Author Interviews, Education, JAMA, Pharmaceutical Companies / 06.07.2022
Geisinger Study Found 79 Physician Contributors to UpToDate and DynaMed with Potential Conflicts of Interest of Nearly $8 Million
MedicalResearch.com Interview with:
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SooYoung VanDeMar[/caption]
SooYoung VanDeMark, MBS
Geisinger Commonwealth School of Medicine
Scranton, Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: Health care providers utilize subscription-based, point-of-care databases such as DynaMed and UpToDate to provide clinical care guidance and remain current on the latest evidence-based findings. Both of these websites maintain this content through a cadre of physician contributors who write and edit articles for these sites. These physician contributors are required to self-report any conflicts of interest (COI) as outlined by the respective policies on each website. However, prior COI research into similarly self-regulated areas, such as medical and pharmacology textbooks, and clinical practice guidelines, has found both appreciable potential COI and inconsistencies between self-reported and industry mandated disclosures (1-3).
This study (4) explored the accuracy of physician contributors to DynaMed and UpToDate by comparing their self-reported disclosure status with the financial remunerations they received from the healthcare industry (e.g., pharmaceutical companies) as reported to the U.S. Centers for Medicare and Medicaid Services’ Open Payments database. Physician contributors who reported “nothing to disclose” on their respective article topic but had an entry on Open Payments for having received money from industry, were classified as discordant and, thus, as having the potential for a COI. Additionally, total remuneration, gender, and payment category were investigated more in depth for each database.
SooYoung VanDeMar[/caption]
SooYoung VanDeMark, MBS
Geisinger Commonwealth School of Medicine
Scranton, Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: Health care providers utilize subscription-based, point-of-care databases such as DynaMed and UpToDate to provide clinical care guidance and remain current on the latest evidence-based findings. Both of these websites maintain this content through a cadre of physician contributors who write and edit articles for these sites. These physician contributors are required to self-report any conflicts of interest (COI) as outlined by the respective policies on each website. However, prior COI research into similarly self-regulated areas, such as medical and pharmacology textbooks, and clinical practice guidelines, has found both appreciable potential COI and inconsistencies between self-reported and industry mandated disclosures (1-3).
This study (4) explored the accuracy of physician contributors to DynaMed and UpToDate by comparing their self-reported disclosure status with the financial remunerations they received from the healthcare industry (e.g., pharmaceutical companies) as reported to the U.S. Centers for Medicare and Medicaid Services’ Open Payments database. Physician contributors who reported “nothing to disclose” on their respective article topic but had an entry on Open Payments for having received money from industry, were classified as discordant and, thus, as having the potential for a COI. Additionally, total remuneration, gender, and payment category were investigated more in depth for each database.
Dr. Soriano[/caption]
Victoria Soriano PhD
Research Assistant/Officer, Population Allergy
University of Melbourne
MedicalResearch.com: What is the background for this study?
Response: Peanut allergy is one of the most common childhood food allergies, and children rarely grow out of it. The only proven way to prevent peanut allergy is to give infants age-appropriate peanut products in the first year of life.
We previously showed there was a dramatic increase in peanut introduction from 2007-11 to 2018-19, following changes to infant feeding guidelines. We wanted to know if earlier peanut introduction would reduce peanut allergy in the general population (in Melbourne, Australia).
Dr. Altan-Bonnet[/caption]
Nihal Altan-Bonnet, Ph.D.
Chief of the Laboratory of Host-Pathogen Dynamics
NHLBI
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Enteric viruses such as norovirus, rotavirus and astrovirus are responsible for nearly 1.5 billion global infections per year resulting in gastrointestinal illnesses and sometimes leading to death in the very young, in the elderly and in the immunocompromised. These viruses have been thought to traditionally infect and replicate only in the intestines, then shed into feces and transmit to others via the oral-fecal route (e.g. through ingestion of fecal contaminated food items).
Our findings reported in Nature, using animal models of norovirus, rotavirus and astrovirus infection, challenge this traditional view and reveal that these viruses can also replicate robustly in salivary glands, be shed into saliva in large quantities and transmit through saliva to other animals.
In particular we also show infected infants can transmit these viruses to their mothers mammary glands via suckling and this leads to both an infection in their mothers mammary glands but also a rapid immune response by the mother resulting in a surge in her milk antibodies. These milk antibodies may play a role in fighting the infection in their infants .
Dr. Barry[/caption]
Michael J. Barry, M.D
Director of the Informed Medical Decisions Program
Health Decision Sciences Center
Massachusetts General Hospital.
Professor of medicine at Harvard Medical School
Dr. Barry was appointed as Vice Chair of USPSTF in March 2021.
He previously served as a member from January 2017 through December 2020.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The Task Force looked at the use of vitamin and mineral supplementation specifically for the prevention of heart disease, stroke, and cancer. We found that there is not enough evidence to recommend for or against taking multivitamin supplements, nor the use of single or paired nutrient supplements, to prevent these conditions.
However, we do know that you should not take vitamin E or beta-carotene for this purpose.
Dr. Dryden-Peterson[/caption]
SCOTT DRYDEN-PETERSON, MD
Assistant Professor, Medicine, Harvard Medical School
Research Affiliate, Immunology and Infectious Diseases
Harvard T.H. Chan School Of Public Health
Associate Physician, Medicine, Infectious Diseases
Brigham And Women's Hospital
Research Associate, Botswana Harvard AIDS Institute
MedicalResearch.com: What is the background for this study?
Response: The combination of the antiviral medicine nirmatrelvir and ritonavir (Paxlovid) which boosts antiviral levels was found to reduce the need for hospitalization by nearly 90% among unvaccinated people. Whether nirmatrelvir plus ritonavir can also help vaccinated people was uncertain.
Colleen Jordan[/caption]
Colleen G. Jordan, MBS
Department of Medical Education
Geisinger Commonwealth School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Opioid addiction and misuse remain a prevalent issue in the United States (U.S.). There have been more than one-million drug overdoses in the U.S. since 1999 [1], largely driven by opioids, which exacerbate the strain on resources in hospitals, treatment centers, first responders, patients, and their families. The existing pharmacotherapies for opioid use disorder (OUD) are not working.
Naloxone is a competitive mu opioid receptor antagonist used to reverse respiratory and CNS depression in those experiencing an opioid overdose but requires further dosing to prevent subsequent overdose. Naltrexone is a competitive mu opioid receptor antagonist, and has extended-release formulations intended to reduce relapse and promote adherence, yet patient noncompliance and retention continue to be limiting factors. Methadone is commonly used to treat opioid addiction as a replacement for illicit opiates but is itself an addictive substance which can result in overdoses [2] and can lead to withdrawal if not closely monitored by a licensed professional. Buprenorphine is currently used to treat opioid use disorder (OUD), and while it reduces illicit drug use, it is less effective than methadone for retaining patients in treatment. For these reasons, there is an urgent need for new opioid misuse interventions.
The objectives of this study [3] were to understand the implications of OUD and overdose treatments and determine the strengths and shortcomings of current treatments in comparison with the novel drug candidate methocinnamox (MCAM). These were completed through an extensive literature review into the history of the opioid epidemic in the United States, opioid receptors in the brain, current pharmacological treatments, and the pharmacological properties of MCAM.
Dr. Duffy[/caption]
Jeanne Duffy, MBA, PhD
Associate Professor of Medicine
Division of Sleep and Circadian Disorders
Harvard Medical School
MedicalResearch.com: What is the background for this study?
Response: Aging is associated with changes in sleep timing, quality and duration, and even older adults without chronic medical problems have shorter and more disrupted sleep than young adults. Many prescription sleep aids increase the risk of nighttime falls, have
adverse effects on next‐day cognition, and are associated with increased mortality, and so are not recommended for long-term use in older adults. In previous studies, we and others have shown that melatonin, a hormone secreted at night, increases sleep duration in young adults but only when administered during the day when endogenous melatonin levels are low. We wanted to explore whether melatonin could improve the sleep of healthy adults and whether, like young adults, its impact depends on when during the day the person is trying to sleep.
