Author Interviews / 23.09.2013

Natasha Tidwell Graduate Research Assistant/Teaching Assistant Department of Psychology Texas A&M University - College Station 208 State Chemistry Building Texas A&M UniversityMedicalResearch.com Interview with: Natasha Tidwell Graduate Research Assistant/Teaching Assistant Department of Psychology Texas A&M University - College Station 208 State Chemistry Building Texas A&M Universit MedicalResearch.com: What are the main findings of the study? Answer: Basically, two studies demonstrated that men’s tendency to engage in “off limits” sexual behaviors more than women is linked to sex differences in impulse, not control. In Study 1, we asked participants to reflect on previous times they succumbed to sexual temptations they felt were inappropriate some way. Based on their responses, we found that men both experienced stronger impulses and engaged in behavior based on these impulses more than women did. However, there was no reported difference in how much men and women exerted self-control. (more…)
Author Interviews, Pediatrics / 23.09.2013

MedicalResearch.com Interview with Selma Salihovic, Doctoral student Center for Developmental Research Örebro University MedicalResearch.com: What are the main findings of the study? Dr. Salihovic: Although previous research has examined the stability of psychopathic traits, our study offer a more nuanced perspective on development. Rather than asking whether psychopathic traits simply increase or decrease in adolescence, we asked about patterns of change for youths with different initial level of psychopathic traits. In this way, we could tease apart those youths with extreme levels from those with low and more transient levels, and follow their unique trajectories over four years. We could see that even among the youths with the highest levels there was a decreasing trend in two out of three core aspects of psychopathy. Although the degree of change was small, it was still a naturally occurring pattern for these youths, which raises the question whether an intervention designed to reduce these levels would have provided even a steeper decrease. (more…)
Author Interviews, Environmental Risks, Heart Disease / 22.09.2013

MedicalResearch.com Interview with: Dr Anoop Shah MBChB Cardiology Research fellow Centre of Cardiovascular sciences Chancellors Building University Of Edinburgh Little France Edinburgh MedicalResearch.com: What are the main findings of the study? Answer: Many studies have shown the effect of air pollution on cardiac mortality and myocardial infarction. Less studies have shown a similar effect on patients with heart failure. We therefore systemically reviewed and pooled data across 12 countries involving over 4 million patients with heart failure. We showed that air pollution has a close temporal association with either being hospitalized or dying from heart failure. Most of the effects of air pollution on patients with heart failure were acute. Most of the data that we analyzed came from developed countries across Europe and the USA. There was a  significant paucity of data from rapidly urbanizing nations such as India and China. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues / 22.09.2013

Argonde van Harten From the Alzheimer Center School for Mental Health and Neurosciences, Maastricht University Medical Center, Maastricht, the Netherlands.MedicalResearch.com Interview Invitation Argonde van Harten From the Alzheimer Center School for Mental Health and Neurosciences, Maastricht University Medical Center, Maastricht, the Netherlands. MedicalResearch.com: What are the main findings of the study? Answer: We found cerebrospinal fluid biomarker evidence of preclinical Alzheimer's disease (AD) predicted cognitive decline in patients with subjective complaints. These patients have cognitive complaints, but are cognitively normal at baseline. Preclinical AD predicted decline in memory performance, executive functions and global cognition over time. Most patients, however, had no evidence of preclinical AD and their cogntive functions generally remained stable over two years. Their memory performance improved. (more…)
Author Interviews, Obstructive Sleep Apnea, Sleep Disorders / 21.09.2013

MedicalResearch.com Interview with: Marc L. Benton, MD, FCCP, FAASM Morristown Medical Center and Atlantic Sleep & Pulmonary Associates, 300 Madison Ave. Third Floor Madison, NJ 07940 MedicalResearch.com: What are the main findings of the study? Dr. Benton:  When compared to a group of matched controls, 12 male golfers who had moderate-severe obstructive sleep apnea syndrome (OSAS) demonstrated statistically significant improvement in their ability to play golf (as measured by changes in the Handicap Index, the standardized indicator of golfing performance) after undergoing CPAP treatment for their condition.  Treatment adherence among the group placed on CPAP was unusually high. (more…)
Author Interviews, Lancet, Smoking / 20.09.2013

Dr. Chris Bullen MBChB MPH PhD FAFPM FNZCPHM Director School of Population Health, The University of Auckland Private Bag 92019 Auckland 1142, New Zealand Co-Director of the NZ Tobacco Control Research Turanga: A national programme of research to inform rapid smoking prevalence reduction.MedicalResearch.com Interview with:

Dr. Chris Bullen MBChB MPH PhD FAFPM FNZCPHM Director School of Population Health, The University of Auckland Private Bag 92019 Auckland 1142, New Zealand Co-Director of the NZ Tobacco Control Research Turanga: A national programme of research to inform rapid smoking prevalence reduction. Web: http://www.turanga.org.nz/ MedicalResearch.com: What are the main findings of the study? Dr. Bullen:
  • E-cigarettes, with or without nicotine, were modestly effective at helping smokers to quit, with similar levels of abstinence as with nicotine patches, and few adverse events.
  • ?At 6 months, verified abstinence was 7·3% with nicotine e-cigarettes, 5·8% with patches, and 4·1% with placebo e-cigarettes. However, there was insufficient statistical power to conclude superiority of nicotine e-cigarettes to patches or to placebo e-cigarettes.
  • No significant differences in rates of adverse events occurrence were found between the groups.
  • E-cigarettes, like the vapes found at MagicVaporizers, were very popular throughout the trial, with almost 90% of users stating they would recommend them to a friend trying to quit smoking.
(more…)
Author Interviews, Breast Cancer, Cancer Research, Lancet / 20.09.2013

Prof Aron Goldhirsch Department of Medicine European Institute of Oncology Via Ripamonti 435, 20141 Milan, ItalyMedicalResearch.com Interview with: Prof Aron Goldhirsch Department of Medicine European Institute of Oncology Via Ripamonti 435, 20141 Milan, Italy MedicalResearch.com: What are the main findings of the study? Prof. Goldhirsch:  Two years of adjuvant trastuzumab after standard chemotherapy is not more effective than is 1 year of treatment with the drug for patients with HER2-positive early breast cancer. (more…)
Author Interviews, Breast Cancer, Lancet / 20.09.2013

Prof John R Yarnold Division of Radiotherapy and Imaging The Royal Marsden NHS Foundation Trust Sutton, Surrey SM2 5PT, UKMedicalResearch.com Interview with: Prof John R Yarnold Division of Radiotherapy and Imaging The Royal Marsden NHS Foundation Trust Sutton, Surrey SM2 5PT, UK   MedicalResearch.com: What are the main findings of the study? Prof. Yarnold: A 3-week schedule of curative post-operative radiotherapy for women with breast cancer involving 15 treatments (fractions) delivered Monday to Friday each week, is at least as safe and effective as historical schedules given over 5 or 6 weeks. In fact the 3-week schedule is gentler on the healthy tissues than earlier standard regimens. (more…)
Author Interviews, Lancet, OBGYNE / 20.09.2013

Prof Sally K Tracy DMid Midwifery and Women's Health Research Unit University of Sydney, Royal Hospital for Women Randwick, NSW, AustraliaMedicalResearch.com Interview with: Prof Sally K Tracy DMid Midwifery and Women's Health Research Unit University of Sydney, Royal Hospital for Women Randwick, NSW, Australia MedicalResearch.com: What are the main findings of the study? Prof. Tracy: We recruited 1748 pregnant women, of all risk types, from two tertiary teaching hospitals in different states in Australia and allocated them to receive either caseload midwifery care (871) or standard maternity care (877). The study found more women in caseload midwifery experienced an unassisted vaginal birth without pharmacological analgesia, and fewer women experienced an elective caesarean. While the trial findings did not show a statistically significant difference in the rate of caesarean sections between either group, the overall rate fell by more than 20 percent from pre-trial levels. Newborn infants in both groups achieved similar physical assessment scores (Apgar scores). A slightly lower number of pre-term births and neonatal intensive care admissions among the midwifery caseload group was not statistically significant. Important secondary findings of the study include:
  • 30 percent more spontaneous onset of labour
  • less induction of labour
  • less severe blood loss, and
  • stronger likelihood of breastfeeding at discharge from hospital.
These small differences accounted for an overall difference of AU$566.74 less with caseload midwifery than with standard care. Caseload midwifery appeared to alter some of the pathways that recurrently contribute to increased obstetric intervention.  Having this level of continuity of care works on the assumption that women will labour more effectively, need to stay in hospital less time and feel a stronger sense of satisfaction and personal control if they have the opportunity to get to know their midwife at the beginning of pregnancy. (more…)
Author Interviews, Cognitive Issues, Mayo Clinic, Parkinson's, PLoS / 19.09.2013

Michelle M. Mielke, Ph.D. Associate Professor Department of Health Sciences Research Division of Epidemiology Mayo Clinic 200 First Street SW Rochester, MN 55905MedicalResearch.com: Interview with: Michelle M. Mielke, Ph.D. Associate Professor Department of Health Sciences Research Division of Epidemiology Mayo Clinic 200 First Street SW Rochester, MN 55905 MedicalResearch.com: What are the main findings of the study? Dr. Mielke: Among Parkinson’s disease (PD) patients, plasma levels of ceramides and monohexylceramides were higher in patients with cognitive impairment or dementia compared to patients who were cognitively normal.  Levels of these lipids were also higher in the combined group of PD patients compared to non-PD controls but the number of controls were small. (more…)
Author Interviews, General Medicine, Lung Cancer / 19.09.2013

MedicalResearch.com Interview with: Jie He, PhD, MD Director, Laboratory of Thoracic Surgery President, Cancer Institute & Hospital, Chinese Academy of Medical Sciences Chaoyang District, Beijing, 100021 MedicalResearch.com: What are the main findings of the study? Dr. Jie He:  The main findings of the study is that we have identified IDH1 as an effective plasma biomarker for the diagnosis of NSCLCs, particularly with high sensitivity and specificity in the diagnosis of lung adenocarcinoma. (more…)
Author Interviews, BMJ, Cancer Research, CMAJ / 19.09.2013

MedicalResearch.com Interview with: Bruno Heleno, PhD fellow Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, 1014 Copenhagen K, Denmark MedicalResearch.com: What are the main findings of the study? Answer: In a literature review of cancer screening trials of a wide range of screening interventions, we found that trials seldom report the information necessary to weigh benefits against harms. (more…)
Author Interviews, CMAJ, Colon Cancer, NEJM / 19.09.2013

Aasma Shaukat, M.D., M.P.H. Dept. of Medicine GI Division, MMC 36 University of Minnesota Minneapolis, MN 55455MedicalResearch.com Interview with: Aasma Shaukat, M.D., M.P.H. Dept. of Medicine GI Division, MMC 36 University of Minnesota Minneapolis, MN 55455 MedicalResearch.com: What are the main findings of the study? Dr. Shaukat: The study showed that screening for colon cancer using stool cards consistently reduces risk of death from colon cancer by one-third through thirty years. The benefit of screening in larger in men compared to women, and for women the benefit seems to start at age 60. However, screening did not make people live longer. (more…)
Author Interviews, JAMA / 19.09.2013

H. Blair Simpson, M.D., Ph.D. Professor of Clinical Psychiatry, College of Physicians and Surgeons at Columbia University Director of the Anxiety Disorders Clinic and the Center for OCD and Related Disorders at the New York State Psychiatric Institute 1051 Riverside Drive, Unit 69 New York, NY 10032MedicalResearch.com Interview with: H. Blair Simpson, M.D., Ph.D. Professor of Clinical Psychiatry, College of Physicians and Surgeons at Columbia University Director of the Anxiety Disorders Clinic and the Center for OCD and Related Disorders at the New York State Psychiatric Institute New York, NY 10032 MedicalResearch.com: What are the main findings of the study? Dr. Simpson: This is the first RCT to compare two recommended SRI augmentation strategies for adults with OCD. Adding EX/RP to SRIs was superior to risperidone and to pill placebo in reducing OCD symptoms and improving insight, functioning, and quality of life. Risperidone was not superior to placebo on any outcome. (more…)
Author Interviews, CMAJ, Orthopedics, Pain Research, University of Michigan / 19.09.2013

Chad M. Brummett, M.D. Assistant Professor, University of Michigan Health System Department of Anesthesiology Division of Pain Medicine 1500 East Medical Center Drive, 1H247 UH, Box 5048 Ann Arbor, MI 48109MedicalResearch.com Interview with: Chad M. Brummett, M.D. Assistant Professor, University of Michigan Health System Department of Anesthesiology Division of Pain Medicine 1500 East Medical Center Drive, 1H247 UH, Box 5048 Ann Arbor, MI 48109 MedicalResearch.com:  What are the main findings of the study? Dr. Brummett: The study found that 42% of new patients presenting to a tertiary care pain clinic with a primary spine pain diagnosis met the American College of Rheumatology (ACR) survey criteria for fibromyalgia, which is a measure of widespread body pain and comorbid symptoms (e.g. trouble thinking, fatigue, mood symptoms, etc.).  Patients categorized as fibromyalgia-positive using the survey measure were distinctly different from those not meeting criteria.  In a multivariate regression model, independent predictors of being categorized as fibromyalgia-positive were female sex, higher neuropathic pain scores, anxiety, and lower physical function. (more…)
Author Interviews, CMAJ, Infections, Outcomes & Safety, Urinary Tract Infections / 18.09.2013

MedicalResearch.com Interview with: Mohamad Fakih, MD, MPH Medical Director, Infection Prevention and Control St John Hospital and Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Fakih: Urinary catheters are commonly used in the hospital.  Although they help in the management of the sickest patients, they also present a risk for infection and other harms to the patient. The Centers for Medicaid and Medicare Services (CMS) have made catheter associated urinary tract infections (CAUTI) publicly reportable, and no longer reimburse hospitals for these infections if they occur in hospital setting. The definition of CAUTI is based on the surveillance definition of the National Healthcare Safety Network (NHSN) by the Centers for Disease Control and Prevention (CDC). We looked at clinician practice, including the Infectious Diseases specialist’s impression and compared them to the NHSN definition. We found a significant difference between what clinicians think is a urinary catheter infection and give antibiotics for it compared to the NHSN definition. The NHSN definition predicted clinical infection by the Infectious Diseases specialist in only about a third of the cases. We also found that Infectious Disease specialists considered patients to have true CAUTI in only half of what clinicians treated as CAUTI. (more…)
Author Interviews, CMAJ, Diabetes / 18.09.2013

Dr. Yunsheng Ma MD, PHD, MPH Division of Preventive and Behavioral Medicine Department of Medicine University of Massachusetts Medical School 55 Lake Avenue North, Worcester, MA 01655MedicalResearch.com Interview with: Dr. Yunsheng Ma MD, PHD, MPH Division of Preventive and Behavioral Medicine Department of Medicine University of Massachusetts Medical School 55 Lake Avenue North, Worcester, MA 01655 MedicalResearch.com: What are the main findings of the study? Dr. Ma: Regardless of race/ethnicity, diabetes increases the risk of mortality the same compared to non-diabetes among different race/ethnicity. However, since there are higher prevalence of  diabetes in Black and Hispanic, death rate due to diabetes is much higher in Black and Hispanic, this is because the diabetes prevalence rates are much higher in these population. Therefore, diabetes prevention is key to reduce diabetes related mortality disparities among racial/ethnic groups. (more…)
Author Interviews, CMAJ, Pediatrics, Psychological Science / 18.09.2013

MedicalResearch.com Interview with: Gianluca Gini, PhD and Tiziana Pozzoli, PhD Department of Developmental and Social Psychology University of Padua, Padua, Italy MedicalResearch.com: What are the main findings of the study? Answer: Results of this meta-analysis show that bullied children are twice as likely as non-bullied children to experience psychosomatic symptoms (e.g., headache, stomachache, backache, abdominal pain, dizziness,  sleeping problems, poor appetite, bedwetting, skin problems, vomiting), especially in samples that included an higher proportion of boys.  Importantly, the same result was found not only with cross-sectional studies but also in a meta-analysis of six studies that employed a longitudinal design. (more…)
Alzheimer's - Dementia, Author Interviews, CMAJ, JAMA, Mayo Clinic, Parkinson's / 18.09.2013

Rodolfo Savica, MD, MSc Department of Neurology, College of Medicine Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MinnesotaMedicalResearch.com Interview with: Rodolfo Savica, MD, MSc Department of Neurology, College of Medicine Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota   MedicalResearch.com: What are the main findings of this study? Dr. Savica: This study is the first in North America to explore the incidence of DLB and PDD in a population based sample. We found that the overall incidence of dementia with Lewy bodies (DLB), considered the second leading cause of neurodegenerative dementia after Alzheimer`s disease, is lower than that of Parkinson`s disease (PD), increases steeply with age, and is markedly higher in men than in women. (more…)
Author Interviews, CMAJ, Social Issues / 18.09.2013

MedicalResearch.com Interview with: Matthew S. Pantell, MD, MS Department of Pediatrics University of California, San Francisco MedicalResearch.com: What are the main findings of the study? Dr. Pantell: First of all, our study confirms the strong association between social isolation and mortality in a nationally representative sample from the US. Furthermore, it shows that, within the same national sample, social isolation is a similarly strong predictor of mortality as compared to smoking, obesity, high blood pressure, and high cholesterol. Examining individual components of social isolation, our study shows that, among both women and men, not living with a partner and not participating in religious activities frequently are strong individual predictors of mortality. Finally, our work shows that infrequent social contact is associated with mortality among women, and not participating in social clubs/organizations is associated with mortality among men. (more…)
Author Interviews, CMAJ, Exercise - Fitness, Pediatrics, Weight Research / 18.09.2013

MedicalResearch.com Interview with: Ronald J. Iannotti, PhD Prevention Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland Trends in Physical Activity, Sedentary Behavior, Diet, and BMI Among US Adolescents, 2001–2009 MedicalResearch.com: What are the main findings of the study? Dr. Iannotti: Although average BMI percentile increased from 2001 to 2005 it did not increase from 2005 to 2009. This is consistent with some recent studies that suggest the increase in overweight and obesity may be leveling off. We suggest that we may be 'bending the curve'. During the same period, physical activity and consumption of fruits and vegetables increased while television watching and consumption of sweets and sweetened beverages decreased. We cannot say whether television watching was replaced with more time spent on computers but we did not find an increase in computer use from 2005 to 2009. (more…)
Author Interviews, CMAJ, MRI, Stroke / 17.09.2013

Tobias Saam, MD Institute of Clinical Radiology Ludwig-Maximilians-Univ Hosp Munich, GermanyMedicalResearch.com Interview with: Tobias Saam, MD Institute of Clinical Radiology Ludwig-Maximilians-Univ Hosp Munich, Germany MedicalResearch.com: What are the main findings of the study? Dr. Saam: The results of our meta-analysis suggest that despite a large degree of detected heterogeneity of the published studies, the presence of intraplaque hemorrhage by MRI in patients with carotid artery disease is associated with an approximately 5.6-fold higher risk for cerebrovascular events, such as TIA or stroke, as compared to subjects without intraplaque hemorrhage. (more…)
Author Interviews, CMAJ / 17.09.2013

Shoshana M. Rosenberg, ScD, MPH Researcher, Susan F. Smith Center for Women's Cancers Dana-Farber Cancer InstituteMedicalResearch.com Interview with: Shoshana M. Rosenberg, ScD, MPH Researcher, Susan F. Smith Center for Women's Cancers Dana-Farber Cancer Institute   MedicalResearch.com: What are the main findings of the study? Answer: Rates of contralateral prophylactic mastectomy (CPM) have been increasing among all breast cancer patients, however this trend has been most pronounced among the youngest women with breast cancer. Because of this trend, we sought to better understand why the youngest women - those diagnosed at age 40 or younger - were deciding to have this surgery. Many women not considered "high-risk", e.g., those without a cancer pre-disposing mutation, cited a desire to prevent the breast cancer from spreading as well as a desire to improve survival as reasons for undergoing the procedure, indicating they overestimate the benefit of having this surgery, as CPM does not affect these outcomes. While CPM does reduce the risk of developing breast cancer in the unaffected breast, in women who are not considered "high-risk", this risk is relatively low, however many women overestimated this risk as well. (more…)
Author Interviews, CMAJ, Melanoma / 17.09.2013

Ze'ev Ronai, Ph.D., Professor and scientific director of Sanford-Burnham Medical Research Institute La Jolla San Diego, Calif.MedicalResearch.com Interview with: Ze'ev Ronai, Ph.D. Professor and scientific director of Sanford-Burnham Medical Research Institute La Jolla San Diego, Calif. MedicalResearch.com: What are the main findings of the study? Answer: This study provides the first direct evidence of the importance of the PDK1 enzyme in the development of melanoma and in the metastasis of this aggressive tumor type. We demonstrate, with a genetic mouse melanoma model (harboring the Braf/Pten mutations commonly seen in human melanomas) and/or pharmacological inhibitors against PDK1, that melanoma requires this enzyme for its development, and more so – for its ability to metastasize. Since PDK1 is key kinase that regulates a number of protein kinases, which are currently being assessed in clinical trials (including AKT), our finding points to a new set of targets that could be more amenable for effective combination therapy in melanoma. (more…)
Author Interviews, CMAJ, Johns Hopkins, Pain Research, Pharmacology / 16.09.2013

Matthew Daubresse, MHS Research Data Analyst Center for Drug Safety and Effectiveness Johns Hopkins School of Public Health 615 N. Wolfe Street, Suite W6023 Baltimore, MD 21205 MedicalResearch.com: What are the main findings of the study? Answer: Over the past decade, prescriptions for non-opioid medications remained stable or declined among ambulatory pain visits in the United States. In visits for new-onset musculoskeletal pain, non-opioid prescribing decreased from 38% of visits in 2000 to 29% of visits in 2010. During this time, opioid prescriptions nearly doubled. Few patient, provider, and visit characteristics were associated with the likelihood of opioid receipt, suggesting increases in opioid prescribing have occurred generally across different groups of patients.  (more…)
Author Interviews, Baylor College of Medicine Houston, CMAJ, Heart Disease, JAMA / 16.09.2013

Faisal G. Bakaeen, MD FACS Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TexasThe Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, TexasMedicalResearch.com Interview with: Faisal G. Bakaeen, MD FACS Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TexasThe Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, Texas   MedicalResearch.com: What are the main findings of the study? Dr. Bakaeen:  The relative use of off-pump CABG peaked at 24% in 2003, followed by a slow decline after that to about 19%. In addition, the conversion rate from off- to on-pump decreased with time and has stayed below 3.5% in recent years. Perioperative mortality rates decreased over time for both on- and off-pump CABG and have stayed below 2% since 2006. The mortality associated with converted cases was high regardless of the surgery year. (more…)
Author Interviews, Dental Research, JAMA / 16.09.2013

Mine Tezal, DDS, PhD Oral Biology University at Buffalo NYS Center of Excellence in Bioinformatics and Life SciencesMedicalResearch.com Interview with: Mine Tezal, DDS, PhD Oral Biology University at Buffalo NYS Center of Excellence in Bioinformatics and Life Sciences MedicalResearch.com: What are the main findings of the study?   Dr. Tezal: We observed an inverse association between dental caries and head and neck cancer (HNSCC), which persisted among never smokers and never drinkers. Besides untreated caries, two other objective measures of long-standing caries history (endodontic treatments and crowns) were also inversely associated with HNSCC with similar effect sizes, supporting the validity of the association.  Missing teeth was associated with increased risk of HNSCC in univariate analyses, but after adjustment for potential confounders, its effect was attenuated and was no longer statistically significant. (more…)
Author Interviews, Baylor College of Medicine Houston, Blood Pressure - Hypertension, Cost of Health Care, JAMA / 16.09.2013

Laura A. Petersen, MD, MPH MEDVAMC Associate Chief of Staff, Research Director, VA HSR&D Center of Excellence (152) 2002 Holcombe Blvd. Houston TX 77030 Professor of Medicine Chief, Section of Health Services Research Baylor College of Medicine www.houston.hsrd.research.va.govAshley Motter HSR&D Center of Excellence Michael E. DeBakey Veterans Affairs Medical CenterMedicalResearch.com Interview with: Laura A. Petersen, MD, MPH MEDVAMC Associate Chief of Staff, Research Director, VA HSR&D Center of Excellence (152) Houston TX 77030 Professor of Medicine Chief, Section of Health Services Research Baylor College of Medicine HSR&D Center of Excellence Michael E. DeBakey Veterans Affairs Medical Center Houston, Texas 77030 MedicalResearch.com: What are the main findings of the study? Dr. Petersen: VA physicians randomized to the individual incentive group were more likely than controls to improve their treatment of hypertension.  The adjusted changes over the study period in Veterans meeting the combined BP/appropriate response measure were 8.8 percentage points for the individual-level, 3.7 for the practice-level, 5.5 for the combined, and 0.47 for the control groups.  Therefore, a physician in the individual group caring for 1000 patients with hypertension would have about 84 additional patients achieving blood pressure control or appropriate response after 1 year.  The effect of the incentive was not sustained after the washout period. Although performance did not decline to pre-intervention levels, the decline was significant.  None of the incentives resulted in increased incidence of hypotension compared with controls.  While the use of guideline-recommended medications increased significantly over the course of the study in the intervention groups, there was no significant change compared to the control group.  The mean individual incentive earnings over the study represented approximately 1.6% of a physician’s salary, assuming a mean salary of $168,000. (more…)