Author Interviews, Cost of Health Care, JAMA, Kidney Disease, UCSF / 27.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46717" align="alignleft" width="155"]Oanh Kieu Nguyen, MD, MA Assistant Professor Division of Hospital Medicine Zuckerberg San Francisco General Hospital UCSF Dr. Nguyen[/caption] Oanh Kieu Nguyen, MD, MA Assistant Professor Division of Hospital Medicine Zuckerberg San Francisco General Hospital UCSF MedicalResearch.com: What is the background for this study? Response: In U.S. citizens and permanent residents with kidney failure or end-stage renal disease (ESRD), having health insurance, Medicare, or Medicaid guarantees access to regularly scheduled hemodialysis 2-3 times per week, the evidence-based standard of care for ESRD. This treatment helps people live relatively normal lives. In 40 of 50 U.S. states, undocumented immigrants with ESRD have limited access to hemodialysis because they are not eligible for any form of federal assistance including Medicare or Medicaid, and must wait until they are life-threateningly ill to receive dialysis through a hospital emergency department, a situation called “emergency-only hemodialysis.” There are an estimated 6,500 undocumented individuals in the U.S. suffering from ESRD. A unique opportunity made it feasible for uninsured undocumented immigrants with ESRD receiving emergency-only dialysis in Dallas, Texas, to enroll in private, commercial health insurance plans in 2015 and made it possible for researchers to compare scheduled vs. emergency-only dialysis among undocumented immigrants with ESRD. This natural experiment included 181 undocumented immigrants, 105 of whom received insurance coverage and enrolled in scheduled dialysis and 76 of whom remained uninsured. 
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, Stanford / 26.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46704" align="alignleft" width="200"]Fatima Rodriguez, MD, MPH, FACC Assistant Professor Cardiovascular Medicine Stanford University School of Medicine Dr. Rodriguez[/caption] Fatima Rodriguez, MD, MPH, FACC Assistant Professor Cardiovascular Medicine Stanford University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The “Hispanic Paradox” is an idea based on some epidemiological observations that Hispanics have lower disease prevalence and mortality (across a wide spectrum of disease states), despite adverse risk profiles and lower socioeconomic status than their non-Hispanic white counterparts. Our study is unique in that it includes a Hispanic population with overall high educational attainment followed longitudinally. In contrast to prior work in this area, we found no evidence in support of the Hispanic paradox for estimated atherosclerotic cardiovascular disease risk, atherosclerotic disease (as measured by CAC), or overall mortality.
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA / 26.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46701" align="alignleft" width="200"]Dr. Jianguo Xu, MD West China Hospital, Sichuan University Chengdu, Sichuan, China West China Hospital Sichuan University[/caption] Dr. Jianguo Xu, MD West China Hospital, Sichuan University Chengdu, Sichuan, China MedicalResearch.com: What is the background for this study? Response: Since the mid-20th century, corticosteroids have been used as adjuvant therapy in the context of sepsis. Although evaluated in numerous randomized clinical trials and meta-analyses, both the safety and efficacy of corticosteroids remain controversial.
Accidents & Violence, Author Interviews, JAMA, Sexual Health, UCSD / 26.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46663" align="alignleft" width="146"]John W. Ayers, PhD, MA Vice Chief of Innovation | Assoc. Professor Div. Infectious Disease & Global Public Health University of California San Diego Dr. Ayers[/caption] John W. Ayers, PhD, MA Vice Chief of Innovation | Assoc. Professor Div. Infectious Disease & Global Public Health University of California San Diego MedicalResearch.com: What is the background for this study?   Response: The greatest barrier to understanding trends around sexual violence is they are largely hidden because victims are unable speak up publicly. Moreover, ongoing monitoring relies on proxies that underreport the scale of the problem such as police or medical records where only the most severe instances or a fraction of all instances of sexual violence are represented. As a result, we know very little about the scale of America's sexual violence problem. It was this backdrop that inspired #MeToo to call on victims to publicly voice their stories thereby revealing the scale of the problem. Our goal was to, for the first time, assess how this change inspired the public to engage with sexual violence issues. By tracking private aggregate internet search query trends we can begin to understand the scale of public engagement with issues around sexual violence including the precise motivation for a search, such as reporting episodes of sexual violence or learning how to prevent sexual violence.
Author Interviews, Education, JAMA, OBGYNE, Pediatrics, Social Issues / 21.12.2018

MedicalResearch.com Interview with "Pregnancy 1" by operalynn is licensed under CC BY 2.0Josephine Funck Bilsteen, MSc Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Section of Epidemiology, Department of Public Health University of Copenhagen Copenhagen, Denmark MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The background of this study is that there is increasing recognition of the longer-term health and social outcomes associated with preterm birth such as independent living, quality of life, self-perception and socioeconomic achievements. However, much less is known about differences in education and income among adults born at different gestational weeks in the term period. In this study shorter gestational duration, even within the term range, was associated with lower chances of having a high personal income and having completed a secondary or tertiary education at age 28 years. This is the first study to show that adults born at 37 and 38 completed weeks of gestation had slightly lower chances of having a high income and educational level than adults born at 40 completed weeks of gestation. 
Author Interviews, Dermatology, JAMA, NYU / 19.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46657" align="alignleft" width="200"]Nicholas A. Soter, MD The Ronald O. Perelman Department of Dermatology New York University School of Medicine New York, New York Dr. Nicholas Soter[/caption] Nicholas A. Soter, MD The Ronald O. Perelman Department of Dermatology New York University School of Medicine New York, New York MedicalResearch.com: What is the background for this study? Response: Nearly 50% of patients with chronic spontaneous urticarial (CSU) (hives) incompletely respond to first-line therapy with H-1 antihistamines. However, in the current literature, there is limited evidence to guide the treatment of CSU after maximal therapy with antihistamines fails.  Two small, randomized, controlled trials suggest that dapsone, which is an antimicrobial therapeutic agent with anti-inflammatory properties, may be a useful second-line therapeutic agent.
Author Interviews, Brigham & Women's - Harvard, JAMA, OBGYNE, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: [caption id="attachment_27170" align="alignleft" width="179"]Krista F. Huybrechts, M.S., Ph.D. Assistant Professor of Medicine at Harvard Medical School Epidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital. Boston, MA 02120 Dr. Krista Huybrechts[/caption] Krista F. Huybrechts, MS PhD Associate Professor of Medicine Brigham and Women’s Hospital Harvard Medical School Boston, MA 02120  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Pregnant women often experience nausea and vomiting, particularly during the first trimester.  Early treatment is recommended to relieve symptoms and prevent progression to hyperemesis gravidarum.  Although not formally approved for this indication, ondansetron is the most frequently prescribed treatment for nausea and vomiting in pregnancy in the US: 22% of pregnant women reportedly used ondansetron in the US in 2014. Despite this common use, the available evidence on the fetal safety of ondansetron is limited and conflicting, and the possibility of a doubling in risk of cleft palate and cardiac malformations has been raised. We therefore evaluated the association between ondansetron exposure during the first trimester of pregnancy, the period of organogenesis, and the risk of congenital malformations in a cohort of 1,816,414,publicly insured pregnancies using the nationwide Medicaid Analytic eXtract data for 2000-2013.  A total of 88,467 women (4.9%) were exposed to ondansetron during the first trimester.  After adjusting for a broad range of potential confounding variables, we found no association with cardiac malformations (RR = 0.99; 95% CI, 0.93 – 1.06)  and congenital malformations overall (RR = 1.01; 95% CI, 0.98 – 1.05). For oral clefts, we found a 24% increase in risk (RR=1.24; 95% CI, 1.03 – 1.48), which corresponds to an absolute risk of 2.7 per 10,000 births (95% CI, 0.2 – 5.2 per 10,000 births).  These findings were consistent across sensitivity analyses, conducted to address potential misclassification and confounding bias. 
Author Interviews, Brigham & Women's - Harvard, Cannabis, JAMA, Mental Health Research, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46574" align="alignleft" width="132"]Sharon Levy, MD, MPH Director, Adolescent Substance Use and Addiction Program Boston Children's Hospital Associate Professor of Pediatrics Harvard Medical School Dr. Levy[/caption] Sharon Levy, MD, MPH Director, Adolescent Substance Use and Addiction Program Boston Children's Hospital Associate Professor of Pediatrics Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​For this study we analyzed data that were collected as part of a larger survey study that recruited a sample of adolescents who were coming to the doctor's office for routine medical care.  We asked them a lot of questions about their health, school, extracurricular activities, plans for the future, substance use patterns and problems associated with use among other things. The main finding was that among the participants who reported marijuana use in the past year, many of them, more than 40%, said that they had experienced either an hallucination, or paranoia/anxiety related to their use. Kids who used more frequently and those who met criteria for a substance use disorder were more likely to experience these symptoms, as were those who had symptoms of depression
Author Interviews, Compliance, Electronic Records, JAMA, Ophthalmology / 18.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46612" align="alignleft" width="80"]Michael Vincent Boland, M.D., Ph.D. Glaucoma Center of Excellence Director of Information Technology, Wilmer Eye Institute Associate Professor of Ophthalmology Johns Hopkins University School of Medicine Baltimore, Maryland Dr. Boland[/caption] Michael Vincent Boland, M.D., Ph.D. Glaucoma Center of Excellence Director of Information Technology, Wilmer Eye Institute Associate Professor of Ophthalmology Johns Hopkins University School of Medicine Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Effective medications are available to treat glaucoma and prevent or stop vision loss.
Unfortunately, patients frequently do not use the eye drops as prescribed, oftentimes simply
because they forget to. Since patient medications are now managed via electronic health
records (EHRs), we built a system to deliver automated reminders to patients using the patient
portal to our EHR. We found that the majority (75%, 66 of 88) of participants that received these reminders found them to be useful, and about half (47%, 41 of 88) the participants wanted to
continue using the reminders after the study ended
Author Interviews, Diabetes, JAMA, Pain Research / 17.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46571" align="alignleft" width="200"]Guy Fagherazzi, MSc, PhD, HDR Senior Research Scientist in Digital & Diabetes Epidemiology Center of Research in Epidemiology and Population Health  Inserm, Paris-South Paris-Saclay University Dr. Guy Fagherazzi[/caption] Guy Fagherazzi, MSc, PhD, HDR Senior Research Scientist in Digital & Diabetes Epidemiology Center of Research in Epidemiology and Population Health Inserm, Paris-South Paris-Saclay University MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Migraine has further been associated with increased risk of overall and specific cardiovascular disease events. Because migraine has also been associated with factors related with insulin resistance and type 2 diabetes, an association between migraine and diabetes has been hypothesized. We observed a lower risk of type 2 diabetes in women with active migraine. We also show a linear decrease of migraine prevalence long before and a plateau long after type 2 diabetes diagnosis. 
Author Interviews, Blood Pressure - Hypertension, Critical Care - Intensive Care - ICUs, Emergency Care, JAMA / 17.12.2018

MedicalResearch.com Interview with:
"intravenous" by thorney torkelson is licensed under CC BY-NC-ND 2.0 <a href="https://creativecommons.org/licenses/by-nc-nd/2.0"> CC BY-NC-ND 2.0</a>Daniel J. Lane PhD
Institute of Health Policy, Management and Evaluation
Dalla Lana School of Public Health, University of Toronto
Rescu, Li Ka Shing Knowledge Institute, St Michael’s Hospital
Toronto, Ontario, Canada

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: Early resuscitation and early antibiotics have become the mainstay treatment for patients with sepsis. The time to initiation of these treatments is thought to be an important factor in patients surviving their disease; however, the independent benefits or harms of intravenous fluid resuscitation, in particular a more aggressive versus more conservative approach to this therapy, remains difficult to evaluate given the concurrent use of these therapies in hospital.

To gain a better understanding of this treatment independent of antibiotic use, we assessed intravenous fluid resuscitation by paramedics on the in-hospital mortality of patients with sepsis. By accounting for the interaction between initial systolic blood pressure and the treatment, we found that earlier resuscitation by paramedics was associated with decreased mortality in patients with low initial blood pressures but not associated with mortality for patients with normal or higher initial blood pressures. 

Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Mediterranean Diet, Women's Heart Health / 10.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46414" align="alignleft" width="117"]Samia Mora, MD, MHS Associate Professor of Medicine Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA Dr. Mora[/caption] Samia Mora, MD, MHS Associate Professor of Medicine Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Mediterranean diet is rich in plants (nuts, seeds, fruits, vegetables, whole grains, legumes) and olive oil, and includes moderate intake of fish, poultry, dairy, and eggs, and alcohol, and rare use of meats and sweets.The Mediterranean diet has been associated with lower risk of cardiovascular disease (CVD) events but the precise mechanisms through which Mediterranean diet intake may reduce long-term risk of CVD are not well understood. We aimed to investigate the biological mechanisms that may mediate this cardiovascular benefit. Using a prospective study of 25,994 initially healthy women enrolled in the Women’s Health Study who were followed up to 12-years, we evaluated potential mediating effects of a panel of biomarkers (in total 40 biomarkers) that represent different CVD pathways and clinical factors. Higher baseline intake of a Mediterranean-type diet was associated with approximately one quarter lower risk of CVD events during the 12 year follow up. For the MED-CVD risk reduction, biomarkers of inflammation, glucose-metabolism/insulin-resistance, and adiposity contributed most to explaining the association, with additional contributions from pathways related to blood pressure, lipids – in particular HDL or triglyceride-rich lipoprotein metabolism, and to a lesser extent LDL cholesterol, branched chain amino acids, and small molecule metabolites. 
ADHD, Author Interviews, Autism, JAMA, Pediatrics, UC Davis / 10.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46451" align="alignleft" width="150"]Meghan Miller, Ph.D. Assistant Professor Department of Psychiatry & Behavioral Sciences UC Davis MIND Institute Sacramento, CA 95817 Dr. Miller[/caption] Meghan Miller, Ph.D. Assistant Professor Department of Psychiatry & Behavioral Sciences UC Davis MIND Institute Sacramento, CA 95817 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study evaluated within-diagnosis sibling recurrence and sibling cross-aggregation of ADHD and autism spectrum disorder among later-born siblings of diagnosed children. We specifically chose to include only families who had at least one subsequent child after the diagnosis of an older child because failing to do so could bias recurrence risk estimates. We found that, compared to later-born siblings of non-diagnosed children, later-born siblings of children with autism were more likely to be diagnosed with autism or with ADHD. Likewise, compared to later-born siblings of non-diagnosed children, later-born siblings of children with ADHD were more likely to be diagnosed with ADHD or with autism.
Author Interviews, Breast Cancer, JAMA, Weight Research / 06.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46432" align="alignleft" width="200"]Neil M. Iyengar, MD Breast Medicine Service Department of Medicine Memorial Sloan Kettering Cancer Center Evelyn H. Lauder Breast And Imaging Center New York, NY Dr. Neil Iyengar[/caption] Neil M. Iyengar, MD Breast Medicine Service Department of Medicine Memorial Sloan Kettering Cancer Center Evelyn H. Lauder Breast And Imaging Center New York, NY  MedicalResearch.com: What is the background for this study? Response: Obesity is one of the leading modifiable risk factors for the development of hormone receptor positive breast cancer in postmenopausal women. Traditionally, physicians use a person's body mass index (weight in kilograms divided by height in squared meters, kg/m2) to estimate body fat levels. A BMI of 30 or greater is considered to be obese, and this level of BMI increases the risk of at least 13 different cancers. However, BMI is a crude measure of body fat and can be inaccurate. For example, some normal weight individuals (BMI less than 25) have obesity-related problems like diabetes and high blood pressure. Before our study, it was unknown whether high body fat levels in normal weight women contributes to obesity-related cancers such as breast cancer.
Author Interviews, Blood Pressure - Hypertension, Duke, Heart Disease, JAMA / 05.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46402" align="alignleft" width="200"]Taku Inohara MD, PhD Duke Clinical Research Institute,  Duke University Medical Center, Durham, North Carolina Department of Cardiology  Keio University School of Medicine, Tokyo, Japan Dr. Inohara[/caption] Taku Inohara MD, PhD Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina Department of Cardiology Keio University School of Medicine, Tokyo, Japan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Transcatheter aortic valve replacement (TAVR) has been increasingly used for treating patients with severe aortic stenosis. Owing to the advancement of TAVR technology, the mortality and heart failure (HF) readmission after TAVR is decreasing over time, but 4.3% experienced readmission due to HF and 23.7% died within 1 year after TAVR. Inhibition of the renin-angiotensin system (RAS) with angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin-receptor blockers (ARBs) is known to improve clinical outcomes in patients with heart failure, but there remains unknown whether a RAS inhibitor is associated with a reduction in mortality and heart failure readmission after TAVR. Using the STS/ACC TVT Registry, a nationwide TAVR Registry in the US, we analyzed 15896 propensity-matched patients who underwent TAVR and found that receiving a prescription for a RAS inhibitor at discharge, compared with no prescription, was associated with a reduced risk for mortality ( 12.5% vs 14.9%) and HF readmission (12.0% vs 13.8%).
Author Interviews, FDA, JAMA, Medical Imaging / 04.12.2018

MedicalResearch.com Interview with: Aldo Badano, Ph.D. Deputy Director, Division of Imaging, Diagnostics, and Software Reliability Office of Science and Engineering Laboratories Center for Devices and Radiological Health Silver Spring, MD 20993 Aldo Badano, Ph.D. Deputy Director, Division of Imaging, Diagnostics, and Software Reliability Office of Science and Engineering Laboratories Center for Devices and Radiological Health Silver Spring, MD 20993  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Expensive and lengthy clinical trials can delay regulatory evaluation of innovative technologies, affecting patient access to high-quality medical products. Although computational modeling is increasingly being used in product development, it is rarely at the center of regulatory applications. Within this context, the VICTRE project attempted to replicate a previously conducted imaging clinical trial using only computational models. The VICTRE trial involved no human subjects and no clinicians. All trial steps were conducted in silico. The fundamental question the article addresses is whether in silico imaging trials are at a mature development stage to play a significant role in the regulatory evaluation of new medical imaging systems. The VICTRE trial consisted of in silico imaging of 2986 virtual patients comparing digital mammography (DM) and digital breast tomosynthesis (DBT) systems. The improved lesion detection performance favoring DBT for all breast sizes and lesion types was consistent with results from a comparative trial using human patients and radiologists. 
Author Interviews, Dental Research, JAMA, Opiods, Pediatrics / 03.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46275" align="alignleft" width="200"]Alan Schroeder MD Associate chief for research Division of pediatric hospital medicine Lucile Packard Children’s Hospital Stanford Dr. Schroeder[/caption] Alan Schroeder MD Associate Chief for Research Division of pediatric hospital medicine Lucile Packard Children’s Hospital Stanford MedicalResearch.com: What is the background for this study? What are the main findings? Response: Third molar “wisdom teeth” extractions are one of the most common surgeries performed in adolescents and young adults, but an adequate appraisal of risks and benefits is lacking. Most patients who undergo this procedure are exposed to opioids post-operatively. We demonstrate that, for privately-insured opioid-naïve patients 16-25 years of age, exposure to opioids from a dental provider is associated with persistent use at 90-365 days in 7% of patients and a subsequent diagnosis relating to abuse in 6% of patients. In contrast persistent use and abuse were significantly lower in control patients not exposed to dental opioids (0.1% and 0.4%, respectively). The median number of pills dispensed for the initial prescriptions was 20.
Author Interviews, Cancer Research, JAMA, OBGYNE / 02.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46338" align="alignleft" width="150"]Dr. Weimin Ye, MD MSC, PhD Department of Medical Epidemiology and Biostatistics Karolinska Institue Prof. Ye[/caption] Dr. Weimin Ye, MD MSC, PhD Department of Medical Epidemiology and Biostatistics Karolinska Institue MedicalResearch.com: What is the background for this study? What are the main findings? Response: Polycystic ovary syndrome (PCOS) is the most common endocrine    disorder affecting 5-10% of women of reproductive age. Characterized by hyperandrogenism and metabolic abnormalities, PCOS is known to be related to various long-term health consequences, including diabetes, cardiovascular disease and endometrial cancer. Besides, inconsistent results have been reported for the associations between PCOS and the risk of ovarian and breast cancer. Studies addressing the risks of other cancers are scarce. Thus, we conducted a large, population-based cohort study with a long follow-up and rather sufficient confounding adjustment to explore the full picture of associations between PCOS and the risks of various cancer types. We found that PCOS is a risk factor for certain types of cancer, including cancers of the endometrium, ovary, endocrine gland, pancreas, kidney and skeletal & hematopoietic system.
Author Interviews, Compliance, JAMA / 01.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46259" align="alignleft" width="160"] Dr. Gurmankin Levy[/caption] Dr. Andrea Gurmankin Levy, PhD MBE Department of Social Sciences Middlesex Community College, Middletown, Connecticut MedicalResearch.com: What is the background for this study? Response: It is so important for clinicians to get accurate information from their patients so that they can make accurate diagnoses and appropriate recommendations. But we know that people tend to withhold information from others, and that this is especially true when it comes to sensitive information. And in fact, in medicine, there is a long-standing conventional wisdom that clinicians need to adjust patients’ answers (e.g., doubling patients’ report of alcohol consumption) to get a more accurate picture. So we wanted to explore this. How many patients withhold medically-relevant information from their clinicians, and why do they do so?  There have been surprisingly few studies looking at this question in a comprehensive way.
Author Interviews, Dermatology, JAMA, Technology / 01.12.2018

MedicalResearch.com Interview with: Philipp Tschandl, MD PhD, Priv.Doz. Department of Dermatology Medical University of ViennaPhilipp Tschandl, MD PhD, Priv.Doz. Assistant Professor Department of Dermatology Medical University of Vienna MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dermatoscopy is a non-invasive imaging technique, where the surface of the skin is rendered translucent and additional important morphologic features become visible from deeper layers. This is achieved through use of immersion fluid or cross-polarised light - equivalent to the effect when using a pair of goggles to look underwater, or polarised sunglasses to reduce glare on glass surfaces. After the first description of “Dermatoskopie" almost 100 years ago by a German dermatologist (Johann Saphier), this technique has evolved to a successful, low-cost, state-of-the-art technique for clinical skin cancer detection in the last decades. Convolutional neural networks (“CNN”) are powerful machine learning methods, and frequently applied to medical image data in the recent scientific literature. They are highly accurate for basic image classification tasks in experimental settings, and found to be as good as dermatologists in melanoma recognition on clinical or dermatoscopic images. In this study we trained a CNN to diagnose non-pigmented skin lesions (where melanomas are only a minority) through analysis of digital images, and compared the accuracy to >90 human readers including 62 board-certified dermatologists. This study expands knowledge in the following ways compared to previous work: - We applied the network for the detection of non-pigmented skin cancer, which is far more common in the (caucasian) population than melanoma. - We created a prediction model that combines analysis of a dermatoscopic and clinical image (“cCNN”) which is able to further increase diagnostic accuracy. - We compared accuracy not only to experts, but users with different level of experience
Author Interviews, Diabetes, Geriatrics, JAMA, Kidney Disease / 01.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46253" align="alignleft" width="200"]Dr. Ziyad Al-Aly, MD Associate Chief of Staff for Research and Education Veterans Affairs St. Louis Health Care System Dr. Al-Aly[/caption] Dr. Ziyad Al-Aly, MD Associate Chief of Staff for Research and Education Veterans Affairs St. Louis Health Care System Institute for Public Health Washington University, St. Louis MO MedicalResearch.com: What is the background for this study? Response: A lot has changed in the US over the past 15 years including aging, population growth, and increased exposure to risk factors such as obesity, elevated blood pressure, etc. With all of these changes, we wondered, how did the burden of kidney disease change in the United States over the past 15 years.
Accidents & Violence, Author Interviews, JAMA, Pediatrics, USPSTF / 28.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46250" align="alignleft" width="200"]Alex Kemper, M.D., M.P.H., M.S.  Dr. Kemper[/caption] Alex Kemper, M.D., M.P.H., M.S.  Dr. Kemper is a board-certified pediatrician and chief of the Division of Ambulatory Pediatrics at Nationwide Children’s Hospital. He is also the deputy editor of Pediatrics. MedicalResearch.com: What is the background for this recommendation statement? What are the main findings and recommendations?  Response: Child maltreatment, which includes abuse and neglect, is a serious health problem that affects too many children in the United States.  Abuse and neglect can have devastating health consequences, including long-term disabilities, depression, physical injury, and even death. In 2016, approximately 676,000 children were subjected to maltreatment, and more than 1,700 children died as a result. Because this is such an important public health issue, the U.S. Preventive Services Task Force looked at the most recent evidence on whether primary care clinicians can help prevent child maltreatment and its negative consequences. We found that, unfortunately, there is not enough evidence to recommend for or against these interventions. The Task Force is calling for more research on this important subject so that we can help prevent children from being abused and neglected.   
Author Interviews, JAMA, Surgical Research, Weight Research / 28.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46233" align="alignleft" width="133"]Michael Rozier, S.J., Ph.D. Assistant Professor, Health Management and Policy College for Public Health and Social Justice St. Louis University Dr. Rozier[/caption] Michael Rozier, S.J., Ph.D. Assistant Professor, Health Management and Policy College for Public Health and Social Justice St. Louis University MedicalResearch.com: What is the background for this study? Response: Patients considering surgery for weight loss have several options, which differ in significant ways, such as expected weight loss, risk of complication, modification of diet, effect on other medical conditions, and more. Previous studies have asked patients why they chose one procedure over another. Instead, we quantified the relative importance of the key characteristics of surgical options. Using a discrete choice experiment, potential patients were given profiles of two weight loss options. They were asked to select one profile based on key characteristics such as out-of-pocket costs, total weight loss, risk of complication, and five other factors.
Author Interviews, JAMA, Neurology, Stroke / 27.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46196" align="alignleft" width="150"]Giacomo Koch, MD, PhD Laboratorio di Neurologia Clinica e Comportamentale Fondazione S. Lucia I.R.C.C.S. taly Dr. Koch[/caption] Giacomo Koch, MD, PhD Laboratorio di Neurologia Clinica e Comportamentale Fondazione S. Lucia I.R.C.C.S. Italy MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We show in this paper that non invasive stimulation of the cerebellum in patients with stroke is able to improve motor functions. In particular we found that after three weeks of repetitive TMS of the intact cerebellum patients with hemiparesis due to stroke in the cerebral hemisphere remarkably improved their ability to walk and keep their balance, thus highly reducing the risk of fall. 
Author Interviews, Cancer Research, Cost of Health Care, JAMA, Pharmacology / 26.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46210" align="alignleft" width="128"]Abiy Agiro, PHD HealthCore Inc Wilmington, Delaware Dr. Agiro[/caption] Abiy Agiro, PHD HealthCore Inc Wilmington, Delaware  MedicalResearch.com: What is the background for this study? Response: Biosimilar approval pathway, authorized in 2010 by the Biologics Price Competition and Innovation Act as part of the Affordable Care Act, aims to increase adoption of biosimilar products and generate significant cost savings to payers and patients alike. Biosimilar filgrastim, used to prevent febrile neutropenia, is one of the first biosimilars to be approved in the United States. A large scale, post-approval real-world analysis was needed that compares biosimilar filgrastim to the original drug for safety and efficacy.
Author Interviews, Cancer Research, JAMA / 26.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46183" align="alignleft" width="200"]Ola Landgren, MD, PhD Professor of Medicine  Chief, Myeloma Service  Department of Medicine  Memorial Sloan Kettering Cancer Center New York, NY 10065 Dr. Landgren[/caption] Ola Landgren, MD, PhD Professor of Medicine Chief, Myeloma Service Department of Medicine Memorial Sloan Kettering Cancer Center New York, NY 10065 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Meta-analysis show that minimal residual disease (MRD) negativity is a strong predictor of longer progression-free survival (PFS). Emerging data show that an increasing proportion of newly diagnosed multiple myeloma patients obtain MRD negativity after modern combination therapy, even in the absence of bone marrow transplant. The first generation of 3-drug combination therapy (RVd) was associated with quite high rates of peripheral neuropathy which may be life-long. The current study was designed to define the rates of peripheral neuropathy in newly diagnosed multiple myeloma treated with the second generation of 3-drug combination therapy (KRd), and per default delayed transplant (i.e. collection of stem cells which were stored for potential future use). This single arm, phase 2 study found no cases of grade 3 peripheral neuropathy. The rates of MRD negativity wereunprecedented; 28 of 45 patients achieved MRD-negative CR (62%). The durability of MRD-negative CR has been observed up to 70 months (median duration 52.4 months). Patients who achieved MRD negativity by the end of cycle 8 had a 78% reduced risk of progression. The results were regardless of age or cytogenetic risk category. The results from this second generation of 3-drug combination therapy (KRd) without transplant,  compare favorably to first generation of 3-drug combination therapy (RVd) followed by stem cell transplant.
Author Interviews, Heart Disease, JAMA, Lifestyle & Health, Nutrition / 26.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46168" align="alignleft" width="120"]Ravi B. Patel, MD Division of Cardiology, Department of Medicine Northwestern University Feinberg School of Medicine Chicago, Illinois Dr. Patel[/caption] Ravi B. Patel, MD Division of Cardiology, Department of Medicine Northwestern University Feinberg School of Medicine Chicago, Illinois MedicalResearch.com: What is the background for this study? What are the main findings? Response: The digital attention of scientific articles can be readily quantified using the Altmetric score. The Altmetric score is a weighted measure, incorporating a variety of media platforms. We aimed to characterize the Top 10% of articles by Altmetric score among 4 major cardiovascular journals (Circulation, European Heart Journal, Journal of the American College of Cardiology, and JAMA Cardiology) in 2017. Our primary findings were: 1) nearly half of the most disseminated articles were not original research investigations, 2) the most common article topic was nutrition/lifestyle, and 3) there was a weak but significant correlation between Altmetric scores and citation number. 
Author Interviews, Dermatology, JAMA / 26.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46193" align="alignleft" width="200"]Dr Tarun Narang MD MNAMS Department of Dermatology, Venereology, and Leprology Postgraduate Institute of Medical Education and Research Chandigarh, India Dr. Narang[/caption] Dr Tarun Narang MD MNAMS Department of Dermatology, Venereology, and Leprology Postgraduate Institute of Medical Education and Research Chandigarh, India MedicalResearch.com: What is the background for this study? Response: Acne is one of the most common dermatological problem for which the patients seek medical care. Post acne scarring is a complication of acne, resulting in long lasting physical disfigurement and low self esteem in the affected individuals. Even though there are various methods like microneedling, chemical peeling, cryorolling and ablative lasers to address the post acne atrophic scarring, these procedures are office based hence physician dependent. A home based treatment modality that can treat post acne atrophic scarring with a comparable efficacy to the procedural modalities of treatment will be beneficial to the patient. Our study was done to assess the efficacy of a topical modality of treatment, tazarotene gel, 0.1% in the management of post acne atrophic scarring in comparison to an established method, the microneedling.
Author Interviews, Environmental Risks, JAMA, Melanoma / 24.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46151" align="alignleft" width="200"]One example of malignant melanoma, courtesy of skin cancer foundation One example of malignant melanoma, courtesy of Skin Cancer Foundation[/caption] Reza Ghiasvand, PhD Oslo Centre for Biostatistics and Epidemiology Faculty of Medicne University of Oslo Oslo, Norway  MedicalResearch.com: What is the background for this study? Response: Melanoma is the most dangerous type of skin cancer. It is estimated that about 288,000 individuals will be diagnosed and about 61,000 will die from it in 2018, with the majority of patients in Australia, New Zealand, Europe and North America. Ultraviolet (UV) exposure (from both the sun and tanning beds) is the most important preventable risk factor for melanoma. However, the association between UV exposure and melanoma is complex and does not accord with a simple model in which risk increases directly with exposure. An individual risk of melanoma also depends on personal characteristics such as skin color and skin sensitivity to the UV exposure, hair color, number of moles, and age. It has been hypothesized that the pattern of UV exposure may play a role in melanoma development in different body sites. For example, melanoma on the trunk (chest and back) has been linked to the recreational UV exposure such as sunbathing and frequent sunburns in people with high number of moles on their body. In contrast, melanomas on the head and neck have been linked to constant sun exposure such as occupational UV exposure, mainly in older people. Epidemiologic and molecular evidence in support of this hypothesis has been published based on analyses of small datasets. Also, melanoma on legs and arms is less studied under this hypothesis. In our study, we examined UV exposure (sunbathing, sunburn and sunbed use) and pigmentary factors (skin, eye, and hair color, freckling, and number of moles), and risk of melanoma on different body sites. We used information from the Norwegian Women and Cancer Study, a population-based cohort study that started in 1991, and includes more than 161,000 Norwegian women followed for an average of 18 years.