Author Interviews, Heart Disease, JAMA, Lipids / 29.10.2014

MedicalResearch.com Interview with: George Thanassoulis, MD MSc FRCP(C) Director, Preventive and Genomic Cardiology FRQ-S Clinician-Scientist/Chercheur-Boursier Clinicien Assistant Professor of Medicine, McGill University McGill University Health Center Montreal, QC Medical Research: What is the background for this study? What are the main findings? Dr. Thanassoulis: Although LDL-C (i.e. bad cholesterol) has been linked with aortic valve disease in several prior reports, randomized trials to lower cholesterol in aortic valve disease were not effective suggesting that cholesterol may not be important in valve disease. To address this, we performed a Mendelian randomization study, that showed that a genetic predisposition to LDL-C, was associated with both calcium deposits on the aortic valve and aortic stenosis (I.e. Valve narrowing).  These results can be viewed as the effect of a life-long increase in LDL-C on the incidence of aortic valve disease and suggest that increases in LDL-C cause aortic stenosis.  
Author Interviews, JAMA, Macular Degeneration / 28.10.2014

Ronald Klein, MD, MPH, Professor Department of Ophthalmology and Visual Sciences University of Wisconsin School of Medicine and Public Health Madison WIMedicalResearch.com Interview with: Ronald Klein, MD, MPH, Professor Department of Ophthalmology and Visual Sciences University of Wisconsin School of Medicine and Public Health Madison WI Medical Research: What are the main findings of the study?  Dr. Klein: We found that more severe age-related macular degeneration (AMD) in 1 eye was associated with increased incidence of age-related macular degeneration [levels 1-2: hazard ratio [HR], 4.90 [95%CI, 4.26-5.63] and accelerated progression [levels 2-3: HR, 2.09 [95%CI, 1.42-3.06]; levels 3-4: HR, 2.38 [95%CI, 1.74-3.25] and incidence of late age-related macular degeneration [levels 4-5: HR, 2.46 [95%CI, 1.65-3.66] in its fellow eye. Less severe AMD in 1 eye was associated with less progression of AMD in its fellow eye. We estimated that 51% of participants who develop any age-related macular degeneration maintained age-related macular degeneration severity states within 1 step of each other between eyes and 90% of participants stay within 2 steps.
Author Interviews, Brain Injury, Cognitive Issues, JAMA, UCSF / 27.10.2014

Raquel C. Gardner, MD, Research Fellow San Francisco VA Medical Center Clinical Instructor Memory and Aging Center, Department of Neurology University of California, San FranciscoMedicalResearch.com Interview with: Raquel C. Gardner, MD, Research Fellow San Francisco VA Medical Center Clinical Instructor Memory and Aging Center, Department of Neurology University of California, San Francisco Medical Research: What are the main findings of the study? Dr. Gardner: We found that people who experience a  traumatic brain injury (TBI )when they are 55 or older have a 26% higher chance of getting dementia over the next 5 to 7 years compared to people who experience bodily trauma.
Author Interviews, JAMA, Pediatrics / 27.10.2014

MedicalResearch.com Interview with: Ian M. Paul, M.D., M.Sc. Professor of Pediatrics and Public Health Sciences Chief, Division of Academic General Pediatrics Associate Vice Chair for Research, Department of Pediatrics Penn State College of Medicine Hershey, PA 17033-0850 Medical Research: What are the main findings of the study? Dr. Paul: This study highlights that a significant placebo effect exists in the treatment of young children with cough due to colds because agave nectar and placebo both resulted in improvement of child symptoms by parents compared with no treatment.
Author Interviews, Bipolar Disorder, JAMA, Schizophrenia / 23.10.2014

Glenn T. Konopaske, MD McLean Hospital, Belmont, Massachusetts Department of Psychiatry, Harvard Medical School Boston, MassachusettsMedicalResearch.com Interview with: Glenn T. Konopaske, MD McLean Hospital, Belmont, Massachusetts Department of Psychiatry, Harvard Medical School Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Konopaske: Using postmortem human brain tissue this study did reconstructions of basilar dendrites localized to pyramidal cells in the deep layer III of the dorsolateral prefrontal cortex. Tissue from individuals with schizophrenia, bipolar disorder or controls was examined. Dendritic spine density (number of spines per μm dendrite) was significantly reduced in bipolar disorder and also reduced in schizophrenia at a trend level. The number of dendritic spines per dendrite and dendrite length were significantly reduced in subjects with schizophrenia and bipolar disorder.
Author Interviews, JAMA, Pediatrics, Weight Research / 23.10.2014

Dr Ken Ong, Programme Leader & Paediatric Endocrinologist MRC Epidemiology Unit, University of Cambridge Box 285 Institute of Metabolic Science Cambridge Biomedical Campus, Cambridge MedicalResearch.com Interview Invitation Dr Ken Ong, Programme Leader & Paediatric Endocrinologist MRC Epidemiology Unit, University of Cambridge Box 285 Institute of Metabolic Science Cambridge Biomedical Campus, Cambridge Medical Research: What are the main findings of this report? Dr. Ong: We found that genetic factors that predict adult obesity were associated with faster weight gain and growth during infancy – the findings indicate that the biological mechanisms that predispose to later obesity are already active from birth.
Author Interviews, JAMA, Mental Health Research / 23.10.2014

Karl Ole Köhler, Research assistant Department of Clinical Medicine The Department of General Psychiatry Aarhus UniversityMedicalResearch.com Interview with: Karl Ole Köhler, Research assistant Department of Clinical Medicine The Department of General Psychiatry Aarhus University   Medical Research: What are the main findings of the study? Response:  We found that anti-inflammatory drugs and ordinary analgesics, which mainly are used against physical disorders, may have treatment effects against depression when used in combination with antidepressants. Thereby, our results furthermore support the hypothesis regarding a comorbidity between inflammatory diseases and depression, i.e. a connection between somatic and mental disorders.
Author Interviews, Cost of Health Care, JAMA, University of Pennsylvania / 22.10.2014

Dr. Harald Schmidt, MA, PhD Assistant Professor, Department of Medical Ethics and Health Policy Research Associate, Center for Health Incentives and Behavioral Economics Perelman School of Medicine University of Pennsylvania Philadelphia, PA 19104-3308MedicalResearch.com Interview with Dr. Harald Schmidt, MA, PhD Assistant Professor, Department of Medical Ethics and Health Policy , Research Associate, Center for Health Incentives and Behavioral Economics, Perelman School of Medicine University of Pennsylvania Philadelphia, PA 19104-3308 Medical Research: What are the main findings of the study? Dr. Schmidt: We reviewed currently available policies for aligning cost and quality of care. We focused on interventions are similar in their clinical effectiveness, have modest differences in convenience, but pose substantial cost differences to the healthcare system and patients. To control health care costs while ensuring patient convenience and physician burden, reference pricing would be the most desirable policy. But it is currently politically unfeasible. Alternatives therefore need to be explored. We propose the novel concept of Inclusive Shared Savings, in which physicians, the healthcare system, and, crucially, patients, benefit financially in moving more patients to lower cost but guideline concordant and therapeutically equivalent interventions.
Author Interviews, JAMA, Opiods, Yale / 21.10.2014

David A. Fiellin, M.D. Professor of Medicine, Investigative Medicine and Public Health Yale University School of MedicineMedicalResearch.com Interview with David A. Fiellin, M.D. Professor of Medicine, Investigative Medicine and Public Health Yale University School of Medicine   Medical Research: What are the main findings of the study? Dr. Fiellin: The main finding of our randomized clinical trial, conducted in primary care, was that among prescription opioid dependent patients, ongoing buprenorphine therapy resulted in better treatment retention and reduced illicit opioid use when compared to buprenorphine taper (detoxification).
Author Interviews, Dermatology, JAMA / 20.10.2014

Marie C. Leger, MD, PhD Ronald O. Perelman Department of Dermatology New York University School of Medicine, New YorkMedicalResearch.com Interview with Marie C. Leger, MD, PhD Ronald O. Perelman Department of Dermatology New York University School of Medicine, New York Medical Research: What are the main findings of the study?
What was most surprising about the results?

 Dr. Leger: Alopecia areata is a T-cell mediated autoimmune disease. As such, there was initially hope that inhibiting the helper T cell cytokine TNF-α could effectively treat this condition. This has not been shown to be the case—in fact, one open-label study of etanercept in 17 patients with moderate to severe alopecia showed no hair regrowth and even worsening of alopecia in several subjects. There have been many other case reports in the dermatologic literature of TNF-α inhibitors causing alopecia areata. In contrast, our case report presents a patient who very clearly grew hair on adalimumab—its strength lies in the fact that her hair loss and regrowth were replicated on withdrawal and rechallenge with the medication. Our patient’s paradoxical response to adalimumab complements other literature suggesting that there are genetic variations in the way a patient’s immune system responds to TNF-α inhibitors. In different individuals, these medications can either treat or cause conditions such as psoriasis or lupus. It seems that this is also the case with alopecia areata.
Author Interviews, JAMA, Surgical Research / 16.10.2014

MedicalResearch.com Interview with: Sayaka Suzuki, MD Department of Clinical Epidemiology and Health Economics, School of Public Health, Faculty of Medicine, Department of Otolaryngology–Head and Neck Surgery, University of Tokyo, Tokyo, Japan Medical Research: What are the main findings of the study? Dr.  Suzuki: We found a slight increase in the risk of severe bleeding requiring surgery for hemostasis in children who were administrated intravenous steroid on the day of tonsillectomy. Physicians should carefully make a decision to use steroids, taking into account patients' choice under being well informed on the risks and benefits of steroid use.
Accidents & Violence, Author Interviews, JAMA / 16.10.2014

Richard M. Costanzo, PhD. Professor of Physiology and Biophysics and Special Assistant to the Vice President for Research Virginia Commonwealth UniversityMedicalResearch.com Interview with: Richard M. Costanzo, PhD. Professor of Physiology and Biophysics and Special Assistant to the Vice President for Research Virginia Commonwealth University Medical Research: What are the main findings of the study? Dr. Costanzo: In this study we found that individuals with varying degrees olfactory impairment have an increased risk of experiencing a hazardous event.  Those with complete loss (anosmia) were three times more likely to experience an event than those with normal olfactory function.  Factors such as age,sex, and race were found to affect an individual’s risk.
Author Interviews, CDC, JAMA, Tobacco / 15.10.2014

Dr. Brian Rostron PhD, MPH Center for Tobacco Products US Food and Drug Administration Silver Spring, MarylandMedicalResearch.com Interview with: Dr. Brian Rostron PhD, MPH Center for Tobacco Products US Food and Drug Administration Silver Spring, Maryland Medical Research: What are the main findings of the study? Dr. Rostron: We estimated that Americans in 2009 had had 14 million major medical conditions such as heart attack, stroke, lung cancer, and COPD that were attributable to smoking.  COPD was the leading cause of smoking-attributable morbidity, with over 7.5 million cases of COPD attributable to smoking.
Author Interviews, Infections, JAMA / 15.10.2014

Andre Kalil, M.D., M.P.H. Professor of Medicine Director, Transplant ID Program University of Nebraska Nebraska Medical Center Omaha, NE 68198-5400MedicalResearch.com Interview with: Andre Kalil, M.D., M.P.H. Professor of Medicine Director, Transplant ID Program University of Nebraska Nebraska Medical Center Omaha, NE 68198-5400 Medical Research: What are the main findings of the study? Dr. Kalil: In recent years, physicians treating staph infections with vancomycin have seen an increase in the minimum inhibitory concentration (MIC), the lowest concentration of an antimicrobial agent that inhibits the growth of a microorganism. This condition is referred to as vancomycin “MIC creep.” It is an indicator that the bacteria might be developing a reduced susceptibility to vancomycin. There also have been reports suggesting that elevations in vancomycin MIC values may be associated with increased treatment failure and death. To determine the effectiveness of vancomycin and other newer antibiotics used to treat Staphylococcus aureus, the UNMC team analyzed nearly 8,300 episodes of Staphylococcus aureus bloodstream infections from patients around the U.S. and in several other countries. The adjusted absolute risk of mortality among patients with Staphylococcus aureus bloodstream infections with high-vancomycin MIC was not statistically different from patients with Staphylococcus aureus bloodstream infections with low-vancomycin MIC.
Author Interviews, JAMA, Lipids, UCSF / 15.10.2014

MedicalResearch.comInterview with: Mary Malloy, M.D. Co-director of the Adult Lipid Clinic and the director of the Pediatric Lipid Clinic UCSF Medical Center Medical Research: What are the main findings of the study? Dr. Malloy: We studied an individual whom we found to be homozygous for a rare loss of function mutation in apolipoprotein E. Because apolipoprotein E is necessary for clearance of lipoproteins from plasma, he has very high levels of cholesterol and triglycerides in blood, and unusual and very severe xanthomas. He had no evidence of neurocognitive or retinal defects.
Author Interviews, JAMA, Pulmonary Disease, Toxin Research / 13.10.2014

Adam Spanier, MD, PhD, MPH, FAAP Associate Professor of Pediatrics Division Head, General Pediatrics & Developmental and Behavioral Pediatrics Medical Director, Pediatrics at Midtown Department of Pediatrics University of Maryland Midtown Campus Baltimore, MD 21201MedicalResearch.com Interview with: Adam Spanier, MD, PhD, MPH, FAAP Associate Professor of Pediatrics Division Head, General Pediatrics & Developmental and Behavioral Pediatrics Medical Director, Pediatrics at Midtown Department of Pediatrics University of Maryland Midtown Campus Baltimore, MD 21201 Medical Research: What are the main findings of the study? Dr. Spanier: Bisphenol A (BPA) is a chemical that is present in many consumer products (lining of canned foods, some plastics, some receipt paper, etc). We found that higher maternal Bisphenol A levels during pregnancy were associated with increased odds of persistent wheezing in children and a decrease in lung function at age four. Child BPA levels were not associated with these poor lung health outcomes.
Author Interviews, C. difficile, Gastrointestinal Disease, JAMA / 13.10.2014

Dr. Ilan Youngster, MD, MMSc Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Division of Infectious Diseases, Boston Children’s Hospital Boston, MassachusettMedicalResearch.com Interview with: Dr.  Ilan Youngster, MD, MMSc Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Division of Infectious Diseases, Boston Children’s Hospital Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Youngster: The main finding is that oral administration seems to be as safe and effective as more traditional routes of delivery like colonoscopy or nasogastric tube. This is important as it allows Fecal microbiota transplantation (FMT) to be performed without the need of invasive procedures, making it safer, cheaper and more accessible to patients.
Author Interviews, JAMA, Mental Health Research / 09.10.2014

Bret R Rutherford, MD Assistant Professor ,Clinical Psychiatry Columbia University College of Physicians and Surgeons Division of Geriatric Psychiatry New York State Psychiatric Institute New York, NY 10032MedicalResearch.com Interview with: Bret R Rutherford, MD Assistant Professor ,Clinical Psychiatry Columbia University College of Physicians and Surgeons Division of Geriatric Psychiatry New York State Psychiatric Institute New York, NY 10032 Medical Research: What are the main findings of the study? Dr. Rutherford: In this meta-analysis of 105 trials of acute antipsychotic drugs for schizophrenia, the placebo response was shown to be significantly increasing from 1960 to the present. Conversely, the treatment change associated with effective dose medication significantly decreased over the same time period. The average participant of a randomized clinical trial (RCT) receiving an effective dose of medication in the 1960s improved by 13.8 points in the BPRS, whereas this difference diminished to 9.7 BPRS points by the 2000s. The consequence of these divergent trends was a significant decrease in drug-placebo differences from 1960 to the present.
Author Interviews, JAMA, Schizophrenia / 09.10.2014

Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine Hofstra North Shore LIJ School of Medicine Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital Investigator Feinstein Institute for Medical Research North Shore Long Island Jewish Health SystemMedicalResearch.com Interview with: Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine Hofstra North Shore LIJ School of Medicine Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital Investigator Feinstein Institute for Medical Research North Shore Long Island Jewish Health System Medical Research: What are the main findings of the study? Dr. Correll: The main findings of the study of 398 patients with first-episode schizophrenia-spectrum disorders who were on average in their mid twenties are that:
  • 1) despite their young age, an average of only 47 days lifetime antipsychotic exposure and overweight/obesity figures that were comparable to similarly aged US population members, there was a clear pattern of increased smoking and several metabolic risk parameters compared to similarly aged persons in the general US population;
  • 2) dyslipidemia, a constellation of at least one relevant abnormal blood fat value, was as frequent as in a 15-20 years older general US population;
  • 3) body composition related risk markers were significantly associated with longer total psychiatric illness duration, whereas metabolic risk markers were significantly associated with the overall very short mean lifetime antipsychotic treatment duration; and
  • 4) relevant for treatment choice and recommendations for patients, significantly higher continuous metabolic risk factor values were associated with olanzapine treatment and, less so, with quetiapine treatment.
Author Interviews, Infections, JAMA / 09.10.2014

MedicalResearch.com Interview with: Dr. Nicolas Garin MD Division of General Internal Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland Division of Internal Medicine, Hôpital Riviera-Chablais, Monthey, Switzerland Medical Research: What are the main findings of the study? Dr. Garin: Empiric treatment with a betalactam drug (monotherapy) was not equivalent to the combination of a betalactam and a macrolide in patients hospitalized for moderate severity pneumonia (proportion of patients not having reached clinical stability at day 7 was 41.2 % in the monotherapy vs. 33.6 % in the combination therapy arm, between arm difference 7.6 %). This occurred despite systematic search for Legionella infection in the monotherapy arm. There was no difference in early or late mortality, but patients in the monotherapy arm were more frequently readmitted. Patients with higher severity of disease (in PSI category IV, or with a CURB-65 score higher than 1) seemed to benefit from combination therapy (HR 0.81 for the primary outcome of clinical instability at day 7), although it was statistically not significant. There was no difference in the primary outcome for patients in PSI category I to III.
Author Interviews, Flu - Influenza, JAMA, Vaccine Studies / 08.10.2014

Robert B Belshe, MD Division of Infectious Diseases, Allergy & Immunology Saint Louis University School of MedicineMedicalResearch.com Interview with: Robert B Belshe, MD  Division of Infectious Diseases, Allergy & Immunology Saint Louis University School of Medicine   Medical Research: What are the main findings of the study? Response: A vaccine that protects against an old strain of avian flu primes the immune system to mount a rapid response when a vaccine designed to protect against a related but different and new strain of avian flu is given a year later, according to Saint Louis University research findings reported in JAMA. In addition, when combined with an adjuvant, which is a chemical that stimulates the immune system to produce more antibodies, a lower dose of the new avian flu vaccine worked better in triggering an immune response than a stronger dose without adjuvant. That means the amount of vaccine against a new strain of bird flu can be stretched to protect more people if an adjuvant is added. Both findings represent important strategies researchers can continue to study to fight new strains of bird flu that people previously have not been exposed to, and consequently can rapidly turn into a pandemic outbreak and public health emergency, said Robert Belshe, M.D., professor of infectious diseases, allergy and immunology at Saint Louis University and the lead author of the article, which appeared in the Oct. 8, 2014 issue of JAMA.
Author Interviews, JAMA, Nutrition / 08.10.2014

Daniel (Dong) Wang MD, MSc Department of Nutrition, Harvard School of Public Health Boston, MA 02115MedicalResearch.com Interview with: Daniel (Dong) Wang MD, MSc Department of Nutrition, Harvard School of Public Health Boston, MA 02115   Medical Research: What are the main findings of the study? Dr. Wang:
  • The overall dietary quality in US adults improved modestly from 1999 to 2010, but the quality of US diet remains far from optimal and huge room exists for further improvements.
  • The improvement in dietary quality was greater among adults with higher socioeconomic status and healthier body weight, thus disparities that existed in 1999 increased over the next decade.
  • More than half of the improvement in diet quality was due to a large reduction in consumption of trans fat.
Author Interviews, JAMA, Surgical Research, University of Pittsburgh, Weight Research / 03.10.2014

Anita P. Courcoulas M.D., M.P.H., F.A.C.S Professor of Surgery Director, Minimally Invasive Bariatric & General Surgery University of Pittsburgh Medical Center MedicalResearch.com Interview with:  Anita P. Courcoulas M.D., M.P.H., F.A.C.S Professor of Surgery Director, Minimally Invasive Bariatric & General Surgery University of Pittsburgh Medical Center Medical Research: What are the main findings of the study? Dr. Courcoulas: This paper was not a study but a summary of findings from a multidisciplinary workshop (and not a consensus panel) convened in May 2013 by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute. The goal of the workshop was to summarize the current state of knowledge of bariatric surgery, review research findings on the long-term outcomes of bariatric surgery, and establish priorities for future research.
Author Interviews, Heart Disease, JAMA / 01.10.2014

MedicalResearch.com Interview with: Joanna Chikwe MD Associate Professor Department of Cardiovascular Surgery Mount Sinai Medical Center and Natalia N. Egorova, PhD Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai New York, New York Medical Research: What are the main findings of the study? Answer: This is one of the largest studies to date on the long-term outcomes of patients after aortic valve replacement. We found that bioprosthetic valves are as safe as mechanical valves in younger patients (age 50-69) - specifically, long-term death rates and stroke risk were very similar in patients who had either valve type. The main differences lay in the risk of other long-term complications: patients who had bioprosthetic valves were more likely to need repeat surgery in the long-term, whereas patients who had mechanical valves were more likely to experience a major bleeding event.
Author Interviews, JAMA, Vitamin D / 01.10.2014

Karin Amrein, MD, MSc Assistant Professor Department of Internal Medicine Division of Endocrinology and Metabolism Medical University of Graz 8036 Graz, AustriaMedicalResearch.com Interview with: Karin Amrein, MD, MSc Assistant Professor Department of Internal Medicine Division of Endocrinology and Metabolism Medical University of Graz 8036 Graz, Austria Medical Research: What are the main findings of the study? Dr. Amrein: This is the first large clinical trial on vitamin D in critical care. In a double-blind, randomized, placebo-controlled clinical trial, a population of mixed adult ICU patients with vitamin D deficiency (defined as 25-hydroxyvitamin D [25(OH)D] level ≤ 20ng/ml) was assigned to receive either vitamin D3 or placebo. We used a high loading dose of vitamin D3 followed by monthly maintenance doses of 90,000 IU for a total of 5 months. Because of a substantially increased risk for skeletal complications below 12ng/ml of 25-hydroxyvitamin D, we used this threshold for a predefined subgroup analysis. Overall, high-dose vitamin D3 compared with placebo did not reduce hospital length of stay (primary endpoint), intensive care unit (ICU) length of stay, hospital mortality, or 6 month-mortality
Author Interviews, JAMA, Orthopedics, Pain Research / 01.10.2014

MedicalResearch.com Interview with: Ben Metcalf BsC (co-author) on behalf or A/Prof Rana Hinman PhD Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia Medical Research: What are the main findings of the study? Dr. Metcalf: This study investigated whether acupuncture is an effective treatment for people aged more than 50 years with chronic knee pain. Participants in our study were randomly assigned to one of four groups; needle acupuncture, laser acupuncture, sham laser acupuncture or no treatment. The people in the treatment groups received acupuncture treatment from a family physician for 12 weeks. Participants were assessed after treatment and again after one year. There were no significant differences in knee pain or physical function between active and sham laser acupuncture at 12 weeks or at one year. Both needle and laser acupuncture resulted in modest improvements in pain compared with no treatment at 12 weeks that were not maintained at one year. Needle acupuncture improved physical function at 12 weeks compared with no treatment but was not different from sham acupuncture and was not maintained at one year.
Author Interviews, Esophageal, JAMA, University of Michigan / 01.10.2014

Megan A. Adams, MD Gastroenterology Fellow University of MichiganMedicalResearch.com Interview with Megan A. Adams, MD Gastroenterology Fellow University of Michigan   Medical Research: What are the main findings of the study? Dr. Adams: Surveys of doctors indicate that their fear of a malpractice lawsuit for missing a diagnosis of esophageal cancer might drive the overuse of tests called upper endoscopies in patients who are at low risk for the cancer. To examine whether this perception of medical liability risk accurately reflects the real likelihood of a malpractice claim, we looked at a national database of malpractice claims, and compared the rate of claims for delay in diagnosis of esophageal cancer in patients without alarm symptoms (weight loss, dysphagia, iron deficiency anemia), with the rate of claims alleging performance of an upper endoscopy without a good reason for performing the procedure. The database contained 278,220 claims filed against physicians in 1985-2012. The incidence of reported medical liability claims for failure to screen for esophageal cancer in patients without alarm features was quite low (19 claims in 11 years, 4 paid). In contrast, there were 17 claims in 28 years for complications of upper endoscopies with questionable indication (8 paid).
Author Interviews, Heart Disease, JAMA / 30.09.2014

MedicalResearch.com Interview with: Marwan Badri MBChB, MRCP Cardiovascular disease fellow Lankenau Medical Center Wynnewood Pa Medical Research : What is the background for this study? Dr. Badri: Recent years witnessed increased emphasis of the role of clinical guidelines in cardiovascular care. Physicians are encouraged to practice within the framework of major society guidelines to deliver better, more cost-effective patient care. It is therefore vital that the recommendations in these guidelines are applicable to most of the patient population. Since some clinical trials have been shown in the past to unfavorably exclude women, racial minorities and elderly patients, we conducted this study to see if the clinical trials used to form the American College of Cardiology/American Heart Association adequately represent these patient groups.
Author Interviews, JAMA, Mental Health Research, Weight Research / 27.09.2014

Stewart Agras, M.D. Professor of Psychiatry Emeritus Stanford University School of MedicineMedicalResearch.com Interview with: Stewart Agras, M.D. Professor of Psychiatry Emeritus Stanford University School of Medicine MedicalResearch: What was the study about? Dr. Agras: Family-based treatment (FBT) has been shown to be more effective than individual psychotherapy for the treatment of adolescent anorexia nervosa. This treatment focuses on helping the family to re-feed their child. The question posed in this study was whether Family-based treatment would have any advantages over Systemic family therapy (SyFT) focusing on family interactions that may affect the maintenance of the disorder. The participants were 164 adolescents with anorexia nervosa and their families – one of the largest studies of its type.
Author Interviews, Cost of Health Care, JAMA, Pharmacology / 27.09.2014

Dr. Song Hee Hong PhD Associate Professor, Health Outcomes and Policy Research Dept. Clinical Pharmacy University of Tennessee Health Science Center Memphis, TN 38163MedicalResearch.com Interview with: Dr. Song Hee Hong PhD Associate Professor, Health Outcomes and Policy Research Dept. Clinical Pharmacy University of Tennessee Health Science Center Memphis, TN 38163 Medical Research: What are the main findings of the study? Dr. Hong: Use of GDDP (generic drug discount programs) increased to 23.1% in 2010 from 3.6% of patients receiving any prescription drugs in 2007. Generic drug discount programs were more valued among the elderly, sicker and uninsured populations. The lower use of Generic drug discount programs among racial/ethnic minorities observed when the program was deployed no longer existed when the program matured.