Author Interviews

29 May

Posted at 11:47h in Author Interviews, Brigham & Women's - Harvard, Cancer Research, FDA, JAMA, Pharmacology
MedicalResearch.com Interview with: [caption id="attachment_49366" align="alignleft" width="200"]Bishal Gyawali  MD PhD Med Onc. Asst. Professor  Dr. Gyawali[/caption] Bishal Gyawali  MD PhD
  • Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
  • Department of Oncology, Department of Public Health Sciences, and Division of Cancer Care and Epidemiology, Queen’s University, Kingston, Ontario, Canada
MedicalResearch.com: What is the background for this study? What are the main findings? Response: Accelerated approval pathway from the FDA allows cancer drugs to come to market sooner by showing improvement in surrogate measures such as change in tumor size. Surrogate measures do not reflect clinical benefit in terms of living longer or feeling better. So, when a drug receives accelerated approval, the drug is required to undergo a confirmatory trial to confirm that true clinical benefit from the drug actually exists. Last year, a paper from the FDA argued that accelerated approval pathway is working effectively because 55% of such drugs confirmed clinical benefit. However, we saw that most of those drugs were actually improving only a surrogate measure even in confirmatory trials. So the confirmatory trials were not confirming clinical benefit but actually confirming benefit in a surrogate endpoint. We investigate that issue in our study using updated results from the confirmatory trials that were ongoing at the time of FDA review. Our main finding is that only one-fifth of cancer drugs that received accelerated approval actually improved overall survival later in confirmatory trials. For, 20% of other drugs, the confirmatory trials tested the same surrogate endpoint as did the preapproval trial. For another 21%, the confirmatory trial showed benefit in a surrogate endpoint different from the one used in preapproval trial. Furthermore, when drugs fail to confirm clinical benefits in confirmatory trials, they still continue to remain on market. 

29 May

Posted at 11:25h in Author Interviews, Exercise - Fitness, JAMA, Mental Health Research, Pediatrics, UCLA
MedicalResearch.com Interview with: Molly C. Easterlin, MD Fellow, UCLA National Clinician Scholars Program Clinical Instructor, Pediatrics, Cedars-Sinai Medical Center  MedicalResearch.com: What is the background for this study? Response: Adverse childhood experiences or ACEs (including physical or emotional neglect or abuse, sexual abuse, domestic abuse, exposure to household substance misuse or mental illness, parental separation or divorce, and parental incarceration) are common with about half of children experiencing 1 and one-quarter of children experiencing 2 or more. Children exposed to adverse childhood experiences have worse mental health throughout life, including higher rates of depression and anxiety. However, little is known about what factors improve long-term mental health in those exposed to ACEs. Additionally, as far as we are aware, no studies have looked at team sports participation as a potential factor that may be associated with improved mental health among those with adverse childhood experiences.

29 May

Posted at 02:15h in Author Interviews, Social Issues
MedicalResearch.com Interview with: [caption id="attachment_49416" align="alignleft" width="200"]Peter Belmi PhDAssistant Professor of Leadership and Organizational BehaviorDarden School of BusinessUniversity of Virginia Dr. Belmi[/caption] Peter Belmi PhD Assistant Professor of Leadership and Organizational Behavior Darden School of Business University of Virginia MedicalResearch.com: What is the background for this study?  Response: We wanted to understand how socioeconomic inequalities perpetuate from one generation to the next. Some scholars have suggested that social inequalities persist because of systemic prejudice that make it difficult for those at the bottom to improve their standing. Other scholars have suggested that structural inequalities may be hard to dismantle because those who wield the most influence are motivated to preserve their advantages. And other scholars have suggested that inequality may perpetuate when mainstream institutions do not acknowledge the values and norms of individuals from underrepresented groups.

29 May

Posted at 01:27h in Author Interviews, CDC, Flu - Influenza, Vaccine Studies
[caption id="attachment_49409" align="alignleft" width="200"]Megan C. Lindley, MPHDeputy Associate Director for ScienceImmunization Services DivisionCDC Megan C. Lindley[/caption] MedicalResearch.com Interview with: Megan C. Lindley, MPH Deputy Associate Director for Science Immunization Services Division CDC MedicalResearch.com: What is the background for this study? Response: Despite longstanding recommendations from the Advisory Committee on Immunization Practices, healthcare personnel influenza vaccination coverage remains below the Healthy People 2020 target of 90%. Healthcare employers use a variety of strategies to promote influenza vaccination among healthcare personnel, including facility-level mandates for vaccination. Several U.S. states have also enacted laws related to healthcare personnel influenza vaccination, but the effect of these laws on vaccination uptake is unclear. Our study used influenza vaccination coverage data reported by over 4,000 U.S. hospitals to examine three kinds of laws: (1) Assessment laws, which require hospitals to assess healthcare personnel influenza vaccination status; (2) Offer laws, which require hospitals to offer the influenza vaccine to healthcare personnel; and (3) Ensure laws, which require hospitals to require healthcare personnel to demonstrate proof of influenza vaccination.

29 May

Posted at 00:01h in Author Interviews, Epilepsy, FDA
MedicalResearch.com Interview with: [caption id="attachment_49403" align="alignleft" width="200"]Dr. Steven S. Chung, MDExecutive Director and Program ChairNeuroscience Institute and Director of the Epilepsy ProgramBanner – University Medical Center Dr. Chung[/caption] Dr. Steven S. Chung, MD Executive Director and Program Chair Neuroscience Institute and Director of the Epilepsy Program Banner – University Medical Center MedicalResearch.com: What is the background for this study? How is Nayzilam different from other treatments for epilepsy? Who/How is it administered?  Response: NAYZILAM is the first medication and only FDA-approved nasal option for treating seizure clusters. NAYZILAM allows for administration by a non-healthcare professional to patients when a seizure cluster occurs, which could provide significant value to patients who currently have limited treatment options for SC. The effectiveness of NAYZILAM was established in a randomized, double-blind, placebo-controlled trial (Study 1; NCT 01390220). Study 1 was conducted in two phases: an open-label Test Dose Phase followed by a randomized, double-blind, placebo-controlled, Comparative Phase. In the Test Dose Phase, tolerability was assessed in 292 patients. Patients were excluded from participation in the Comparative Phase if they failed to meet pre-defined blood pressure, heart rate, sedation, electrocardiogram, and peripheral oxygen saturation criteria. In the Comparative Phase, 201 patients treated a single seizure cluster episode in an outpatient setting. Numerical differences in favor of NAYZILAM were observed on each of the components of the treatment success responder definition; termination of seizure(s) within 10 minutes after initial dose of study drug (80.6 versus 70.1%) and the absence of seizure recurrence between 10 minutes and 6 hours after the initial dose of study drug (58.2 versus 37.3%). Study 1 also evaluated the occurrence and time to next seizure after the initial blinded dose of study drug. A smaller proportion of NAYZILAM-treated patients experienced the next seizure within 24 hours after the initial blinded dose of study drug (37.3% versus 46.3%). NAYZILAM-treated patients experienced a statistically longer time-to-next-seizure than the placebo group.  

28 May

Posted at 23:46h in Author Interviews, Baylor University Medical Center Dallas, Gastrointestinal Disease
MedicalResearch.com Interview with: [caption id="attachment_49399" align="alignleft" width="115"]Dr. Rhonda Souza, MDBaylor University Medical CenterCenter for Esophageal ResearchDallas, TX 75246 Dr. Souza[/caption] Dr. Rhonda Souza, MD Baylor University Medical Center Center for Esophageal Research Dallas, TX 75246  MedicalResearch.com: What is the background for this study?   Response: Eosinophilic esophagitis (EoE) is a modern disorder of the esophagus caused by an allergy to certain foods. EoE causes esophageal symptoms like difficulty swallowing and heartburn and is diagnosed when biopsies of the esophagus taken during endoscopy show numerous eosinophils, which are a type of inflammatory blood cell.  There are few established treatments for EoE. One such treatment is a diet that eliminates the offending food allergens, and another is to use steroids to reduce the number of eosinophils in the esophagus. However, the most common treatment for adults with eosinophilic esophagitis is to use proton pump inhibitors (PPIs), which block the proton pumps in stomach cells that make acid.  In earlier studies, we found that PPIs also can block proton pumps in esophageal cells.  Those proton pumps are activated by chemicals that the body produces in response to allergens including interleukin (IL)-13 or IL-4.  Il-13 and IL-4, which cause the esophagus to produce eotaxin-3, a molecule that attracts eosinophils. What remained unknown, however, was the mechanism whereby these interleukins activate proton pumps in the EoE esophagus. In our present study, we explored whether IL-4 works by increasing calcium levels in esophageal cells from EoE patients.

28 May

Posted at 23:28h in Author Interviews, Dermatology
MedicalResearch.com Interview with: Venkateswarlu (Venkat) NelabhotlaPresident & Board MemberVyome Therapeutics Inc., Venkateswarlu (Venkat) Nelabhotla President & Board Member Vyome Therapeutics Inc.,  MedicalResearch.com: What is the background for this study? Response: There are only a handful of antibiotics that are approved for use against the bacterial strain P.acnes that causes acne vulgaris. Because of the lack of new antibiotic treatment options, similar antibiotics are overused resulting in 1 out of 3 patients developing resistance against treatment, ultimately causing a decline in response rates. There is a clear unmet medical need for these patients; currently, patients do not have access to topical antibiotic treatments capable of an effective response without generating resistance. This study was designed to test the efficacy of VB-1953 in such moderate to severe acne patients, who were carrying resistant acne-causing bacteria and had failed to respond to currently approved antibiotics. VB-1953, a bactericidal topical gel formulated antibiotic, differs from these older generation antibiotics in its novel mechanism of action, through which it can kill both sensitive as well as resistant bacteria, while also reducing inflammation . The earlier generation of antibiotics, including treatments like clindamycin, are bacteriostatic in action, i.e. they merely prevent the growth of acne-causing bacteria. VB-1953 is the first bactericidal antibiotic for the treatment of acne that kills acne-causing bacteria. VB-1953 also retards the development of resistance, and reduces inflammation associated with acne via an independent immunomodulatory effect. 

28 May

Posted at 23:10h in Author Interviews, Brigham & Women's - Harvard, JAMA, Lipids
MedicalResearch.com Interview with: [caption id="attachment_49391" align="alignleft" width="133"]Samia Mora, MD, MHSAssociate Physician, Brigham and Women's HospitalAssociate Professor of Medicine, Harvard Medical SchoolBrigham and Women's HospitalDepartment of MedicinePreventive MedicineBoston, MA 02115  Dr. Mora[/caption] Samia Mora, MD, MHS Associate Physician, Brigham and Women's Hospital Associate Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Preventive Medicine Boston, MA 02115  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Lipid testing plays a major role in cardiovascular disease (CVD) risk screening, prediction, and treatment. In the past decade, several pivotal studies (including the Women’s Health Study, the Copenhagen City Heart Study, and the Copenhagen General Population Study) compared populations of individuals who had fasting lipid testing with populations of individuals who had nonfasting lipid testing, and found that non-fasting lipids were at least as good as fasting lipids in cardiovascular risk screening and predicting CVD risk. To date, however, no study has examined the cardiovascular predictive value of lipids measured on the same individuals who had both fasting and nonfasting lipid testing. This is important because individual-level variability in fasting versus nonfasting lipids may not be captured when looking at population-level risk associations, and evidence from randomized studies is lacking. Furthermore, it is unclear whether substituting nonfasting lipids would misclassify cardiovascular risk for individuals who may be eligible for statin therapy.

28 May

Posted at 22:56h in Author Interviews, Outcomes & Safety, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_49386" align="alignleft" width="133"]Janice D. Walker, RN, MBABeth Israel Deaconess Medical Center Janice Walker[/caption] Janice D. Walker, RN, MBA Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: In 2010-2011, we launched a pilot intervention in which a limited number of primary care doctors shared the notes they wrote about an office visit with their patients via secure online portals they accessed through their health systems; this practice became known as open notes (our program is called “OpenNotes”). We then surveyed patients and their primary care providers to get feedback on their experiences and published the results in the Annals of Internal Medicine in 2012. After the study, the three large health systems that participated—Beth Israel Deaconess Medical Center in Boston, University of Washington Medicine in Seattle, and Geisinger in rural Pennsylvania—made open notes available across ambulatory specialties. In this paper, “OpenNotes After 7 Years: Patient Experiences with Ongoing Access to their Clinicians’ Outpatient Visit Notes," we wanted to examine the ongoing experiences and perceptions of patients who read ambulatory notes written by a broad range of doctors, nurses and other clinicians. We did this by surveying patients who had been seen in a hospital or community based practice, were registered on their patient portal, and had at least one note available to read in a recent 12-month period. The main measures include patient-reported behaviors and their perceptions concerning the benefits and risks of reading their visit notes.

27 May

Posted at 10:42h in Author Interviews, JAMA, Mental Health Research, Surgical Research, UCSF
MedicalResearch.com Interview with: [caption id="attachment_49343" align="alignleft" width="144"]Carter Lebares, MDAssistant Professor of SurgeryDirector, Center for Mindfulness in SurgeryDepartment of Surgery, UCSF Dr. Lebares[/caption] Carter Lebares, MD Assistant Professor of Surgery Director, Center for Mindfulness in Surgery Department of Surgery, UCSF  MedicalResearch.com: What is the background for this study?  Response: This study was inspired by extensive evidence of the effectiveness of mindfulness-based interventions (MBIs) for mitigating stress and enhancing performance in other high-stress populations like police and the military.  We know that overwhelming stress is related to burnout and to cognitive errors - two critical issues within surgery, today. This prompted us to tailor and streamline an MBI specifically for surgeons, and to test it in our trainees.

27 May

Posted at 10:40h in Author Interviews, Frailty, Hospital Readmissions, JAMA, Stanford, Surgical Research
MedicalResearch.com Interview with: hospital-frailty-surgeryKara Anne Rothenberg.MD Postdoctoral Research Fellow, Vascular Surgery Shipra Arya, MD SM FACS Associate Professor of Surgery Stanford University School of Medicine MedicalResearch.com: What is the background for this study? Response: There is a growing body of literature showing that frailty, a syndrome where patients have increased vulnerability to a stressor (such as surgery), is associated with increased postoperative complications, failure to rescue, and hospital readmissions. The Risk Analysis Index (RAI), is an easy to use frailty measurement tool that better predicts postoperative mortality than age or comorbidities alone. As the rates of outpatient surgeries rise nationwide, we noted that most of the surgical frailty studies focus only on inpatient surgeries. Elective, outpatient surgery is generally considered low risk for complications and unplanned readmissions, however we hypothesized that for frail patients, it might not be.

27 May

Posted at 10:36h in Author Interviews, Heart Disease, JAMA, NIH, Stroke
MedicalResearch.com Interview with: [caption id="attachment_49363" align="alignleft" width="128"]Lenore J. Launer, PhD.Chief Neuroepidemiology Section Intramural Research ProgramNational Institute on Aging Dr. Launer[/caption] Lenore J. Launer, PhD. Chief Neuroepidemiology Section Intramural Research Program National Institute on Aging MedicalResearch.com: What is the background for this study? What are the main findings? Response: The prevalence of cerebral infarction on MRI can be as high as 30% in community-based studies. These lesions detected on brain MRI, are often clinically silent, but are associated with impairments in cognitive and physical function and can increase the risk for clinical events. For a large number, the origin of these brain lesions is unknown. There is also a lack of population-based data on unrecognized myocardial infarction, which is associated with an increased for clinical coronary disease and mortality. Unrecognized MI was detected in 17% of participants using state-of-the-art cardia MRI, a more sensitive measure of the lesions, than the standard ECG. We investigated the contribution to these lesions of recognized and unrecognized myocardial infarction [MI] identified on cardiac MRI. We found both recognized and unrecognized myocardial infarction increased the risk for cerebral infarction, and that in particular unrecognized MI was associated with cerebral infarction of embolic origins of an unknown source. Given their prevalence, unrecognized MI may be an underestimated contributor to the risk for cerebral infarction in older persons. 

25 May

Posted at 00:07h in Addiction, Author Interviews, OBGYNE, Pediatrics, Tobacco Research, UCSD
MedicalResearch.com Interview with: [caption id="attachment_49370" align="alignleft" width="169"]Davide Dulcis, PhDAssociate ProfessorDepartment of Psychiatry, UCSD School of MedicineUniversity of California, San DiegoLa Jolla, CA 92093-0603 Dr. Dulcis[/caption] Davide Dulcis, PhD Associate Professor Department of Psychiatry, UCSD School of Medicine University of California, San Diego La Jolla, CA 92093-0603 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Previous studies in humans have shown that pre-natal and early life exposure to nicotine can lead to altered children behavior and propensity for drug abuse, but the precise mechanisms involved are still unclear. In this pre-clinical study we showed how nicotine “primes” neurons of the mouse brain’s reward center for a fate they normally would not have taken, making them more susceptible to the effects of nicotine when the animals are again exposed to nicotine later in life, said Dr. Benedetto Romoli, first author of the research article.  

24 May

Posted at 21:06h in Author Interviews, Cognitive Issues, Gender Differences
MedicalResearch.com Interview with: Tom Chang PhD, BS, MIT Associate Professor of Finance and Business Economics Marshall School of Business MedicalResearch.com: What is the background for this study? What are the main findings? Response: There have been many studies showing that women prefer higher indoor temperatures than men, however nobody looked at the effect of temperature on performance. We show that the battle for the thermostat is not just about the comfort. It is much more – in our experiment, women’s cognitive functioning is the best at high temperatures, whereas men’s at low temperatures. Significantly, the positive effect of increased temperatures on women’s performance is much stronger than the negative effect on men. The most surprising was that the effect of temperature on women is so strong. For instance, at low temperatures, men outperform women in a simple math task. However, when we increase the temperature, women become better and better (1.76% increase of solved tasks with each 1 Celsius increase), and at high temperatures women and men perform on the same level – the gender difference disappears. 

24 May

Posted at 20:52h in Author Interviews, Hearing Loss, JAMA, NIH, NYU/NYMC
MedicalResearch.com Interview with: [caption id="attachment_49355" align="alignleft" width="150"]Jan Blustein, MD PhDProfessor of Health Policy and MedicineWagner Graduate School and School of MedicineNew York University, New York Dr. Blustein[/caption] Jan Blustein, MD PhD Professor of Health Policy and Medicine Wagner Graduate School and School of Medicine New York University, New York MedicalResearch.com: What is the background for this study?   Response: The National Institutes of Health (NIH), the nation’s largest public funder of health research, provides annual reports about levels of funding for many diseases and conditions.  These reports, issued as part of the NIH’s Research, Condition and Disease Categorization (RCDC) process, allow members of the public to track funding across key conditions and across time. Hearing loss is not included among the reported conditions. This runs counter to two of the NIH’s stated goals, according to researcher Jan Blustein (M.D., Ph.D.), professor of health policy and medicine at New York University’s Robert F. Wagner Graduate School of Public Service, in a Research Letter in the May 15th issue of the Journal of the American Medical Association Otolaryngology and Head & Neck Surgery. “First, the NIH is committed to transparency about how it divides funds across diseases and conditions,” said Dr. Blustein.  “Second, it has said that it will prioritize its funding to those conditions that cause the greatest disease burden.”  Hearing loss causes great disease burden, ranking 10th in the U.S. among all conditions as a contributor to Disability Adjusted Life Years (a widely-used measure of disease burden), according to the World Health Organization.

23 May

Posted at 12:22h in Author Interviews, Dental Research, Opiods, Pain Research
MedicalResearch.com Interview with: Dr. Katie Suda, PharmD, M.S. Associate Professor College of Pharmacy University of Illinois at Chicago Dr. Susan Rowan, DDS Clinical Associate Professor, Executive Associate Dean of Clinical Affairs College of Dentistry University of Illinois at Chicago,  MedicalResearch.com: What is the background for this study?  Dr. Katie Suda: Dentists treat a lot of pain – we have all probably had the experience of a terrible tooth ache. All dentists treat pain worldwide so we would not expect a large difference in which pain medication is prescribed. However, our results show that US dentists prescribe opioids more frequently than is likely needed. This is especially true because studies have shown that non-opioid pain medications are similar or more effective for the treatment of oral pain. 

23 May

Posted at 12:16h in Allergan, Author Interviews, Bipolar Disorder, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_49298" align="alignleft" width="200"]Dr. Stephen Stahl MD PhDProfessor of Psychiatry University of California San Diego Dr. Stahl[/caption] Dr. Stephen Stahl MD PhD Professor of Psychiatry University of California San Diego  MedicalResearch.com: What is the background for this study? How does cariprazine differ from other medications for bipolar depression?  MedicalResearch.com: It is important to note that cariprazine, a dopamine D3-preferring D3/D2 receptor and serotonin 5-HT1A receptor partial agonist, is approved for the treatment of schizophrenia (1.5-6 mg/d) and bipolar mania (3-6 mg/d) in adults. It is not yet approved for depressive episodes related to bipolar I disorder (bipolar depression). In these data that focus on the investigational use for the treatment of bipolar depression, cariprazine has demonstrated efficacy vs placebo (PBO) in 3 phase 2/3 studies of patients with bipolar depression (NCT01396447, NCT02670538, NCT02670551). These analyses investigated the efficacy of cariprazine in patients with bipolar depression and concurrent manic symptoms (mixed features). 

22 May

Posted at 22:08h in Author Interviews, Brain Injury, Cognitive Issues, Technology
MedicalResearch.com Interview with: [caption id="attachment_49309" align="alignleft" width="165"]Dr.. Mahncke Dr. Mahncke[/caption] Dr. Henry W. Mahncke PhD Research neuroscientist CEO of Posit Science Corporation  MedicalResearch.com: What makes this study newsworthy?  Response: Mild Traumatic Brain Injury (mTBI) is a complex condition to treat. Patients can report many symptoms (e.g., cognitive deficits, depression, anxiety, stress, fatigue, pain, sleep difficulties, disorientation, emotional issues). Prior to this study, conducted at five military and veterans’ medical centers, there has been no highly-scalable intervention to treat the cognitive deficits associated with mTBI. This study showed that a plasticity-based, computerized, brain-training app can drive statistically and clinically significant gains in overall cognitive performance. Given the number of service members and vets with persistent cognitive deficits from TBIs, that’s a big deal.

22 May

Posted at 11:03h in Author Interviews, JAMA, Lipids, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_49239" align="alignleft" width="148"]Amanda Marma Perak, MD, MSAssistant Professor of Pediatrics (Cardiology) and Preventive Medicine Dr. Marma Perak[/caption] Amanda Marma Perak, MD, MS Assistant Professor of Pediatrics (Cardiology) and Preventive Medicine MedicalResearch.com: What is the background for this study? Response: Blood cholesterol is a critical initiator of atherosclerotic plaques in the arteries that can lead to heart attack in adulthood. It is well established that these changes in the blood vessels occur already in childhood. Thus, it is important to know the status of cholesterol levels in youth to inform public health efforts aimed at preventing cardiovascular disease in the population. In the US there have been changes in childhood obesity prevalence (which may worsen cholesterol levels), the food supply (such as reduction of trans fats which may improve cholesterol levels), and other factors in recent years. We therefore designed a study to examine trends in cholesterol levels among youth in recent years.

22 May

Posted at 11:00h in Author Interviews, Cost of Health Care, JAMA
MedicalResearch.com Interview with: [caption id="attachment_49269" align="alignleft" width="150"]Dan LyPh.D. Program in Health PolicyHarvard Dan Ly[/caption] Dan Ly, MD, MPP Ph.D. Program in Health Policy Harvard MedicalResearch.com: What is the background for this study? Response: There is some mixed evidence regarding whether state level tort reform reduces defensive medicine, or the practicing of medicine in such a way to reduce medical liability. This includes “positive” defensive medicine, or performing certain tests and procedures to reduce such liability. Other research finds that the perception of malpractice risk drives such defensive medicine, including the use of diagnostic imaging, such as CT scans and MRIs. I was interested in exploring what influenced the perception of this risk, hypothesizing that, for a physician, a report of an injury against one’s colleague might increase the perception of this risk and lead to an increase the use of diagnostic imaging.

22 May

Posted at 10:57h in Annals Internal Medicine, Author Interviews, Technology
MedicalResearch.com Interview with: [caption id="attachment_49198" align="alignleft" width="129"]Coleman Drake, PhDAssistant Professor, Health Policy and ManagementPitt Public HealthUniversity of Pittsburgh Graduate School of Public Health Dr. Drake[/caption] Coleman Drake, PhD Assistant Professor, Health Policy and Management Pitt Public Health University of Pittsburgh Graduate School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Telemedicine is frequently proposed as a solution to improve access to care in rural areas where driving to the nearest physician can take up to several hours. However, there needs to be sufficient broadband infrastructure for patients to actually use telemedicine. We found that broadband infrastructure is often insufficient to support telemedicine in the most rural areas, particularly in areas where there is inadequate access to primary care physicians and psychiatrists. 

22 May

Posted at 10:53h in Author Interviews, Colon Cancer
MedicalResearch.com Interview with: [caption id="attachment_49285" align="alignleft" width="200"]Dr. Reinier G. S. Meester, PhDPostdoctoral scholar in the Department of MedicineDivision of Gastroenterology and HepatologyStanford Dr. Meester[/caption] Dr. Reinier G. S. Meester, PhD Postdoctoral scholar in the Department of Medicine Division of Gastroenterology and Hepatology Stanford MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Incidence of colorectal cancer has increased for decades in adults under age 50 years in the United States. However, there is still uncertainty regarding the underlying causes of this increase. We studied the patterns in the stage at diagnosis from cancer registry data to assess whether the increases may be due more common use of colonoscopy in the ages 40-49 years, which account for nearly 3 out of 4 young-onset cases. If the increase in incidence were the result of earlier detection from increased colonoscopy use, earlier stage at diagnosis would be expected, whereas if the increased incidence were the result of true rises in risk, relatively later stage at diagnosis would be expected. Our results suggest that the incidence of late-stage (metastatic) colorectal cancer increased at almost twice the relative rate since 1995 (2.9% per year) compared to earlier stages (1.3-1.4% per year). Over 1 in 4 young-onset cases are now diagnosed at a late stage vs. approximately 1 in 5 cases in the 1990s.

22 May

Posted at 00:40h in Author Interviews, Immunotherapy, NEJM, Pulmonary Disease
MedicalResearch.com Interview with: [caption id="attachment_49320" align="alignleft" width="148"]Gerard J. Criner, MD, FACP, FACCPChair and Professor, Thoracic Medicine and SurgeryLewis Katz School of MedicineTemple University Dr. Criner[/caption] Gerard J. Criner, MD, FACP, FACCP Chair and Professor, Thoracic Medicine and Surgery Lewis Katz School of Medicine Temple University  MedicalResearch.com: What is the background for this study? Response: An earlier, Phase II trial of benralizumab found a non-statistically significant reduction in COPD exacerbation rate for patients with eosinophilic inflammation in the airways. In this Phase III trial, the researchers sought to discover whether benralizumab's ability to deplete the airways of blood eosinophils in patients with eosinophilic inflammation would lead to a reduction in COPD exacerbations. The Phase III, randomized, double-blind, placebo-controlled, parallel-group clinical trials GALATHEA and TERRANOVA evaluated the efficacy and safety of benralizumab for the prevention of exacerbations in patients with moderate to very severe COPD, eosinophilic inflammation, and increased risk of exacerbations. Benralizumab is a type of drug called an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody. It is approved by the FDA for the treatment of severe eosinophilic asthma.

21 May

Posted at 12:33h in Author Interviews, CDC, OBGYNE, Pediatrics, Sexual Health, STD
MedicalResearch.com Interview with: Lee Warner, PhD Chief of the Women’s Health and Fertility Branch Division of Reproductive Health CDC MedicalResearch.com: What is the background for this study? Response: Previous research has found lower prevalence of condom use combined with the most effective reversible contraceptive methods among teens, but this is the first study to our knowledge to confirm the finding among sexually active teen mothers in the postpartum period. Our new paper finds that only 3 in 10 postpartum teen mothers report using condoms combined with a more effective contraceptive method (either long-acting reversible contraception or LARC or a non-LARC hormonal method). Dual use was 50 percent lower among LARC users compared with users of non-LARC hormonal methods.

20 May

Posted at 19:42h in Accidents & Violence, Author Interviews, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_49279" align="alignleft" width="200"]Jeffrey Colvin, MD, JDDepartment of PediatricsChildren's Mercy HospitalKansas City, MO 64111 Dr. Colvin[/caption] Jeffrey Colvin, MD, JD Department of Pediatrics Children's Mercy Hospital Kansas City, MO 64111  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior studies have found that infants spend an average of 5-6 hours a day in sitting devices. Sitting devices include car seats, swings, infant seats, and strollers. Given how much time infants are spending in sitting devices, we wanted to know if sleep-related infant deaths (such as Sudden Infant Death Syndrome or "SIDS") was occurring in those devices. We examined over 10,000 infant sleep-related deaths from 45 states. We found that 3% (or 348) of the deaths occurred in sitting devices. Two-thirds of the deaths in sitting devices were in car seats. What was most surprising was that less than 10% of the deaths in car seats occurred in cars. Instead, the great majority occurred in the child's home or the home of a relative, friend, or babysitter. In 1/3 of the deaths in car seats, the supervising adult was asleep. 

20 May

Posted at 17:32h in Author Interviews, Hospital Readmissions, JAMA, Neurology, Outcomes & Safety, University of Pennsylvania
MedicalResearch.com Interview with: [caption id="attachment_49220" align="alignleft" width="180"]Sameed Khatana, MDFellow, Cardiovascular Medicine, Perleman School of MedicineAssociate Fellow, Leonard Davis Institute of Health EconomicsUniversity of Pennsylvania Dr. Khatana[/caption] Sameed Khatana, MD Fellow, Cardiovascular Medicine, Perleman School of Medicine Associate Fellow, Leonard Davis Institute of Health Economics University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: There has been a growing use of quality metrics and indices in the US healthcare system. Much attention has been paid to quality measurement programs used by public payors, however, the use of such programs by commercial payors is much less studied. "Centers of excellence" are one type of quality designation program that is growing in use by commercial payors where certain hospitals are determined to be "high quality" for a certain disease state or procedure based on meeting certain criteria. For some people, this is even impacting the choice of providers and hospitals they can use by payors. We evaluated centers of excellence programs from three large commercial payors, Aetna, Cigna and Blue Cross Blue Shield, targeted at cardiovascular diseases and interventions and examined publicly reported outcomes for all hospitals performing percutaneous coronary interventions (cardiac stenting) in New York State. 

20 May

Posted at 17:29h in Accidents & Violence, Author Interviews, JAMA
MedicalResearch.com Interview with: [caption id="attachment_49216" align="alignleft" width="200"]XinQi DongDirector, Institute for Health, Health Care Policy, and Aging ResearchHenry Rutgers Distinguished Professor of Population Health SciencesProfessor, Department of Medicine - Division of General Internal Medicine, Robert Wood Johnson Medical School XinQi Dong[/caption] XinQi Dong Director, Institute for Health, Health Care Policy, and Aging Research Henry Rutgers Distinguished Professor of Population Health Sciences Professor, Department of Medicine - Division of General Internal Medicine, Robert Wood Johnson Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Interpersonal violence is a substantial public health issue across all socio-demographic and socioeconomic strata globally. A depth of prior studies have found that victims of childhood sexual abuse might have higher risks of re-experiencing sexual violence as adults. But the “re-victimization” phenomenon has been insufficiently examined among the rapidly growing aging populations. There lacks examinations about life-course violence experiences and the accumulative effect of which in older ages. Our study examined three most common forms of interpersonal violence (child maltreatment, intimate partner violence, and elder abuse) across the life span and found an interconnectedness among them. Individuals with a history of child maltreatment and/or intimate partner violence had two to six times higher risks of elder abuse compared to those without a past experience of the violence. 

20 May

Posted at 03:13h in Author Interviews, Diabetes, Ophthalmology
MedicalResearch.com Interview with: [caption id="attachment_49207" align="alignleft" width="150"]Thulasiraj RavillaExecutive Director – LAICO &Director – OpeationsAravind Eye Care SystemTamilnadu, India  Mr. Thulasiraj[/caption] Thulasiraj Ravilla Executive Director – LAICO & Director – Opeations Aravind Eye Care System Tamilnadu, India  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Diabetic Retinopathy (DR) is a visual consequence of diabetes and various other studies have reported that in India, 10% to 30% of adults with diabetes have DR, with higher rates found in older people and urban areas. Undetected DR leads to vision loss and eventually blindness. Thus early identification of DR is critical to initiate appropriate treatment to reduce the rate of vision loss. Conventional approaches of requesting diabetologists to refer patients with diabetes to an ophthalmologist has been ineffective due to compliance issues, both by the diabetologists and the patients. Similarly screening through outreach eye camps have not been found to be effective in India and other developing countries owing to inadequate eye care resources. Teleretinal screening for Diabetic Retinopathy is increasingly being used in India. Evidence from randomized clinical trials on the benefits of teleretinal screening is limited. Whatever evidence is there are from high income countries, which often have little relevance to developing countries.

19 May

Posted at 20:01h in Author Interviews, Psychological Science, Sexual Health
MedicalResearch.com Interview with: Prof. Leif Edward Ottesen KennairDepartment of PsychologyFaculty of Social and Educational SciencesNorwegian University of Science and TechnologyProf. Leif Edward Ottesen Kennair Department of Psychology Faculty of Social and Educational Sciences Norwegian University of Science and Technology MedicalResearch.com: What is the background for this study?   Response: Previous studies on intercourse frequency mainly focused on individual data, with no possibility to verify the perceived initiative or frequency. Couples data gave us that possibility. Previous studies had also mainly treated relationship quality as one measure. Therefore it was also interesting to distinguish between various aspects of relationship qualities to try to disentangle how these different aspects were related to frequency of intercourse. In addition we had some ideas about how a measure of sexual personality or sociosexuality—how interested in short-term sex one is—might be relevant for compromise within the relationship?