Author Interviews, Heart Disease, JAMA, Occupational Health / 07.09.2019

MedicalResearch.com Interview with: Rachel Zeig-Owens, Dr.P.H., MPH FDNY Research Assistant Professor Albert Einstein Medical CenterMedicalResearch.com: What are the main findings? Response: We found that the most exposed members, those who arrived first at the World Trade Center (WTC ) site—when the air-borne dust was thickest—have a 44% increased risk of cardiovascular disease (CVD) compared to those who arrived later in the day. This is a level risk that was similar to other known risk factors for CVD.(more…)
Author Interviews, Cost of Health Care, JAMA, Medicare / 06.09.2019

MedicalResearch.com Interview with: Md Momotazur Rahman PhD Associate Professor of Health Services, Policy and PracticeMargot Schwartz MPH Doctoral programBrown UniversityMedicalResearch.com: What is the background for this study? Response: Although one third of Medicare beneficiaries are currently enrolled in Medicare Advantage (MA), it is difficult to assess the quality of healthcare providers that serve MA beneficiaries, or to compare them to providers that serve Traditional Medicare (TM) beneficiaries.While Medicare Advantage plans are required to cover the same minimum healthcare services as TM, MA beneficiaries receive care from their plan’s network of preferred providers, while TM beneficiaries may select any Medicare-certified provider. The objective of this study is to compare the quality of Home health Agencies (HHAs) that serve Medicare Advantage and TM beneficiaries. Approximately 3.5 million Medicare beneficiaries receive home health care annually. (more…)
Author Interviews, Cost of Health Care, JAMA, Medical Imaging, UCSF / 05.09.2019

MedicalResearch.com Interview with: Rebecca Smith-Bindman, MD Professor, Department of Radiology and Biomedical Imaging, Epidemiology and Biostatistics Philip R. Lee Institute for Health Policy Studies University of California, San FranciscoMedicalResearch.com: What is the background for this study? Response: Medical imaging increased rapidly from 2000 to 2006. The rise in imaging can be attributed to improvements in technical aspects of imaging, strong physician and patient demand, and strong financial incentives. While imaging contributes to accurate disease diagnosis and improved treatment, imaging can also increase costs and patient harms, such as incidental findings, overdiagnosis, anxiety, and radiation exposure associated with increased risk of cancer. Potential overuse of diagnostic testing has been addressed by the American Board of Internal Medicine Foundation’s Choosing Wisely Campaign and initiatives by payers to reduce imaging through payment reductions, but there remains uncertainty in the impact of these initiatives on imaging rates.The objective of our study was to evaluate recent trends in medical imaging.Our study assessed imaging from 2000 through 2016 among individuals enrolled in diverse U.S. integrated healthcare systems and among individuals residing in Ontario, Canada and assessed changes in medical imaging utilization over time by country, health system, and patient demographic factors. (more…)
ADHD, Author Interviews, Autism, JAMA, OBGYNE / 30.08.2019

MedicalResearch.com Interview with: Tianyang Zhang, MSc Centre for Psychiatry Research, Department of Clinical NeuroscienceStockholm Health Care Services, Stockholm County Council Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm, SwedenMedicalResearch.com: What is the background for this study? Response: We know that births by caesarean delivery are linked to several negative health outcomes in the children, such as obesity, asthma, allergy, and type 1 diabetes. However, the association between c-section and neurodevelopmental and psychiatric disorders has been less studied. In addition, it is unclear whether the extent of this association is different if a caesarean section is performed planned in advance or urgently due to medical reasons during a delivery.(more…)
Author Interviews, JAMA, Opiods, Primary Care / 30.08.2019

MedicalResearch.com Interview with: Dr. Hannah T. Neprash, PhD Assistant Professor, Division of Health Policy and Management School of Public Health University of MinnesotaMedicalResearch.com: What is the background for this study? Response: Physicians play a pivotal role in the opioid epidemic and it's important to understand what factors that drive opioid prescribing. Variation in opioid prescribing across physicians has been well-documented, but there’s very little research on variation within physicians…which is surprising, given the widespread concern about time pressure and cognitive fatigue having a potentially detrimental effect on the quality of care provided by physicians.(more…)
Author Interviews, Breast Cancer, Cancer Research, Genetic Research, JAMA, Ovarian Cancer, USPSTF / 28.08.2019

MedicalResearch.com Interview with: Dr. Carol Mangione, M.D., M.S.P.H., F.A.C.P. Division Chief of General Internal Medicine and Health Services Research Professor of Medicine Barbara A. Levey, MD, and Gerald S. Levey, MD, endowed chair in Medicine David Geffen School of Medicine University of California, Los Angeles (UCLA) Professor of public health at the UCLA Fielding School of Public Health.MedicalResearch.com: What is the background for this study? What are the main findings?Response: Every year, too many American women are faced with the challenge of dealing with a cancer diagnosis related to potentially harmful mutations of the BRCA1 and BRCA2 genes. However, the Task Force found that there are several steps women can take to determine if they’re potentially at increased risk for BRCA gene mutations – and if genetic counseling and BRCA testing are needed.It is important to note that while some women can benefit from risk assessment, counseling, and testing, these services are not for everyone.(more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Medicare / 28.08.2019

MedicalResearch.com Interview with: Jose F. Figueroa, MD, MPH Instructor , Harvard Medical School, Department of Medicine Brigham and Women’s HospitalMedicalResearch.com: What is the background for this study? Response: Hospitalizations related to ambulatory-care sensitive conditions are widely considered a key measure of access to high-quality ambulatory care. It is included as a quality measure in many national value-based care programs. To date, we do not really know whether rates of these avoidable hospitalizations are meaningfully improving for Medicare beneficiaries over time.(more…)
Author Interviews, Education, JAMA, Opiods, Social Issues / 28.08.2019

MedicalResearch.com Interview with: Isaac Sasson, PhD Department of Sociology and Anthropology and the Herczeg Institute on Aging Tel Aviv University Tel Aviv, IsraelMedicalResearch.com: What is the background for this study? Response: Life expectancy at birth in the United States has been declining steadily since 2014, which is very unusual for a high-income country in times of peace. In fact, the last time that life expectancy declined in the US was in the early 1990s, and only briefly. Studies from the past few years have shown that the rise in mortality is concentrated among middle-aged Americans and particularly the lower socioeconomic classes.Our study analyzed over 4.6 million death records in 2010 and 2017 to understand which causes of death account for the rise in mortality among white and black non-Hispanic US adults. In addition, given the substantial socioeconomic inequality in health in the US, we broke down our results by level of education, which is a good proxy for socioeconomic status. Essentially, our goal was to measure how many years of life were lost, on average, to each cause of death across different social groups.(more…)
Author Interviews, Brain Injury, Erectile Dysfunction, JAMA / 26.08.2019

MedicalResearch.com Interview with: Rachel Grashow PhD Research Associate Department of Environmental Health Football Players Health Study at Harvard University Harvard T.H. ChanMedicalResearch.com: What is the background for this study? Response: It has been previously shown in small studies of boxers and military personnel that traumatic brain injuries can damage the pituitary gland, which serves as the "master controller" of hormone function in the brain. These studies on individuals at risk for repeated head injury found that hits on the head caused deficiencies in certain hormones, such as growth hormone and testosterone, which could have downstream effects on sexual function. Only one large study was conducted that used Taiwanese health insurance data and looked at single traumatic brain injuries and risk of erectile function (ED). In that study, men who experienced a single severe TBI were more than twice as like to report ED after their injury. In light of these findings, important questions remain regarding whether multiple head injuries are associated with pituitary or sexual dysfunction in a large population with other ED-related health issues. The Football Players Health Study at Harvard University asked former NFL players to fill out a questionnaire that interrogated demographic factors, football-related exposures and current health conditions. Specifically, we asked participants to self-report the frequency of ten different concussion symptoms experienced during professional play, as well as whether a clinician had ever recommended or prescribed medication for low testosterone or ED. (more…)
Author Interviews, JAMA, Kidney Disease, Transplantation / 26.08.2019

MedicalResearch.com Interview with: Alexandre Loupy, MD PhD Nephrologist, Department of Nephrology & Kidney Transplantation Necker Hospital, Paris Head of the Paris Transplant Group (Inserm)MedicalResearch.com: What is the background for this study? Response: The lack of organs for kidney transplantation is a major public health problem across the world, due to its attributable mortality and excess cost to healthcare systems while waitlisted patients are maintained on chronic dialysis. Nearly 5,000 people in the US and 3,500 people in Europe die each year while waiting for a kidney transplant. Yet in the US, over 3,500 donated kidneys are discarded annually, representing almost 18% of the available organs, while the discard rate in France is only 6,8%, though these countries have similar organ allocation systems and offer the same treatments to patients after transplant.We thus compared the use of donated kidneys in the US to France from 2004-2014 in much more depth, using a new approach based on validated analytic methods and computer simulation.(more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Mental Health Research, Sleep Disorders / 23.08.2019

MedicalResearch.com Interview with:Chenlu Gao, MA Graduate Student Department of Psychology and Neuroscience Baylor UniversityMichael Scullin, PhD Assistant Professor Department of Psychology and Neuroscience Baylor UniversityMedicalResearch.com: What is the background for this study?Response: According to the World Alzheimer Report, dementia affects 50 million adults worldwide, and this number is expected to approach 131 million by 2050. Dementia patients often require assistance with daily activities from caregivers. The Alzheimer’s Association reported that, in the United States, 16 million caregivers spend on average 21.9 hours per week providing care for patients with dementia.Being a caregiver is stressful, which not only challenges emotional, cognitive, and physical health, but is also associated with shorter and poorer sleep at night. If a caregiver cannot obtain restorative sleep at night, their quality of life and their abilities to perform the caregiving role can be compromised. For example, sleep loss may jeopardize caregivers’ memory, causing them to forget medications or medical appointments for the patients. Sleep loss can also impair immune functions, causing the caregivers to suffer from illnesses. In the long-term, sleep loss is associated with cortical thinning and accumulation of beta-amyloid and tau, which increase the risks of dementia.Undoubtedly, there is a need to systematically study whether caregivers sleep less or worse during the night and whether we can improve their sleep quality through low-cost behavioral interventions. To answer these questions, we systematically reviewed and meta-analyzed 35 studies with data from 3,268 caregivers of dementia patients. (more…)
Author Interviews, Cancer Research, JAMA / 23.08.2019

MedicalResearch.com Interview with: Prof. Dr. Lukas Flatz MD Institute of Immunobiology Kantonsspital St Gallen, St Gallen SwitzerlandMedicalResearch.com: What is the background for this study? Response: Toxicity is an important limiting factor of treatment with checkpoint inhibitors. We aimed in investigating the relationship between immune-related adverse events during anti-PD-1 therapy and tumor mutational burden by comparing large scale surveillance data of irAEs with the median tumor mutational burden across multiple cancer types.(more…)
Author Interviews, Diabetes, JAMA, PTSD / 21.08.2019

MedicalResearch.com Interview with: Jeff Scherrer, Ph.D. Associate professor; Research director Department of Family and Community Medicine Saint Louis University Center for Health Outcomes ResearchMedicalResearch.com: What is the background for this study? Response: This study was part of a larger NIH grant to determine if PTSD is associated with poor health behaviors and subsequently whether PTSD remains an independent risk factor for diabetes and heart disease. Our second focus of the grant was to measure if those patients who experience clinically meaningful PTSD improvement have improved health behaviors (e.g. seeking help to lose weight) and a lower risk for diabetes and heart disease.The rationale for this study of PTSD improvement and lower risk for diabetes is supported from other investigators' findings that PTSD treatment completion is often followed by improvement in sleep, depression, pain and general physical complaints and lower blood pressure. Because we have found the association between PTSD and incident diabetes is largely explained by obesity, depression and other comorbid conditions that are more common in patients with vs. without PTSD, we hypothesized that improvements in PTSD would be associated with lower risk of diabetes either directly or due to improvements in these comorbid diabetes risk factors. (more…)
Author Interviews, Hospital Acquired, JAMA / 20.08.2019

MedicalResearch.com Interview with: Todd Campbell Lee MD MPH FACP FIDSA Consultant in Internal Medicine and Infectious Diseases Director, MI4 Clinical Trials Platform Associate Professor of Medicine, McGill University Montreal, QuebecMedicalResearch.com: What is the background for this study? Response: For a number of years people have been advocating for a move towards single-patient rooms in hospital design. This was articulately argued for in an opinion piece by Detsky and Etchells in 2008 (https://jamanetwork.com/journals/jama/article-abstract/182433) as being important for a move to safe and patient-centered design.One of the major selling points has always been a reduction in the risk of nosocomial, or hospital-associated, infections given reduced opportunities for contamination between patients; however, only a few studies have specifically looked at this issue. Overall, despite some strong work, many of these studies were limited by only looking at specific units, over limited periods of time, and using before-after comparisons which did not account for change over time either within or outside of the institution.We knew that in 2015 our old hospital would close and within the same day all patients would be moved to a brand new hospital with 100% single patient rooms -- most of which have a private bathroom for patients and a separate hand-washing sink for staff. So in 2014, we designed this study, obtained ethics review, and then waited patiently for several years to pass after the move so that we could rigorously evaluate the impact. We looked at monthly rates of vancomycin-resistant Enterococcus (VRE) colonizations and infections, methicillin-resistant Staphylococcus aureus (MRSA) colonization and infections, and Clostridium (now Clostrideroides) difficile infections (CDI).We chose these because we had good long term data on their rates and because we could compare the rates over time before and after the move and contrast them with the province of Quebec as a whole. (more…)
Author Interviews, Dental Research, JAMA, Mental Health Research, Mineral Metabolism, Pediatrics / 19.08.2019

MedicalResearch.com Interview with: Rivka Green, MA Doctoral Candidate Clinical Developmental Neuropsychology York UniversityMedicalResearch.com: What is the background for this study? What are the main findings?Response: We conducted a study on 512 mother-child pairs from 6 major cities across Canada, about half of whom lived in a region that receives fluoridated water.We found that prenatal fluoride exposure was associated with lower IQ scores in 3-4 year old children. (more…)
Author Interviews, Cognitive Issues, End of Life Care, Gender Differences, JAMA / 16.08.2019

MedicalResearch.com Interview with: Dr. Nathan Stall, MD Geriatrician and Research fellow Women’s College Research Institute   Dr. Paula Rochon,MD, MPH, FRCPC Periatrician and Vice-President of Research Women’s College HospitalMedicalResearch.com: What is the background for this study? Response: The advanced stages of the dementia are characterized by profound memory impairment, an inability to recognize family, minimal verbal communication, loss of ambulatory abilities, and an inability to perform basic activities of daily living. Nursing homes become a common site of care for people living with advanced dementia, who have a median survival of 1.3 years. In the advanced stages of the disease, the focus of care should generally be on maximizing quality of life.Our study examined the frequency and sex-based differences in burdensome interventions received by nursing home residents with advanced dementia at the very end of life. Burdensome interventions include a variety of treatment and procedures that are often avoidable, may not improve comfort, and are frequently distressing to residents and their families. We found that in the last 30 days of life, nearly one in 10 nursing home residents visited an emergency department, more than one in five were hospitalized, and one in seven died in an acute care setting. In addition, almost one in 10 residents received life-threatening critical care; more than one in four were physically restrained; and more than one in three received antibiotics. (more…)
Author Interviews, JAMA, Outcomes & Safety, Surgical Research, University of Michigan / 15.08.2019

MedicalResearch.com Interview with: Kyle Sheetz, MD, MSc Research Fellow Center for Healthcare Outcomes and Policy University of MichiganMedicalResearch.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.(more…)
Author Interviews, JAMA, Mayo Clinic, Pancreatic, USPSTF / 14.08.2019

MedicalResearch.com Interview with: Dr. Chyke A. Doubeni, M.D., M.P.H.Dr. Doubeni is a family physician and The inaugural director of the Mayo Clinic Center for Health Equity and Community Engagement ResearchMedicalResearch.com: What is the background for this study? Response: The U.S. Preventive Services Task Force uses systematic review of existing research to make recommendations on clinical preventive services that are delivered in primary care, with the goal to promote and improve health for all Americans. Although pancreatic cancer is an uncommon condition in the general population, it is often deadly.Pancreatic cancer is now the third most common cause of cancer death in the United States, and could become the second leading cause if current trends continue. The vast majority of people with pancreatic cancer are diagnosed at a late stage and, unfortunately, even when caught early enough when surgery could be most effective, only a little over one-third of patients survive beyond five years.(more…)
Author Interviews, Blood Pressure - Hypertension, Duke, Heart Disease, JAMA, Race/Ethnic Diversity / 14.08.2019

MedicalResearch.com Interview with: Yuichiro Yano MD Assistant Professor in Family Medicine and Community Health Duke UniversityMedicalResearch.com: What is the background for this study? What are the main findings?Response: African Americans are disproportionally affected by hypertension-related cardiovascular disease compared with other racial/ethnic groups in the United States and have higher blood pressure levels inside and outside the clinic than whites and Asians.However, little is known, among African Americans, regarding whether higher mean blood pressure measured outside of the clinic setting on 24-hour ambulatory blood pressure monitoring is associated with an increased risk for cardiovascular disease events, independent of blood pressure measured in the clinic setting. (more…)
Author Interviews, Heart Disease, JAMA, Pediatrics / 14.08.2019

MedicalResearch.com Interview with: Dr Juan Pablo Kaski MD(Res) FRCP FESC Director of the GOSH Centre for Inherited Cardiovascular DiseasesGreat Ormond Street Hospital, University College London Institute of Cardiovascular Science, London, UKMedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Hypertrophic Cardiomyopathy?Response: Hypertrophic cardiomyopathy (HCM) is a genetic condition characterised by abnormal thickening of the muscle of the heart and can affect people of all ages. It is associated with an increased risk of sudden cardiac death (SCD) and, in the last few years, a clinical risk tool that estimates the 5-year risk of SCD in adults with HCM has been developed.However, there are no similar risk models in children, where risk stratification has traditionally been based on clinical risk factors extrapolated from the adult population. We have recently shown that this approach does not discriminate risk well in children, and so the aim of this study was to develop a new risk tool to provide an individualised risk of SCD in children with HCM.(more…)
Author Interviews, Environmental Risks, JAMA, NIH, Pulmonary Disease / 13.08.2019

MedicalResearch.com Interview with: Joel Kaufman, MD, MPH, Professor Environmental & Occupational Health Sciences, Medicine, and Epidemiology University of WashingtonMedicalResearch.com: What is the background for this study? What are the main findings?Response: Increasingly, it is recognized that chronic lung diseases like emphysema occur in nonsmokers and rates of these diseases are continuing to increase. We really need to understand what’s causing chronic lung disease. Air pollutants are known to make disease worse in people with prior lung disease, but little is known about whether long-term exposure to air pollutants can cause chronic lung disease.We found that higher residential concentrations of air pollutants—especially ozone and traffic-related air pollutants—are associated with changes in the lung—emphysema-like changes in the lung. The associations were strong and suggest that air pollution may be an important contributor to chronic lung disease.(more…)
Author Interviews, Breast Cancer, JAMA, UCLA / 12.08.2019

MedicalResearch.com Interview with: Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLAMedicalResearch.com: What is the background for this study? What are the main findings?
  • A pathologist makes the diagnosis of breast cancer versus non-cancer after reviewing the biopsy specimen. Breast biopsies are performed on millions of women each year and It is critical to get a correct diagnosis so that we can guide patients to the most effective treatments.
  • Our prior work (Elmore et al. 2015 JAMA) found significant levels of disagreement among pathologists when they interpreted the same breast biopsy specimen. We also found that pathologists would disagree with their own interpretations of breast biopsies when they where shown the same biopsy specimen a year later.
  • In this study, 240 breast biopsy images were fed into a computer, training it to recognize patterns associated with several types of breast lesions, ranging from benign (noncancerous) to invasive breast cancer. We compared the computer readings to independent diagnoses made by 87 practicing U.S. pathologists and found that while our artificial intelligence program came close to performing as well as human doctors in differentiating cancer from non-cancer, the AI program outperformed doctors when differentiating ductal carcinoma in situ (DCIS) from atypia, which is considered the greatest diagnostic challenge.
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Author Interviews, Diabetes, JAMA / 12.08.2019

MedicalResearch.com Interview with: Pooyan Kazemian, Ph.D. Instructor in Medicine Massachusetts General HospitalMedicalResearch.com: What is the background for this study? Response: Advances in diabetes care can meaningfully improve outcomes only if they effectively reach the populations at risk. However, it is not known if recent innovations in diabetes treatment and care models have reached the United States population at risk.(more…)
Author Interviews, JAMA, Orthopedics, Pediatrics / 09.08.2019

MedicalResearch.com Interview with:Dr Ahmed Elhakeem PhD Senior Research Associate in Epidemiology University of BristolMedicalResearch.com: What is the background for this study? What are the main findings?Response: We know that the denser (stronger) your bones are, the less likely they are to break (fracture).We also have reliable evidence that later maturing adolescents tend on average to have lower bone density than their earlier maturing peers.We wanted to find out how the timing of puberty might influence the development of bone density throughout adolescence and into early adult life. We did this by following up a large group of young people born in the early 90s around Bristol, UK that took part in a unique study (the Children of the 90s study) that included repeated density scans over a 15-year period from age ten to 25.We found that those later maturing adolescents that got their growth spurt at an older age tended to catch-up to some degree to their earlier maturing peers during puberty however, they continued on average to have lower bone density than average for several years into adulthood. (more…)
Author Interviews, Cancer Research, JAMA, MRI, Prostate Cancer / 07.08.2019

MedicalResearch.com Interview with: Dr Martha Elwenspoek PhD Research Associate in Epidemiology and Health Services Research NIHR CLAHRC West, BristolMedicalResearch.com: What is the background for this study? Response: Prostate cancer is one of the most common cancers in men. Prostate cancer is usually diagnosed by taking 10 to 14 systematic samples from the prostate guided by ultrasound. However, these biopsies are unpleasant for patients, can miss cancer even when it’s present, can misclassify the severity of the cancer, and can cause side effects, such as bleeding and infection.If biopsies could be targeted better, men wouldn’t have to undergo so many and there would be less risk of getting a misleading result. Multiparametric MRI (mpMRI) scans are sometimes used before doing a biopsy to help diagnose prostate cancer, and while this approach is now being recommended by the UK National Institute for Clinical Excellence (NICE) their use isn’t widespread.(more…)
Author Interviews, Education, Gender Differences, JAMA, Surgical Research / 07.08.2019

MedicalResearch.com Interview with: Maria S. Altieri, MD, MS Invasive Surgery Stony Brook, NYMedicalResearch.com: What is the background for this study? What are the main findings?Response: For majority of residents, training years coincide with prime child bearing years. Historically, surgical residency has not been conducive for having children, as it is one of the most demanding experiences, requiring long hours, high stress levels, and the acquisition of clinical and technical skills over a short period of time.However, with recent trends towards a more favorable work-life balance and the 80-hour work week, more male and female residents are having children or considering having children during training. Thus, the topic of parental leave during residency is becoming more fundamental. However, there is little research on the attitudes of residents towards their pregnant peers and parental leave.We wanted to examine the perceptions of surgical trainees towards parental leave and pregnancy during residency. Through understanding the perceptions of current residents, obstacles could be identified which could lead to potential changes in policies that could help to normalize parenthood and parental leave during surgical training. (more…)
Author Interviews, Dental Research, JAMA, OBGYNE, Pediatrics, Vitamin D / 06.08.2019

MedicalResearch.com Interview with: Hans Bisgaard, DMSc, MD Head of COPSAC, Professor Professor of Pediatrics, University of Copenhagen Founder and Head of the Copenhagen Prospective Studies on Asthma in Childhood; Gentofte Hospital, University of Copenhagen and Naestved HospitalMedicalResearch.com: What is the background for this study? Response: Enamel defects is a global health challenges affecting typically 1/3 of school children and more in some regions. It leads to break down of the teeth and caries later on.MedicalResearch.com: What are the main findings?Response: Supplementation with high-dose vitamin D compared to standard dose in the third pregnancy trimester in a mother child cohort of 588 pairs lead to a significant reduction of enamel defects.Enamel defects was found in 28% of children by age 6 after standard dose of vitamin D supplementation (400 i.u.), compared to 15% after 7-fold higher dose vitamin D.(more…)
Author Interviews, Cost of Health Care, JAMA, NYU, Ophthalmology, Pharmaceutical Companies / 02.08.2019

MedicalResearch.com Interview with: Cassandra L. Thiel, PhD Assistant Professor NYU Langone School of Medicine Department of Population Health NYU Wagner Graduate School of Public Service NYU Tandon School of EngineeringMedicalResearch.com: What is the background for this study? Response: Most healthcare professionals and researchers are aware that the healthcare sector makes up about 18% of the US Gross Domestic Product. What many do not realize is that all of that economic activity results in sizable resource consumption and environmental emissions. The healthcare industry is responsible for 10% of the US’s greenhouse gas (GHG) emissions and 9% of air pollutants.1 Sustainability in healthcare is a developing field of research and practice, and my lab offers data and information by quantifying resource use and emissions of healthcare delivery. We started looking at cataract surgery a few years ago, in part because operating rooms (ORs) typically represent the largest portion of spending and garbage generation in a hospital.2,3 Cataract surgeries are interesting because they are one of the most common surgeries performed in the world. In the US, we spend $6.8 billion on them each year. Any changes we can make to individual cases would have much larger, global impacts.I studied cataract surgeries at a world-renowned, high-volume eye surgery center in India and helped validate that clinical care could be designed in a way that was effective, cost-efficient, and resource efficient. Compared to the same procedure in the UK, this surgery center generates only 5% of the carbon emissions (with the same outcomes).2 This site’s standard policy is to multi-dose their eye drops, or use them on multiple patients until the bottle was empty. As such, the site generated very little waste.Returning to the US, I observed cataract cases and heard the complaints of OR staff that they had to throw out many partially used or unused pharmaceuticals. In reviewing the literature, we could not find a study that quantified how much we were throwing away and what it cost us to do so. We, therefore, set up a study to look at this particular issue.(more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, JAMA, Ophthalmology / 01.08.2019

MedicalResearch.com Interview with: Daejoon Alex Hwang, PhD Instructor in Ophthalmology Investigator, Schepens Eye Research Institute of Mass. Eye and Ear Harvard Medical SchoolMedicalResearch.com: What is the background for this study? Response: Yellow night driving glasses are sold with promises to reduce headlight glare from oncoming traffic and help aging individuals see better at night. Despite a 1997 ruling by the Federal Trade Commission against one company’s claims, the products still remain popular online.We tested three commercially available yellow lens night driving glasses and compare their effectiveness with clear lens glasses on our novel headlight glare simulator in the driving simulator.(more…)