Author Interviews, Cancer Research, JAMA / 21.03.2019
The Word ‘Cancer’ Still Affects How Patients Feel About Their Disease, Even if Low Risk
MedicalResearch.com Interview with:
[caption id="attachment_48037" align="alignleft" width="150"] Dr. DIxon[/caption]
Peter R. Dixon, MD
Department of Otolaryngology-Head & Neck Surgery
Institute of Health Policy, Management and Evaluation
University of Toronto
Toronto, Ontario, Canada
MedicalResearch.com: What is the background for this study?
Response: The word ‘cancer’ is often associated with an aggressive and lethal disease. Innovations in screening and diagnostic tests detect some ‘cancers’ that -- even if left untreated -- pose very low-risk of any symptoms, progression, or mortality. Still, many of these low-risk cancers are treated aggressively and those treatments can have harmful consequences and side-effects.
We were interested in determining how influential the word ‘cancer’ is in decisions made by patients about low-risk malignant neoplasms relative to other labels for the same disease.
Dr. DIxon[/caption]
Peter R. Dixon, MD
Department of Otolaryngology-Head & Neck Surgery
Institute of Health Policy, Management and Evaluation
University of Toronto
Toronto, Ontario, Canada
MedicalResearch.com: What is the background for this study?
Response: The word ‘cancer’ is often associated with an aggressive and lethal disease. Innovations in screening and diagnostic tests detect some ‘cancers’ that -- even if left untreated -- pose very low-risk of any symptoms, progression, or mortality. Still, many of these low-risk cancers are treated aggressively and those treatments can have harmful consequences and side-effects.
We were interested in determining how influential the word ‘cancer’ is in decisions made by patients about low-risk malignant neoplasms relative to other labels for the same disease.
Dr. Leung[/caption]
Alexander A. Leung, MD, MPH
Department of Community Health Sciences
Department of Medicine
University of Calgary
Calgary, Alberta, Canada
MedicalResearch.com: What is the background for this study?
Response: The 2017 American College of Cardiology and American Heart Association (ACC/AHA) blood pressure guidelines redefined hypertension according to a blood pressure cutoff of ≥130/80 mm Hg, compared to the traditional cutoff of ≥140/90 mm Hg.
Dr. Rhee[/caption]
Chanu Rhee, MD,MPH
Assistant Professor of Population Medicine
Harvard Medical School / Harvard Pilgrim Health Care Institute
Assistant Hospital Epidemiologist
Brigham and Women’s Hospital
MedicalResearch.com: What is the background for this study?
Response: Sepsis is the body’s reaction to a serious infection that results a cascade of inflammation in the body and organ dysfunction, such as low blood pressure, confusion, or failure of the lungs, kidneys, or liver. Sepsis is a major cause of death, disability, and cost in the U.S. and around the world. Growing recognition of this problem has led to numerous sepsis performance improvement initiatives in hospitals around the country. Some of these efforts have also been catalyzed by high-profile tragic cases of missed sepsis leading to death, which may have contributed to a perception that most sepsis deaths are preventable if doctors and hospitals were only better at recognizing it.
However, the extent to which sepsis-related deaths might be preventable with better hospital-based care is unknown. In my own experience as a critical care physician, a lot of sepsis patients we treat are extremely sick and even when they receive timely and optimal medical care, many do not survive. This led myself and my colleagues to conduct this study to better understand what types of patients are dying from sepsis and how preventable these deaths might be. 
Dr. Kuan-Pin Su[/caption]
Kuan-Pin Su, MD, PhD
China Medical University
Taichung, Taiwan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Delirium, also known as acute confusional state, is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of the environment. Delirium can often be traced to one or more contributing factors, such as a severe or chronic illness, changes in metabolic balance (such as low sodium), medication, infection, surgery, or alcohol or drug intoxication or withdrawal. It’s critically important to identify and treat delirium because some of the contributing factors could be life-threatening. However, there is no sufficient evidence for choice of medication to treat or prevent the symptoms of delirium.
A recent paper, Association of Delirium Response and Safety of Pharmacological Interventions for the Management and Prevention of Delirium A Network Meta-analysis, published in JAMA Psychiatry provides important findings of this missing piece in that important clinical uncertainty. The leading author, Professor Kuan-Pin Su, at the China Medical University in Taichung, Taiwan, concludes the main finding about treatment/prevention of delirium: “In this report, we found that the combination of haloperidol and lorazepam demonstrated the best option for treatment of delirium, while ramelteon for prevention against delirium. 
Dr. Li[/caption]
Fuzhong Li, Ph.D.
Senior Scientist
Oregon Research Institute
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Injurious falls among community-dwelling older adults are a serious public health and cost-bearing problem worldwide.Exercise has been shown to reduce falls and injurious falls among older adults. However, evidence is limited with regard to the type of exercise interventions that are most effective, without exacerbating the risk in some individuals, in reducing injurious falls.
This study addresses this knowledge gap in the field of falls prevention. Findings from this study showed that a six-month Tai Ji Quan program reduced the incidence of injurious falls among frail elderly by 53% compared to a regular (multimodal) exercise intervention. The effect of the Tai Ji Quan intervention was shown to be robust, and still evident at follow-up examinations six months after the study.
Dr. Jeremiah Schuur[/caption]
Jeremiah Schuur, MD, MHS FACEP
Physician-in-chief for emergency medicine at Lifespan and Chair of the department of Emergency Medicine
Brown
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Firearm injury is a leading cause of injury and death in the United States. Many physician groups advocate for evidence-based policies, such as universal background checks, to reduce this morbidity and mortality.
We studied contributions of the 25 largest political action committees (PACs) affiliated with physician professional groups during the 2016 election cycle and found that almost all gave more money to political candidates who voted against universal background checks and were endorsed by the NRA.
These PACs contributed to more than twice as many incumbent US Senate candidates who voted against an amendment to expand firearm background checks than those who voted for the amendment. In the US House of Representatives, the pattern of giving was similar. These PACs gave $2.8 million more to candidates who did not sponsor a bill to expand background checks than to those who did. Finally, these physician PACs were more than twice as likely to contribute to and gave almost $1.5 million dollars more to candidates rated A by the NRA.
Dr. Jagpreet Chhatwal[/caption]
Jagpreet Chhatwal PhD
Assistant Professor, Harvard Medical School
Senior Scientist, Institute for Technology Assessment
Massachusetts General Hospital
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