York Academy Of Medicine Research Articles

THE DEVELOPMENT AND UTILIZATION OF IMAGE:NYC: THE INTERACTIVE MAP OF AGING

Abstract Online interactive maps are an effective tool to visualize and understand socio-spatial locations of populations layered across the availability of relevant resources. These maps are integral in efforts to advance policies, programs and planning for specific sociodemographic groups. This presentation will describe the development and impact of IMAGE:NYC, The Interactive Map of Aging by The New York Academy of Medicine (NYAM) in partnership with the Center for Urban Research at The Graduate Center at the City University of New York. IMAGE:NYC displays the current and projected population of adults aged 65 and older in New York City with overlays of age-friendly resources, services, and amenities at the neighborhood level. The map draws on several data sources such as the 2016-2020 American Community Survey, local and federal voting patterns, and up-to-date information on health, recreational and housing services. The map has served as an invaluable tool for NYC policymakers, planners, researchers, health care and social service providers. In addition, the IMAGE:NYC model has also been replicated by Rutgers University to create similar maps for two counties in New Jersey. This session will demonstrate the utility of this mapping tool and concrete ways to develop a similar map in other localities.

VISUALIZING AGING EQUITY: CROSS-SECTORAL PARTNERSHIPS TO CREATE MAPPING TOOLS FOR SOCIAL CHANGE

Abstract This symposium will feature ways in which gerontologists are advancing the development of online, interactive mapping tools on aging. Utilizing GIS mapping technology and leveraging cross-sectoral partnerships, the speakers will present case illustrations of efforts to develop aging-focused mapping tools that aggregate data sources at the municipal, state, and national levels to advance a spatial awareness of supports for older adults across diverse communities. First, as an example from the nonprofit sector, the New York Academy of Medicine will present on IMAGE:NYC, The Interactive Map of Aging. This presentation will describe the utility of this tool for policymakers, planners, researchers, and social service providers. Representing work from within the academic sector, the Rutgers School of Social Work will describe an academic-public sector partnership to adapt the IMAGE:NYC map for two counties in New Jersey. Next, presenters from the University of North Texas will describe their partnership with the City of San Antonio to develop an intelligent demand responsive transportation system for older adults and individuals with disabilities. This project involves the use of GIS mapping tools and qualitative research methods to identify place-based transportation gaps and strategies for improvement. Focusing on the national level, the National Council on Aging will describe its work developing mapping tools, including a map that displays area-level rates in eligibility gaps for three federal benefit programs. With an orientation to aging equity, these tools hold promise for fostering inclusive and healthy communities where older adults of diverse intersectional socio-spatial positions can age well. This is an Environmental Gerontology Interest Group Sponsored Symposium.

A scoping review examining the association of housing quality and psychosocial well-being following homelessness: an ecological systems perspective

ABSTRACT Housing quality (HQ) has been previously associated with health and quality of life. Although HQ is an important factor in preventing homelessness, little is known about the range and breadth of this body of literature. To identify existing studies, we conducted a scoping review guided by the question: “in what ways has housing quality been associated with psychosocial well-being following homelessness in existing peer-reviewed literature?” using the framework proposed by Arksey & O'Malley and PRISMA-ScR guidelines. Our search was deployed in eight databases. A total of 713 titles and abstracts were screened following the removal of duplicates, and 32 articles were included in narrative synthesis. Six themes emerged from our data analysis of included articles: 1) quality of housing affecting well-being; 2) feeling forced to live in unsafe and poor-quality housing due to no other options; 3) HQ mediated by housing first; 4) determinants of HQ; 5) standardized measures of HQ; and 6) HQ is de-emphasized in research and practice following homelessness. Our findings demonstrate that HQ is associated with psychosocial well-being at micro, meso, exo, and macro systems levels for persons experiencing homelessness. We argue addressing HQ following homelessness is a key homelessness prevention strategy.

MP21-14 INCREASING HEALTH EQUITY THROUGH VOTER REGISTRATION IN OUTPATIENT CLINICS; THE ACTION PROJECT

You have accessJournal of UrologyCME1 Apr 2023MP21-14 INCREASING HEALTH EQUITY THROUGH VOTER REGISTRATION IN OUTPATIENT CLINICS; THE ACTION PROJECT Farah Rahman, Katherine Campbell, and Ranjith Ramasamy Farah RahmanFarah Rahman More articles by this author , Katherine CampbellKatherine Campbell More articles by this author , and Ranjith RamasamyRanjith Ramasamy More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003246.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While national organizations such as the AUA demonstrate the importance of advocacy on the federal and state level by lobbying government officials, advocacy can also take the face of patient empowerment. Voter registration in the US is an individually-driven responsibility. In turn, the group of registrants is not representative of community demographics. Voting disparities in marginalized communities are correlated with higher health disparities. Sicker or uninsured citizens are more supportive of expanding governmental healthcare, but are less likely to vote due to barriers such as registration. ACTION is built on the notion that outpatient clinics are uniquely positioned within minority communities to serve as non-partisan voter registration sites. The goal is to lessen disparities in civic engagement and increase downstream health equity through patient empowerment. METHODS: ACTION was based out of Loyola Outpatient Clinic in Maywood, Illinois. Volunteers were instructed to speak to patients about their registration and mail-in ballot status. All patient interactions were conducted in the clinic waiting room. The intervention was evaluated on the number of registrants, mail-in ballot applications, and survey results. RESULTS: Over 3 months, students volunteered for 43 shifts on 25 days. During this time, volunteers registered 52 patients, 29% of which identified as first-time voters. Volunteers submitted 78 mail-in ballot applications. 84.5% of survey respondents agreed that ACTION was a good idea and 78% agreed that they would like to see this service provided in more medical spaces, such as the main hospital, other specialty clinics, and the emergency room. Lastly, 88% of respondents claimed they had the correct identification at their doctor’s appointment for online voter registration, overcoming a major identified barrier in voter registration. CONCLUSIONS: The results of the study demonstrate the important role outpatient medical clinics can play in easing the civic engagement process for traditionally disenfranchised patients. Volunteers averaged 2.08 registered voters and 3.12 mail-in ballot applications per day. For reasons of efficiency, proper documentation to register, and the number of newly registered first-time voters—health clinics prove to be an efficacious location for voter registration. As the AUA commits itself to supporting diversity and equity, the option of mobile voter registration to increase patient empowerment and equitable health policies presents itself as a medium to achieve this success. Source of Funding: New York Academy of Medicine © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e291 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Farah Rahman More articles by this author Katherine Campbell More articles by this author Ranjith Ramasamy More articles by this author Expand All Advertisement PDF downloadLoading ...

Addressing the National Crisis Facing Black and Latina Women, Birthing People, and Infants: The Maternal and Child Health Equity Summit.

To address the national crisis of maternal and infant health disparities, especially outcomes experienced by Black and Latina women and birthing people, The New York Academy of Medicine, the Icahn School of Medicine at Mount Sinai, the Blavatnik Family Women's Health Research Institute, and the University of Pennsylvania Health System and Perelman School of Medicine hosted the Maternal and Child Health Equity Summit. The primary purpose of the summit was to disseminate findings to a national audience of two National Institutes of Health-funded mixed-methods studies that investigated the contribution of hospital quality to disparities in maternal and infant Health in New York City (R01MD007651 and R01HD078565). In addition, the summit showcased factors in maternal and infant health inequity from leading diverse experts in both fields and identified outstanding challenges to reducing maternal and infant morbidity and mortality disparities and strategies to address them. Summit presenters and participants identified five primary areas of focus in proposed clinical actions and approaches for maternal and neonatal health care based on discussions during the summit: 1) quality and standardization of care; 2) adjustment of care strategy based on patient-reported experience; 3) health care professional and institutional accountability to patients; 4) commitment to building trust; and 5) anti-racism practices in education, training, and hiring. Recommendations from this conference should inform hospital care and public policy changes and frame a national agenda to address perinatal health disparities for Black, Indigenous, and other women and birthing people of color.

John Greenwood's sidenotes on a 1778 John Hunter text at The New York Academy of Medicine.

John Greenwood (1760-1819) was George Washington's preferred dentist. He practiced in New York and made at least one of eight sets of dentures Washington wore (currently in the collection of the New York Academy of Medicine (NYAM). We know very little about John Greenwood's (JG) formal education, except that he came from a famous family of dentists. He inherited from his father, Isaac Greenwood, one important book of the time, John Hunter's 1778 treatise, A Natural History of the Human Teeth. That copy was donated to the New York Academy of Medicine by descendants of John Greenwood. Recently, we became aware of extensive marginalia that John Greenwood wrote in this book. The present article describes John Greenwood's opinion on a variety of dental subjects such as the causes and mechanisms of tooth destruction and gum disease and the presence of microscopic annamalcula that were thought to be connected to poor oral hygiene. Although John Greenwood was self-educated, his observations are surprisingly insightful and at least 37 years ahead of what was described in the contemporary literature.

Fireside Chat on the Asian American, Native Hawaiian, and Pacific Islander Special Edition of the Health Equity Journal Featuring Authors.

Fireside Chat on the Asian American, Native Hawaiian, and Pacific Islander Special Edition of the Health Equity Journal Featuring Authors.

A Good Time to Be Born

A Good Time to Be Born

The Role of Ethnic Disparities in the Outcomes of Bariatric Surgery: A Systematic Review and Meta-Analysis.

Bariatric surgery is increasingly performed over the past decade for the treatment of morbid obesity. It has beneficial effects on weight reduction, along with diabetes remission. Conflicting results have been reported to evaluate the effect of ethics differences on the outcomes of bariatric surgery. We conducted this meta-analysis to outline the effects of ethnic differences on the outcomes of bariatric surgery, including weight reduction, biochemical variables, diabetes, and hypertension remission. A comprehensive literature search was conducted, using PubMed, Web of Science (ISI), Google Scholar, Popline, Global Health Library (GHL), Virtual Health Library (VHL) including Cochrane database, New York Academy of Medicine (NYAM), and System for Information on Grey Literature in Europe (SIGLE) for studies reporting body mass index (BMI), percentage of excess weight loss (%EWL), waist circumference, hypertension, lipid profile, and diabetes variables. We used the National Heart, Lung, and Blood Institute (NHLBI) tool (Bethesda, MD: NHLBI, National Institutes of Health {NIH}) for quality assessment. Comprehensive Meta-Analysis version 2 software (Englewood, NJ: Biostat, Inc.) was applied to perform the meta-analysis of the variables of interest. We included 23 studies of 71,679 subjects, who underwent bariatric surgery. The majority of the included cases were Whites 55,030 (77%), while 705 (1%) were Asians. The percentages of Blacks, African Americans, Hispanics, and Non-Hispanics were 9.3%, 1.3%, 10.4%, and 1%, respectively. BMI showed no significant difference between Whites vs African American and Hispanic vs Non-Hispanic groups (MD: 0.858; 95% CI: 3.408-1.691; p = 0.509 and MD: 0.455; 95% CI: 2.444-1.554; p = 0.663, respectively). The same result was reported for %EWL, comparing Whites vs African Americans. Lipid biochemical variables, diabetes remission, and hypertension control were significantly more seen among the Asian population. In conclusion, we reported a significant ethnic diversity and reduction in waist circumference, hyperlipidemia, and the associated morbidity one year after bariatric surgery in the Asian population. Further, high-quality prospective studies should focus on the social and psychological ethnic differences associated with obesity.

Dupilumab therapy in atopic dermatitis is safe during COVID-19 infection era: A systematic review and meta-analysis of 1611 patients.

The aim of this meta‐analysis is to evaluate the safety of dupilumab use in the management of atopic dermatitis (AD) during the current pandemic regarding the risk and the hazards of COVID‐19 infection. Seven databases (Google Scholar, Web of Science, Scopus, Virtual Health Library, PubMed, System for Information on Gray Literature in Europe, and The New York Academy of Medicine) were searched for eligible studies from inception until November 24, 2021. The quality of evidence was rated using the National Institute of Health and the Joanna Briggs Institute Critical Appraisal tool. Meta‐analysis was performed when the outcome is presented ≥2 studies. A total of 12 papers including 1611 AD patients were included in the study. The prevalence of COVID‐19 in AD treated with dupilumab was 3.2% (95% confidence interval [CI]: 1.7–5.8). COVID‐19 symptoms were reported by five patients who were presented with one or more of the following symptoms (fatigue, loss of taste and smell, runny nose, conjunctivitis, gastrointestinal symptoms, fever, cough, and dyspnea). Only three cases of COVID‐19 were hospitalized with a prevalence of 4.5%, while no patients with COVID‐19 died. Dupilumab is safe regarding the risk and the hazards of COVID‐19 in AD patients. Thus, based on these results continuation of dupilumab in AD patients is recommended, since dupilumab seems to be safe and crucial for a better disease outcome.

Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review

BackgroundHospitals have implemented diverse quality improvement (QI) interventions to reduce rates of catheter-associated urinary tract infections (CAUTIs). The economic value of these QI interventions is uncertain.ObjectiveTo systematically review economic evaluations...

Safety factors as a 'design' principle of animal form and function: an historical perspective.

For well over 150 years, factors of safety (also known as safety factors) have been a fundamental engineering concept that expresses how much stronger a system is compared with the intended load. The pioneering work of Robert McNeill Alexander in the early 1980s applied this engineering concept to biomechanics. Over the next decade, evidence from comparative biomechanics supported the idea that safety factors are a fundamental principle of animal form and function. In terms of physiology, Jared Diamond related the maximal capacity of a physiological process to normal functional demands and incorporated evolutionary thinking into the concept of safety factors. It was proposed that evolutionary reasoning is required to understand the magnitudes of biological reserve capacities, an idea called 'quantitative evolutionary design'. However, the general idea of safety factors as related to organismal form and function is much older. In 1906, Samuel James Meltzer, a physiologist and physician, presented the 5th Harvey Lecture to the New York Academy of Medicine; a lecture entitled 'The Factors of Safety in Animal Structure and Animal Economy', which was later published in Science in 1907. The 1907 paper is rarely cited and has never been cited within comparative biomechanics or comparative physiology. The purpose of this Commentary is to highlight Meltzer's historical contribution to the concept of safety factors as a general principle of organismal 'design'.

Patrick Romanell, William Osler, and philosophy in medicine

In 1974, Patrick Romanell (1912–2002) published a paper in the Bulletin of the New York Academy of Medicine taking William Osler (1849–1919) to task for dismissing philosophy as a distinguishing feature of the nature of medicine. Osler had expressed this thought in the Silliman Lectures given at Yale in 1913 on the Evolution of Modern Medicine. That the nature of medicine is underpinned by an understanding of the nature of man requires that the pedagogy and practice of medicine incorporate not only the empirical science that is the basis for clinical practice, but also the logical and metaphysical concepts of the nature of man. These concepts are informed by the humanities that include history, literature, and the arts. Despite Romanell’s critique of Osler’s statement, Romanell ultimately corroborates other statements made by Osler in the lecture series, substantiating Osler’s deep appreciation for the nature of man and a philosophy of medicine that deserves emulation.

His Royal Highness Prince Wongsa Dhiraj Snid and Western Medicine

On the 150th anniversary of the passing of Phra Chao Barommawongse Ther Krom Luang Wongsa Dhiraj Snid (H.R.H. Prince Wongsa Dhiraj Snid) on August 14, 1871, the information about the acceptance of western doctors upon the prince as a corresponding fellow of the New York Academy of Medicine, elected in 1853 is presented along with the information about the 5 generations of doctors in the Snidvongs Royal Family.

Transition Readiness Assessment of Adolescents with Sickle Cell Disease and Their Caretakers at the Sickle Cell Clinic in Kumasi, Ghana

Background: Sickle Cell Disease (SCD) is associated with high child mortality in sub-Saharan Africa (SSA). Improved medical services within an established SCD program in Kumasi, Ghana have focused on enhanced newborn screening and comprehensive pediatric SCD care (Ohene-Frempong et al., 2008). These efforts have improved SCD survival and increased the need for adolescents to transition to adult care. We sought to understand patient and caretaker perspectives on transition to adult care for adolescents with SCD visiting the Komfo Anokye Teaching Hospital Sickle Cell Clinic (KATH SCC) in Kumasi, Ghana, where the transition occurs by age 15 years.Methods: Structured interviews were conducted with adolescents aged 12-15 years and adults who accompanied them to KATH SCC. Interviews queried 4 areas that are relevant for assessing transition readiness in the U.S.: SCD medical knowledge, symptom self-management, psychosocial impact, transition preparation. Interview questions were adapted from two surveys that assessed transition readiness of adolescents with SCD in the U.S. (Telfair et al., 2004; Treadwell et al., 2016) and modified to fit the Ghanaian context. Interviews were conducted in English or Twi (the prevalent local language), per participant preference. Responses were transcribed during the interview, and later translated into English, as needed, by one interviewer (MKS) for descriptive statistics and qualitative analysis.Results: In total, 46 children (mean age 13 years) and 46 accompanying adults were consented (or assented) and interviewed. Most participants selected Twi for interviews. Adults were either parents (70%) or close relatives, with mean age 39.8 years (range 18-70). SCD type was determined by clinic records: 59% of children interviewed had HbSS, 35% HbSC, and 6% had no SCD type recorded. Most children and their caretakers had some knowledge about SCD and management: 61% of children knew that SCD is a blood disorder, while 74% knew that SCD is an inherited disorder. Majority of children knew what to do to ease pain in crisis (61%), where to go for care (85%), what care is helpful (72%), and could engage with the hospital team independently (87%). Gaps in knowledge were evident for up to one third of children for each question. Their responses were corroborated by at least 46% of adults. Significantly fewer children (39%) knew their SCD type compared to the adults (63%) (p=0.02). Children who reported knowing how to handle a pain crisis used a combination of analgesics, folic acid, penicillin, and a local ointment, but did not understand that folic acid and penicillin are maintenance medications that do not relieve painful episodes. Children appeared more concerned than adults about their current health and social stigmatization than about future health-related challenges. Seventy-six percent of children worried about having SCD, 28% felt like burdens to family, 37% told their friends about having SCD, but 96% had plans for their future. Adults had different perspectives of disease burden, where only 48% and 6% believed their child worried and felt like a burden, respectively. Few children (35%) and adults (37%), were aware of the requirement to switch to adult care by age 15, but most (72% or 74%) were willing to transition when asked to do so.Conclusions: To the best of our knowledge, this is the first study of perspectives about care transition for adolescents with SCD and their caregivers in SSA. Our clinic-based assessment at a single site suggests that the youth and their adult caregivers are informed about SCD but lack information relevant to adequate medical care, are concerned about peer stigmatization and were unaware of the need to transition. Challenges to successful transition in the country may include the relatively young age of transition and gaps in knowledge needed for successful self-management. Future efforts to improve transition to adult SCD care may need to include education of adolescents and families about the disease, self-management, and transition and address sense of self-burden to families and stigmatization among peers. Generalizability of our findings and practical methods to address needs for SCD transition within Africa remain to be tested.Acknowledgments: Support to MKS by David E. Rogers Student Fellowship Award from New York Academy of Medicine and IFAP Global Program of Columbia University. We thank KATH SCC staff for facilitating this research. DisclosuresNo relevant conflicts of interest to declare.

Interventions to improve upper extremity reaching function in persons with stroke: a scoping review protocol

Background A majority of stroke patients have persisting upper extremity impairments, with a large number of individuals who do not regain the ability to reach and manipulate everyday objects despite receiving prolonged and intensive therapy. Varied interventions have been employed to improve reaching functions. However, there is a lack of a comprehensive and updated review of all the interventions that can be used to improve upper extremity reaching function in stroke. Objective To review the existing interventions aimed to improve upper extremity reaching function in persons with stroke. Inclusion criteria Studies with quantitative, qualitative, and mixed methods design which have employed interventions to improve upper extremity reaching function following stroke and have been published from database inception to 25th February 2021 in English. Methods The proposed scoping review will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist and will be conducted as per the methodological framework proposed by Arksey and O’Malley. A database-specific search strategy will be used in four electronic databases (MEDLINE, Scopus, CINAHL, Web of Science) and four grey literature platforms (ProQuest, MedNAR, OpenGrey, New York Academy of Medicine). The screening and extraction of data from eligible studies will be done independently by two reviewers. The extracted data will be presented with the help of tables and visual representation. Discussion Previously conducted reviews have enumerated the various types of interventions that have been used to improve upper extremity reaching function, but are incomprehensive and in need of an update. This review will provide an overview of all the therapeutic interventions which might aid in clinical decision making during stroke rehabilitation.

Editorial introductions

Editorial introductions

Social Determinants of Health in People with Kidney Disease: An Introduction.

The papers that follow derive from talks delivered at the 2020 Alison Norris Symposium at the New York Academy of Medicine (NYAM). The program title was Social Determinants of Kidney Health, the fifth in a biennial series established to memorialize the life and work of Dr. Norris. Dr. Norris was a

Individuals' experiences of the integration of substance use/addiction and HIV/AIDS services in community settings: a qualitative systematic review protocol.

The objectives of this systematic review are: i) to identify, appraise, and synthesize the best available evidence on individuals' experiences of the integration of substance use/addiction and HIV/AIDS services in community settings, and ii) to identify barriers to and facilitators of the integration of the services. The integration of drug use treatment and HIV services has shown to improve HIV prevention, decrease HIV infection and progression, while improving access to social and support services among substance users. Combined pharmacological and behavioral drug use treatments have been proven to diminish behaviors that increase HIV risk, decrease incidence of the disease, and improve adherence to antiretroviral therapy among individuals who use drugs and are HIV-positive. The populations of interest in this review include patients who have experienced integrated substance use/addiction and HIV services, as well as health care professionals and policy makers who have been involved in developing or implementing integrated substance use/addiction and HIV/AIDS services. Eligible studies will focus on the views, attitudes, understandings, and perceptions of patients, health care professionals, and policy makers resulting from experience in developing or implementing strategies that have or could inform the integration of substance use/addiction and HIV/AIDS services in community settings. Searches will be conducted in MEDLINE, Embase, PsycINFO, and CINHAL. The search for unpublished studies will include OpenGrey, Grey Matters, New York Academy of Medicine's Grey Literature Report, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform. Selected studies will be critically appraised by two independent reviewers for methodological quality. Data will be extracted and then synthesized following the JBI meta-aggregative approach. PROSPERO CRD42020185858.

Malignant Progression of Monoclonal Gammopathy of Undetermined Significance: A Systematic Review and Meta-Analysis

Introduction: Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic premalignant plasma cell dyscrasia that occurs in 3-5% of patients above the age of 50. In addition to its known progression to multiple myeloma (MM), MGUS is associated with higher risks of second malignancies. The progression from MGUS to more advanced diseases has a significant impact on overall survival. This systematic review and meta-analysis therefore aimed to comprehensively evaluate the incidence of malignant progression and the development of second malignancies in patients with MGUS. Methods: The protocol of our study was registered in PROSPERO with ID(CRD42018092067). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive electronic search in nine electronic databases, including PubMed, Google Scholar, POPLINE, WHO health library, System for Information on Grey Literature in Europe, Scopus, Web of Science, Virtual Health Library, and The New York Academy of Medicine. The following predetermined search terms were used: (monoclonal gammopathy of undetermined significance or MGUS); (incidence or progression or transformation); (myeloma or lymphoma or amyloidosis or macroglobulinemia or leukemia or plasmacytoma or malignancy or malignant). Risk of bias was assessed using the National Institute of Health (NIH) study quality assessment tool. Random-effects model was used to synthesize the pooled event rates of MGUS progression and development of second malignancies. Statistical heterogeneity was evaluated using Cochran's Q statistics and I² tests, with p-value≤0.10 or I² value>50% considered as statistically significant. Sub-group analysis based on the duration of follow-up was conducted to obtain rates of progression in patients who were followed-up for 0-5 years, 5-10 years, and more than 10 years. Meta-regression based on age, gender, immunoglobulin subtype of MGUS, and publication year was performed to explore any statistically significant heterogeneity if there were more than 10 studies. Publication bias was assessed using Begg's funnel plot and Egger's regression test if the number of studies was more than 10. Results: A total of 4690 articles were identified. Of those, 315 articles were found eligible for full-text screening. We finally included 48 studies for analysis including a total of 20945 patients with a mean age of 64.1 years. The mean duration of follow-up was 7.43 (1.8-34.1) years. The overall cumulative rate of MGUS progression and development of second malignancies was 8.6% (95% CI, 7.2-10.2%). The rates stratified based on years of follow-up were 6.9% (95% CI, 5.3-8.9%) at 0-5 years, 8.8% (95% CI, 6.4-11.8%) at 5-10 years, and 14.9% (95% CI, 10.8-20.2%) beyond 10 years. Rates of progression to MM, Waldenstrom macroglobulinemia, and amyloidosis were 5.8% (95% CI, 4.7-7.2%), 2.1% (95% CI, 1.1-4.0%), and 0.7% (95% CI, 0.3-1.5%) respectively. The rates of development of non-Hodgkin lymphoma and leukemia were 2.5% (95% CI, 1.5-4.3%) and 1.4% (95% CI, 0.4-4.4%) respectively. The rate of development of solid tumors was 6.4% (95% CI, 2.5-15.4%). Meta-regression for evaluation of statistical heterogeneity was performed for most outcomes, except for those with less than 10 studies (leukemia, amyloidosis, solid tumors, and follow-up beyond 10 years). Age and publication year were the source of heterogeneity in most. Overall risk of progression does not vary with MGUS subtypes. There was no publication bias based on Begg's funnel plot and Egger's regression test. Conclusions: The risks of MGUS malignant progression and development of other hematological/solid malignancies remain significant, approximating 15% after 10 years of diagnosis. Future efforts could be directed toward better cancer surveillance and deferral of malignant progression among patients with MGUS. Disclosures No relevant conflicts of interest to declare.