Author Interviews, Baylor College of Medicine Houston, JAMA, Outcomes & Safety, Surgical Research / 17.01.2014

MedicalResearch.com Interview with: Daniel A. Anaya, MD, FACS Associate Professor of Surgery - Surgical Oncology Michael E. DeBakey Department of Surgery Baylor College of Medicine Chief, General Surgery & Surgical Oncology SectionDirector, Liver Tumor Program Michael E. DeBakey VA Medical Center Houston, TX 77030 and Dr. Courtney J. Balentine, MD First author and surgical resident at Baylor College of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Anaya:  That a good proportion of patients having colorectal operations will need additional assistance to recover during the postoperative period, resulting in being discharged to other facilities (nursing facilities, skilled care, etc) after surgery, and that hospitals where a higher-volume of colorectal operations are performed are more likely to discharge patients back to home after surgery. (more…)
Alcohol, Author Interviews, General Medicine, Karolinski Institute / 17.01.2014

Andrea Bellavia MSc Institute of Environmental Medicine, Karolinska Institutet Stockholm, SwedenMedicalResearch.com Interview with: Andrea Bellavia MSc Institute of Environmental Medicine, Karolinska Institutet Stockholm, Sweden Dr. Montgomery: What are the main findings of the study? Answer: We evaluated for 15 years a cohort of Swedish men and women and observed, after taking into account various socio-demographic, dietary, and lifestyle factors, that a low daily consumption of alcoholic beverages is tied with longer survival. (more…)
Author Interviews, Brigham & Women's - Harvard, Health Care Systems, JAMA, Medical Research Centers, Outcomes & Safety / 17.01.2014

Elliot Wakeam MD Center for Surgery and Public Health Brigham and Women's Hospital Boston MA 02115MedicalResearch.com Interview with Elliot Wakeam MD Center for Surgery and Public Health Brigham and Women's Hospital Boston MA 02115 MedicalResearch.com: What are the main findings of the study? Dr. Wakeam: Our study examined failure to rescue (FTR), or death after postoperative complications, in safety net hospitals. Prior work has shown that hospital clinical resources can improve rescue rates, however, despite having higher levels of technology and other clinical resources that should lead to better rates of patient rescue, safety net hospitals still had greater rates of death after major complications. (more…)
Author Interviews, JAMA, Nutrition, Pediatrics, University of Michigan / 14.01.2014

Yvonne M. Terry-McElrath, MSA Institute for Social Research, University of Michigan, Ann ArborMedicalResearch.com Interview with: Yvonne M. Terry-McElrath, MSA Institute for Social Research, University of Michigan, Ann Arbor MedicalResearch.com: What are the main findings of the study? Answer: This study examined 2007-2012 commercialism trends in schools attended by nationally representative samples of US elementary and secondary students. While some measures showed significant decreases over time (especially beverage vending measures), most students at both elementary and secondary school levels continued to be exposed to school-based commercialism. Commercialism increased significantly with grade level. The most frequent type of commercialism varied by school level:  food coupons used as incentives was most common at the elementary school level, while exclusive beverage contracts were the most prevalent type of commercialism for middle and high school students. (more…)
Author Interviews, Diabetes, Diabetes Care, Pediatrics, Stanford / 11.01.2014

Naama Barnea-Goraly M.D. Center for Interdisciplinary Brain Sciences Research Stanford UniversityMedicalResearch.com Interview with: Naama Barnea-Goraly M.D. Center for Interdisciplinary Brain Sciences Research Stanford University MedicalResearch.com: What are the main findings of the study? Answer: Our main findings showed that compared with age and sex matched controls, children with type 1 diabetes have significant differences in white matter structure in widespread brain regions. Within the type 1 diabetes group, earlier onset of diabetes and longer duration were associated with greater alterations in white matter structure. In addition, measures of hyperglycemia and glucose variability, but not hypoglycemia were associated with white matter structure; however, hypoglycemia exposure and the number of severe hypoglycemia events in our sample were too small to identify statistically meaningful differences. Finally, we observed a significant association between white matter structure and cognitive ability in children with type 1 diabetes, but not in controls. (more…)
Author Interviews, Depression, JAMA, Johns Hopkins, Mental Health Research, Pain Research / 07.01.2014

Madhav Goyal MD, MPH Assistant Professor General Internal Medicine Johns Hopkins School of MedicineMedicalResearch.com Interview with: Madhav Goyal MD, MPH  Assistant Professor General Internal Medicine Johns Hopkins School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Goyal:
  • The evidence is moderately strong that there is a small but consistent benefit for mindfulness meditation programs to improve 3 symptoms: anxiety, depression, and pain.  We found low level evidence that mindfulness meditation helps with symptoms of stress and distress, as well as with the mental health dimension of quality of life.
  • For the symptoms of anxiety and depression for which we find moderate evidence of benefit, we need to keep in mind that most of the trials didn't study people with a clinical diagnosis of anxiety or depression (although a few did).  Most were studying diverse patient populations who may have had a low level of these symptoms, such as those with  breast cancer, fibromyalgia, organ transplant recipients, and caregivers of people with dementia.
  • We found about a 5-10% improvement in anxiety symptoms compared to placebo groups.  For depression, we found a roughly 10-20% improvement in depressive symptoms compared to the placebo groups. This is similar to the effects that other studies have found for the use of antidepressants in similar populations.
  • While we found that the evidence was moderately strong that mindfulness meditation programs may improve pain, there weren't as many trials evaluating chronic pain, and so we don't understand what kinds of pain this type of meditation may be most useful for.
(more…)
Author Interviews, Blood Pressure - Hypertension, Gender Differences, Wake Forest / 02.01.2014

Carlos M Ferrario, MD, FAHA, FASH, FACC Dewitt-Cordelll Professor of Surgical Sciences Professor, Internal Medicine-Nephrology Professor, Physiology-Pharmacology Wake Forest University School of Medicine Winston-Salem, NC 27157-1032 Vice-President, Consortium Southeastern Hypertension Control Editor-in-Chief Therapeutic Advances in Cardiovascular DiseaseMedicalResearch.com Interview with: Carlos M Ferrario, MD, FAHA, FASH, FACC Dewitt-Cordelll Professor of Surgical Sciences Professor, Internal Medicine-Nephrology Professor, Physiology-Pharmacology Wake Forest University School of Medicine Winston-Salem, NC 27157-1032 Vice-President, Consortium Southeastern Hypertension Control Editor-in-Chief, Therapeutic Advances in Cardiovascular Disease MedicalResearch.com: What are the main findings of the study? Dr. Ferrario: A significant and unexpected difference in the hemodynamic mechanisms that account for the elevated blood pressure between untreated hypertensive men and women. The main findings were: "Despite there being no differences between women and men in terms of office blood pressure, heart rate and body mass index, men demonstrated lower values of pulse pressure, systemic vascular resistance, brachial artery pulse wave velocity and augmentation index. In each of the three hypertension categories, the increased blood pressure in men was associated with significant augmentations in stroke volume and cardiac output compared with women. Sex-related hemodynamic differences were associated in women with higher plasma levels of leptin, hs-CRP, plasma angiotensin II and serum aldosterone. In women but not men, hs-CRP correlated with plasma concentrations of transforming growth factor β1 (TGFβ1) and body weight; in addition, plasma TGFβ1 correlated with levels of serum vascular cell adhesion molecule 1." (more…)
Author Interviews, Duke, JAMA, Pediatrics, Sexual Health / 31.12.2013

Stewart C. Alexander, PhD Department of Medicine Duke University Medical Center Durham, North CarolinaMedicalResearch.com Interview with: Stewart C. Alexander, PhD Department of Medicine Duke University Medical Center Durham, North Carolina MedicalResearch.com: What are the main findings of the study? Dr. Alexander: Adolescents are reluctant to talk about sex with their doctors and won't raise the topic with their doctors. For physicians, there are common and valid barriers to talking about sexuality with adolescents, including time pressures and discomfort with the topic. Two-thirds of adolescents in our study had some sexuality talk during their annual visit, lasting 36 seconds long. Girls, African Americans, and older teens were more likely to receive sexuality talk. Additionally, longer visits and visits where the physician talked confidentially with their adolescent patient were more likely to have sexuality talk. Our study suggest that sexuality conversations in annual visits can be improved. (more…)
Author Interviews, Cognitive Issues, JAMA, Mayo Clinic, Thyroid Disease / 31.12.2013

Ajay K Parsaik, MD, MS Department of Psychiatry and Behavior Sciences The University of Texas Medical School, Houston Department of Neurology and Mayo Alzheimer’s Disease Research Center, Mayo Clinic, Rochester, MinnesotaMedicalResearch.com Interview with: Ajay K Parsaik, MD, MS Department of Psychiatry and Behavior Sciences The University of Texas Medical School, Houston Department of Neurology and Mayo Alzheimer’s Disease Research Center, Mayo Clinic, Rochester, Minnesota MedicalResearch.com: What are the main findings of the study? Dr. Parsaik: Main findings of our study are that clinical and subclinical hypothyroidism is not associated with mild cognitive impairment in an elderly population after accounting for possible confounding factors and interactions. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Hospital Readmissions, Medical Research Centers / 31.12.2013

Dr. Jacques Donzé MD PhD Research Associate Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital Harvard Medical School, Boston, MA 02115, USADivision of General Internal Medicine, Bern University Hospital, 3010 Bern, SwitzerlandMedicalResearch.com Interview with: Dr. Jacques Donzé MD PhD Research Associate Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital Harvard Medical School, Boston, MA 02115, MedicalResearch.com: What are the main findings of the study? Dr. Donzé: In a large retrospective cohort study, we identified the primary diagnoses of 30-day potentially avoidable readmissions in medical patients according to the most common comorbidities. Interestingly, almost all of the top five diagnoses of potentially avoidable readmissions for each comorbidity were possible direct or indirect complications of that comorbidity. Patients with cancer, heart failure, and chronic kidney disease had a significantly higher risk of potentially avoidable readmission than those without those comorbidities. Also, when readmitted, patients with chronic kidney disease had a 20% higher risk of having the readmission be potentially avoidable. (more…)
Author Interviews, Ophthalmology, Transplantation, UT Southwestern / 31.12.2013

Dr. Jerry Y. Niederkorn, Ph.D. George A. and Nancy P. Shutt Professorship in Medical Sciences Royal C. Miller Chair in Age-Related Macular Degeneration Research Professor of Ophthalmology and Microbiology Vice Chair, Research (Department of Ophthalmology) Department of Ophthalmology, University of Texas Southwestern Medical Center Dallas, TXMedicalResearch.com Interview with: Dr. Jerry Y. Niederkorn, Ph.D. George A. and Nancy P. Shutt Professorship in Medical Sciences Royal C. Miller Chair in Age-Related Macular Degeneration Research Professor of Ophthalmology and Microbiology Vice Chair, Research (Department of Ophthalmology) Department of Ophthalmology, University of Texas Southwestern Medical Center Dallas, TX FN-γ Blocks CD4+CD25+ Tregs and Abolishes Immune Privilege of Minor Histocompatibility Mismatched Corneal Allografts MedicalResearch.com: What are the main findings of the study? Dr. Niederkorn: These findings indicate that a combination of two simple maneuvers increases the acceptance of corneal transplants. In the past, there was no clear benefit in performing tissue matching of the cornea donor’s major histocompatibility complex (MHC) with the recipient of the corneal transplant. However, our study in experimental animals revealed that blocking a single immune system molecule called interferon-gamma (IFN-γ) combined with matching the corneal transplant donor with the transplant recipient’s MHC gene complex reduced the risk of rejection to less than 10% in the total absence of anti-rejection drugs. This study revealed that blocking this single immune system molecule promoted the development of immune system cells called T regulatory cells (Tregs) that suppressed the lymphocytes that are responsible for attacking organ transplants. (more…)
Author Interviews, Gastrointestinal Disease, University of Pennsylvania / 26.12.2013

dr_henry_p_parkmanMedicalResearch.com Interview Invitation with Henry P. Parkman, MD Professor, Medicine Director, GI Motility Laboratory Temple University, Philadelphia, Pennsylvania
MedicalResearch.com: What are the main findings of the study? Dr. Parkman: Gastroparesis remains a challenging syndrome to manage with few effective treatments and a lack of rigorously controlled trials. Tricyclic antidepressants are often used to treat refractory symptoms of nausea, vomiting, and abdominal pain.  Evidence from well-designed studies for this is lacking. However, in this study, among patients with idiopathic gastroparesis, the use of nortriptyline compared with placebo for 15 weeks did not result in improvement in overall symptoms. These findings do not support the use of nortriptyline for idiopathic gastroparesis. (more…)
Author Interviews, Gastrointestinal Disease, JAMA, Johns Hopkins, Surgical Research / 22.12.2013

Nita Ahuja, MD Departments of Surgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MarylandMedicalResearch.com Interview with: Nita Ahuja, MD Departments of Surgery and Oncology, Johns Hopkins University School of Medicine Baltimore, Maryland MedicalResearch.com: What are the main findings of the study? Dr. Ahuja: Across the nation, laparoscopic colectomy is performed about as frequently as open colectomy, despite being associated with a lower complication rate and a lower overall hospital cost. On the other hand,  an exponentially growing prevalence was found with robotic colectomy, a procedure that has so far demonstrated only equivalent outcomes with laparoscopic colectomy but a higher overall cost. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Mayo Clinic / 20.12.2013

Dr. Ronald C. Petersen M.D., Ph.D. Division of Epidemiology Department of Health Sciences Research; Department of Neurology Mayo Clinic, Rochester, MNMedicalResearch.com Interview with: Dr. Ronald C. Petersen M.D., Ph.D. Division of Epidemiology Department of Health Sciences Research; Department of Neurology Mayo Clinic, Rochester, MN MedicalResearch.com: What are the main findings of the study? Dr. Petersen: The diagnosis of mild cognitive impairment increases the likelihood of developing dementia. (more…)
Author Interviews, Cost of Health Care, Education, JAMA, University of Pennsylvania / 19.12.2013

Mitesh Patel, MD, MBA RWJF Clinical Scholar, University of Pennsylvania Mitesh Patel, MD, MBA is a Robert Wood Johnson Clinical Scholar the University of Pennsylvania and primary care physician at the Philadelphia VA Medical CenterMedicalResearch.com Interview with: Mitesh Patel, MD, MBA RWJF Clinical Scholar, University of Pennsylvania Mitesh Patel, MD, MBA is a Robert Wood Johnson Clinical Scholar the University of Pennsylvania and primary care physician at the Philadelphia VA Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Patel: We evaluated survey responses from nearly 300 internal medicine residency programs directors to assess whether residency programs were teaching residents the fundamental concepts of practicing high-value, cost-conscious care.  We found that 85% of program directors feel that graduate medical education has a responsibility to help curtail the rising costs of health care.  Despite this, about 6 out of every 7 internal medicine residency programs have not yet adopted a formal curriculum teaching new physicians these important concepts. (more…)
Author Interviews, Chemotherapy, Gastrointestinal Disease, Hepatitis - Liver Disease, MD Anderson / 10.12.2013

Harrys A. Torres, MD, FACP Assistant Professor Director of Hepatitis C Clinic Department of Infectious Diseases, Infection Control and Employee Health The University of Texas MD Anderson Cancer CenterMedicalResearch.com Interview with: Harrys A. Torres, MD, FACP Assistant Professor, Director of Hepatitis C Clinic Department of Infectious Diseases, Infection Control and Employee Health The University of Texas MD Anderson Cancer Center MedicalResearch.com: What are the main findings of the study? Dr. Torres: The main findings of the study were that patients with hepatitis C virus (HCV) infection who were successfully treated with antivirals and attained sustained virologic response (SVR) did not have a relapse of HCV infection after receiving immunosuppressive chemotherapy for cancer. Patients in the study received different chemotherapeutic agents, including rituximab and systemic corticosteroids. Durability of SVR was maintained up to 14 years after chemotherapy in cancer patients. (more…)
Author Interviews, Blood Pressure - Hypertension, Compliance, JACC, Outcomes & Safety, UT Southwestern / 10.12.2013

Dr. Wanpen Vongpatanasin, MD Professor of Medicine Director, Hypertension Section Cardiology Division UT Southwestern Medical CenteMedicalResearch.com Interview with; Dr. Wanpen Vongpatanasin, MD Professor of Medicine Director, Hypertension Section, Cardiology Division UT Southwestern Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Vongpatanasin: We found that more than 50% of patients with resistant hypertension were non-adherent to at least one drug prescribed by their primary care physicians for blood pressure control. When we provided this information back to the patients, as part of care in our hypertension specialty clinic, we found that many patients report difficulty taking prescribed medications due to either associated side effects or cost of the medication. When we adjusted patient's medications to fit their needs, BP levels were substantially improved during subsequent visits without increasing the number of medications. (more…)
Author Interviews, Mayo Clinic, Menopause, Sugar / 06.12.2013

Maki Inoue-Choi, PhD, MS, RD Division of Cancer Epidemiology and Genetics, National Cancer Institute National Institute on Minority Health and Health Disparities, NIH Rockville, MD 20850MedicalResearch.com Interview with: Maki Inoue-Choi, PhD, MS, RD Division of Cancer Epidemiology and Genetics, National Cancer Institute National Institute on Minority Health and Health Disparities, NIH Rockville, MD 20850 MedicalResearch.com: What are the main findings of the study? Answer: In our study, postmenopausal women who reported higher consumption of sugar-sweetened beverages were more likely to develop estrogen-dependent type I endometrial cancer, the most common type of this cancer. (more…)
Author Interviews, Sleep Disorders, University of Pittsburgh, Weight Research / 06.12.2013

Dr G. Neil Thomas, 
Regional Director, NIHR Research Design Service West Midlands 
 Deputy Director, Master of Public Heath Programme 
Reader in Epidemiology Department of Public Health, Epidemiology and Biostatistics
 School of Health and Population Sciences
 College of Medical and Dental Sciences The University of Birmingham
 Edgbaston, Birmingham, B15 2TTMedicalResearch.com Interview with: Dr G. Neil Thomas, 
Regional Director, NIHR Research Design Service West Midlands Deputy Director, Master of Public Heath Programme 
Reader in Epidemiology Department of Public Health, Epidemiology and Biostatistics
 School of Health and Population Sciences
 College of Medical and Dental Sciences The University of Birmingham
 Edgbaston, Birmingham, B15 2TT MedicalResearch.com: What are the main findings of the study? Dr. Thomas: This population of severely obese individuals (mean BMI 47kg/m2) from a regional specialist weight management service poor sleep quality (Pittsburgh Sleep Quality Index, PSQI) and daytime sleepiness (Epworth Sleepiness Scale) were strongly associated with poorer quality of life (Impact of Quality of Life-Lite (IWQOL-Lite) (more…)
Author Interviews, Depression, Education, End of Life Care, JAMA, Stanford / 06.12.2013

J. Randall Curtis, MD, MPH Professor of Medicine Director, UW Palliative Care Center of Excellence Section Head, Pulmonary and Critical Care Medicine, Harborview Medical CenterA. Bruce Montgomery, M.D. – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine University of Washington, Seattle, WA 98104MedicalResearch.com Interview with: J. Randall Curtis, MD, MPH Professor of Medicine Director, UW Palliative Care Center of Excellence Section Head, Pulmonary and Critical Care Medicine, Harborview Medical CenterA. Bruce Montgomery, M.D. – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA 98104 MedicalResearch.com: What are the main findings of the study? Dr. Curtis: We examined the effect of a communication-skills intervention for internal medicine and nurse practitioner trainees on patient- and family-reported outcomes.  The study was funded by the National Institutes of Nursing Research of the National Institutes of Heatlh.  We conducted a randomized trial with 391 internal medicine and 81 nurse practitioner trainees at two universities.  Participants were randomized to either an 8-session simulation-based, communication-skills intervention or to usual education.  We collected outcome data from a large number of patients with life-limiting illness and their families, including 1866 patient ratings and 936 family ratings.  The primary outcome was patient-reported quality of communication and, overall, this outcome did not change with the intervention.  However, when we restricted our analyses to only patients who reported their own health status as poor, the intervention was associated with increased communication ratings. Much to our surprise, the intervention was associated with a small but significant increase in depression scores among post-intervention patients.  Overall, this study demonstrates that among internal medicine and nurse practitioner trainees, simulation-based communication training compared with usual education improved communication skills acquisition, but did not improve quality of communication about end-of-life care for all patients.  However, the intervention was associated with improved patient ratings of communication for the sickest patients. Furthermore, the intervention was associated with a small increase in patients’ depressive symptoms, and this appeared most marked among patients of the first-year residents. (more…)
Author Interviews, Education, JAMA, University of Pennsylvania / 06.12.2013

James Guevara, MD, MPH Associate Professor of Pediatrics & Epidemiology Senior Diversity Search Advisor, Perelman School of Medicine University of Pennsylvania,Director of Interdisciplinary Initiatives PolicyLab: Center to Bridge Research, Practice, & Policy The Children's Hospital of Philadelphia,Philadelphia, PA 19104MedicalResearch.com Interview with: James Guevara, MD, MPH Associate Professor of Pediatrics & Epidemiology Senior Diversity Search Advisor, Perelman School of Medicine University of Pennsylvania,Director of Interdisciplinary Initiatives PolicyLab: Center to Bridge Research, Practice, & Policy The Children's Hospital of Philadelphia,Philadelphia, PA  19104 MedicalResearch.com: What did the study attempt to address? Dr. Guevara: Medical schools have sought to build more diverse faculty in their institutions through faculty development programs targeted to underrepresented minority faculty members. This study was conduct by THE CHILDREN'S HOSPITAL OF PHILADELPHIA'S POLICYLAB  and The University of Pennsylvania and sought to determine if there was an association between minority faculty development programs and the representation, recruitment, and promotion of underrepresented minority faculty. (more…)
Author Interviews, Breast Cancer, Nutrition, Pediatrics, University of Michigan / 01.12.2013

Richard Schwartz, Ph.D. Professor, Associate Dean for Graduate Academic and Student Affairs College of Natural Science Michigan State University Department of Microbiology and Molecular Genetics Michigan State University East Lansing, MI 48824-4320MedicalResearch.com Interview with: Richard Schwartz, Ph.D. Professor, Associate Dean for Graduate Academic and Student Affairs College of Natural Science Michigan State University Department of Microbiology and Molecular Genetics Michigan State University East Lansing, MI 48824-4320 MedicalResearch.com: What are the main findings of the study? Dr. Schwartz: The main finding is that exposure to a high fat diet from the age of puberty onwards hastened the development of chemical carcinogen-induced breast cancer in absence of weight gain. We also found that prior to the appearance of any tumors, we could detect changes in the mammary gland that included increased cellular proliferation, increased vascularity, and changes in immune function. (more…)
Author Interviews, Endocrinology, Menopause, PNAS, Stanford / 28.11.2013

Dr. Victor W. Henderson MD Professor of Health Research and Policy and of Neurology and Neurological Sciences Stanford University, Stanford, CA 94305MedicalResearch.com Interview with: Dr. Victor W. Henderson MD Professor of Health Research and Policy and of Neurology and Neurological Sciences Stanford University, Stanford, CA 94305 MedicalResearch.com: What are the main findings of the study? Dr. Henderson: Estrogen or hormone therapy effects on some health outcomes differ by age, harmful at one age and beneficial at another. This difference is sometimes referred to as the “critical window” or “timing” theory. It is controversial whether the so-called critical-window applies to memory or other cognitive skills. In assessing the critical window hypothesis, we found that the relation between blood levels of estrogen and memory or reasoning skills is the same in younger postmenopausal women as in older postmenopausal women.  Essentially, there is no association at either age. (more…)
AHRQ, Author Interviews, Electronic Records, Hospital Readmissions, University of Pennsylvania / 28.11.2013

Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center for Evidence-based Practice Medical Director, Clinical Decision Support Chair, Department of Medicine Quality Committee Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center University of Pennsylvania Philadelphia, PA 19104MedicalResearch.com Interview with: Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center for Evidence-based Practice Medical Director, Clinical Decision Support Chair, Department of Medicine Quality Committee Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center University of Pennsylvania Philadelphia, PA 19104 MedicalResearch.com: What are the main findings of the study? Dr. Umscheid: We developed and successfully deployed into the electronic health record of the University of Pennsylvania Health System an automated prediction tool which identifies newly admitted patients who are at risk for readmission within 30 days of discharge.  Using local data, we found that having been admitted to the hospital two or more times in the 12 months prior to admission was the best way to predict which patients are at risk for being readmitted in the 30 days after discharge. Using this finding, our automated tool identifies patients who are “high risk” for readmission and creates a “flag” in their electronic health record (EHR). The flag appears next to the patient’s name in a column titled “readmission risk.” The flag can be double-clicked to display detailed information relevant to discharge planning.  In a one year prospective validation of the tool, we found that patients who triggered the readmission alert were subsequently readmitted 31 percent of the time. When an alert was not triggered, patients were readmitted only 11 percent of the time.  There was no evidence for an effect of the intervention on 30-day all-cause readmission rates in the 12-month period after implementation. (more…)
Author Interviews, Exercise - Fitness, Karolinski Institute / 25.11.2013

MedicalResearch.com Interview with: Elin Ekblom Bak | Doktorand Institutionen för Medicin, Enheten för klinisk epidemiologi, Karolinska universitetssjukhuset Solna 114 86 Stockholm MedicalResearch.com: What are the main findings of the study? Answer: That we, in a large sample of 60 y old men and women, found that a generally active day life (compared with an inactive daily life) was significantly associated with a better metabolic health at baseline, and a reduced risk with 27% for a first time cardiovascular event and 30% for all-cause mortality during 12.5 years of follow up. This was seen regardless of intentional exercise. Why this is important is because the focus is often of just exercise for health benefits and longevity. Exercise is still important, but, as we saw in this study, the activity that we do during the extended hours of daily living is as important and has a significant effect on cardiovascular health and longevity. These results are in a reversed way in line with the detrimental effects of prolonged sitting (regardless exercise habits) now frequently reported in an increasing amount of research studies. This is because sedentary time mainly replaces time in daily activity, and vice versa (daily activity replace time spent sitting). (more…)
Author Interviews, Autism, McGill, Pediatrics / 25.11.2013

Dr. Michael Shevell Chair of the Pediatrics Department at the McGill Faculty of Medicine and Pediatrician-in-Chief at the Montreal Children’s Hospital and the McGill University Health CentreMedicalResearch.com Interview Dr. Michael Shevell Chair of the Pediatrics Department at the McGill Faculty of Medicine and Pediatrician-in-Chief at the Montreal Children’s Hospital and the McGill University Health Centre MedicalResearch.com: What are the main findings of the study? Dr. Shevell: At risk term infants who have spent some time in a Level III NICU after birth are at substantially increased later risk for an autistic spectrum disorder. Frequently this disorder occurs in conjunction with substantial co-morbidity. (more…)
Author Interviews, Cognitive Issues, Erasmus, Statins / 25.11.2013

Prof Ype Elgersma PhD Professor, Neuroscience Neuroscience Institute, Erasmus University Rotterdam Rotterdam, NetherlandsMedicalResearch.com Interview with: Prof Ype Elgersma PhD Professor, Neuroscience Neuroscience Institute, Erasmus University Rotterdam Rotterdam, Netherlands MedicalResearch.com: What are the main findings of the study? Answer: Research in genetic mouse models suggested that inhibition of HMG-CoA-reductase by statins might ameliorate the cognitive and behavioral phenotype of children with Neurofibromatosis type 1 (NF1), an autosomal dominant disorder. In a 12-month randomized placebo-controlled study including 84 children with NF1, we found that simvastatin, an inhibitor of the HMG-CoA-reductase pathway had no effect on full-scale intelligence, attention problems or internalizing behavioral problems, or on any of the secondary outcome measures. (more…)
Author Interviews, Compliance, Connective Tissue Disease, UCSF / 25.11.2013

Dr. Jinoos Yazdany MD, MPH Assistant Professor in Residence UCSF School of MedicineMedicalResearch.com Interview with: Dr. Jinoos Yazdany MD, MPH Assistant Professor in Residence UCSF School of Medicine MedicalResearch.com: What are the main findings of the study? Answer: For almost all of the drugs we examined, we found that less than half of patients adhered to treatment.  For some drugs, less than one-third of individuals were adherent. The average medication possession ratios were low across all drugs. We found that several factors played an important part in adherence.  Younger individuals were less likely to adhere to treatment for several drugs, and we also found racial/ethnic differences, with Black, Hispanic and Native populations having lower adherence.  We also found geographic variation in adherence, with individuals in the Northeast being the most likely to adhere to treatment. (more…)
Author Interviews, Blood Clots, Case Western, Cleveland Clinic, JAMA / 24.11.2013

Ilke Sipahi, MD Department of Cardiology Acibadem University Medical School, Istanbul, Turkey Harrington Heart and Vascular Institute, University Hospitals Case Medical Cente Case Western Reserve University School of Medicine, Cleveland, OhioMedicalResearch.com Interview with: Ilke Sipahi, MD Department of Cardiology Acibadem University Medical School, Istanbul, Turkey Harrington Heart and Vascular Institute, University Hospitals Case Medical Cente, Case Western Reserve University School of Medicine, Cleveland, Ohio MedicalResearch.com: Were you surprised at the extreme difference between these 2 analyses? Answer: I was surprised. However, it is not unusual to find completely contradictory results in medical studies. I was more surprised at the fact that FDA paid more attention to it administrative observational dataset rather than the huge large randomized clinical trials, all showing excess GI bleeds with dabigatran (Pradaxa). Anyone who is even slightly familiar with the medical literature knows that randomized trials are the gold standard in medical studies. (more…)