Author Interviews, Diabetes, Diabetes Care, FDA, Pharmacology / 20.03.2014

Christian Hampp PhD Senior Staff Fellow/Epidemiologist at FDA Division of Epidemiology-I, Office of Pharmacovigilance and Epidemiology, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MDMedicalResearch.com Interview with: Christian Hampp PhD Senior Staff Fellow/Epidemiologist at FDA Office of Pharmacovigilance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD MedicalResearch.com: What are the main findings of the study? Dr. Hampp: Our study described U.S. market trends for antidiabetic drugs, focusing on newly approved drugs, concomitant use of antidiabetic drugs, and effects of safety concerns and restrictions on thiazolidinedione use. We found that since 2003, the number of adult antidiabetic drug users increased by approximately 43% to 18.8 million in 2012.  During 2012, 154.5 million prescriptions for antidiabetic drugs were filled in outpatient retail pharmacies.  Since 2003, metformin use increased by 97% to 60.4 million prescriptions dispensed in 2012.  Among antidiabetic drugs newly approved for marketing between 2003 and 2012, the dipeptidyl-peptidase-4 (DPP-4) inhibitor sitagliptin had the largest share with 10.5 million prescriptions in 2012. Possibly triggered by safety concerns, the use of pioglitazone declined in 2012 to approximately 52% of its peak in 2008, when 14.2 million prescriptions were dispensed in outpatient retail pharmacies and the use of rosiglitazone use decreased to fewer than 13,000 prescriptions dispensed in retail or mail-order pharmacies in 2012. (more…)
Author Interviews, CMAJ, Emergency Care, Gender Differences, Heart Disease, McGill / 20.03.2014

MedicalResearch.com Interview with: Roxanne Pelletier, PhD Postdoctoral Fellow Division of Clinical Epidemiology  McGill University Health Centre (MUHC) 687 Pine Avenue West, V Building, Room V2.17 Montreal, QcRoxanne Pelletier, PhD Postdoctoral Fellow Division of Clinical Epidemiology McGill University Health Centre (MUHC) 687 Pine Avenue West, V Building, Room V2.17 Montreal, Qc MedicalResearch.com: What made you want to study this disparity between men and women and heart attacks?  Dr. Pelletier:  Despite enhanced medical treatment and decrease in the incidence of heart diseases, important sex disparities persist in the risk of mortality following a cardiac event: the risk of mortality is higher in women compared to men, and this sex difference is even more important in younger adults. Therefore, we aimed to investigate potential mechanisms underlying this sex difference in mortality. (more…)
Author Interviews, Heart Disease, JAMA, NIH, Omega-3 Fatty Acids / 19.03.2014

MedicalResearch.com Interview with: Denise Bonds, MD, MPH National Heart, Lung, and Blood Institute (NHLBI)  MedicalResearch.com: What are the main findings of the study? Dr.Bonds: We found no cardiovascular benefit to supplementation of the diet with either omega-3 fatty acids or with the macular xanthophyll’s lutein and zeaxanthin. (more…)
Author Interviews, Genetic Research, Lipids, University of Michigan / 19.03.2014

dr_cristen_j_willerMedicalResearch.com Interview with: Cristen J. Willer, PhD Assistant Professor Division of Cardiovascular Medicine, Dept of Internal Medicine Dept of Human GeneticsDept of Computational Medicine and Bioinformatics University of Michigan Ann Arbor, MI 48109-5618 MedicalResearch.com: What are the main findings of the study? Dr. Willer: We wanted to find new genes related to heart disease, so we examined the DNA of approximately 10,000 Norwegian individuals and found 10 genes that are important regulators of blood cholesterol levels. Nine of these were well known to be related to lipids, but one gene was new.  It turned out to be in a region we'd previously noticed to be related to cholesterol, but it was a big region and we hadn't been able to pinpoint the gene yet.  Using this new approach, focusing on DNA differences that result in slightly different proteins in people, we zeroed in on the gene.  We then altered this gene in mice, and saw the predicted changes in cholesterol levels in mice. (more…)
Alzheimer's - Dementia, Author Interviews, PNAS, University of Michigan / 19.03.2014

Yanzhuang Wang, PhD Associate professor Dept. of Molecular, Cellular and Developmental Biology and Dept. of Neurology University of Michigan Ann Arbor, MI 48109-1048MedicalResearch.com Interview with: Yanzhuang Wang, PhD Associate professor Dept. of Molecular, Cellular and Developmental Biology and Dept. of Neurology University of Michigan Ann Arbor, MI 48109-1048  MedicalResearch.com: What are the main findings of the study? Dr. Wang: We learned how to repair a cellular structure called the Golgi apparatus that is broken in Alzheimer’s disease. This helps us understand how to reduce the formation of the toxic plaques that kill cells in the brain of Alzheimer's patients. The formation of amyloid plaques is a hallmark of Alzheimer’s disease; but exactly how much the plaques contribute to the disease is still not known. Our study found that the broken Golgi in the disease may be a major source of the toxicity of amyloid plaques. We showed in this study that repairing the Golgi can reduce the formation of the toxic plaques and thus may delay the disease development. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Genetic Research, Medical Research Centers, Nutrition, Weight Research / 19.03.2014

Prof. Lu Qi, Assistant Professor, Department of Nutrition Harvard School of Public Health and Channing Division of Network Medicine Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MAMedicalResearch.com Interview with: Prof. Lu Qi, Assistant Professor, Department of Nutrition Harvard School of Public Health and Channing Division of Network Medicine Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA MedicalResearch.com: What are the main findings of the study? Dr. Lu Qi: In this study, we for the first time provide reproducible evidence from three large cohort studies to show that the association between regular consumption of fried foods and higher BMI was particularly pronounced among people with a greater genetic predisposition to obesity. On the other hand, the adverse genetic effects on BMI were also amplified by consuming more fried foods, the effects among those who ate fried foods more than four times a week was about twice as large compared with those who ate them less than once a week. (more…)
Cognitive Issues, JAMA, Mayo Clinic, Medical Research Centers, Pulmonary Disease / 19.03.2014

Michelle M. Mielke, Ph.D. Associate Professor Department of Health Sciences Research, Division of Epidemiology Department of Neurology Mayo Clinic Rochester, MN 55905MedicalResearch.com Interview with: Michelle M. Mielke, Ph.D. Associate Professor Department of Health Sciences Research, Division of Epidemiology Department of Neurology Mayo Clinic Rochester, MN 55905 MedicalResearch.com: What are the main findings of the study? Dr. Mielke: Using a population-based sample of cognitively normal individuals, aged 70-89 at baseline, we found that a medical-record confirmed diagnosis of COPD was associated with an increased risk of mild cognitive impairment, specifically non-amnestic mild cognitive impairment.  The risk of mild cognitive impairment increased with a longer duration of COPD such that individuals who had COPD for more than 5 years had a 2.5-fold increased risk of developing non-amnestic mild cognitive impairment. (more…)
Author Interviews, Nutrition, Pediatrics, Vanderbilt, Weight Research / 19.03.2014

Dr. Eliana M. Perrin, MD, MPH Associate Vice Chancellor for Research, and Director, Office of Research Development University of North Carolina at Chapel Hill  and Associate Professor Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine University of North Carolina at Chapel Hill, School of Medicine Chapel Hill, NC 27599-7225MedicalResearch.com Interview Invitation with: Dr. Eliana M. Perrin, MD, MPH Associate Vice Chancellor for Research, and Director, Office of Research Development University of North Carolina at Chapel Hill  and Associate Professor Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine University of North Carolina at Chapel Hill, School of Medicine Chapel Hill, NC 27599-7225 MedicalResearch.com: What are the main findings of the study? Dr. Perrin: The study included a large, diverse sample of 863 low-income parents of two-month-olds participating in Greenlight, an obesity prevention trial taking place at four medical centers: UNC, New York University, Vanderbilt University and the University of Miami.  Among all of the parents, behaviors that are thought to be related to later obesity were highly prevalent. Exclusive formula feeding was more than twice as common (45 percent) as exclusive breastfeeding (19 percent). Twelve percent had already introduced solid food, 43 percent put infants to bed with bottles, 23 percent propped bottles instead of holding the bottle by hand (which can result in overfeeding), 20 percent always fed when the infant cried, and 38 percent always tried to get their children to finish their milk.  In addition, 90 percent of the infants were exposed to television and 50 percent actively watched TV (meaning parents put their children in front of the television in order to watch).  There were differences in these behaviors by race and ethnicity, and study results show that culturally-tailored counseling should be offered to parents of different backgrounds who may feed and play with their children differently. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Medical Research Centers, Outcomes & Safety / 18.03.2014

MedicalResearch.com Interview with: Dr. Atul Shinagare MD Department of Radiology and Center for Evidence-Based Imaging, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115Dr. Atul Shinagare MD Department of Radiology and Center for Evidence-Based Imaging, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 MedicalResearch.com: What are the main findings of the study? Answer: We evaluated 100 randomly selected patients from a cohort of 1771 patients evaluated for asymptomatic hematuria in 2004 at our institution in order to assess physician adherence to the 2001 American Urological Association (AUA) guidelines for evaluating patients and its impact on the diagnosis of urologic cancer. We found that most (64%) patients were not evaluated according to the guidelines, that there was substantial variation in the evaluation, and that the evaluation depended largely on the type of hematuria and physician specialty. Only 5% of patients were found to have urologic cancer, and all of them were evaluated according to the guidelines. No additional urologic cancers were diagnosed in patients in whom guidelines were not followed; however, since not all patients were tested thoroughly, occult malignancies may have been present. (more…)
Author Interviews, Cost of Health Care, JAMA, Pain Research, Pharmacology, Radiology, University of Michigan / 17.03.2014

Dr. Brian C. Callaghan MD Department of Neurology University of Michigan Health System, Ann ArborMedicalResearch.com Interview Invitation with: Dr. Brian C. Callaghan MD Department of Neurology University of Michigan Health System, Ann Arbor MedicalResearch.com: What are the main findings of the study? Dr. Callaghan:  The main findings are that we order headache neuroimaging (MRIs and CTs) frequently, this accounts for approximately $1 billion dollars annually, and the number of tests ordered is only increasing with time. (more…)
Author Interviews, NIH / 15.03.2014

Peter F. Schnatz, D.O. Associate Chair & Residency Program Director The Reading Hospital Department of OB/GYN Reading, PA  19612-6052MedicalResearch.com Interview with: Peter F. Schnatz, D.O. Associate Chair & Residency Program Director The Reading Hospital Department of OB/GYN Reading, PA  19612-6052 MedicalResearch.com: What are the main findings of the study? Dr. Schnatz: In a subsample of 576 women from the parent WHI CaD (calcium plus vitamin D supplementation)  trial* , there was a significant (38%) increase in mean serum 25OHD3 concentrations after two years (95% CI 1.29-1.47, p< 0.001) for women randomized to CaD (24.3ng/mL vs. 18.2 ng/mL). Women randomized to CaD had a 4.5 mg/dL mean decrease in LDL-C which was statistically significant.  After accounting for serum 25OHD3 concentration, the effect of CaD was attenuated, suggesting that higher concentrations of 25OHD3, in response to CaD supplementation, are associated with improved LDL-C. In observational analyses, higher concentrations of 25OHD3 were associated with significantly higher HDL-C along with significantly lower LDL-C and TG concentrations. * 1,000 mg of elemental calcium plus 400 IU of vitamin D3 daily (more…)
Compliance, Diabetes, Diabetes Care, Vanderbilt / 15.03.2014

Chandra Y. Osborn, PhD, MPH Assistant Professor of Medicine & Biomedical Informatics Division of General Internal Medicine & Public Health Center for Health Services Research Vanderbilt University Medical Center  Nashville, TN 37232-8300MedicalResearch.com Interview with: Chandra Y. Osborn, PhD, MPH Assistant Professor of Medicine & Biomedical Informatics Division of General Internal Medicine & Public Health Center for Health Services Research Vanderbilt University Medical Center Nashville, TN 37232-8300 MedicalResearch.com: What are the main findings of your study? Dr. Osborn:  We found that knowing how to take your diabetes medications (e.g., what to do if a dose is missed), believing medications are good for you, and having the appropriate skills to take them regardless of the situation (e.g., when life is busy, when in public) accounts for 41% of why people successfully take their diabetes medications, which, in turn, explains 9% of their glycemic control. (more…)
Cognitive Issues, General Medicine, PLoS, University of Pittsburgh / 15.03.2014

Dr Tobias Teichert Assistant Professor of Psychiatry University of Pittsburgh Pittsburgh, PA 15261MedicalResearch.com Interview with: Dr Tobias Teichert Assistant Professor of Psychiatry University of Pittsburgh Pittsburgh, PA 15261 MedicalResearch.com:  What are the main findings of the study? Dr. Teichert:  "Our study provided three main findings: First, we measured how long it takes subjects to allocate attention to a relevant target and how effectively they can block out the distractors. We found that after 120 msec selective attention is fully engaged and completely blocks out the distractor. Based on this finding, we predicted that subjects should be able to improve decision accuracy by delaying decision onset, and that this should be more effective than simply prolonging the whole decision process. Most importantly, we found that subjects indeed use this more effective way of improving decision onset: On average, subjects delayed decision onset by about 50 msec when we asked them be as accurate as possible. The good news is that people seem to use this more optimal mechanism automatically, without being told to do so and without being aware of what they do. The bad news is that we don’t seem to be using this skill quite as effectively as we could. In our case, subjects could have improved accuracy even further by delaying decision onset by an additional 50 ms. However, taken together, our findings show that decision onset is to some degree under cognitive control, and that we might be able to devise training strategies to harness its full potential” (more…)
AHA Journals, Author Interviews, Race/Ethnic Diversity, Stroke, University of Michigan / 14.03.2014

Lynda D. Lisabeth, PhD Interim Chair and Associate Professor Department of Epidemiology University of Michigan Ann Arbor, MichiganMedicalResearch.com Interview with: Lynda D. Lisabeth, PhD Interim Chair and Associate Professor Department of Epidemiology University of Michigan Ann Arbor, Michigan MedicalResearch.com: What are the main findings of the study? Dr. Lisabeth: The main findings were that Mexican Americans scored worse than non-Hispanic whites on all outcomes measured at 90 days following stroke, including neurologic, functional and cognitive outcomes, after adjustment for confounding factors. Further, we found that one-third of Mexican American stroke survivors have post-stroke dementia. Mexican Americans experienced more aphasia than non-Hispanic whites. Levels of functional impairment were substantial, with Mexican Americans on average experiencing moderate functional disability. Mexican Americans reported significantly greater difficulty than non-Hispanic whites with all activities of daily living (ADLs) and instrumental activities of daily living (IADLs) that were studied. (more…)
Accidents & Violence, Author Interviews, Duke, JAMA, Ophthalmology / 14.03.2014

Glenn Yiu, MD, PhD Duke Ophthalmology Duke University Medical CenterMedicalResearch.com Interview with: Glenn Yiu, MD, PhD Duke Ophthalmology Duke University Medical Center MedicalResearch.com:  What are the main findings of the study? Dr. Yiu: This paper reported a child who suffered injury to both eyes from a powerful blue laser pointer purchased via the internet from overseas. Our report reviews the scientific basis for laser injuries in eyes and the factors that may affect outcomes, such as power, wavelength, duration, and distance of exposure. Newer green and blue lasers, especially high-powered ones, may be more prone to inducing eye injuries. We summarized the clinical features of ocular laser injuries, methods of prevention, and discussed how consumer availability of high powered lasers may require careful federal regulations. (more…)
AHA Journals, Heart Disease, Karolinski Institute, Kidney Disease / 13.03.2014

Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden.MedicalResearch.com Interview with: Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden. MedicalResearch.com: What are the main findings of the study? Dr. Holzmann: The main finding is that patients with renal dysfunction are at increased risk of cardiovascular events after undergoing CABG for acute coronary syndromes. (more…)
Author Interviews, Genetic Research, Mayo Clinic, Mental Health Research, Nature / 12.03.2014

MedicalResearch.com Interview with: Prof. Dr. Sven Cichon, PhD Director, Division of Medical Genetics University Hospital Basel Human Genomics Research Group Department of Biomedicine University of Basel Basel, Switzerland MedicalResearch.com: What were the main findings of the study? Answer: We have identified two new gene regions that represent pieces of the jigsaw puzzle of genetic and non-genetic factors that lead to the development of bipolar disorder. One is the gene ADCY2 (Adenylate Cyclase 2) which is involved in signal transmission within nerve cells. The other region comprises two genes, both presumably playing a role in neurodevelopmental processes (MIR2113 and POU3F2). Importantly, these results come out of the largest of these kinds of studies so far, involving altogether more than 24,000 people. (more…)
Author Interviews, JAMA, Pediatrics, Tobacco, UCSF / 12.03.2014

Lauren Dutra, ScD Postdoctoral Scholar, UCSF School of Medicine Cardiovascular Research Institute San Francisco, CA 94143MedicalResearch.com Interview with: Lauren Dutra, ScD Postdoctoral Scholar, UCSF School of Medicine Cardiovascular Research Institute San Francisco, CA 94143 MedicalResearch.com: What are the main findings of the study? Answer: Middle and high school students who used e-cigarettes were more likely to smoke tobacco cigarettes. They were also more likely to progress from experimenting with tobacco cigarettes to becoming regular smokers. Teen smokers who used e-cigarettes were more likely to be planning to quit in the next year and less likely to have abstained from smoking recently, compared to smokers who had never used e-cigarettes. They were also more likely to be heavier smokers (smoke more cigarettes per day) than those who had never tried e-cigarettes, that being said there are eliquids available that have no nicotine content whatsoever and these are therefore a much healthier option, you can see a wide variety of these at Gourmet E-Liquid. (more…)
Annals Thoracic Surgery, Author Interviews, NIH, Pulmonary Disease / 09.03.2014

Surya P Bhatt MD Assistant Professor Division of Pulmonary and Critical Care Medicine University of Alabama at BirminghamMedicalResearch.com Interview with: Surya P Bhatt MD Assistant Professor Division of Pulmonary and Critical Care Medicine University of Alabama at Birmingham MedicalResearch.com: What are the main findings of the study? Dr. Bhatt:  The forced vital capacity (FVC) maneuver is a difficult maneuver for many patients and the forced expiratory volume in the first 6 seconds (FEV6) has been shown to be a reliable substitute. We used imaging findings on computed tomography, COPD questionnaires and tests of exercise capacity to compare these two spirometric measures (FEV1/FVC and FEV/FEV6) in the diagnosis of airflow obstruction, and showed that FEV6 can be reliably substituted for FVC. Our findings suggest that using FEV6 may in fact identify more patients with disease than by using FVC. (more…)
Author Interviews, Hospital Acquired, Infections, NIH, Surgical Research, University of Pennsylvania, Wake Forest / 09.03.2014

William G Ward, Sr. MD Chair of Orthopaedic Surgery, Chief of Musculoskeletal Service Line - Guthrie Clinic One Guthrie Square Sayre, Pennsylvania 18840 (Professor Emeritus - Wake Forest University Dept of Orthopaedic Surgery)MedicalResearch.com Interview with: William G Ward, Sr. MD Chair of Orthopaedic Surgery, Chief of Musculoskeletal Service Line - Guthrie Clinic Sayre, Pennsylvania 18840 (Professor Emeritus - Wake Forest University Dept of Orthopaedic Surgery) MedicalResearch.com: What are the main findings of this study? Dr. Ward: The main findings of the study include:
  1. The use of disposable spun-lace “paper” gowns was associated with a dramatic decrease in the likelihood of culture-detected bacterial contamination on the surgeon’s gloved hand and gown sleeve.
  2. For a double-gloved surgeon, changing the outer glove just prior to implant handling should decrease bacterial contamination from the surgeon by about 50%.
  3. Bacteria suspended in saline solution transgressed the material of standard reusable scrub attire in 96% (26/27) of tested gowns and in 0% (0/27) of spun-lace disposable “paper” gowns. (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, Genetic Research, University of Pennsylvania / 05.03.2014

MedicalResearch.com Interview with: Brendan Keating D.Phil Assistant Professor, Dept of Pediatrics and Surgery, University of Pennsylvania Lead Clinical Data Analyst, Center for Applied Genomics Children's Hospital of Philadelphia,Brendan Keating D.Phil Assistant Professor, Dept of Pediatrics and Surgery, University of Pennsylvania Lead Clinical Data Analyst, Center for Applied Genomics Children's Hospital of Philadelphia Michael V. Holmes, MD, PhD, MSc, BSc, MRCP Transplant Surgery Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USAMichael V. Holmes, MD, PhD, MSc, BSc, MRCP Transplant Surgery Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA MedicalResearch.com: What are the main findings of the study? Answer: We found that individuals with a genetically-elevated BMI had higher blood pressure, inflammatory markers, metabolic markers and a higher risk of type 2 diabetes, although there was little correlation with coronary heart disease in this study population of over 34,500 European-descent individuals of whom over 6,000 had coronary heart disease. (more…)
Author Interviews, Heart Disease, JAMA, Karolinski Institute, Kidney Disease / 04.03.2014

Juan Jesus Carrero PhD (Pharm and Med) Associate Professor in Renal Medicine Karolinska Institutet, Sweden.MedicalResearch.com Interview with: Juan Jesus Carrero PhD (Pharm and Med) Associate Professor in Renal Medicine Karolinska Institutet, Sweden.   MedicalResearch.com: Why did you choose to study this particular question? Answer: We chose this question because there is currently an important knowledge gap regarding safety and effectiveness of common drugs in individuals with chronic kidney disease. Because kidney dysfunction interferes with drug metabolism and drug elimination, patients with kidney dysfunction have traditionally been excluded from randomized controlled trials. Yet, practice guidelines are afterwards extrapolated to those in the absence of formal evaluation. (more…)
Author Interviews, Cannabis, McGill, Rheumatology / 04.03.2014

Mary-Ann Fitzcharles, MB, ChB, MRCP(UK), FRCP(C) McGill University Health Centre Division of Rheumatology and Alan Edwards Pain Management UnitMedicalResearch.com Interview with: Mary-Ann Fitzcharles, MB, ChB, MRCP(UK), FRCP(C) McGill University Health Centre Division of Rheumatology and Alan Edwards Pain Management Unit MedicalResearch.com: What are the highlights of your review? Dr. Fitzcharles: Thank you for your interest in the review article which will shortly be published in Arthritis Care & Research. This was not a research study but rather a review focused towards the use of herbal cannabis for patients with rheumatic diseases. The essence of our message after a thorough review of the literature is that there is not a single study published regarding efficacy or side effects of herbal cannabis in the rheumatic diseases. It is notable that almost 2 thirds of persons using herbal cannabis for therapeutic reasons report use for musculoskeletal complaints. In the 21st century, we cannot rely upon heresay or anecdote to justify use of a treatment intervention. It is unacceptable to recommend use of a substance without knowledge of concentration of molecules in the product, any knowledge of blood concentrations that might have a positive or negative effect, and formal study in defined patient populations with acceptable endpoint criteria and evidence for short and long term risks. (more…)
Author Interviews, BMJ, Cancer Research, University of Michigan / 04.03.2014

Sameer Saini MD Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USAMedicalResearch.com Interview with: Sameer Saini MD Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA MedicalResearch.com: What are the main findings of the study? Dr. Saini: The way that quality measures are defined can have important implications for how care is actually delivered. Current colorectal cancer screening quality measures use age to identify screen-eligible patients, encouraging screening in patients between 50 and 75 years of age. But they do not explicitly incorporate health status. In this context, our study had two main findings.
  • First, by focusing on age alone, we are not screening everyone who is likely to benefit. Specifically, many healthy people over 75 years of age (who are outside the target age range of the quality measure) may benefit from screening, but the current measure does not encourage screening in this population, leading to low screening use.
  • Second, some people who are NOT likely to benefit are being screened unnecessarily, like those with serious health problems. For example, people between ages 70-75 with serious health problems (who have limited life expectancy) are unlikely to benefit from screening, and may even be harmed by it. But the current quality measure encourages screening in such individuals due to their age, yielding relatively high screening rates. If the system focused on age and health status (rather than age alone), screening use would be more aligned with screening benefit, and we would have better health outcomes.
(more…)
Author Interviews, Health Care Systems, Lancet, Nursing, University of Pennsylvania / 04.03.2014

Professor Linda H Aiken PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology Director of the Center for Health Outcomes and Policy Research Center for Health Outcomes and Policy Research University of Pennsylvania School of NursingMedicalResearch.com Interview with: Professor Linda H Aiken PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology Director of the Center for Health Outcomes and Policy Research Center for Health Outcomes and Policy Research University of Pennsylvania School of Nursing MedicalResearch.com: Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. Against that backdrop, can you start by letting us know the background of the study?  Prof. Aiken: European Surgical Outcomes Study in 28 countries showed higher than necessary deaths after surgery. A comparable study in the US showed that despite the nation spending hundreds of millions of dollars on improving patient safety, there were no improvements in adverse outcomes after surgery in US hospitals between 2000 and 2009.  Clearly it is time to consider new solutions to improving hospital care for surgical patients, who make up a large proportion of all hospital admissions.  Our study was designed to determine whether there are risks for patients of reducing hospital nurse staffing, and what, if any, are the benefits to patients of moving to a more educated nurse workforce. (more…)
Annals Thoracic Surgery, Author Interviews, Dental Research, Heart Disease, Infections, Mayo Clinic / 01.03.2014

Dr. Kendra J. Grim Department of Anesthesiology Mayo Clinic, Rochester, MN 55905MedicalResearch.com Interview with: Dr. Kendra J. Grim Department of Anesthesiology Mayo Clinic, Rochester, MN 55905 MedicalResearch.com: What are the main findings of the study? Dr. Grim: “The current guidelines say that if possible, treating the dental problems that patients have before heart surgery is best, to try to prevent both early and late heart infections. But the data is very unclear, because it’s very difficult to study. We found in our study that their risk of serious complications after having teeth removed may be higher than we thought. We were primarily looking at stroke, heart attack, renal failure and death. We found that actually the incidence of having one of those major morbidities was 8 percent.  Of that 8 percent, we had six patients, or 3 percent, of the total group who died between their dental surgery and scheduled heart surgery, so these patients never made it to their heart surgery. An additional 3 percent of patients died after heart surgery. “ (more…)
Author Interviews, HIV, Johns Hopkins / 25.02.2014

Samuel R. Friedman PhD Institute of Infectious Disease Research National Development and Research Institutes, Inc. New York, NY Department of Epidemiology Johns Hopkins Bloomberg School of Public Health, Baltimore, MDMedicalResearch.com Interview with: Samuel R. Friedman PhD Institute of Infectious Disease Research National Development and Research Institutes, Inc. Ny, NY Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore, MD MedicalResearch.com: What are the main findings of the study? Dr. Friedman: The main finding is that programs that helped protect people who inject drugs from HIV and those that helped them to get medical care seem to be associated with less HIV disease and less death related to HIV disease among the heterosexual population of large United States metropolitan areas. This is important.  Drug users in the US are widely despised, and their has been a lot of political opposition to programs like syringe exchange and drug abuse treatment. Our findings show that these programs are associated with better health and less death in the broader population.  It makes more sense to help people--even those you despise--stay uninfected, and to get medical care, than to restrict or attack programs for them. (more…)
Annals Internal Medicine, Author Interviews, Cost of Health Care, Heart Disease, UCSF / 25.02.2014

Dhruv S. Kazi, MD, MSc, MS Assistant Adjunct Professor Division of Cardiology San Francisco General Hospital Department of Medicine, and Department of Epidemiology and Biostatistics University of California San FranciscoMedicalResearch.com Interview with: Dhruv S. Kazi, MD, MSc, MS Assistant Adjunct Professor Division of Cardiology San Francisco General Hospital Department of Medicine, and Department of Epidemiology and Biostatistics University of California San Francisco MedicalResearch.com: What is the background of your study? Dr. Kazi: When we first asked the research question -what is the role of genotyping among patients receiving a stent for ACS, we quickly realized that there were no RCTs that had directly compared ticagrelor with prasugrel. But in our opinion, that was precisely the reason to build a model and systematically synthesize the available literature. There are nearly half a million PCIs for ACS in the US each year, and each time, the physician and patients have to examine the trade-offs between the various alternatives. What our model does is that it explicates the trade-offs - makes them transparent, and quantifies them.  So patients and physicians can make an informed decision on what is the optimal therapy for them. (more…)
Author Interviews, CT Scanning, Lancet, Medical Imaging, MRI, Pediatrics, Stanford / 20.02.2014

Dr Heike Daldrup-Link Associate Professor of Radiology Stanford University School of Medicine, Palo AltoMedicalResearch.com: Interview with: Dr Heike Daldrup-Link Associate Professor of Radiology Stanford University School of Medicine, Palo Alto   MedicalResearch.com: What are the main findings of the study? Answer: We use magnetic resonance imaging, a technology based on magnetic fields rather than radiotracers or x-rays. The underlying technology is not new – it has been used for tumor staging for many years. This is an advantage as MR scanners are available in nearly every major Children’s Hospital where children with cancer are treated. What is new about our approach is that we combined anatomical and functional images, similar to current approaches that use radiotracers and CT (PET/CT):  We first acquired scans that showed the anatomy of the patient very well and we then acquired scans that depict tumors as bright spots with little or no background information. We did that by using an iron supplement as a contrast agent: The iron supplement can be detected by the MRI magnet and improved tumor detection and vessel delineation MR scans. We then fused the anatomical scans with the tumor scans. (more…)