally more willing to prioritize family. Women's greater willingness to prioritize family was partially explained by higher perceived family benefits, and men's greater willingness to prioritize work by lower perceived family costs. Women (compared to men) placed more weight on family benefits and less weight on career costs when considering prioritizing family over work. These findings reveal how gendered perceptions and weighting shape decision-making about work and family, which can inform policies and programs to promote more equitable career and caregiving outcomes. The online version contains supplementary material available at 10.1007/s11199-026-01663-0.
Studying at university is a transitional and dynamic period, which provides an optimal opportunity for fostering healthy behaviors. But the high prevalence of problematic internet use (PIU) among students may hinder the development and establishment of healthy behaviors and a health-promoting lifestyle (HPL). PIU is important due to its impact on academic performance, social relationships, and policymaking on this issue. This study aimed to investigate the relationship between PIU and health literacy (HL) with HPL among students. This cross-sectional descriptive-analytical study was performed on 525 students of the University of Social Welfare and Rehabilitation Sciences in 2024, who were selected by convenience sampling. An electronic questionnaire was sent to students, which consisted of demographic, Walker's HPL, Caplan's PIU, and Tavousi's HL questionnaire. Data were analyzed using SPSS Statistics version 25 (IBM Corp., Armonk, NY, USA). The mean score of PIU was 55.55 ± 15.63. The mood regulation dimension had the highest score, and negative outcomes had the lowest score. HPL score was at a moderate level, and the severity of PIU was at a mild level. There was a significant negative correlation between HPL and PIU. Also a positive correlation was observed between HL and HPL. PIU and HL are significantly related to HPL. Managers and policymakers are encouraged to develop special programs to reduce the negative effects of PIU by enriching students' free time, teaching media literacy, as well as increasing HL and health-promoting behaviors to improve students' quality of life, which affects their academic performance and careers.
The objective of this study is to assess the prevalence of migration intent among interns and residents at a tertiary care institution in Pakistan and to identify perception-based factors associated with this intent. A cross-sectional study was conducted at PNS Shifa Hospital using a structured, self-administered Google Form questionnaire (Google Inc., Mountain View, CA, USA). A total of 252 participants (house officers and postgraduate trainees) were recruited. Data were analyzed using IBM SPSS Statistics software, version 27 (IBM Corp., Armonk, NY, USA). Chi-square tests and binary logistic regression were applied to identify significant factors of migration intent. Out of 252 participants, 52% expressed a preference for postgraduate training abroad, with the United Kingdom (54.2%), the Middle East (16.8%), and the United States (15.3%) being the most preferred destinations. Key push factors included low salary (65.6%), poor working conditions (53.4%), and unemployment (46.6%). Logistic regression analysis demonstrated that perception of better quality of life (OR = 1.91, p = 0.015), improved training opportunities (OR = 1.77, p = 0.024), and a better working environment (OR = 1.95, p = 0.010) were significant predictors of migration intent. This study provides institution-level evidence on migration intent among early-career doctors, highlighting the role of perception-driven factors in shaping career decisions. A substantial proportion of participants expressed an intention to pursue postgraduate training abroad, primarily due to perceived socioeconomic and training-related advantages abroad. These findings may inform institutional-level retention strategies and highlight areas for further multicenter and longitudinal research.
Achieving sustainable development goal 4 in education hinges on teachers' sustainable career development, in which career calling serves as an endogenous driving force. This study investigated how perceived social support, vocational outcome expectations, professional identity and career calling were related among pre-service teachers. A questionnaire survey was conducted among 1,029 Chinese pre-service teachers. Structural equation modeling (SEM) was employed to analyze the relationships among perceived social support, vocational outcome expectations, professional identity, and career calling. The results revealed that perceived social support was significantly and positively related to vocational outcome expectations, professional identity and career calling. Furthermore, vocational outcome expectations and professional identity mediate the relationship between perceived social support and career calling both individually and in series. Our findings highlight that social support constitutes a key factor in promoting career calling among pre-service teachers. Implications include the need to construct a multi-dimensional social support system to strengthen pre-service teachers' vocational outcome expectations and professional identity, thereby facilitating the development of their career calling.
Understanding the factors that shape occupational therapy (OT) career pathways is crucial for strengthening recruitment and retention. In the Philippines, limited research has examined why students choose OT and how they navigate their entry-level education. This study explored the lived experiences of Filipino OT graduates to understand their career decision-making and educational journeys. A qualitative descriptive phenomenological approach was used. In-depth interviews were conducted with nine Filipino OT graduates who completed their entry-level education in the Philippines. Data were analyzed using Colaizzi's method to identify key influences and shared experiences. Four themes captured participants' experiences: (1) deciding to enter OT, shaped by family guidance, immersion experiences, personal interests, and peer influence; (2) affirming their decision through clinical exposure, academic preparation, and personal growth; (3) navigating challenges associated with academic load, OT's broad scope, pandemic-related gaps, and limited public awareness; and (4) perspectives on raising awareness through school-based advocacy, digital platforms, and personal storytelling. Supportive learning environments and mentorship contributed to their persistence. Findings underscore the need for strengthened career guidance, improved public awareness of OT, and educational strategies supporting identity formation and resilience. These insights may inform program development and workforce policies in the Philippines and similar contexts.
The United States surgical workforce faces an impending crisis, with projections of a shortage of 10,000-19,900 surgeons by 2036 and no meaningful expansion of general surgery residency positions. In this fixed-capacity system, retention is synonymous with workforce production. Yet, attrition disproportionately affects trainees from underrepresented backgrounds, resulting in preventable losses of talent and leadership potential. This manuscript expands upon the 2025 Academic Surgical Congress Presidential Address, using the framework of "Hidden Figures" to explore how systemic invisibility, lack of sponsorship, and absence of allyship undermine resident persistence and career advancement. Through personal narrative and professional reflection, Dr Callisia Clarke illustrates how microinvestments, intentional leadership development, and caritas-driven allyship can reverse attrition trends and strengthen the academic surgical pipeline. Throughout this commentary, brief italicized passages reflect personal narrative from her Presidential Address, followed by analytic reflections that situate these experiences within broader structural and workforce challenges in academic surgery. True workforce sustainability calls for a change from symbolic diversity to measurable retention, promotion, and belonging.
Katherine C. Barnett studies cell death and damage in viral infections, focusing on how these processes activate innate immunity and shape viral pathogenesis. In this mSphere of Influence article, she highlights how the work of Aguirre et al. (Nat Microbiol 2:17037, 2017, https://doi.org/10.1038/nmicrobiol.2017.37) changed her perception of how RNA viruses interact with pattern recognition receptors and how later the work of Wang et al. (Nature 616:152-158, 2023, https://doi.org/10.1038/s41586-023-05851-w) shaped her concept of cell death in viral infections. Framing these findings in different models of pathogen detection by the innate immune system, she reflects on how her understanding of the role of damage in RNA virus infection has evolved throughout her career.
Background and aim Artificial intelligence (AI) has become an indispensable component of medical practice. Studies have shown that medical students worldwide are often ill-prepared to take full advantage of these technologies in their future practice due to inadequate training and a shortage of qualified instructors. These factors hinder the adoption of AI-focused curricula; therefore, this study aims to explore medical students' and faculty's knowledge and attitudes toward AI applications in the medical field, as well as their readiness for its integration into the medical curriculum, highlighting both the benefits and barriers. Methods A cross-sectional study was conducted on medical students (years 1-5) and faculty members from the University of Sharjah College of Medicine (UOSCOM), Sharjah, UAE. They were recruited via convenience sampling between February and March 2023. Students and faculty completed self-administered questionnaires, both online and in person. Analysis was performed using IBM SPSS Statistics for Windows, Version 26 (Released 2018; IBM Corp., Armonk, NY, USA). Results Of a total of 413 participants, 74.3% (faculty and students) agreed that the medical field has benefited from AI. Interestingly, 54.3% of students agreed on implementing AI in the curriculum, and 79.3% believe it is necessary, as they see it as a way to empower their careers in the future. However, 51.9% expressed concerns regarding the increase in workload. Of the 45 faculty participants, 66.7% believe that teaching AI would be an addition to their CVs, while 40% disagree that adding the course will increase their workload. Moreover, 77.8% are willing to participate in the course. Conclusions and recommendations The findings revealed a general positive perception, with both groups acknowledging the benefits of AI in medicine. Students show awareness of AI applications in education and healthcare, while faculty express willingness to teach AI courses for professional development. However, we recommend that future studies assess students' baseline computer knowledge and correlate faculty members' specialty fields with their willingness to teach.
Neurosurgery carries one of the highest complication-associated morbidity burdens of any surgical specialty. While patient-facing consequences of adverse events are well documented, the psychological, professional, and financial impact on the operating neurosurgeon, the "second victim," remains poorly characterized, limiting the development of evidence-based support frameworks. To examine the psychological and behavioral sequelae experienced by neurosurgeons following major surgical complications and to identify unmet institutional support needs. A cross-sectional anonymous online survey was distributed to neurosurgeons across varied practice settings and career stages across Pakistan. Domains included complication exposure, emotional impact, confidence changes, decision-making modifications, Morbidity and Mortality conference participation, support received, financial consequences, medicolegal concern, and preferred support modalities. Descriptive statistics were applied. Eighty-one neurosurgeons participated. Major complications were reported by 96%; neurological deficit and postoperative infection were most common, 62% each. Over 63% rated emotional impact at 4 or 5 out of 5, and 73% reported a post-complication decline in surgical confidence. Fear or hesitation in managing similar cases affected 72%. 86% modified their decision-making through increased conservatism, defensive documentation, and greater second-opinion seeking yet 77.8% received no formal support. Financial consequences affected 27.2%, and 75.3% perceived inadequate institutional financial protection. Surgical complications impose a substantial multidimensional burden on neurosurgeons, encompassing emotional distress, confidence erosion, and financial strain. The near-universal absence of formal support represents a critical institutional gap. Structured peer support, reflective debriefing, and financial protection mechanisms should be systematically integrated into neurosurgical practice.
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This study focuses on characterizing the voices that are amplified through peer reviewed publication and how they relate to one another. This study aims to 1) identify patterns of author collaboration and representation, 2) assess how this varies among different journals, 3) examine the relationship between author collaboration and quantitative publication. This is a bibliometric analysis using descriptive statistics and network analysis, examining all publications in four influential emergency medicine journals from January 2015 through December 2024. Authors and journals were assessed on quantity of publications, patterns of co-authorship, and network characteristics of individual and aggregate journals. There is a sharp right-skew of authorship - most authors have only a single article published in ten years. The most prolific authors in emergency medicine demonstrate significantly more publications than their peers. Journals show a propensity to publish multiple articles from a small number of authors, but there is variation among journals as to how many unique authors appeared during the timeframe studied. There was a gender disparity identified among the top authors, most of whom were men. Bibliometric analysis is able to demonstrate academic influence while also casting light on the role of journals in peer-reviewed publication patterns. Publication is a vital component of academic success and tangible evidence of professional influence. How authors collaborate and journals select manuscripts is impactful, and unfortunately this study demonstrates inequity among the most visible authors in the most impactful journals.
While metabolic dysfunction-associated steatotic liver disease (MASLD) has been consistently associated with increased cardiovascular risk in the general population, its association with cardiovascular disease (CVD) mortality in adults with established cardiometabolic risk factor (including obesity, hypertension, diabetes mellitus, or dyslipidemia) remains inconsistent. We aimed to determine whether frailty confounds the MASLD-CVD mortality association. We analyzed 10,413 US NHANES III adults with ≥ 1 cardiometabolic risk factor. Frailty was quantified using a 49-item frailty index (FI, ranging from 0 [maximal robustness] to 1 [severe frailty]) and categorized into quartiles. Associations between MASLD and CVD mortality were assessed using multivariable Cox proportional hazards models with and without frailty adjustment. Interaction and mediation analyses were also performed. Over a mean follow-up of 23.36 years, 1,375 (13.20%) CVD deaths occurred. Frailty was significantly associated with both MASLD and CVD mortality. There was no evidence of interaction between MASLD and frailty, and mediation analysis showed no indirect effect of MASLD on CVD mortality through frailty. In absence of frailty adjustment, MASLD was not associated with CVD mortality (HR = 0.92, 95% CI: 0.78-1.10). After adjustment for frailty, MASLD was independently associated with higher CVD mortality (HR = 1.19, 95% CI: 1.07-1.32). Stratified by FI quartiles, significant associations were observed only in the higher frailty quartiles (Q3: HR = 1.35, 95% CI: 1.03-1.77; Q4: HR = 1.70, 95% CI: 1.07-2.69). The population attributable fraction of MASLD for CVD mortality was 10.1-12.5% after frailty adjustment. Frailty may confound the MASLD-CVD mortality relationship in people with cardiometabolic risk factors. The association between MASLD and CVD mortality is detected only when frailty is adjusted for.
Organizational bullying among nursing faculty is a systemic and pervasive issue with profound psychological, professional, and institutional consequences. Despite increasing awareness, the literature remains fragmented, and a comprehensive synthesis is lacking. This systematic review followed PRISMA guidelines and examined empirical studies on organizational bullying among nursing faculty, with no date restrictions applied. A structured search across five databases (PubMed, Scopus, Web of Science, CINAHL, and Embase) identified studies that met inclusion criteria related to the consequences, contributing factors, and interventions. The Mixed Methods Appraisal Tool (MMAT) was used to assess study quality. Fifteen studies meeting the quality threshold were included. Organizational bullying was consistently associated with psychological distress (e.g., anxiety, depression, burnout, suicidal ideation), professional disengagement, and intent to leave. Contributing factors were categorized into structural and organizational (e.g., hierarchical power imbalances, toxic workplace culture), managerial and HR-related (e.g., lack of leadership support, poor reporting mechanisms), and individual/social (e.g., gender or ethnic discrimination, early-career vulnerability). Intervention strategies identified included policy reforms, leadership training, supportive reporting systems, and psychological support services, though evidence on their effectiveness remains limited. Organizational bullying in nursing academia is a serious and multifaceted challenge with detrimental effects on individuals and institutions. Addressing it requires a comprehensive, evidence-based approach that includes structural reforms, leadership development, and psychosocial support systems. Academic institutions must prioritize the creation of safe, inclusive, and respectful environments to retain faculty and sustain the quality of nursing education.
To evaluate longitudinal trends in gender and regional equity in membership and governance representation within the European Society of Gynaecological Oncology and the European Network of Young Gynaecological Oncologists. We analyzed European Society of Gynaecological Oncology and European Network of Young Gynaecological Oncologists membership and governance data from 2013 to 2024. Descriptive analyses were supplemented with multi-variable logistic regression models to identify predictors of female membership and European Society of Gynaecological Oncology Council representation, including European Network of Young Gynaecological Oncologists status, calendar year or Council term, and United Nations geographic region. European Society of Gynaecological Oncology and European Network of Young Gynaecological Oncologists membership increased from 1588 members in 2013 to 3385 in 2024, and female members reached parity by 2024. Female membership was associated with European Network of Young Gynaecological Oncologists participation (odds ratio 1.82, 95% confidence interval 1.73 to 1.91, p <.001) and calendar year (odds ratio 1.04 per year, 95% confidence interval 1.03 to 1.05, p <.001). Compared with Western Europe, female membership was higher in Northern Europe (odds ratio 1.69, 95% confidence interval 1.55 to 1.84, p <.001) and lower in Eastern Europe (odds ratio 0.78, 95% confidence interval 0.71 to 0.85, p <.001) and non-European regions (odds ratio 0.80, 95% confidence interval 0.74 to 0.86, p <.001). Gender was not associated with Council membership (odds ratio 0.95, 95% confidence interval 0.63 to 1.42, p =.79), and no independent temporal trend was observed (odds ratio 0.91 per term, 95% confidence interval 0.81 to 1.03, p =.13). Geographic variation was evident, with lower odds of Council representation in Eastern Europe (odds ratio 0.54, 95% confidence interval 0.28 to 0.98, p =.05), while estimates for non-European regions were unstable because of sparse representation. European Society of Gynaecological Oncology and European Network of Young Gynaecological Oncologists have made substantial progress toward gender equity at the membership level, largely through early-career engagement. Governance representation appears to be influenced more by geographic and structural factors than by gender, highlighting the need for equity-focused strategies that sustain gender-balanced leadership development while addressing regional disparities.
Physician wellness discussions often center on burnout and negative aspects of clinical practice. Less is known about what brings professional satisfaction to physicians, particularly among emergency medicine (EM) residents. Understanding drivers of professional satisfaction is important for the future of the specialty as they may influence residents' career decisions. This study aimed to identify drivers of professional satisfaction among a national cohort of EM residents. We conducted a mixed methods study using a survey administered following the 2024 ABEM In-Training Examination to EM residents in ACGME-accredited programs. The single-item, free-text survey question asked: "List the top 3 drivers of your professional satisfaction in EM." Responses were linked to resident demographics, year in training, and program length. Using an exploratory, sequential mixed methods design, we developed a codebook via team-based thematic analysis. We subsequently quantified theme prevalence, summarized the top 10 themes, and compared the top 5 themes across strata by demographics and program characteristics. 3914 of 9820 eligible residents (39.9%) responded. Our team identified 41 unique themes from these responses. The top 10 drivers of professional satisfaction by frequency were: (1) EM community/team culture, (2) positive impact on patients, (3) work-life balance, (4) bedside patient interactions, (5) clinical variety, (6) shift work flexibility, (7) financial compensation, (8) opportunities for procedures, (9) EM clinical skill set, and (10) critical care opportunities. The most prevalent themes did not vary by resident demographics. In a national cohort of EM residents, we identified a list of key drivers of professional satisfaction that clustered into a small number of highly prevalent themes. The most important factors were related to the people and culture of the program and making a positive impact on patients. These findings may inform strategies to strengthen EM resident professional fulfillment and support the future of the specialty.
Proliferative vitreoretinopathy (PVR) is the leading cause of failure after rhegmatogenous retinal detachment (RRD) repair, yet no baseline biomarkers exist to stratify risk. In this retrospective, nested case-control study we asked whether the vitreous proteome at the time of primary RRD repair predicts subsequent PVR. Undiluted vitreous (1.0 mL) was obtained by pars plana vitrectomy from 16 eyes of 16 patients (8 who later developed PVR and 8 matched RRD controls) and analyzed by tandem mass tag (TMT)-multiplexed liquid chromatography-tandem mass spectrometry. Of 918 proteins identified, 876 were retained after contaminant filtering. After Benjamini-Hochberg correction for multiple comparisons, no proteins were differentially expressed between cases and controls. Six proteins (decorin, arrestin-C, pre-mRNA processing factor 6, C-reactive protein, fructose-1,6-bisphosphatase 1 and an immunoglobulin kappa variable chain) reached nominal significance (p < 0.05) but did not survive correction. The most abundant vitreous constituents included albumin, retinol-binding protein 4 and serotransferrin. In this limited cohort, no large or statistically robust baseline proteomic differences were detected between eyes that subsequently developed PVR and matched controls. We hypothesize that the molecular drivers of PVR may emerge postoperatively rather than being present at the time of the index detachment, although larger studies will be required to confirm or refute this possibility. Data are available via ProteomeXchange with identifier PXD077831.
Background  Accurate interpretation of common orthopaedic radiographs is an important skill for junior clinicians working in emergency, trauma, and orthopaedic settings. Missed fractures and unrecognised malalignment remain important causes of diagnostic error, particularly in busy major trauma centres where the first review of imaging may take place before a formal radiology report is available. Structured, case-based teaching may improve both diagnostic accuracy and clinician confidence, but local educational interventions should be evaluated using objective measures. Methods  We conducted a prospective single-centre educational quality improvement study at a UK major trauma centre between January 2025 and March 2026. Foundation doctors, core trainees, physician associates, clinical fellows, and other early-career clinicians rotating through trauma and orthopaedics or the emergency department were invited to attend a 45-minute senior-led teaching session on a systematic approach to common orthopaedic radiographs. Participants completed a 25-item image-based assessment and a 0-10 confidence rating scale immediately before and after the session. Those who consented to follow-up were also invited to complete a voluntary six-week retention assessment. The primary outcome was change in total radiograph interpretation score. Secondary outcomes included domain-specific accuracy, self-rated confidence, and the frequency of predefined critical errors. Results  Forty-eight clinicians completed paired pre- and post-session assessments. The mean test score increased from 58.9% (SD 11.3) before teaching to 82.1% (SD 11.3) immediately after teaching, giving a mean paired improvement of 23.2 percentage points (95% CI: 20.8-25.6; p < 0.001; Cohen's d_z = 2.83). Mean self-rated confidence increased from 4.5 ± 1.6 before teaching to 7.7 ± 1.8 after teaching. Improvements were seen across fracture detection, recognition of alignment and dislocation, hardware assessment, assessment of view adequacy, and escalation planning. Thirty-four participants completed the six-week retention assessment, with a retained mean score of 76.8% (SD 11.7). Critical errors fell from 146 before teaching to 48 after teaching, representing a 67.1% relative reduction. Conclusions  A single structured, interactive orthopaedic X-ray teaching session was associated with significant immediate improvements in image interpretation accuracy and self-rated confidence among early-career clinicians at a major trauma centre, with partial retention at six weeks. Embedding short, recurring, case-based radiograph teaching into trauma and orthopaedic induction may be a practical way to support diagnostic safety. Further multicentre studies using validated image banks and patient-linked diagnostic outcomes are warranted.
Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by bone fragility and recurrent fractures. Emerging biologics demonstrate promise by targeting bone-remodeling pathways, yet evidence for their efficacy and safety remains fragmented and heterogeneous, and no prior systematic review in OI has incorporated artificial intelligence (AI) to synthesize it. This study aims to systematically evaluate the efficacy and safety of novel biologics in patients with OI using an AI-assisted workflow for evidence synthesis. We conducted a systematic review and meta-analysis of interventional trials of denosumab, setrusumab, teriparatide, romosozumab, and fresolimumab. Data were retrieved from PubMed, Web of Science, Embase, ScienceDirect, the Cochrane Library, and ClinicalTrials.gov up to December 1, 2025. Eligible studies enrolled individuals with OI, reported areal bone mineral density (aBMD) and/or fractures, and were randomized, nonrandomized, or single-arm studies; case series were excluded. As a methodological feature, GPT-4o was integrated into the workflow to perform a parallel 2-stage screening (title/abstract and full text) and to assist with risk of bias assessment using an adapted Cochrane RoB 2 tool. The primary outcome, percentage change in aBMD, was synthesized using a random-effects meta-analysis. GPT-4o was benchmarked against human reviewers using sensitivity, specificity, and weighted Cohen κ. Thirteen trials (n=684) were systematically reviewed, of which 10 (n=333) contributed to meta-analyses. In children, denosumab produced the greatest 12-month increase in lumbar spine aBMD (25.49%, 95% CI 17.14%-33.84%). In adults, setrusumab at 12 months yielded the highest improvement (9.38%, 95% CI 6.5%-12.26%). Across trials, no biologic significantly reduced fracture incidence compared to bisphosphonates. Safety profiles varied: denosumab was associated with a high risk of hypercalcemia in children (30.95%), whereas setrusumab had no treatment-related serious adverse events. AI achieved high sensitivity in abstract (97.4%) and full-text (88.9%) screening, and reduced total screening time by over 95%. Although there was substantial agreement with humans in the quality assessment (Cohen κ=0.778, 95% CI 0.710-0.846), the model exhibited optimism and positional biases due to reliance on probabilistic language patterns rather than structured clinical reasoning. This review is the first to synthesize and quantitatively compare skeletal outcomes across multiple biologics in OI with an AI-assisted review workflow. Denosumab and setrusumab demonstrate promising efficacy in improving lumbar spine aBMD across ages, although current evidence does not support superior fracture reduction over bisphosphonates. GPT-4o can substantially accelerate evidence synthesis but should be deployed with explicit human oversight in tasks requiring contextual understanding and clinical reasoning. These findings should be interpreted cautiously given the small and heterogeneous trial base. Taken together, our workflow presented how evidence synthesis may be scaled and operationalized in real-world rare disease research.