Annals Internal Medicine, Author Interviews, Education, Electronic Records / 30.01.2017

MedicalResearch.com Interview with: Dresse Nathalie Wenger Cheffe de clinique FMH médecine interne Département de Médecine Interne CHUV - Lausanne  MedicalResearch.com: What is the background for this study? Response: The structure of a residents’ working day dramatically changed during the last decades (limitation of working hours per week, wide implementation of electronic medical records (EMR), and growing volume of clinical data and administrative tasks), especially in internal medicine with increasing complexity of patients. Electronic Medical Records (EMR) have some positive effects but negative effects have been also described ie more time writing notes, more administrative works, and less time for communication between physicians and patients. Few time motion studies have been published about the resident's working day in Internal Medicine: the impact of the computer, and what really do the residents do during their work, especially the time spent with the patient versus the computer, as now the EMRs are widely implemented. Previous studies have been mostly performed in the US, so we decided to conduct one observational and objective study in Europe. (more…)
Author Interviews, Education, Neurological Disorders, Neurology, University of Pittsburgh / 30.01.2017

MedicalResearch.com Interview with: Neil A. Busis, M.D. University of Pittsburgh Physicians Department of Neurology Chief of Neurology, UPMC Shadyside Director of Community Neurology MedicalResearch.com: What is the background for this study? Response: Previous studies showed that neurologists have both one of the highest rates of burnout and the lowest rates of satisfaction with work-life balance, compared to other physicians. The mission of the American Academy of Neurology (AAN) is to promote the highest quality patient-centered neurologic care and enhance member career satisfaction. This is why AAN President Dr. Terrence Cascino initiated this research, to better define the issue. Our findings can guide current and future programs to prevent and mitigate neurologist burnout, promote neurologist career satisfaction and well-being, and direct efforts to advocate on behalf of neurologists and their patients. (more…)
Author Interviews, Education, PNAS / 20.01.2017

MedicalResearch.com Interview with: Janet Shibley Hyde Evjue-Bascom Professor Helen Thompson Woolley Professor of Psychology and Gender & Women’s Studies Director, Center for Research on Gender & Women University of Wisconsin Madison, WI MedicalResearch.com: What is the background for this study? Response: The background is that, in the U.S. and many other Western nations, we don’t have enough people going into STEM fields (Science, Technology, Engineering, and Mathematics). Innovations in STEM fields are enormously important in 21st century economies. So, we need to encourage more people to go into STEM fields. To do that, they have to major in a STEM field in college, and to do that, they need to prepare in high school. (more…)
Author Interviews, Education, Nature / 12.01.2017

MedicalResearch.com Interview with: Prof. Shulamit (Shu) Kahn Department of Markets, Public Policy and Law Questrom School of Business Boston University MedicalResearch.com: What is the background for this study? What are the main findings? Response: We started this research because Donna Ginther (Kansas) and I had an NIH R01 to study gender differences in biomedical careers. We quickly discovered that a major problem for women was the fact that between many years of graduate study and long postdocs, their biological clocks had almost expired before they would have a decent amount of time in their lives to think about having children. (more…)
Author Interviews, Education / 17.12.2016

MedicalResearch.com Interview with: Pallavi Amitava Banerjee, PhD Lecturer, Graduate School of Education University of Exeter, UK MedicalResearch.com: What is the background for this study? Response: Science technology engineering mathematics skills are highly valued in the UK as in most other developed countries of the world. Concerns were raised in the past by the Royal Society, Science Council and other learned societies and the UK Parliament about the insufficient number of young people wanting to take up these subjects beyond school. What then followed were a range of STEM enrichment and enhancement activities delivered at the local and national level. These activities were run to help young people appreciate science and math better to break the myth that these are only for the brainy. Students from secondary schools did hands-on practical activities, had STEM ambassador visits and several other events organized. (more…)
Author Interviews, Education, JAMA, Surgical Research / 15.12.2016

MedicalResearch.com Interview with: Mohammed Al-Omran, MD, MSc, FRCSC Head, Division of Vascular Surgery St. Michael’s Hospital Professor, Department of Surgery University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response: General surgery residency is among the most demanding clinical training programs in medicine. Several studies have suggested surgical residents have a relatively high attrition rate; however, no study has systematically reviewed the overall prevalence and causes of attrition among general surgery residents. We included over 20 studies representing 19,821 general surgery residents in our review. Most studies were from the US. We found the pooled estimate of attrition prevalence among general surgery residents was 18%. Female residents were more likely to leave than male (25% versus 15%), and residents were most likely to leave after their first training year (48%). Departing residents most commonly switched to another medical specialty (such as anaesthesia, plastic surgery, radiology or family medicine) or relocated to another general surgery program. The most common causes of attrition were uncontrollable lifestyle (range of 18% to 88%) and transferring to another specialty (range of 18% to 39%). (more…)
Author Interviews, Dermatology, Education, JAMA, Melanoma / 15.12.2016

MedicalResearch.com Interview with: June K. Robinson, MD Research Professor of Dermatology Northwestern University Feinberg School of Medicine Department of Dermatology Chicago, IL 60611 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This is a secondary finding from a randomized controlled trial of a structured skills training program for melanoma patients and their skin check partners. The pairs learned and performed skin self-examination for the early detection of melanoma. They continued to perform skin checks for 2 years and trained pairs identified more early melanoma (melanoma in situ and Stage 1A melanoma) than controls. (more…)
Author Interviews, Education, JAMA, Outcomes & Safety, UCSF / 12.12.2016

MedicalResearch.com Interview with: Charlie M. Wray, DO, MS Assistant Clinical Professor of Medicine University of California, San Francisco Department of Medicine San Francisco VA Medical Center MedicalResearch.com: What is the background for this study? Response: Since the establishment of residency duty hour regulations in 2010, which subsequently lead to increased discontinuity of inpatient care and more resident shift work, educators and researchers have attempted to establish which shift handoff technique(s) or strategies work best. National organizations, such as the ACGME, AHRQ, and the Joint Commission have made specific recommendations that are considered "best practice". In our study, using an annual national survey given to Internal Medicine Program Directors, we examined the degree of implementation of these recommended handoff strategies and the proportion of Program Director satisfaction with each of the respective strategies. (more…)
Author Interviews, Education, JAMA, Outcomes & Safety / 09.12.2016

MedicalResearch.com Interview with: Joshua L Denson MD Pulmonary and Critical Care Medicine University of Colorado School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Miscommunication during physician transition in care has been associated with adverse patient events and medical errors; however, an understudied topic is the transition in care that occurs each month when resident physicians switch clinical rotations, also called an end-of-rotation transition. During this handoff, hospitalized patients (up to 10-20) are handed over to an oncoming physician who has never met the patients. We sought to investigate if this type of transition was associated with worse patient outcomes, specifically mortality. On July 1, 2011, the Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulations limited first-year resident physicians (interns) to 16 continuous hours of work. Although these rules do not appear to have affected overall patient safety outcomes, they have been associated with an increase in shift-to-shift handoffs among training physicians. Given this, we wanted to study how they might impact patient outcomes surrounding end-of-rotation transitions in care. (more…)
ADHD, Author Interviews, Education, JAMA, UCSF / 08.12.2016

MedicalResearch.com Interview with:  

Lisa Meeks , PhD Director, Medical Student Disability UCSF Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was the first study to include students with AD/HD, learning, psychological, and chronic health conditions. This study found that the prevalence of students with disabilities is up to four times higher than previous studies indicated.

AD/HD, learning, and psychological disabilities were the most prevalent, suggesting that most students with disabilities in medicine have non-apparent disabilities. Within MD granting programs, the number of students self-reporting disability varied between 0% and 12%. Explanations for the high variability between programs are unknown, however, anecdotal reports suggest the degree to which programs have dedicated resources and inclusive practices for students with disabilities influence student disclosure. (more…)
Author Interviews, Education, JAMA / 06.12.2016

MedicalResearch.com Interview with: Karen E. Hauer, MD, PhD Associate Dean, Competency Assessment and Professional Standards Professor of Medicine, UCSF San Francisco, CA  94143 MedicalResearch.com: What is the background for this study? Response: As part of the Accreditation Council for Graduate Medical Education (ACGME)’s Next Accreditation System, residency programs are now required to rate residents using the Milestones. Evidence of validity of Milestone ratings is needed to show whether this rating system measures meaningful aspects of residents’ practice. In the field of internal medicine, we compared ratings of residents using the old evaluation form, the pre-2015 Resident Annual Evaluation Summary (RAES), which has a non-developmental rating scale that rates residents from unsatisfactory to superior on a 9-point scale, with developmental Milestone ratings. This was a cross-sectional study of all United States internal medicine residency programs in 2013-14, including 21,284 internal medicine residents. Milestone ratings are submitted by residency program directors working with Clinical Competency Committees. We correlated RAES and Milestone ratings by training year; correlated ratings of Medical Knowledge milestones using the two systems with American Board of Internal Medicine (ABIM) certification examination scores; and examined ratings of unprofessional behavior using the two systems. (more…)
Author Interviews, Education, Pediatrics, Technology / 01.12.2016

MedicalResearch.com Interview with: Dr Katie (Katherine) Twomey ESRC Future Research Leaders Fellow, Lancaster University Senior Research Associate, ESRC International Centre for Language and Communicative Development (LuCiD)   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although we know that toddlers can quickly work out what new words mean, it's not yet clear exactly how they do it. For example, when they see a new object alongside their favorite toy truck and hear a new word "block", we know that they will link "block" to the new object. They could do this by thinking in detail about what they already know, for example "if my toy is called "truck", then "block" must be the name of the new object". Equally, however, they could quickly link the new word to the new object without thinking about it in-depth. We tested this second possibility using iCub, a humanoid robot which learns by making quick associations between what it sees and what it hears, without the ability to think in detail about what it already knows. We replicated two studies of toddlers' early word learning with iCub and found that even though it can only learn through making simple links between words and objects, it behaved exactly as children did in the original experiments. (more…)
Author Interviews, Cancer Research, Education, Surgical Research / 22.11.2016

MedicalResearch.com Interview with: Dr. Dmitri Alden MD, FACS Surgical Oncologist, specializes in liver cancer, bile duct cancer, metastatic ovarian cancer and pancreatic cancer at Lenox Hill Hospital, NY Dr. Alden is an advocate of the role of empathy in medicine and discusses his passion for compassionate care in this interview. Please see his bio and website at http://www.liversurgeryny.com. MedicalResearch.com: Why do you feel that empathy is a vital part of treating a patient? Response: Over the last decade many physicians, patients and other professionals began to recognize that medical care is much more than treatment with medications or an act of surgery. Healing involves pain and suffering and dealing with psychological issues connected to the stress of being taken out of one’s normal life routine. Pain is now considered a “vital sign” and only recently it became mandatory to address it properly and document it in a medical record. Empathy in my opinion is a “vital sign” of any relationship that forms between a patient and a medical professional. When expressed genuinely, it makes a tremendous impact on patient’s overall experience and recovery. MedicalResearch.com: How do you define empathy in regards to medical treatment? Response: Empathy is understanding and true genuine caring. Patients and doctors create a unique and very personal relationship built on trust and “chemistry”. The doctor’s ability to express empathy, step in the patient’s shoes, get to know their life, loves, personal problems and to structure care around this unique individual enhances the patient’s belief in the route of treatment chosen and the doctor’s ability to provide a cure. MedicalResearch.com: Do you feel that the medical system doesn't emphasize empathy enough? Response: Doctors are trained without an emphasis on empathy. They focus on acquiring immense amounts of information that need to be learned during medical school and residency. Emotions are currently left to the side in order to succeed. The end product is often a machine that knows what to do in any medical situation but has difficulty to connect on an emotional level. I feel that empathy is also a very important step towards achieving successful outcomes because a patient will feel more invested in following the doctor's advice if he feels there is compassion and understanding. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Education, Heart Disease, Outcomes & Safety / 15.11.2016

MedicalResearch.com Interview with: Dr. Sean van Diepen, MD, FRCPC Assistant Professor of Critical Care Medicine and Cardiology Coronary Intensive Care Unit Co-Director University of Alberta Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies have documented a wide variation in CCU admission rates for patients hospitalized with acute coronary syndromes (ACS) or heart failure (HF). The reasons underpinning these differences are incompletely understood and little is known about the associations between hospital type, resource utilization, and clinical outcomes among patients admitted to the CCU with an ACS or HF. In a national cohort of 220,759 patients, we observed that CCU admission rates varied by hospital type: 41% in teaching hospitals, 29.9% in large teaching hospitals, 42.6% in medium community hospitals and13.7% in small community hospitals. The percentage of patients that did not receive critical care therapies within the first 2 days of admission were: 35.5%, 58.0%, 83.3% and 95.6%, respectively. Compared large community hospitals, community hospitals all had higher adjusted in hospital mortality rates. (more…)
Asthma, Author Interviews, Education, Pediatrics / 14.11.2016

MedicalResearch.com Interview with: Manoj Warrier, M.D. Allergy, Asthma & Sinus Care Center Adjunct Associate Professor of Pediatrics Saint Louis University and Cardinal Glennon Children's Medical Center St. Louis, MO 63127 MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2012, Missouri House Bill 1188 was passed, which allowed trained employees in Missouri schools to administer asthma related rescue medications at their discretion to students experiencing an asthma exacerbation, even if the individual student did not have their own supply of the medication. The Asthma and Allergy Foundation of America St. Louis Chapter (AAFA-STL) was instrumental in facilitating passage of this bill and also created the RESCUE (Resources for Every School Confronting Unexpected Emergencies) program, which provides equipment and access to free medications to treat acute asthma symptoms, mainly supporting schools with lower income populations. AAFA-STL tracked how often RESCUE supplies were used and found that equipment was used 1357 individual times in 2013-2014 school year, with students going back to class 86.07%, sent home 10.83%, and sent to emergency department (ED) only 1.33% of the time. In the 2014-2015, they found similar results with equipment used 1720 individual times, with students going back to class 84.48%, sent home 10.81%, and sent to ED 3.14% of the time. (more…)
Author Interviews, Autism, Education, Lancet, Pediatrics / 26.10.2016

MedicalResearch.com Interview with: Prof. Tony Charman Chair in Clinical Child Psychology King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN) Department of Psychology PO77, Henry Wellcome Building De Crespigny Park Denmark Hill London MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study is a follow-up of a treatment trial on which we have previous reported. In the original Preschool Autism Communication Trial (PACT), 152 children aged 2-4 with autism were randomised to receive the 12 month early intervention or treatment as usual. The type of early intervention used in this study focuses specifically on working with parents. Through watching videos of themselves interacting with their child and receiving feedback from therapists, parents are able to enhance their awareness and response to their child’s unusual patterns of communication; they become better able to understand their child and communicate back appropriately in a focused way. Parents take part in 12 therapy sessions over 6 months, followed by monthly support sessions for the next 6 months. In addition, parents agree to do 20-30 minutes per day of planned communication and play activities with the child. The study published today is the follow-up analysis of the same children approximately 6 years after the end of treatment. The main findings are that children who had received the PACT intervention aged 2-4 had less severe overall symptoms six years later, compared to children who only received ’treatment as usual’ (TAU) with improved social communication and reduced repetitive behaviours, although no changes were seen in other areas such as language or anxiety. These findings on an international recognised and blind rated observational measure of autism symptoms were accompanied by improvements in children’s communication with their parents for the intervention group, but no differences in the language scores of children. Additionally, parents in the intervention group reported improvements in peer relationships, social communication and repetitive behaviours. However, there was no significant difference between the two groups on measures of child anxiety, challenging behaviours (eg, conduct/oppositional disorder) or depression. (more…)
Author Interviews, Education, JAMA, Mental Health Research, Pediatrics / 06.10.2016

MedicalResearch.com Interview with: Laurie Miller Brotman, PhD Bezos Family Foundation Professor of Early Childhood Development Director, Center for Early Childhood Health and Development Department of Population Health NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Children attending high-poverty schools are often exposed to an accumulation of stressors and adverse childhood experiences that can interfere with optimal mental health and learning. This study examines mental health and academic outcomes through second grade in nearly 800 Black and Latino children who participated in a randomized controlled trial of ParentCorps--a family-centered, school-based intervention in pre-kindergarten. In the original trial, elementary schools with pre-k programs serving primarily Black and Latino children from low-income families were randomized to receive ParentCorps or standard pre-k programming. ParentCorps includes professional development for pre-k and kindergarten teachers on family engagement, social-emotional learning, and behavioral regulation, and a program for families and pre-k students provided over four months at the school by specially trained pre-k teachers and mental health professionals. ParentCorps creates a space for families to come together, reflect on their cultural values and beliefs, and set goals for their children. Parents learn a set of evidence-based strategies and choose which ones fit for their families—such as helping children solve problems and manage strong feelings, reinforcing positive behavior, setting clear rules and expectations, and providing effective consequences for misbehavior. Teachers and parents help children learn social, emotional and behavioral regulation skills such as identifying feeling sad, mad, or scared, calming bodies during stressful situations, paying attention, and solving problems together. This three year follow-up study finds that ParentCorps as an enhancement to pre-k programming in high-poverty schools results in fewer mental health problems (behavioral and emotional problems) and better academic performance through second grade. (more…)
Author Interviews, Cancer Research, Cognitive Issues, Education, Lancet, Leukemia, Mental Health Research, Pediatrics / 04.10.2016

MedicalResearch.com Interview with: Yin Ting Cheung, PhD Department of Epidemiology and Cancer Control and Noah D Sabin, MD Department of Diagnostic Imaging St Jude Children's Research Hospital Memphis, TN MedicalResearch.com: What is the background for this study? What are the main findings? Response: Long-term survivors of childhood acute lymphoblastic leukemia (ALL) who are treated with high-dose intravenous methotrexate or intrathecal chemotherapy are at risk for neurocognitive impairment, particularly in cognitive processes such as processing speed, attention and executive function. However, many children who receive these therapies do not experience significant impairments, suggesting the need for biomarkers to identify patients at greatest risk. Prior research from our team demonstrated that, during chemotherapy, patients were at risk for white matter changes in the brain, also known as leukoencephalopathy. No studies documented the persistence or impact of brain leukoencephalopathy in long-term survivors of childhood ALL treated on contemporary chemotherapy-only protocols. In this study, we included prospective neuroimaging from active therapy to long-term follow-up, and comprehensive assessment of brain structural and functional outcomes in long-term survivors of ALL treated with contemporary risk-adapted chemotherapy. We demonstrated that survivors who developed leukoencephalopathy during therapy displayed more neurobehavioral problems at more than 5 years post-diagnosis. Moreover, these survivors also had reduced white matter integrity at long-term follow-up, and these structural abnormalities were concurrently associated with the neurobehavioral problems. (more…)
Accidents & Violence, Author Interviews, Education, Technology / 03.10.2016

MedicalResearch.com Interview with: Barak Ariel, PhD Jerry Lee Fellow in Experimental Criminology and Lecturer in Experimental Criminology University of Cambridge Alex Sutherland, D.Phil. RAND Europe MedicalResearch.com: What is the background for this study? Response: The very first randomised-controlled experiment on cameras in Rialto (California) was originally intended to ‘cut red tape’, but Rialto Police Department decided instead to look at whether wearing the cameras could help reduce complaints and police use-of-force. That study found that cameras did cut use-of-force and complaints, with the latter almost to zero in the 12 months of the experiment. Given that each complaint costs, millions of dollars in the US, there was a lot of interest following that study, and that research was seen as crucial in the widespread adoption of Body-Worn Cameras in the US and other countries. Although Rialto is typical of a lot of mid-sized police forces in the US, it is just one location at one time – so the roll out that was taking place had a very weak evidence base. The same results might not be found in other locations and given that many police forces started to roll out cameras without evidence, there was a strong justification for replicating the study. This paper (and two others already published) report results from x10 RCTs that took place in the UK and US, with more than 2 million residents, over a period of a year. (more…)
Author Interviews, Breast Cancer, Cancer Research, Education / 30.09.2016

MedicalResearch.com Interview with: Adam Brufsky, MD, PhD, FACP Medical Director of the Women's Cancer Center University of Pittsburgh Medical Center MedicalResearch.com: What is the background for this study? What are the main findings?
  • The Make Your Dialogue Count survey was conducted by Harris Poll on behalf of Novartis between June 20 and August 22, 2014. A total of 359 surveys were collected among women 21 years+ living with advanced breast cancer in addition to 234 caregivers of women with advanced breast cancer and 252 licensed oncologists who treat at least five advanced breast cancer patients per month within the United States. Novartis conducted the survey with guidance from oncologists, patient advocacy experts and a psychologist to better understand the dialogue around treatment goals and decisions that takes place among advanced breast cancer patients, caregivers and oncologists.
  • Main survey findings show communication gaps exist in discussions between patients and oncologists, particularly around treatment plans and goals.
  • 89% of patients and 76% of oncologists said that it’s important or very important to discuss long-term treatment plans beyond the current recommended treatment at their initial advanced breast cancer diagnosis. Yet, 43% of patients reported that this did not take place.
  • 70% of patients and 65% of oncologists said that it’s important or very important to refer patients to support services at their initial advanced breast cancer diagnosis. Yet, only 36% of patients reported that this was something their doctor did.
  • 23% of oncologists said that at times their emotions have kept them from sharing certain information with their advanced breast cancer patients, and 27% of oncologists said that, in certain situations, they do not discuss with patients the fact that advanced breast cancer is incurable.
(more…)
Author Interviews, Education, Mental Health Research, University of Michigan / 25.09.2016

MedicalResearch.com Interview with: Katherine J. Gold, MD MSW MS Department of Family Medicine Institute for Healthcare Policy and Innovation; Depression Center University of Michigan With co-authors Louise B. Andrew MD JD; Edward B. Goldman JD; Thomas L. Schwenk MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is common knowledge that physicians are often hesitant to seek care for mental health concerns. Knowing that female physicians have increased rates of both depression and suicide, we surveyed female physicians who were mothers and who participated in a closed FaceBook group about their mental health, treatment, and opinions about licensing. More than 2100 U.S. physicians responded, representing all specialties and states. Almost half of participants reported that at some point since medical school they had met criteria for a mental illness but didn’t seek treatment. Reasons included feeling like they could get through without help (68%), did not have the time (52%), felt a diagnosis would be embarrassing or shameful (45%), did not want to ever have to report to a medical board or hospital (44%), and were afraid colleagues would find out (39%). Overall, 2/3 identified a stigma-related reason for not seeking help. Almost half reported prior diagnosis or treatment, but just 6% of these women stated they had disclosed this to a state medical board on a licensing application, though states vary on what information they require be disclosed. (more…)
Author Interviews, Education / 15.09.2016

MedicalResearch.com Interview with: Mr. Alexander Burgoyne Department of Psychology Michigan State University East Lansing, MI MedicalResearch.com: What is the background for this study? What are the main findings? Response: Within the field of psychology, the question of whether intelligence has a role in chess expertise has been debated since at least 1927 with the publication of "Psychologie des schachspiels" by Djakow, Petrowski, and Rudik. More recently, the titles of popular press books such as Talent is Overrated speak to the belief that individual differences in abilities, such as intelligence, do not matter, or can be circumvented by training. We analyzed a half-century worth of research on intelligence and chess skill and found that cognitive ability contributes meaningfully to individual differences in chess skill, particularly in younger and/or less skill players. (more…)
Author Interviews, Education, Pediatrics, Technology / 14.09.2016

MedicalResearch.com Interview with: Jesus Pujol, MD Director of the MRI Research Unit. Department of Radiology. Hospital del Mar Barcelona MedicalResearch.com: What is the background for this study? Response: The pros and cons of video gaming in children have been extensively debated. There are relevant amounts of data indicating both the positive and negative effects of video games. Nevertheless, a key question for many parents remains unanswered: How long should children play? To provide some clarity, we have investigated the relationship between weekly video game use and certain cognitive abilities and conduct-related problems. (more…)
Author Interviews, BMJ, Education, Surgical Research / 03.09.2016

MedicalResearch.com Interview with: Miss Hui-Ling Kerr SpR Trauma and Orthopaedics Department of Trauma and Orthopaedic Bristol Royal Infirmary, Bristol, UK MedicalResearch.com: What is the background for this study? Response: Gender inequality at consultant level in surgery has not improved despite greater opportunities for women and only a small proportion of women apply to become surgical trainees. We wanted to find out if the lack of female surgical role models acted as a deterrent to first year female junior doctors and final year medical students towards a career in surgery. (more…)
Author Interviews, Education, JAMA / 30.08.2016

MedicalResearch.com Interview with: Daniel J. Morgan M.D., M.S Associate Professor Epidemiology & Public Health University of Maryland School of Medicine MedicalResearch.com: What is the background for this study? Response: Physicians are generally taught if a treatment is indicated, not how well the treatment works. Although this has been part of evidence based medical training, doctors still perform poorly with ability to understand risk and how treatment limits risk (Bayesian reasoning). Many publications focus on relative risk reduction which inflates the perception of an effect over the more accurate absolute risk reduction. (more…)
Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Education / 30.08.2016

MedicalResearch.com Interview with: Deborah Blacker MD, ScD Director of the Gerontology Research Unit Department of Psychiatry Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings Response: Many observational studies have found that those who are cognitively active have a lower risk of developing Alzheimer's disease or any type of dementia. However, we and others have been concerned that these findings might be spurious due to two potential biases:
  • 1) “confounding,” meaning that those who are cognitively active have lower rates of Alzheimer’s disease for another reason, in particular the effect of greater education, which is associated with both lower risk of Alzheimer’s and higher levels of cognitive activity; and
  • 2) “reverse causation,” meaning that theassociation could be due to a reduction in cognitive activity among those already in the long preclinical phase of cognitive decline before Alzheimer’s dementia (rather than the lack of cognitive activity causing the Alzheimer’s). Our study performed a systematic review of the literature on the association, and then a set of bias analyses to assess whether confounding or reverse causation could account for the observed associations.
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Accidents & Violence, Author Interviews, CDC, Education, Sexual Health / 27.08.2016

MedicalResearch.com Interview with: Laura Kann, Ph.D. Chief of the School-Based Surveillance Branch Division of Adolescent and School Health CDC MedicalResearch.com: What is the background for this study? Response: CDC has been using the Youth Risk Behavior Survey (YRBS) to collect data on the sexual identity of high school students at the state and local levels and on the prevalence of health risk behaviors among gay, lesbian, and bisexual students for many years. Starting with the 2015 YRBS cycle, we had enough support to add questions to the national YRBS to provide the first ever nationally representative look at health risk behaviors among these students. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Education, Heart Disease, JAMA / 16.08.2016

MedicalResearch.com Interview with: Rory Brett Weiner, MD Assistant Professor of Medicine Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: The increased use of noninvasive cardiac imaging and Medicare spending in the late 1990s and early 2000s has led to several measures to help optimize the use of cardiac imaging. One such effort has been the Appropriate Use Criteria (AUC) put forth by the American College of Cardiology Foundation. The AUC for echocardiography have been useful to characterize practice patterns and more recently been used as a tool to try to improve ordering of echocardiograms. Our research group previously conducted a randomized study of physicians-in-training (cardiovascular medicine fellows) and showed that an AUC based educational and feedback intervention reduced the rate of rarely appropriate transthoracic echocardiograms (TTEs). The current study represents the first randomized controlled trial of an AUC education and feedback intervention attending level cardiologists. In this study, the intervention group (which in addition to education received monthly feedback emails regarding their individual TTE ordering) ordered fewer rarely appropriate TTEs than the control group. The most common reasons for rarely appropriate TTEs in this study were ‘surveillance’ echocardiograms, referring to those in patients with known cardiac disease but no change in their clinical status. (more…)
Author Interviews, Diabetes, Education, OBGYNE / 09.08.2016

MedicalResearch.com Interview with: Dr Valerie Holmes Senior Lecturer Centre for Public Health School of Medicine, Dentistry and Biomedical Science Queen's University Belfast Belfast MedicalResearch.com: What is the background for this study? Response: Women with diabetes, type 1 diabetes and type 2 diabetes, are advised to plan for pregnancy as there are higher risks of complications for both the mother and baby when compared to the general maternity population. Careful planning in partnership with diabetes care teams, especially in relation to achieving optimum blood glucose control and taking folic acid can significantly reduce the risks. However, while most women know that they should plan for pregnancy, they are unaware as to why this is important or how to engage with the process, and thus the majority of women (up to two thirds of women) enter pregnancy unprepared. This study describes the implementation of a regional preconception counsellng resource, in the format of a DVD, into routine care in Northern Ireland to raise awareness of pregnancy planning. The authors assessed if the introduction of this resource improved pregnancy planning among women with diabetes in the region. (more…)
Author Interviews, Education, Pediatrics / 06.08.2016

MedicalResearch.com Interview with: David C. Geary, Ph.D. Curators’ Distinguished Professor Thomas Jefferson Fellow Department of Psychological Sciences Interdisciplinary Neuroscience Program University of Missouri Columbia, MO MedicalResearch.com: What is the background for this study? What are the main findings? Response: In an earlier study, we found that children’s understanding of numbers and the relations among them (e.g., that 6 = 5 + 1 & 4 + 2 & 3 + 3…) at the beginning of 1st grade predicted their performance on math measures in adolescence, controlling IQ, working memory, family background and other factors. These are measures that predict employability and wages in young adults and thus is practically important. We were interested in understanding the very early quantitative knowledge that predicts children’s later number knowledge. We tested children on a variety of quantitative measures 2 years before they entered kindergarten and in kindergarten gave them the same type of number test that we used in the first study. We found that 3 year olds' cardinal knowledge was critical to their later understanding of number relations, controlling IQ and many other factors. Cardinal knowledge is their understanding of the quantities associated with number words. So, if you ask a child to give you 3 toys, and they give you a handful, they do not understand what ‘three’ means. Young children with poor knowledge of number words, we at risk for poor math outcomes in kindergarten, controlling other factors. (more…)