Author Interviews, JAMA, Outcomes & Safety, Surgical Research, University of Michigan / 15.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50705" align="alignleft" width="160"]Kyle Sheetz, MD, MSc Research Fellow Center for Healthcare Outcomes and Policy University of Michigan Dr. Sheetz[/caption] Kyle Sheetz, MD, MSc Research Fellow Center for Healthcare Outcomes and Policy University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Various patient safety organizations and clinical societies continue to advocate for volume thresholds as a means to improve the short-term safety and overall effectiveness of high risk cancer surgeries in the United States. We asked two questions with this study: 1) What proportion of U.S. hospitals meet discretionary volume standards? 2) Do these standards differentiate hospitals based on short-term safety outcomes (mortality and complications)? We found that a relatively low proportion of hospitals meet even modest volume standards put forth by the Leapfrog Group. These standards did not differentiate hospitals based on outcomes for 3 of 4 high risk cancer operations reported by the Leapfrog Group. However, using higher thresholds, we were able to demonstrate a significant relationship between higher hospital volume and better outcomes, which has been reported numerous times.
Author Interviews, HIV, University of Michigan / 15.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50266" align="alignleft" width="200"]Rogério Meireles Pinto, LCSW, Ph.D. Professor and Associate Dean for Research University of Michigan School of Social Work  Dr. Pinto[/caption] Rogério Meireles Pinto, LCSW, Ph.D. Professor and Associate Dean for Research University of Michigan School of Social Work MedicalResearch.com: What is the background for this study? Response: In order to decrease the rate of HIV infection, interventions to scale up PrEP will need to address identified barriers at multiple ecological levels. In the past decade, interventions proposed to address PrEP implementation barriers were limited to one ecological level or another (e.g., individual or community). The failure to consider interventions targeting multiple ecological levels simultaneously may help explain why PrEP implementation is lagging. This failure is also due to methodological limitations of PrEP implementation studies.This high-quality paper presents a thorough and theoretically grounded review of original research on HIV Pre-Exposure Prophylaxis (PrEP) implementation in the U.S.
Annals Internal Medicine, Author Interviews, Infections, University of Michigan / 09.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50132" align="alignleft" width="125"]Valerie M. Vaughn, MD MSc Assistant Professor of Medicine and Research Scientist, Division of Hospital Medicine The Patient Safety Enhancement Program and Center for Clinical Management Research Michigan Medicine and the Ann Arbor VA Medical Center Dr. Vaughn[/caption] Valerie M. Vaughn, MD MSc Assistant Professor of Medicine and Research Scientist, Division of Hospital Medicine The Patient Safety Enhancement Program and Center for Clinical Management Research Michigan Medicine and the Ann Arbor VA Medical Center  MedicalResearch.com: What is the background for this study? Response: Pneumonia is one of the top causes for hospitalization and one of the main reasons for antibiotic use in US hospitals. In the past decade, studies have suggested that patients can be safely treated with short course antibiotic therapy instead of the prolonged courses we used to prescribe. Our study looked at prescribing practices in 43 hospitals across the state of Michigan to see if we were appropriately prescribing short course therapy, and if so, how that affected patients.
Addiction, Author Interviews, JAMA, Opiods, University of Michigan / 30.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49992" align="alignleft" width="135"]Rebecca L. Haffajee, J.D., Ph.D., M.P.H. Assistant Professor Department of Health Management & Policy University of Michigan School of Public Health Dr. Haffajee[/caption] Rebecca L. Haffajee, J.D., Ph.D., M.P.H. Assistant Professor Department of Health Management & Policy umichsphumichsph MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Evidence suggests that the availability of medications to treat opioid use disorder (OUD) has been slow to expand, particularly in rural areas, despite the efficacy and effectiveness of these medications in reducing overdose deaths and other adverse life outcomes. We were interested in understanding the characteristics of counties both with high need (as measured by above-national rates in opioid overdose deaths) AND low provider capacity to deliver medications to treat OUD in 2017. We found that such "opioid high-risk" counties were likely to be in the East North Central (e.g., Michigan, Ohio, Illinois, Indiana), South Atlantic (e.g., North Carolina, South Carolina, Virginia, West Virginia), and Mountain (e.g., New Mexico, Arizona, Nevada) regions. We also found that these opioid high-risk counties were more likely to have higher rates of unemployment and less likely to have fewer primary care clinicians or be micropolitan
Author Interviews, Geriatrics, JAMA, Ophthalmology, University of Michigan / 21.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49831" align="alignleft" width="144"]Joshua R. Ehrlich, MD, MPH Assistant Professor, Ophthalmology and Visual Sciences Kellogg Eye Center Department of Ophthalmology and Visual Sciences University of Michigan Dr. Ehrlich[/caption] Joshua R. Ehrlich, MD, MPH Assistant Professor, Ophthalmology and Visual Sciences Kellogg Eye Center Department of Ophthalmology and Visual Sciences University of Michigan  MedicalResearch.com: What is the background for this study?   Response: This study came out of data collected as part of the National Poll on Healthy Aging (NPHA). The NPHA is funded by AARP and the Institute for Healthcare Policy and Innovation at the University of Michigan to inform the public, healthcare providers, and policymakers on a variety issues related to health. The vision survey, conducted in March 2018, was just one of many NPHA surveys. Due to aging of the population, the number of older U.S. adults with blindness and vision impairment is expected to double over the next 30 years. Thus, this study was designed to provide crucial data  on contemporary data on patterns of eye care utilization in older adults.
Accidents & Violence, Author Interviews, Cost of Health Care, JAMA, Surgical Research, University of Michigan / 05.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49606" align="alignleft" width="156"]Dr. Mark R. Hemmila MD Associate Professor of Surgery Division of Acute Care Surgery University of Michigan Dr. Hemmila[/caption] Dr. Mark R. Hemmila MD Associate Professor of Surgery Division of Acute Care Surgery University of Michigan  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Traumatic injury has a tendency to be thought of as a disease that preferentially impacts younger people.  We wanted to explore the prevalence and impact of traumatic injury within the population of patients for whom Medicare is the third party payer. 
Author Interviews, JAMA, Opiods, Primary Care, University of Michigan / 11.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49122" align="alignleft" width="140"]Kao-Ping Chua, M.D., Ph.D.Department of PediatricsSusan B. Meister Child Health Evaluation and Research CenterUniversity of Michigan, Ann Arbor Dr. Kao-Ping Chua[/caption] Kao-Ping Chua, M.D., Ph.D. Department of Pediatrics Susan B. Meister Child Health Evaluation and Research Center University of Michigan, Ann Arbor MedicalResearch.com: What is the background for this study?   Response: Doctor and pharmacy shopping is a high-risk behavior in which patients obtain opioid prescriptions from multiple prescribers and fill them at multiple pharmacies. Because this behavior is associated with a high risk of overdose death, there have been many efforts to help clinicians detect doctor and pharmacy shopping among patients prescribed opioids. For example, 49 states have a prescription drug monitoring program that provides information on patients’ prior controlled substance prescriptions. In contrast, there has been little attention to the possibility that patients prescribed opioids may have family members who are engaged in opioid doctor and pharmacy shopping. Such family members may divert opioids prescribed to patients because of their access to these opioids.
AACR, Author Interviews, Cancer Research, HPV, University of Michigan, Vaccine Studies / 05.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48381" align="alignleft" width="157"]Diane Harper, M.D., M.P.H., M.S.Professor of Family Medicine and Obstetrics and GynecologySenior Associate Director, Michigan Institute for Clinical and Health ResearchPhysician Director for Community Outreach, Engagement and Health Disparities,Rogel Cancer CenterMichigan Medicine Dr. Harper[/caption] Diane Harper, M.D., M.P.H., M.S. Professor of Family Medicine and Obstetrics and Gynecology Senior Associate Director, Michigan Institute for Clinical and Health Research Physician Director for Community Outreach, Engagement and Health Disparities, Rogel Cancer Center Michigan Medicine  MedicalResearch.com: What is the background for this study? Response: There is no current cure for women with HPV infection that has progressed to CIN 2/3 disease. The only treatment is for the diseased cervix, and does not eliminate the risk of another CIN 2/3 from the HPV infection 15-20 years later. This vaccine is made from a live virus that has 3 genes inserted:  human cytokine IL-2, and modified forms of HPV 16 E6 and E7 proteins. When the vaccine is injected subcutaneously, the proteins for HPV 16/E6 and E7 and the cytokine LI-2 proteins are made. These proteins trigger the immune response.  This is very different form imiquimod which is topical and not specific for HPV.
Author Interviews, Flu - Influenza, Infections, PLoS, University of Michigan / 25.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47142" align="alignleft" width="135"]Betsy Foxman PhD Hunein F. and Hilda Maassab Endowed Professor of Epidemiology Director, Center for Molecular and Clinical Epidemiology of Infectious Diseases Ann Arbor, Michigan 48109-2029 Dr. Foxman[/caption] Betsy Foxman PhD Hunein F. and Hilda Maassab Endowed Professor of Epidemiology Director, Center for Molecular and Clinical Epidemiology of Infectious Diseases Ann Arbor, Michigan 48109-2029 MedicalResearch.com: What is the background for this study? Response: Influenza is a major cause of human illness and death worldwide. Vaccines are the best available means of prevention. However, vaccine effectiveness has been low to moderate in recent years and coverage remains low in many countries. There is increasing evidence suggesting the microbiome plays an important role in shaping host immunity and may be a potential target for reducing disease. In our study, we used a household transmission study to explore whether the respiratory microbiome was associated with influenza susceptibility. 
Author Interviews, Cannabis, University of Michigan / 17.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46988" align="alignleft" width="175"]Daniel J. Kruger, PhD Research Assistant Professor University of Michigan Dr. Kruger[/caption] Daniel J. Kruger, PhD Research Assistant Professor University of Michigan MedicalResearch.com: What is the background for this study? Response: We study health-related behaviors, such as diet and the consumption of caffeine and alcohol. Given the recent trends in legalization of cannabis for medical and even recreational purposes, we were concerned with the narrow focus of current public health efforts regarding cannabis. Although some in the field take a harm-reduction approach to substance use, too many efforts focus solely on abstinence. These programs are a legacy from the era of prohibition, and we know that there are disadvantages to such a restricted scope in public health. For example, municipalities that eliminated or blocked accurate and effective sex education had increases in teenage pregnancy rates. There are so many public health-related aspects of cannabis, beyond risks and adverse effects, which need to be addressed by systematic scientific research. Because of the legal history of cannabis, there is little integration with the mainstream health care system. The focus of the current study was investigating how medical cannabis users perceived medical cannabis in comparison to pharmaceutical drugs and other aspects of the mainstream health care system and how they navigated they relationships between these currently separate systems
Author Interviews, NEJM, Pediatrics, Smoking, Tobacco, Tobacco Research, University of Michigan / 30.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46749" align="alignleft" width="159"]Richard Miech Ph.D Professor Principal Investigator, Monitoring the Future Institute for Social Research University of Michigan Dr. Miech[/caption] Richard Miech Ph.D Professor Principal Investigator, Monitoring the Future Institute for Social Research University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Every year Monitoring the Future conducts a survey to examine trends in adolescent substance use.  We draw a random sample of schools from a list of all schools in the United States and conduct our survey in ~400 schools.  Our survey is representative of U.S. 8th, 10th, and 12th grade students.  In other words, our results are what you would find if you surveyed every single 8th, 10th, and 12th graders in the United States, within the bounds of a small sampling error of a few percentage points. An increase in vaping is the big news for 2018.  In 10th and 12th grade the increase in nicotine vaping was the largest we've ever seen for any substance in the past 43 years.  As a result of this increase in nicotine vaping, overall use of nicotine increased as well, which suggests that vaping is drawing youth into nicotine use.  We also saw a significant increase in marijuana vaping.
Author Interviews, Cost of Health Care, JAMA, University of Michigan / 17.11.2018

MedicalResearch.com Interview with: Renuka Tipirneni, MD, MSc Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine, Divisions of General Medicine and Hospital Medicine, and Institute for Healthcare Policy & Innovation Ann Arbor, MI 48109Renuka Tipirneni, MD, MSc Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine Divisions of General Medicine and Hospital Medicine, and Institute for Healthcare Policy & Innovation Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Navigating health insurance and health care choices is challenging and requires significant health insurance literacy (knowledge and application of health insurance concepts). We looked at the association between U.S. adults' health insurance literacy and avoidance of health care services due to perceived cost. We found that 30% of people we surveyed reported delayed or foregone care because of perceived cost, and that those with lower health insurance literacy reported significantly greater avoidance of both preventive and nonpreventive health care services.
Author Interviews, JAMA, Opiods, Surgical Research, University of Michigan / 07.11.2018

MedicalResearch.com Interview with: Joceline Vu, MD Resident, PGY-5 Department of Surgery University of Michigan  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study examined how much opioid patients use after surgery, and looked at factors that might predispose some patients to use more or less. Patient opioid use after surgery is an interesting question that’s gained a lot of attention recently, because it’s different from other uses for opioids. If you have chronic pain, you’re probably going to use all of your prescription. But if you have surgery, you may not take all of your pills, and this leaves people with leftover pills that can be dangerous later. From this study, we found that patients only use, on average, about quarter of their prescription, meaning that a lot of them are left with leftover pills. Moreover, we found that the biggest determinant of how much they used wasn’t how much pain they reported, or any other factor—it was how big their original prescription was. What this means is that opioid use after surgery isn’t just determined by pain, but also by what surgeons prescribe. It’s important to keep this in mind as we try to reduce unnecessary opioid prescribing after surgical procedures. 
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Toxin Research, University of Michigan / 26.10.2018

MedicalResearch.com Interview with: [caption id="attachment_45491" align="alignleft" width="132"]Sung Kyun Park Sc.D. M.P.H. Associate professor of epidemiology and environmental health sciences University of Michigan School of Public Health, Ann Arbor, Michiga Dr. Park[/caption] Sung Kyun Park Sc.D. M.P.H. Associate professor of epidemiology and environmental health sciences University of Michigan School of Public Health Ann Arbor, Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is poorly understood that why some patients need more drugs to control high blood pressure than others. Resistant hypertension is that blood pressure is not controlled with 3 medications of different classes including diuretics or is required 4 or more medications of different classes for blood pressure controls. Genes, obesity, physical inactivity, high salt diet, pain medications may do something. Lead is a widespread environmental toxin that can influence high blood pressure. In this study, we examined whether long-term exposure to lead, measured as bone lead, is associated with the risk of resistant hypertension. Bone lead offers a better method over blood lead measurement to discern long-term lead exposure and accumulation. The main finding of our study is that low-level lead exposure, measured in the tibia (hard bone), is associated with higher risk of development of resistant hypertension in a cohort of patients diagnosed with hypertension. 
ADHD, Author Interviews, Psychological Science, University of Michigan / 11.10.2018

MedicalResearch.com Interview with: [caption id="attachment_45226" align="alignleft" width="128"]Holly White, PhD Research Scientist Basic and Applied Cognition Laboratory Department of Psychology University of Michigan Dr. White[/caption] Holly White, PhD Research Scientist Basic and Applied Cognition Laboratory Department of Psychology University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was inspired by my previous findings of higher originality and creative achievement among adults with ADHD, as well as my personal observations of individuals with ADHD choosing non-traditional approaches to problem solving. College students with ADHD sometimes ignore task instructions and examples, and while this may lead to errors, it may also lead to extraordinarily unique answers and solutions. I was curious as to whether this tendency of ADHD individuals to think in an unconventional and expansive manner might lead to resistance to conformity during creative tasks. In the present study, college students with ADHD were less likely to copy experimenter-provided task examples, compared to non-ADHD peers, on a product label invention task. ADHD participants were also less likely to create imaginary fruits that resembled typical Earth fruit, compared to non-ADHD participants. Students with ADHD were less likely to conform to pre-existing prototypes of fruit and therefore invented more original creations. Individuals with ADHD may be more flexible in tasks which require creating something new, and less likely to rely on examples and previous knowledge. As a result, the creative products of individuals with ADHD may be more innovative, relative to creations of non-ADHD peers. 
Author Interviews, JAMA, Ophthalmology, Primary Care, University of Michigan / 11.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44400" align="alignleft" width="142"]Joshua Ehrlich, MD, MPH Assistant Professor of Ophthalmology and Visual Sciences University of Michigan Dr. Ehrlich[/caption] Joshua Ehrlich, MD, MPH Assistant Professor of Ophthalmology and Visual Sciences University of Michigan  MedicalResearch.com: --Describe the “important role” that primary care providers play in promoting eye health? Response: Primary care is the entryway into the health system for many individuals. The poll suggests that when primary care providers discuss vision with their patients, they are more likely to get eye exams. It also suggests that primary care providers are having these conversations most often with those who have certain risk factors for eye disease, such as diabetes or a family history of vision problems, as well as those with fewer economic resources. Promoting these kinds of conversations could bolster this trend, increasing the number of diabetics and other high risk individuals who get appropriate eye care.
Addiction, Author Interviews, JAMA, Mental Health Research, University of Michigan / 10.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44382" align="alignleft" width="133"]Lauren B. Gerlach, D.O. Clinical Lecturer Department of Psychiatry University of Michigan Dr. Gerlach[/caption] Lauren B. Gerlach, D.O. Clinical Lecturer Department of Psychiatry University of Michigan MedicalResearch.com: What is the background for this study?  Response: In this study we used data from the Supporting Seniors Receiving Treatment and Intervention or SUSTAIN program. The program provides a supplement to a Pennsylvania medication coverage program for low-income older adults. It provides behavioral health and case management services by phone across the state. This included detailed interviews to screen for mental health issues including anxiety, depression, sleep issues, and pain, as well as analysis of prescription records and other clinical data. Among older adults prescribed a new benzodiazepine prescription by a non-psychiatric provider, we determined how many then went on to long-term use of the medication and what patient and clinical characteristics predicted long-term use over the following year.
Author Interviews, Compliance, Cost of Health Care, University of Michigan / 05.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43725" align="alignleft" width="135"]A. Mark Fendrick, M.D. Professor, Division of General Medicine, Department of Internal Medicine and Department of Health Management and Policy Director, University of Michigan Center for Value-Based Insurance Design Ann Arbor, Michigan 48109-2800 Dr. Fendrick[/caption] A. Mark Fendrick, M.D. Professor, Division of General Medicine, Department of Internal Medicine and Department of Health Management and Policy Director, University of Michigan Center for Value-Based Insurance Design Ann Arbor, Michigan 48109-2800 MedicalResearch.com: What is the background for this study? What are the main findings? Response: As Americans are being asked to pay more for the medical care, in terms of copayments and deductibles, one in four Americans reports having difficulty paying for their prescription drugs. One potential solution is “value-based insurance design,” or V-BID. V-BID, is built on the principle of lowering or removing financial barriers to essential, high-value clinical services. V-BID plans align patients’ out-of-pocket costs, such as copayments and deductibles, with the value of services to the patient. They are designed with the tenet of “clinical nuance” in mind— in that the clinical benefit derived from a specific service depends on the consumer using it, as well as when, where, and by whom the service is provided. According to a literature review published in the July 2018 issue of Health Affairs,  The researchers found that value-based insurance design programs which reduced consumer cost-sharing for clinically indicated medications resulted in increased adherence at no change in total spending. In other words, decreasing consumer cost-sharing meant better medication adherence for the same total cost to the insurer.
Author Interviews, CDC, HIV, University of Michigan / 26.06.2018

MedicalResearch.com Interview with: [caption id="attachment_42366" align="alignleft" width="200"]Rogério M. Pinto, LCSW, Ph.D. Associate Professor Associate Dean for Research School of Social Work University of Michigan Ann Arbor, USA Dr. Pinto[/caption] Rogério M. Pinto, LCSW, Ph.D. Associate Professor Associate Dean for Research School of Social Work University of Michigan Ann Arbor, Michigan MedicalResearch.com: What is the background for this study? Response: This research, published in Health Education & Behavior (https://doi.org/10.1177/1090198118760681),highlights the crucial role of providers of social and public health services in helping patients to access lifesaving HIV services. Before 2012, providers were encouraged and trained to link patients to behavioral interventions to help patients modify their behaviors to protect themselves against HIV transmission and infection. A shift in policy from targeting anyone at risk to those at highest risk (called “High Impact Prevention”) made these interventions less available (they were actually discontinued) and new policy dictated that providers should have as many people as possible access HIV testing and link them to HIV primary care in order to receive antiretroviral medication.
Author Interviews, HIV, University of Michigan / 13.06.2018

MedicalResearch.com Interview with: [caption id="attachment_42366" align="alignleft" width="200"]Rogério M. Pinto, LCSW, Ph.D. Associate Professor Associate Dean for Research School of Social Work University of Michigan Ann Arbor, USA Dr. Pinto[/caption] Rogério M. Pinto, LCSW, Ph.D. Associate Professor Associate Dean for Research School of Social Work University of Michigan Ann Arbor, USA MedicalResearch.com: What is the background for this study? Response: This integrative review, published in the journal AIDS and Behavior, includes content from 47 peer-reviewed scholarly articles reporting multiple barriers to high-risk individuals trying to access pre-exposure prophylaxis (PrEP), the HIV drugs that reduce subsequent risk of infection. We found 31 potential solutions to 30 barriers at the patient, provider and health-system levels. In synthesizing this research from a multi-level perspective, based upon a socioecological model, our report contributes much-needed analysis to the rapidly expanding field of PrEP implementation research. At this stage in the scale-up of U.S. PrEP programs, it is important to systematically and comprehensively analyze and integrate knowledge about the successes of and the barriers to PrEP implementation. Our review provides a comprehensive analysis and informs the direction of PrEP implementation across a variety of settings.
Author Interviews, JAMA, Thromboembolism, University of Michigan / 31.05.2018

MedicalResearch.com Interview with: Paul Grant, MD [caption id="attachment_41858" align="alignleft" width="125"]Associate Professor of Medicine Associate Chief Medical Information Officer Director, Perioperative and Consultative Medicine Division of Hospital Medicine Department of Internal Medicine Michigan Medicine University of Michigan Dr. Grant[/caption] Associate Professor of Medicine Associate Chief Medical Information Officer Director, Perioperative and Consultative Medicine Division of Hospital Medicine Department of Internal Medicine Michigan Medicine University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that hospitalized medical patients are at risk for venous thromboembolism VTE, but the severity of patient risk can vary significantly. National guidelines have consistently stated that low-risk patients should not receive VTE prophylaxis beyond early ambulation. In this retrospective cohort study, we analyzed data from 52 hospitals participating in the Michigan Hospital Medicine Safety consortium. Trained medical record abstractors at each hospital collected data from 44,775 medical patients including VTE risk factors, type of VTE prophylaxis administered, and contraindications to pharmacologic prophylaxis. Individual patient risk of VTE was determined using the Padua risk assessment model. Of the 32,549 low-risk patients, 77.9% received excess venous thromboembolism prophylaxis as either pharmacologic prophylaxis (30.6%), mechanical prophylaxis (20.8%), or both (26.5%). In the 12,226 high-risk patients, VTE prophylaxis was underused in 22% of patients. The rates of inappropriate prophylaxis varied considerably by hospital. 
Author Interviews, Biomarkers, Breast Cancer, Technology, University of Michigan / 16.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41768" align="alignleft" width="200"]Greg Thurber, PhD Assistant Professor Department of Chemical Engineering Assistant Professor Department of Biomedical Engineering University of Michigan  Dr. Thurber[/caption] Greg Thurber, PhD Assistant Professor Department of Chemical Engineering Assistant Professor Department of Biomedical Engineering University of Michigan  MedicalResearch.com: What is the background for this study? Response: Most current disease screening strategies rely on either blood tests, where the physician can obtain information on specific disease molecules but has no idea where they originated in the body, or anatomical imaging, where the physician can see changes in the structure of tissues but doesn’t have any molecular information. We wanted to develop a method that could provide both molecular information and an image of where these molecules were located. We know from decades of research in cancer that this is a molecular disease, so providing molecular information to the physician will help improve detection and diagnosis. Breast cancer screening provides an excellent opportunity to apply this approach to improve detection. Currently, estimates indicate that we are overspending $4 billion per year on the overdiagnosis and overtreatment of breast cancer because we cannot accurately determine which patients need treatment and which can be safely monitored with no intervention. Despite this problem with overdiagnosis, however, screening saves lives…we simply need a better way. Molecular imaging has the capability of providing both molecular information and the location within the body. However, most of these techniques are expensive and use ionizing radiation, meaning there is a small risk of actually causing cancer. This is not acceptable for screening large numbers of otherwise healthy patients. To avoid this risk and provide a safe, inexpensive, and relatively easy method for patients to undergo screening, we decided to develop near-infrared fluorescent imaging agents that can be taken as a pill. The goal is for the patient to simply take a pill a day or two before their visit, and then the physician shines near-infrared light on the breast tissue to detect tumors where they ‘light up’ by giving off a different color of light.
Author Interviews, Opiods, Race/Ethnic Diversity, University of Michigan / 03.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41477" align="alignleft" width="160"]Matthew A. Davis, MPH, PhD Assistant Professor Department of Systems, Populations and Leadership University of Michigan Dr. Davis[/caption] Matthew A. Davis, MPH, PhD Assistant Professor Department of Systems, Populations and Leadership University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: The premise for the study was based on prior work that demonstrated that the likelihood of being prescribed an opioid differs according to a patient’s race and ethnicity.  Collectively this work has shown that Non-Hispanic Whites are more likely to receive opioids than other groups for pain. We decided to look at trends in the prescribing of different pain medications over the last 16 years to see if we could detect any differences in prescribing patterns among racial and ethnic groups.  To do so we used national health data for a large sample of Americans who live with significant pain.
Author Interviews, Heart Disease, JACC, Outcomes & Safety, Surgical Research, University of Michigan / 12.04.2018

MedicalResearch.com Interview with: [caption id="attachment_41141" align="alignleft" width="149"]Donald Likosky, Ph.D., M.S. Associate Professor Head of the Section of Health Services Research and Quality Department of Cardiac Surgery. University of Michigan Dr. Likosky[/caption] Donald Likosky, Ph.D., M.S. Associate Professor Head of the Section of Health Services Research and Quality Department of Cardiac Surgery. University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Michigan was one of several states to expand Medicaid. Current evaluations of the Michigan Medicaid expansion program have noted increases in primary care services and health risk assessments, but less work has evaluated its role within a specialty service line. There has been concern among some that Medicaid patients, who have traditionally lacked access to preventive services, may be at high risk for poor clinical outcomes if provided increased access to cardiovascular interventions. Using data from two physician-led quality collaboratives, we evaluated the volume and outcomes of percutaneous coronary interventions and coronary artery bypass grafting 24mos before and 24mos after expansion. We noted large-scale increased access to both percutaneous coronary interventions (44.5% increase) and coronary artery bypass grafting (103.8% increase) among patients with Medicaid insurance. There was a decrease in access for patients with private insurance in both cohorts. Nonetheless, outcomes (clinical and resource utilization) were not adversely impacted by expansion. 
Author Interviews, JAMA, Ophthalmology, University of Michigan / 16.03.2018

MedicalResearch.com Interview with: [caption id="attachment_40613" align="alignleft" width="125"]Maria A. Woodward, MD, MSc Department of Ophthalmology and Visual Sciences W. K. Kellogg Eye Center Institute for Healthcare Policy and Innovation University of Michigan Ann Arbor, MI Dr. Woodward[/caption] Maria A. Woodward, MD, MSc Department of Ophthalmology and Visual Sciences W. K. Kellogg Eye Center Institute for Healthcare Policy and Innovation University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Many people go to emergency departments seeking care for their eye problems. We wished to investigate which factors are associated with the involvement of ophthalmologist consultants in the care of these patients and whether any disparities exist. 
Author Interviews, JAMA, University of Michigan, Urinary Tract Infections / 12.03.2018

MedicalResearch.com Interview with: [caption id="attachment_40520" align="alignleft" width="148"]Keith S. Kaye, MD, MPH Professor of Medicine, Division of Infectious Diseases University of Michigan Medical School Ann Arbor MI  Dr. Kaye[/caption] Keith SKayeMD, MPH Professor of Medicine, Division of Infectious Diseases University of Michigan Medical School Ann Arbor MI  MedicalResearch.com: What is the background for this study? Response: Complicated complicated urinary tract infections (cUTI), including acute pyelonephritis, are a major cause of hospital admissions, and are associated with significant morbidity and mortality and can be difficult to treat. While the most common pathogen is Escherichia coli, the more problematic pathogens are multidrug-resistant (MDR) gram-negative organisms including other Enterobacteriaceae species. The prevalence of cUTI due to MDR gram-negative bacteria has risen. In some instances, MDR gram-negative bacteria isolated from the urinary tract can cause bacteremia. Vabomere was approved by the U.S. Food and Drug Administration (FDA) in August 2017 for the treatment of adult patients with cUTI, including pyelonephritis, caused by designated susceptible Enterobacteriaceae: Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae species complex.   Vabomere is a fixed-dose (2g/2g) combination product of a carbapenem and a β-lactamase inhibitor with potent in vitro activity against Klebsiella pneumoniae carbapenemase (KPC)-producing carbapenem-resistant Enterobacteriaceae (CRE), an important MDR organism associated with serious infections. The Targeting Antibiotic Non-susceptible Gram-negative Organisms (TANGO I) trial was the pivotal Phase 3 study that compared the efficacy and safety of Vabomere to piperacillin-tazobactam in the treatment of patients with cUTI and acute pyelonephritis.
Author Interviews, Salt-Sodium, University of Michigan / 23.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37686" align="alignleft" width="101"]Julia Wolfson, PhD MPP Assistant Professor Department of Health Management and Policy Department of Nutritional Sciences University of Michigan School of Public Health Ann Arbor, MI 48109 Dr. Wolfson[/caption] Julia Wolfson, PhD MPP Assistant Professor Department of Health Management and Policy Department of Nutritional Sciences University of Michigan School of Public Health Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Over the past several years, Large chain restaurants in the United States have made some progress in introducing new lower calorie items on their menus. Since 2012, calories of items consistently on restaurant menus in all years have not significantly change. In this study, we examined the sodium content of restaurant menu items among 66 of the 100 largest restaurants in the US. We examined sodium content among items on the menu in all years (2012-2016) and among newly introduced items in 2013, 2014, 2015 and 2016 compared to items on the menu in 2012 only. We found that sodium content of menu items on the menu in all years did not change, but that restaurants were introducing new, lower sodium menu items. However, sodium content of restaurant menu items remains high. This is important because diets high in sodium are associated with serious adverse health outcomes including hypertension, stroke and cardiovascular disease.
Author Interviews, Gastrointestinal Disease, Pharmaceutical Companies, University of Michigan / 23.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37675" align="alignleft" width="106"]William D. Chey Dr. Chey[/caption] William D. Chey, M.D., F.A.C.G. Timothy T. Nostrant Professor of Gastroenterology & Nutrition Director, Digestive Disorders Nutrition & Lifestyle Program Michigan Medicine Ann Arbor, Michigan  MedicalResearch.com: What is the background for this study? Response: Functional Dyspepsia (FD) has been characterized as recurring indigestion with no known organic cause and is an area of high unmet medical need. This medical condition, which is non-life threatening, can have a significant impact on an individual’s quality of life. It remains poorly recognized and presents a significant management challenge for providers and patients. Gastrointestinal symptoms can include epigastric pain or discomfort, inability to finish a normal-sized meal, heaviness, pressure, nausea, bloating and belching. Currently, there are no FDA-approved drugs for FD. Off-label medications are used to treat the condition and patient dissatisfaction remains high.[1] In a real-world, observational study, called FDACT™ (Functional Dyspepsia Adherence and Compliance Trial), we analyzed information on the frequency of FD symptoms, daily consumption of capsules, onset of action, improvement in FD symptoms, quality of life and patient satisfaction among 600 patients who took FDgard®, a nonprescription medical food specially formulated for the dietary management of FD.
Author Interviews, Education, Pediatrics, Sleep Disorders, University of Michigan / 22.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36583" align="alignleft" width="180"]Galit Dunietz, Ph.D., MPH Doctor of Philosophy Department of Neurology University of Michigan  Ann Arbor MI Dr. Dunietz[/caption] Galit Dunietz, Ph.D., MPH Epidemiologist, Sleep Disorders Center Department of Neurology University of Michigan Ann Arbor MI MedicalResearch.com: What is the background for this study? What are the main findings? Response: Insufficient sleep has a negative impact on health, cognition and mood and is linked to motor vehicle accidents. However, sleep loss in adolescents has become an epidemic and arises in part from biological processes that delay sleep and wake timing at the onset of puberty. This biology does not fit well with early school start times (before 8:30 a.m.). Despite recommendations from the American Academy of Pediatrics and the American Academy of Sleep Medicine to delay school start times, most schools in the U.S. have current start times before 8:30 a.m. In this nationally representative study of US parents of teens, we examined whether parents supported or opposed later school start times (after 8:30 a.m.). We also examined what may have influenced their opinions. We found that only about half of surveyed parents of teens with early school start times supported later school start times. Opinions appeared to depend in part on what challenges and benefits were expected to result from the change. For example, parents who expected an improvement in their teen’s academic performance or sleep quantity tended to support the change, whereas parents that expected negative impact on afterschool activities or transportation opposed delays in school start times.  We also found that parents had misconception about sleep needs of their adolescents, as the majority perceived 7-7.5 hours of sleep as sufficient, or possibly sufficient even at this young age when 8-10 hours are typically recommended.