Author Interviews, Brigham & Women's - Harvard, JAMA, Nutrition, Social Issues / 09.03.2020

MedicalResearch.com Interview with: Alon Peltz, MD MBA MHS  Department of Population Medicine Harvard Pilgrim Health Care Institute MedicalResearch.com: What is the background for this study? Response: Thank you for taking an interest in our study. This study represented a collaboration between investigators from Harvard Medical School and Boston University School of Medicine. SNAP is an important U.S. federal aid program that serves nearly 40 million persons annually with well-established health, nutrition, and financial benefits. Families can be eligible for the SNAP program under “federal” rules or “categorical eligibility” rules that extend SNAP support to otherwise ineligible families who receive benefits under certain social assistance programs, such as Temporary Assistance for Needy Families. In July 2019, the U.S. Department of Agriculture proposed new SNAP policies that would limit qualifications via the categorical eligibility route. Although these new policies have not been finalized, it is estimated that 1 in 10 U.S. families currently participating in SNAP may lose their benefits. We wanted to investigate the potential ramifications of these changes to help inform policymakers of the vulnerabilities of the families who receive SNAP benefits and may be at risk for disenrollment if the proposed policies are implemented. (more…)
Author Interviews, Compliance, Electronic Records, JAMA, University of Pennsylvania / 05.03.2020

MedicalResearch.com Interview with: Alexander C. Fanaroff, MD, MHS Assistant Professor of Medicine, Division of Cardiovascular Medicine University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: This is a secondary analysis of the ARTEMIS, a cluster randomized trial of copayment assistance for P2Y12 inhibitors in patients that had myocardial infarction. One of the primary endpoints of ARTEMIS was persistence with P2Y12 inhibitors: Did the patient continue to take a P2Y12 inhibitor over the entire 1 year following MI? In ARTEMIS, we captured persistence data in two ways, patient report and pharmacy fill records. What we did in this study was to look at the agreement between persistence as measured by these two methods. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmaceutical Companies / 04.03.2020

MedicalResearch.com Interview with: Olivier Wouters, Ph.D. Assistant Professor of Health Policy Department of Health Policy (COW 2.06) London School of Economics and Political Science MedicalResearch.com: What is the background for this study? What are the main findings? Response: Drug companies often point to high research and development costs as justification for the rising prices of new medicines. Yet most prior analyses of research and development costs have been based on confidential data voluntarily supplied by drug companies to researchers with financial ties to the industry. Independent teams have not been able to verify those findings. (more…)
Author Interviews, Cost of Health Care, JAMA, University of Pittsburgh / 04.03.2020

MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy MedicalResearch.com: What is the background for this study? Response: Prior research found that list prices of drugs more than doubled in the last decade. However, because prior research was based on list prices, it did not account for manufacturer discounts, which have also increased in the past few years. We leveraged net pricing data from the investment firm SSR health to estimate increases in drug prices after accounting for discounts. (more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, JAMA, Pediatrics / 03.03.2020

MedicalResearch.com Interview with: Hooman Azad First author and a 3rd year medical student Feinberg School of Medicine Northwestern University Eric Fleegler, MD MPH FAAP Senior author and Pediatric Emergency Physician Boston Children’s Hospital Assistant Professor of Pediatrics and Emergency Medicine Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Pediatric firearm violence is a public health crisis. The firearm fatality rate has increased by >50% over the past 10 years. Over our 26-year study period (1991-2016), 13,697 children under the age of 15 died at the hands of a firearm. Laws have been employed to try to reduce these deaths, and Child Access Prevention (CAP) laws, which aim to hold parents liable for the safe storage of their firearms, were passed in 25 states between 1989-2000. No new state passed a CAP laws after the year 2000. Child Access Prevention laws come in two flavors – recklessness laws that hold firearm owners liable for directly providing firearms to a minor, and negligence laws that hold the firearm owner liable for the unsafe storage of firearms with variability in how storage is defined and what penalties are imposed. (more…)
Addiction, Author Interviews, JAMA, Pediatrics / 02.03.2020

MedicalResearch.com Interview with: Karl Alcover, PhD Postdoctoral Research Associate Behavioral Health Innovations Washington State University MedicalResearch.com: What is the background for this study? Response: It has been a public health focus to prevent early exposure to drugs. Our paper shows that the average age of initiation of drug use among adolescents and young adults has been increasing from 2004 to 2017. We found that 12 of 18 drugs (including alcohol and tobacco products) had statistically increasing average ages of initiation. To our knowledge, no studies have documented these findings. We think this is great news because delaying initiation of drugs prevents early exposure, which we know is associated with various long-term negative health outcomes. Also, these promising trends may serve as initial evidence that prevention strategies, especially those that focus on adolescents and young adults, are working. (more…)
Author Interviews, JAMA, Mental Health Research / 28.02.2020

MedicalResearch.com Interview with: Dr. Aristotle Voineskos MD, PhD, FRCPC Director, Slaight Family Centre for Youth in Transition and Head, Kimel Family Translational Imaging-Genetics Laboratory Campbell Family Mental Health Research Institute CAMH University of Toronto MedicalResearch.com: What is the background for this study? Response: Uncontrolled studies in humans have shown conflicting results regarding effects of antipsychotic medications on brain structure. Recent studies in animals (e.g. rats and non-human primates) show that these medications may be associated with brain volume loss. To date, our knowledge of the effects of antipsychotic medications on brain structure in humans have been limited by the lack of a double-blind, randomized, placebo-controlled trial with brain imaging. Ours is the first such study. It is considered unethical to do such a study in people with schizophrenia, because of the life-saving benefits of these medications in this illness. However, in people with depression also experiencing psychosis, it was possible to do such a study once people experienced remission from their illness. (more…)
Aging, Author Interviews, JAMA / 27.02.2020

MedicalResearch.com Interview with: Dr. Konstantin G. Arbeev, PhD Associate Research Professor Biodemography of Aging Research Unit (BARU) Social Science Research Institute (SSRI) Duke University Dr. Abraham Aviv, MD Department Pediatrics Director, The Center of Human Development and Aging Rutgers New Jersey Medical School MedicalResearch.com: What is the background for this study? Response: A body of research has shown that having comparatively short leukocyte telomere length (LTL) is associated with increased risk of death in adults.    (more…)
Author Interviews, Fertility, Heart Disease, JAMA, OBGYNE / 27.02.2020

MedicalResearch.com Interview with: Shi Wu Wen PhD Senior Scientist, Clinical Epidemiology Program Professor, Department of Obstetrics & Gynecology University of Ottawa MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that having a baby as a result of using assisted procedures such as IVF nearly doubles the chance that a baby will have heart problems. (more…)
Author Interviews, Gastrointestinal Disease, JAMA, Microbiome / 25.02.2020

MedicalResearch.com Interview with: Drs. R.P.J. Willems  |  Arts-onderzoeker Medische Microbiologie en Infectiepreventie Amsterdam MedicalResearch.com: What is the background for this study? Does your study refer to both PPIs and H2-blockers?  Response: There is mixed evidence on the associated risk of colonization and infection with multidrug-resistant microorganisms with acid suppressive therapy. We therefore aimed to investigate current literature in order to determine whether acid suppressants facilitate intestinal colonization with multidrug-resistant microorganisms. We included studies on PPIs, H2 blockers and antacids. (more…)
Aging, Author Interviews, Cannabis, Geriatrics, JAMA, NYU / 24.02.2020

MedicalResearch.com Interview with: Benjamin H. Han, MD MPH Assistant Professor Division of Geriatric Medicine and Palliative Care New York University School of Medicine MedicalResearch.com: What is the background for this study? Response: In the past, the prevalence of cannabis use (both for recreational and for medicinal purposes) was very low among adults age 65 and older. As a reference, the national prevalence rate of past-year cannabis use among adults age 65 and older in 2006-2007 was 0.4%, it has increased dramatically since then. (more…)
Author Interviews, Education, Gender Differences, JAMA, Race/Ethnic Diversity, Yale / 24.02.2020

MedicalResearch.com Interview with: Katherine A. Hill, BA, BS Yale School of Medicine New Haven, Connecticut MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that mistreatment is a common and damaging experience for medical students. However, there is little research on whether the prevalence of medical student mistreatment varies by demographic factors such as student sex, race/ethnicity, and sexual orientation.  (more…)
Author Interviews, Health Care Systems, Heart Disease, JAMA, Medicare / 24.02.2020

MedicalResearch.com Interview with: Rishi K. Wadhera, MD Beth Israel Deaconess Medical Center Harvard Medical Faculty Physicians MedicalResearch.com: What is the background for this study? Response: In recent years, the Centers for Medicare and Medicaid Services has implemented nationally mandated value-based programs to incentivize hospitals to deliver higher quality care. The Hospital Readmissions Reduction Program (HRRP), for example, has financially penalized hospitals over $2.5 billion to date for high 30-day readmission rates. In addition, the Value-Based Purchasing Program (VBP) rewards or penalizes hospitals based on their performance on multiple domains of care.  Both programs have focused on cardiovascular care. The evidence to date, however, suggests that these programs have not improved health outcomes, and there is growing concern that they may disproportionately penalize hospitals that care for sick and poor patients, rather than for poor quality care. (more…)
Author Interviews, JAMA, Surgical Research / 23.02.2020

MedicalResearch.com Interview with: Paulina Salminen MD PhD Chief and Professor of surgery Turku University, Finland MedicalResearch.com: What is the background for this study? Response: Appendectomy has been the standard treatment for uncomplicated acute appendicitis and currently one of the most commonly performed surgical procedures. We now know that there are two different forms of acute appendicitis: the more common milder uncomplicated acute appendicitis and the more severe complicated acute appendicitis. While the complicated form is primarily still treated surgically, in recent years evidence from randomised trials and meta-analyses show that antibiotics are a safe and efficient treatment of uncomplicated acute appendicitis  also at long-term follow-up. Quality of life (QOL) and patient satisfaction after antibiotic therapy or appendectomy for uncomplicated acute appendicitis have been studied previously in a pediatric population but not in an adult population. Our aim was to compare long-term quality of life and patient satisfaction after antibiotic therapy and appendectomy for the treatment of uncomplicated acute appendicitis in patients enrolled in the original APPAC trial. (more…)
Author Interviews, Cancer Research, Cost of Health Care, JAMA, University of Pennsylvania / 20.02.2020

MedicalResearch.com Interview with: Samuel Takvorian, MD, MS Instructor in the Division of Hematology and Oncology LDI Associate Professor University of Pennsylvania Perelman School of Medicine MedicalResearch.com: What is the background for this study? Response: The Affordable Care Act’s Medicaid expansions have been associated with improved access to care, affordability, and for certain surgical and medical conditions, health outcomes. However, studies have also suggested unintended consequences such as lengthened wait times, and there is continued debate about the overall impact of the expansions. (more…)
Author Interviews, Cancer Research, Dermatology, JAMA / 19.02.2020

MedicalResearch.com Interview with: Nikolai Dyrberg Loft MD, Ph.D.-fellow Department of Dermatology and Allergy Gentofte Hospital Hellerup MedicalResearch.com: What is the background for this study? Response: Epidemiological studies examining the association between psoriasis or psoriatic arthritis and cancer have reported conflicting results. Some studies report an increased risk of cancer in individuals with psoriasis or psoriatic arthritis and others do not. Whether individuals with psoriasis or psoriatic arthritis have an increased risk of cancer is important as this might help guiding in clinical practice. In order to determine if there is an increased risk of cancer and the magnitude of this risk, a systematic review of the literature and meta-analysis is needed.  (more…)
Author Interviews, Cost of Health Care, Health Care Systems, JAMA / 19.02.2020

MedicalResearch.com Interview with: Jane M. Zhu, MD, MPP, MSHP Assistant Professor of Medicine Division of General Internal Medicine Oregon Health and Sciences University Penn LDI Adjunct Senior Fellow MedicalResearch.com: What is the background for this study? Response: In recent years, private equity firms have been rapidly entering the health care sector, including by purchasing physician medical groups. There’s a lot of interest in this trend but very little empirical research to understand its scope, characteristics, and effects. (more…)
Author Interviews, Genetic Research, Heart Disease, Imperial College, JAMA / 19.02.2020

MedicalResearch.com Interview with: Dr. Ioanna Tzoulaki Imperial College London MedicalResearch.com: What is the background for this study? Response: Considerable progress has been made in identifying genetic variants that are associated with heart disease. We aimed to investigate whether genetic information can be used to assess the risk of individuals developing heart disease in the future and whether genetic tests can improve current risk assessment strategies which are based on easy to measure factors such as age, sex, smoking status, cholesterol levels, blood pressure and presence of type 2 diabetes. (more…)
Author Interviews, Blood Pressure - Hypertension, Columbia, Heart Disease, JAMA / 17.02.2020

MedicalResearch.com Interview with: George Hripcsak, MD, MS Vivian Beaumont Allen Professor of Biomedical Informatics Chair, Department of Biomedical Informatics Columbia University Director, Medical Informatics Services NewYork-Presbyterian Hospital/Columbia MedicalResearch.com: What is the background for this study? Response: Diuretics are considered among the best drugs to treat hypertension, but there are no randomized studies to tell us which diuretic is best. Hydrochlorothiazide is the most frequently used diuretic for hypertension, but another drug, chlorthalidone, is gaining favor, with the most recent US hypertension guideline expressing a preference for it. Chlorthalidone is known to be longer acting and therefore perhaps more effective. Other (non-randomized) studies have been inconsistent, and some of them imply that chlorthalidone may be more effective. But other studies have shown that chlorthalidone may have more side effects. (more…)
Author Interviews, Brigham & Women's - Harvard, Dermatology, Gender Differences, JAMA, Melanoma / 12.02.2020

MedicalResearch.com Interview with: Arash Mostaghimi, MD, MPA, MPH Director, Inpatient Dermatology , Brigham and Women's Hospital Instructor, Harvard Medical School Department of Dermatology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Smaller studies have demonstrated increased risk for skin cancer among gay men.  Prior to this study this data had not been confirmed in a nationally representative database. (more…)
Aging, Author Interviews, Cost of Health Care, JAMA, University of Michigan / 10.02.2020

MedicalResearch.com Interview with: Renuka Tipirneni, MD, MSc, FACP Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine Divisions of General Medicine and Hospital Medicine and Institute for Healthcare Policy & Innovation Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? Response: While U.S. adults age 50-64 previously had more limited options for health insurance before Medicare at age 65, the Affordable Care Act expanded the number of options, including Marketplace plans (e.g., through HealthCare.gov) and Medicaid. This expanded set of options may complicate decisions about health insurance near retirement. In addition, several policy challenges to the Affordable Care Act may add uncertainty to the decision-making process. (more…)
Author Interviews, C. difficile, Health Care Systems, Hospital Acquired, JAMA / 06.02.2020

MedicalResearch.com Interview with: Valerie Vaughn MD, MSc Assistant Professor of Medicine; Hospital Medicine VA Ann Arbor Healthcare System and University of Michigan Medical School @ValerieVaughnMD MedicalResearch.com: What is the background for this study? Response: Health care-associated infection are a major patient safety problem. Fortunately, they can often be prevented through key practices. The Department of Veterans Affairs has been an early adopters of these key strategies through a combination of policies, directives, and initiatives which have aimed to reduce health care-associated infection. No one had previously looked across infections to see whether key infection prevention practices are being used in the VA. (more…)
Author Interviews, Cancer Research, Colon Cancer, Gastrointestinal Disease, JAMA / 03.02.2020

MedicalResearch.com Interview with: Jordan J. Karlitz, MD Staff Gastroenterologist Southeast Louisiana Veterans Health Care System Associate Professor, Division of Gastroenterology Director, GI Hereditary Cancer and Genetics Program, Tulane University School of Medicine MedicalResearch.com: What is the background for this study? Response: Currently, there is debate over whether average-risk colorectal cancer screening should begin at age 45 or 50. Given this controversy, we sought to conduct a colorectal cancer incidence rate analysis by yearly-age, as opposed to age range blocks (i.e. 30-39, 40-49 etc.) as has been done in the past. We believed that this type of "high definition" analysis would allow a better understanding of incidence rates of those approaching or at screening in age.  We were particularly interested in the transition from age 49 to 50 as this is when average risk screening has historically been recommended.  (more…)
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Pediatrics / 03.02.2020

MedicalResearch.com Interview with: Dr. Jonathan R. Skirko, MD , MHPA, MPH Assistant professor Division of Pediatric Otolaryngology University of Utah Health  MedicalResearch.com: What is the background for this study? Response: Obstructive sleep apnea is a common problem that that impacts the lives of many people. Understanding treatment effectiveness is important and Health-State Utility is a standardized way of assessing quality of life.  Before this study, we didn't have a way of measuring quality of life in this population in this important way. You have to accurately measure something before you can improve it. (more…)
Author Interviews, Hip Fractures, JAMA, Orthopedics / 31.01.2020

MedicalResearch.com Interview with: Alison M. Cogan, PhD, OTR/L Polytrauma/TBI Advanced Fellow Washington DC VA Medical Center Washington DC MedicalResearch.com: What is the background for this study? Response: Medicare is shifting from a volume- to value-based payment for postacute care services, in which value is determined by patient characteristics and functional outcomes. Matching therapy time and length of stay (LOS) to patient needs is critical to optimize functional outcomes and manage costs. The objective of this study was to investigate the association among therapy time, LOS, and functional outcomes for patients following hip fracture surgery. This retrospective cohort study analyzed data on patients from 4 inpatient rehabilitation facilities and 7 skilled nursing facilities in the eastern and midwestern United States. Participants were patients aged 65 years or older who received inpatient rehabilitation services for hip fracture and had Medicare fee-for-service as their primary payer. We categorized patients into nine recovery groups based on low, medium, and high therapy minutes per day and low, medium, or high rate of functional gain per day. We measured the groups for functional mobility independence and self-care capabilities at the time each patient was discharged. (more…)
Author Interviews, Health Care Systems, JAMA / 30.01.2020

MedicalResearch.com Interview with: Coleman Drake, PhD Assistant Professor, Health Policy and Management Pitt Public Health Affiliate faculty member Medicaid Research Center and Center for Pharmaceutical Policy and Prescribing MedicalResearch.com: What is the background for this study? Response: The religious directives of Catholic hospitals prohibit the provision of many forms of contraception. To examine how Catholic hospitals restrict access to reproductive health services, we examined the market share of Catholic hospitals in every county in the continental US. We found that nearly 40% of women of reproductive-aged women live in counties with high or dominant Catholic hospital market share. We also examined whether the networks of Health Insurance Marketplace (i.e., Obamacare) plans direct their enrollees toward or away from Catholic hospitals, and thus reproductive health services.  (more…)
Abuse and Neglect, Author Interviews, JAMA, Pediatrics, Tobacco / 30.01.2020

MedicalResearch.com Interview with: Hongying (Daisy) Dai, PhD Associate Professor Department of Biostatistics | College of Public Health University of Nebraska Medical Center Omaha, NE MedicalResearch.com: What is the background for this study? Response: E-cigarette use increased dramatically from 11.7% to 27.5% for high school students and from 3.3% to 10.5% for middle school students during the periods of 2017 - 2019. In September 2018, the Food and Drug Administration (FDA) warned that youth e-cigarette use is reaching an epidemic proportion. Exposure to secondhand aerosol (SHA) from e-cigarettes is not harmless as e-cigarettes aerosol contains nicotine and potentially harmful substances, including carbonyl compounds, TSNAs, heavy metals, and glycols. This study analyzed the 2015-2018 National Youth Tobacco Survey (NYTS) and the main findings are:
  • The prevalence of secondhand aerosol exposure significantly increased from 25.6% in 2017 to 33.2% in 2018 (p<.001) after being stable during 2015 and 2017 (25.2% vs. 25.6%, p>0.05). The increase of SHA exposure from 2017 to 2018 was observed across socio-demographic groups.
  • Among never tobacco users in 2018 NYTS, students who reported secondhand aerosol exposure (vs. no) had higher odds of susceptibility to use e-cigarettes (38.8% vs. 21.0%) and cigarettes (30.7% vs. 21.2%) and higher odds of reporting exposure to e-cigarette marketing.
(more…)
Author Interviews, JAMA, Pediatrics, Weight Research / 29.01.2020

MedicalResearch.com Interview with: Dr. Carol Chelimo PhD Research Fellow Dept. of Paediatrics, School of Medicine University of Auckland MedicalResearch.com: What is the background for this study? Response: New Zealand has the third highest prevalence of obesity among Organisation for Economic Co-operation and Development countries. Pediatric obesity is associated with development of cardiovascular risk factors in later life, such as type 2 diabetes, hypertension, dyslipidemia, and metabolic syndrome. Antibiotic exposures in early life may affect weight by altering the gut microbiota, potentially increasing the risk of childhood obesity. The overall aim of this research was to examine whether repeated antibiotic exposure by age 48 months is associated with higher body mass index (BMI) at age 54 months. Specifically, it evaluates whether the number, timing (age), and type of antibiotic exposures are associated with a higher body mass and an increased likelihood of overweight and obesity. This work incorporates antibiotic exposure during pregnancy (more…)
Author Interviews, Dartmouth, JAMA, Pharmaceutical Companies, Primary Care / 27.01.2020

MedicalResearch.com Interview with: Steven Woloshin, MD, MS Professor of Medicine and Community and Family Medicine Professor, The Dartmouth Institute for Health Policy and Clinical Practice MedicalResearch.com: What is the background for this study? Response: Industry spends more on detailing visits and free samples than any other form of prescription drug marketing.  There is good evidence that these activities can lead to more use of expensive new drugs over equally effective cheaper options.  Given these concerns there have been efforts by some hospitalls and practices to restrict these forms of marketing. We asked physicians in group practices delivering primary care about how often pharmaceutical reps visit their practice and whether they have a free sample closet.  (more…)
Author Interviews, JAMA, Primary Care / 22.01.2020

MedicalResearch.com Interview with: Leah Marcotte, MD Clinical Assistant Professor, Medicine University of Washington
Joshua M. Liao, MD, MSc, FACP Assistant Professor, Department of Medicine Director, UW Medicine Value and Systems Science Lab Medical Director of Payment Strategy, UW Medicine University of Washington
  MedicalResearch.com: What is the background for this study? Response: In the last 7 years, Medicare has implemented payment reforms to encourage primary care and other ambulatory providers for dedicated care coordination activities. One such reform, Transitional Care Management (TCM) billing codes, was introduced in 2013 and emphasized coordination during care transitions from hospital to home – a particularly vulnerable period in which patients may be at risk for adverse outcomes. TCM services include patient contact (e.g., phone call) within two business days of discharge, a visit (e.g., office or home-based) within 14 days of discharge with at least moderate complexity medical decision making, and medication reconciliation. TCM services may be delivered after inpatient hospitalization, observation stay, skilled nursing facility admission or acute rehab admission. There have been few studies that have looked at early data in Transitional Care Management, and none that have described national use of and payment for these codes over an extended period of time. We analyzed a national Medicare dataset looking at 100% of submitted and paid TCM claims from 2013-2018.  (more…)