Author Interviews, Cost of Health Care, Diabetes, JAMA, Pediatrics / 01.06.2020

MedicalResearch.com Interview with: Kao-Ping Chua, M.D., Ph.D. Assistant Professor, Pediatrics, Medical School Susan B. Meister Child Health Evaluation and Research Center University of Michigan MedicalResearch.com: What is the background for this study? Response: Due to high and rising prices, insulin has become increasingly unaffordable for patients with type 1 diabetes who must pay out-of-pocket for this life-saving medication. Over the past 5 months, many states and insurers have taken steps to cap insulin out-of-pocket spending. For example, Cigna imposed a $25 monthly cap earlier this year. This week, the Centers for Medicare and Medicare Services announced a $35 monthly cap for many Medicare Part D beneficiaries. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics / 01.06.2020

MedicalResearch.com Interview with: Katri RäikkönenKatri Räikkönen Professor, Department of Psychology and Logopedics University of Helsinski MedicalResearch.com: What is the background for this study? Response: Maternal antenatal corticosteroid treatment is standard care when there is a risk for preterm delivery. The treatment improves the prognosis of babies born preterm. In high-income countries, antenatal corticosteroid treatment has been in routine use for over 30 years. Recommendations and clinical care guidelines for maternal antenatal corticosteroid treatment differ between continents and countries. In Finland the treatment is currently recommended when the risk for preterm delivery is at 34 gestational weeks or less. In select cases, the treatment is recommended even later in gestation. Corticosteroids accelerate fetal maturation, especially in the lungs, and increase the child’s resilience to the stress that results from being born preterm. However, antenatal corticosteroids not only cross the placenta, but also cross the the blood-brain barrier and may harm fetal brain development. We are not aware of previous population-based studies that would have tested if maternal antenatal corticosteroid treatment would be associated with mental and behavioral disorders in children and we are not either aware of studies that would have tested if any associations would be explained by shared genetic or familial factors. (more…)
Author Interviews, Blood Clots, Clots - Coagulation, COVID -19 Coronavirus, JAMA / 29.05.2020

MedicalResearch.com Interview with: Dr Tristan Morichau-Beauchant, MD. Intensive Care Unit Centre Cardiologique du Nord Saint-Denis, France MedicalResearch.com: What is the background for this study? Response: During the spread of the COVID-19 epidemic in France, early reports on severe patients stated a highly increased inflammatory response associated with procoagulant changes in coagulation pathways and high D-Dimer levels. Preliminary reports from the intensive care community signaled frequent events of deep vein thrombosis (DVT) among this population. We decided to perform prospectively a venous ultrasonogram of the inferior limbs for all patients with severe COVID-19 pneumonia at admission in our ICU.  All patients had acute respiratory distress syndrome according to the Berlin definition an required mechanical ventilation. Considering the high prevalence of venous thrombosis at admission we repeated a venous ultrasonography after 48 hours if the first exam was normal. All patients received standard anticoagulant prophylaxis since hospital admission. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA / 28.05.2020

MedicalResearch.com Interview with: Soumya Sen PhD McKnight Presidential Fellow Mary & Jim Lawrence Fellow of Carlson School Director of Research, MIS Research Center Associate Professor, Information & Decision Sciences Carlson School of Management University of Minnesota, Minneapolis, MN MedicalResearch.com: What is the background for this study? Response: As the Covid-19 pandemic unfolded across the United States, one of the greatest barriers to understanding the extent of the problem was the lack of reliable and consistent data. Some of the metrics being reported, such as case count and death, are insufficient for hospital capacity planning. Case count is a conservative estimate of the actual number of infected individuals in the absence of community-wide serologic testing, while death count is a lagging metric and insufficient for proactive hospital capacity planning. A more valuable metric for assessing the effects of public health interventions on the health care infrastructure is hospitalizations. Therefore, the Medical Industry Leadership Institute (MILI) and the Management Information Systems Research Center (MISRC) at the Carlson School of Management launched the COVID-19 hospitalization tracking project in March to consistently track and report daily hospitalizations from all reporting states. Tracking daily hospitalization data is a major step forward in quantifying the current impact on local hospital systems, modeling and  forecasting future utilization needs, and tracking the rate of change in the disease severity. It is also useful for understanding the role of health policy interventions in slowing or reducing the impact of the pandemic. (more…)
Author Interviews, Cancer Research, JAMA, Yale / 28.05.2020

MedicalResearch.com Interview with: Daniel J. Boffa, MD Associate Professor of Thoracic Surgery Yale School of Medicine MedicalResearch.com: What is the background for this study? Response: The study examined networks that formed around hospitals that had been previously ranked in the top-50 by US News and World Report.  These top-ranked hospitals have shared their brand with hospitals in their network, which leads some people to believe that the care is the same at top-ranked hospitals and their affiliate hospitals.  We wanted to determine if outcomes after complex surgical procedures were truly the same at affiliate hospitals and top-ranked hospitals.  (more…)
Author Interviews, Gender Differences, JAMA, Surgical Research, University of Pittsburgh / 21.05.2020

MedicalResearch.com Interview with: Sara P. Myers, M.D., Ph.D. University of Pittsburgh School of Medicine  MedicalResearch.com: What is the background for this study? Response: Compared to other fields, medicine, and especially academic surgery and its subspecialties, trail with respect to gender diversity. Considering that these fields were traditionally male-dominated, two issues that may present ongoing challenges to the retention and promotion of women are pro-male bias and negative stereotypes about women. Training specific to pursuing a surgical career begins in residency, so it is important to understand how these issues affect motivation and achievement during this formative period. In our study we first evaluated the association between pro-male bias and research-related career engagement using a survey methodology, and then looked at whether evoking negative stereotypes about women was associated with reduced performance on a simulated technical skill assessment called the Fundamentals of Laparoscopic Surgery (FLS) assessment.  (more…)
Author Interviews, JAMA, Orthopedics, Race/Ethnic Diversity, Surgical Research / 19.05.2020

MedicalResearch.com Interview with: Alyson Cavanaugh, PT, PhD Joint Doctoral Program in Epidemiology University of California, San Diego/ San Diego State University MedicalResearch.com: What is the background for this study? Response: More than 700,000 total knee replacements are performed annually in the United States, but there is a racial disparity in outcomes after the surgery. If the knee replacement procedure is considered a highly effective treatment, why don't black women present with the same outcomes as whites? Physical function when going into surgery has a large impact on the potential functional outcomes after surgery. Our hypothesis was that black women were presenting to surgery with poorer physical function, which was contributing to poorer functional outcomes after surgery. (more…)
Author Interviews, JAMA, STD / 19.05.2020

MedicalResearch.com Interview with: Barbara Van Der Pol, PhD, MPH President, American STD Association President-Elect, International Society fo STD Research Professor of Medicine & Public Health Director, STD Diagnostics Lab Director, UAB STD Clinical Research Organization University of Alabama at Birmingham Birmingham, AL  35294 MedicalResearch.com: What is the background for this study? Response: For many decades, public health programs focused on control and prevention of sexually transmitted infections (STI) have relied on lab based tests that required a 1-day to 1-week wait for test results.  Efforts to shorten the duration of infection lead to treating at the time of the clinic visit based on the association between certain clinical signs or symptoms and the likelihood of infection. Unfortunately, more than ½ of infected persons do not have signs or symptoms so they receive no treatment until test results are available. Thus, a test that could be performed at the clinical site with a limited wait time would improve the accuracy of treatment and shorten the duration of infection. Such a strategy will hopefully reduce the number of return clinic visits, the possibility of transmission, and the potential for consequences of untreated infection such as infertility.  (more…)
Author Interviews, Cost of Health Care, JAMA / 19.05.2020

MedicalResearch.com Interview with: James D. Chambers, PhD, MPharm, MSc Associate Professor of Medicine Tufts Medical Center Institute for Clinical Research and Health Policy Studies MedicalResearch.com: What is the background for this study? Response: We know that biosimilars have not had the same uptake in the US as they have had elsewhere. We know that this is in part due to reference product manufacturer tactics to delay biosimilar market entry and patent disputes. In this study we examined whether lack of preferred coverage by commercial health insurers may also play a role. (more…)
Author Interviews, Cost of Health Care, JAMA, Primary Care / 19.05.2020

MedicalResearch.com Interview with: Sara Martin, MD, MSc Santa Rosa Family Medicine Residency Program Santa Rosa, California MedicalResearch.com: What is the background for this study? Response: To improve access to comprehensive primary care, we need to understand how much is being spent on primary care. Until recently, the United States lacked any data-based estimate of primary care expenditure.  This study utilizes Medical Expenditure Panel Survey (MEPS)data from 2002 – 2016 to estimate the percentage of healthcare expenditures that was spent on primary care. Most discussions around health care expenditure in the U.S. focus on the fact that we spend more than any other country and do not have the corresponding outcomes to match that investment.  This paper focuses the conversation around the distribution of the expenditure. (more…)
Author Interviews, JAMA, Pediatrics, Social Issues, Technology / 18.05.2020

MedicalResearch.com Interview with: Pooja S. Tandon, MD, MPH Center for Child Health, Behavior and Development Seattle Children's Research Institute MedicalResearch.com: What is the background for this study? Response: Cell phone use is common among middle and high school students, yet we do not have an understanding of school cell phone policies and practices in the U.S. We conducted a survey of public schools serving grades 6-12. The survey sent to over 1,100 school principals, representing a national sample of schools across the U.S., asked questions about the presence of a cell phone policy for students and staff and restrictions on phone use. Additional questions addressed consequences of policy violation, the use of cell phones for curricular activities and principals’ attitudes toward cell phone policies. (more…)
Author Interviews, Cannabis, CDC, JAMA, Pediatrics, Tobacco Research / 18.05.2020

MedicalResearch.com Interview with: Susan Hocevar Adkins, MD Lead Author, Senior Medical Officer, and Commander United States Public Health Service CDC MedicalResearch.com: What is the background for this study? Response: Since August 2019, the Centers for Disease Control and Prevention (CDC), the US Food and Drug Administration (FDA), and state, local, and territorial health departments have been investigating a national outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI). Although clinical presentation and outcomes of EVALI patients generally have been reported, data on adolescent patients are more limited. This article fills this gap by using data from national EVALI surveillance at CDC to examine demographic, substance use, and clinical characteristics of adolescent EVALI patients relative to young adult and adult EVALI patients. (more…)
Author Interviews, JAMA, Surgical Research, Weight Research / 16.05.2020

MedicalResearch.com Interview with: Wei Bao, MD, PhD Assistant Professor Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242 and Dr. Yangbo Sun, PhD (Former postdoc research scholar at University of Iowa) Tenure-track Assistant Professor The University of Tennessee Health Science Center.   MedicalResearch.com: What is the background for this study? Response: Obesity is a rising epidemic in the United States and worldwide. Bariatric surgery has been shown to be the most effective and durable treatment for clinically morbid obesity which is difficult to reverse through traditional approaches such as lifestyle intervention. There has been long-standing uncertainty and debate regarding the value of pre-operative weight loss as a requirement for bariatric surgery. Meanwhile, one of the major indicators for surgery outcomes is 30-day mortality after surgery, which is especially important for bariatric surgery because the vast majority of the patients undergoing bariatric surgery are voluntary and if the surgery were not performed, they are not supposed to die in short term. So far, the association of pre-operative weight loss with 30-day mortality after bariatric surgery remains unclear. Therefore, in this study, we examined the associations of pre-operative BMI and weight loss with 30-day mortality following bariatric surgery using a large database among ~500,000 patients who underwent bariatric surgery in the United States and Canada. (more…)
Author Interviews, Cancer Research, Genetic Research, JAMA / 14.05.2020

MedicalResearch.com Interview with:
  • Sung Jun Ma, MD, resident physician in Radiation Medicine at Roswell Park Comprehensive Cancer Center (first author)
  • Oluwadamilola T. Oladeru, MD, a resident physician at Massachusetts General Hospital Cancer Center
MedicalResearch.com: What is the background for this study? Response: More than 40% of women with hormone receptor-positive, HER2-negative early-stage breast cancer have high recurrence scores (RS) of 26-30. Optimal adjuvant systemic therapy in this subgroup remains unclear, and national guidelines currently recommend either chemoendocrine therapy or endocrine therapy alone. In addition, the difference in overall survival of a patient with a RS 26-30 versus RS >30 is unclear. (more…)
Author Interviews, Breast Cancer, Cancer Research, Genetic Research, JAMA / 08.05.2020

MedicalResearch.com Interview with: Anurag K. Singh MD Professor of Oncology Director of Radiation Research Leader, Cell Stress and Biophysical Therapy Program Associate Dean Graduate Medical Education, Research Roswell Park Comprehensive Cancer Center Buffalo NY MedicalResearch.com: What is the background for this study? Response: More than 40% of women with hormone receptor-positive, HER2-negative early stage breast cancer with high recurrence scores (RS) have RS of 26-30. Optimal adjuvant systemic therapy in this subgroup remains unclear, and national guideline currently recommends either chemoendocrine therapy or endocrine therapy alone. In addition, the difference in overall survival of a patient with a RS 26-30 versus RS >30 is unclear.   (more…)
Author Interviews, JAMA, Pediatrics, Tobacco Research, USPSTF / 05.05.2020

MedicalResearch.com Interview with: Dr. Michael Silverstein M.D., M.P.H Professor of Pediatrics Director of the Division of General Academic Pediatrics Vice Chair of Research, Department of Pediatrics Boston University School of Medicine MedicalResearch.com: What is the background for this study? Response: The number of children and teens who use tobacco products continues to be a major issue in the U.S., driven largely by an increase in e-cigarette use, which makes preventing tobacco use among young people critical to the health of our nation. To help prevent kids and teens from starting to use tobacco, the Task Force recommends clinicians provide behavioral interventions, such as education or brief counseling.   (more…)
Author Interviews, Cancer Research, JAMA / 04.05.2020

MedicalResearch.com Interview with: Emerson Y. Chen, MD Assistant Professor of Medicine, Medical Oncology Knight Cancer Institute, Oregon Health & Science University Portland, OR 97239 MedicalResearch.com: What is the background for this study? Response: Our research group had previously studied how oncology drugs are approved in these two previous papers listed below. One is focused on the time delay trade-off from surrogate endpoints (i.e. response rate and progression-free survival) over definite endpoints (i.e. overall survival and quality of life). The other is focused on how promising the response rate of a drug candidate have to be to be considered for oncology drug approval.  (more…)
Author Interviews, Beth Israel Deaconess, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity / 01.05.2020

MedicalResearch.com Interview with: Rishi Wadhera, MD, MPP, MPhil Instructor in Medicine at Harvard Medical School Cardiologist,Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: With more than a million confirmed cases of COVID-19 in the United States, there is growing concern that low-income communities and racial/ethnic minorities may be disproportionately shouldering the burden of the pandemic. New York City, which is comprised of 5 boroughs (Bronx, Brooklyn, Manhattan, Queens, and Staten Island) with unique demographic and socioeconomic characteristics, has emerged as the epicenter of the COVID-19 outbreak. (more…)
Addiction, Author Interviews, JAMA, Opiods / 24.04.2020

MedicalResearch.com Interview with: Tami L. Mark, PhD Senior Director, Behavioral Health Financing and Quality Measurement RTI International  MedicalResearch.com: What is the background for this study? Response: There are effective medications to treat opioid use disorder. Federal and state policymakers have tried to improve access to these medications. However, medications to treat opioid use disorders are still often subject to prior authorization. Studies of other medications finds that prior authorization can reduce access. This study looked at whether removing prior authorization in Medicare Part D plans was associated with increases in the use of medications to treat opioid use disorder.  (more…)
Author Interviews, Emergency Care, Heart Disease, JAMA, UT Southwestern / 22.04.2020

MedicalResearch.com Interview with: Rebecca Vigen, MD, MSCS Assistant Professor of Internal Medicine UT Southwestern MedicalResearch.com: What is the background for this study? Response: Emergency department overcrowding is an urgent health priority and chest pain is a common reason for emergency department visits.  We developed a new protocol that uses high sensitivity cardiac troponin testing with a risk assessment tool that guides decisions on discharge and stress testing for patients presenting with chest pain. The protocol allows us to rule out heart attacks more quickly than the protocols utilizing an older troponin assay. (more…)
Author Interviews, Cannabis, JAMA, Pulmonary Disease / 22.04.2020

MedicalResearch.com Interview with: Alex Hollingsworth PhD Assistant Professor O'Neill School of Public and Environmental Affairs Indiana University MedicalResearch.com: What is the background for this study? What are the main findings? Response: I've been working with Coady Wing and Ashley Bradford on a few different studies of the effects of recreational marijuana laws on drug and alcohol use. Soon after EVALI became a major issue, the prevailing theory from the CDC and others was that EVALI was caused by the use of vitamin E acetate in illegal THC vaping products. Our group read about this and we thought about some of the things that often happen in black markets for illegal drugs. For instance, during the alcohol prohibition era, bootleg alcohol producers often made and sold alcohol products that were not that safe to drink. In more recent years, there are cases where black market sellers of illegal drugs like heroin try to increase profit margins by adding other substances, which can be harmful. We thought that maybe something like that could be happening in EVALI. Perhaps people in states where recreational marijuana is legal tended to purchase marijuana products from the legal market and the legal market was not selling any marijuana vaping products that included vitamin E acetate. (more…)
Abuse and Neglect, Author Interviews, JAMA, Pediatrics / 21.04.2020

MedicalResearch.com Interview with: Barbara Chaiyachati, MD PhD SafePlace: The Center for Child Protection and Health Division of General Pediatrics The Children’s Hospital of Philadelphia, Center for Pediatric Clinical Effectiveness University of Pennsylvania Philadelphia, Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Children in foster care have high rates of medical problems including chronic diseases. There is less known about the differences in mortality for children in foster care. Looking at national data from 2003 to 2016, this study finds that children (ages 1 to 18) in foster care have higher mortality compared to children in the general population and that the difference in mortality has increased over time.   (more…)
Author Interviews, Diabetes, JAMA, Surgical Research / 14.04.2020

MedicalResearch.com Interview with: Katherine Moll Reitz, MD General Surgery Resident University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: Surgical interventions both save lives and improve the quality of those lives each day. However, these same interventions and the recovery thereafter are a major physiologic stressor. Younger, more resilient patients tend to recover faster, with fewer postoperative complications when compared to older, frailer patients undergoing the same surgical treatments. Therefore, investigators at University of Pittsburgh and UPMC have begun focusing on prehabilitation in order to optimize at risk patients preoperatively. Just as an athlete would train for an upcoming event, prehabilitation (including smoking cessation, healthy eating, and physical activity increases) prepares or trains patients for their surgical intervention and can improve their postoperative outcomes. Currently, there is no medication available to aid in this training process, improving patients’ response to the physiologic stress of surgery. Therefore, we are interested in exploring potential safe, well tolerated medical therapies which can optimize patients as pharmacologic prehabilitation. (more…)
Accidents & Violence, Author Interviews, JAMA, Ophthalmology, Pediatrics / 13.04.2020

MedicalResearch.com Interview with: Natasha Nayak Kolomeyer, MD Glaucoma Service, Wills Eye Hospital Co-authors: Eric J. Shiuey, MS Sidney Kimmel Medical College, Thomas Jefferson University Anton M. Kolomeyer, MD, PhD Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Philadelphia, Pennsylvania MedicalResearch.com: What is the background for this study? Response: I still remember the 6-year-old boy that was brought in to our emergency room on July 4th with a ruptured globe (severe eye trauma) due to fireworks; he permanently lost vision in that eye despite surgery. This is not a rare occurrence especially around certain holidays. (more…)
Author Interviews, JAMA, Pediatrics / 10.04.2020

MedicalResearch.com Interview with: Dr Alfredo Tagarro MD PhD Pediatrician - Hospital Universitario Infanta Sofía Clinical Research - Fundación Investigación Hospital Assistant Professor - Universidad Europea de Madrid Madrid MedicalResearch.com: What is the background for this study? Response: Madrid is being hit hard by the disease. Almost all doctors, including pediatricians, are dedicated to attending COVID-19 patients, essencially adults. However, there are some moderate and severe cases among children. In Madrid, clinical pediatricians from 30 hospitals joined their efforts to report and analyze pediatric patients with COVID-19.   (more…)
Author Interviews, JAMA, Kidney Disease, Medicare / 10.04.2020

MedicalResearch.com Interview with: Lead and Senior coauthors contributing to this interview: Abby Hoffman, BA is a Pre-Doctoral Fellow in Population Health Sciences at Duke University and a PhD Candidate in Health Policy and Management University of North Carolina at Chapel Hill. Virginia Wang, PhD, MSPH is an Associate Professor in the Department of Population Health Sciences, Associate Director of the Center for Health Innovation and Outcomes Research, and Core Faculty in the Margolis Center for Health Policy at Duke University and Investigator at the Durham VA HSR&D Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT).   MedicalResearch.com: What is the background for this study? Response: It is well established that healthcare providers are sensitive to changes in price, though their behavioral response varies. Dialysis facilities are particularly responsive to changes in Medicare reimbursement. Many dialysis patients are eligible for Medicare regardless of age, but dialysis facilities generally receive significantly higher reimbursement from private insurers than from Medicare. In 2011, Medicare implemented a new prospective bundled payment for dialysis that was expected to decrease Medicare payment and reduce overall revenues flowing into facilities. Then the Affordable Care Act (ACA) rules against refusing to insure patients for preexisting conditions and the 2014 ACA Marketplace provided an additional avenue for patients to purchase private insurance. As a result of these policies, dialysis facilities had a strong motivation and opportunity to increase the share of patients with private insurance coverage. We were interested in understanding whether dialysis facilities were shifting their payer mix away from Medicare, possibly in response to these policy changes.  (more…)
Accidents & Violence, Author Interviews, JAMA, Johns Hopkins, Pediatrics / 07.04.2020

MedicalResearch.com Interview with: Johnathon P. Ehsani, PhD Assistant Professor Johns Hopkins School of Public Health MedicalResearch.com: What is the background for this study? Response: Car crashes are the leading cause of death and disability for young people. So, what can parents do during the learner stage of licensing to reduce their teenagers’ crash risk during independent driving? The learner stage is a brief window of opportunity to influence the safety of their teenager. This is when teenagers are required to practice driving under the supervision of a licensed adult – typically mom or dad. Once teenagers get their license to start driving on their own, their crash risk increases - but parents have fewer chances to intervene at that point.  (more…)
Author Interviews, Baylor College of Medicine Houston, COVID -19 Coronavirus, JAMA, Stanford / 07.04.2020

MedicalResearch.com Interview with: Melissa Bondy, PhD Chair, Department of Epidemiology and Population Health Stanford University  MedicalResearch.com: What is the background for this study? Response: Faculty researchers in Stanford’s Department of Epidemiology & Population Health and collaborators from Baylor College of Medicine and Stanford’s Department of Dermatology developed an online survey aimed at rapidly assessing public concerns about the COVID-19 crisis. This survey, which was posted on 3 social media platforms (Twitter, Facebook, and Nextdoor) on March 14, 2020, collected invaluable data about COVID-19, including symptoms, concerns, and individual actions taken by respondents. Twitter and Facebook posts were sharable to facilitate snowball sampling. The survey was comprised of 21 (multiple-choice, single-choice, numeric, and open-ended) questions, which were designed to collect data concerning respondent demographics and recent cold and flu-like illnesses (if any), as well as information about participants’ concerns and any lifestyle changes that occurred as a result of the COVID-19 crisis. All questions were optional, so response rates were variable.  (more…)