Author Interviews, Cost of Health Care, JAMA, Opiods / 01.04.2020

MedicalResearch.com Interview with: Aparna Soni PhD, Assistant Professor Department of Public Administration and Policy School of Public Affairs American University Washington, DC MedicalResearch.com: What is the background for this study? Response: The United States is in the midst of an opioid epidemic. Opioids are responsible for nearly 50,000 deaths per year and present a substantial financial burden on hospitals. The rate of opioids-related hospital events has tripled since 2005. We are particularly concerned about rising hospitalizations because they may stem from a lack of access to treatment for individuals with opioid use disorder. Medication-assisted treatment is effective in treating opioid use disorder but can be unaffordable for people without health insurance. (more…)
AstraZeneca, Author Interviews, Diabetes, Heart Disease, JAMA / 01.04.2020

MedicalResearch.com Interview with: John J. V. McMurray,  MD FRCP FESC FACC FAHA FRSE FMedSci British Heart Foundation Cardiovascular Research Centre University of Glasgow Glasgow, United Kingdom  Kieran F Docherty DAPA-HF investigator British Heart Foundation Cardiovascular Research Centre, University of Glasgow     MedicalResearch.com: What is the background for this study? Response: DAPA-HF was a double-blind randomized controlled trial comparing dapagliflozin 10 mg once daily with placebo in 4744 patients with heart failure and reduced ejection fraction (HFrEF). The primary outcome was a composite of time to occurrence of a worsening heart failure event (principally heart failure hospitalization) or cardiovascular death, whichever came first. Dapagliflozin reduced the primary outcome by 26% and reduced the risk of each of heart failure hospitalization and cardiovascular death individually, as well as overall mortality. Patient symptoms were also improved. The aim of the present report was to examine the effect of dapagliflozin separately in patients with and without type 2 diabetes at baseline (45/55% split in the trial). The reason for this was that dapagliflozin was originally introduced as a glucose-lowering medication for the treatment of type 2 diabetes. We find that dapagliflozin was equally beneficial in patients with and without diabetes and was as well tolerated in patients without diabetes as in those with diabetes. More remarkably, among the patients without diabetes, dapagliflozin was as effective in participants with a completely normal glycated haemoglobin (HbA1c) as in those with prediabetes. In patients with a normal HbA1c, dapagliflozin did not lead to any reduction in HbA1c, but did improve clinical outcomes.  (more…)
Author Interviews, Erectile Dysfunction, JAMA, Karolinski Institute / 23.03.2020

MedicalResearch.com Interview with: Alexander Stridh, MSc Department of Clinical Neuroscience Karolinska Institute Solna, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​We wanted to investigate how large the effect size is in the placebo arm of clinical trials with PDE5Is for erectile dysfunction. The major findings in this study is that there is a placebo response in general in ED, though it is hard to tell if this is a genuine placebo effect rather than normal fluctuations in symptom severity among patients. Another interesting finding was that the placebo response seems largely more important when the cause of ED is mainly due to psychogenic factors, as in post traumatic stress disorder. Lastly there was an important finding that there was no difference between placebo and active drug with daily treatment of PDE5Is  for long term recovery of erectile function after prostate cancer treatment, a practice which is common in some places and seems to be questionable.  (more…)
Author Interviews, JAMA, Opiods, Pediatrics / 23.03.2020

MedicalResearch.com Interview with: Leah Nelson, MD MS Addiction Medicine Fellow University of New Mexico MedicalResearch.com: What is the background for this study? Response: With the progression of the opioid epidemic over the past decade, more women of reproductive age are seeking treatment for addiction. Many more pregnant women are prescribed methadone and buprenorphine, two opioid medications that prevent relapse and overdose. Maternal use of mediations for opioid use disorder is recommended because it lowers the risk to the fetus from uncontrolled drug use and also allows the mother to engage with prenatal care and social work. Subsequently, the number of infants born after prenatal exposure to opioids is increasing. Several previous studies have shown measurable differences in the cognitive scores of children after prenatal opioid exposure. However, much of the previous work was done on convenience samples (easy to recruit rather than rigorously matched for comparability) and the demographic characteristics of both mothers and children in the exposed and unexposed groups varied widely on important factors such as maternal education, socioeconomics, employment, tobacco use, and infant gender. Each of these factors has been demonstrated to impact early childhood development in the absence of opioid exposure. (more…)
Addiction, Author Interviews, JAMA, Mental Health Research / 20.03.2020

MedicalResearch.com Interview with: Jiajin Yuan, Ph.D Professor of Psychology Director, The Laboratory for Affect Cognition and Regulation, Faculty of Psychology, Southwest University, Chongqing, China MedicalResearch.com: What is the background for this study? Response: Impulsivity is a critical symptom of methamphetamine addiction, and this symptom plays an important role in compulsive, unresistable drug-seeking behavioral and is thus detrimental to the rehabilitation. Impulsivity in drug addiction also contributes to disruption of people's goal pursuit/goal maintenance, and aggressive/violent behaviors after drug use. Also, lack of suitable intervention for addiction-related impulsivity is known to be a risky factor for the drug reuse after successful rehabilitation. Thus, rehabilitaton targeted at impulsivity in methamphetamine addicts is important to comprehensive rehabilitation of the drug addiction and also to successful return to social life after rehabilitation (more…)
Author Interviews, Dental Research, JAMA, Pain Research / 19.03.2020

MedicalResearch.com Interview with: Dr. Romesh P. Nalliah BDS, MHCM Associate Dean for Patient Services Clinical Professor Institute for Healthcare Policy & Innovation Michigan Institute for Data Science Director, Synergy Program MedicalResearch.com: What is the background for this study? Response: We designed and conducted this study because there is a paucity of knowledge related to opioid prescribing for acute dental pain. (more…)
Author Interviews, Gastrointestinal Disease, JAMA, Orthopedics, Pediatrics / 17.03.2020

MedicalResearch.com Interview with: Yun-Han Wang, PhD Student Karolinska Institute MedicalResearch.com: What is the background for this study? Response: Proton pump inhibitor (PPI) use has been linked to increased risk of fracture in adults. Despite an increasing trend in prescription of PPIs in children, there is scarce evidence regarding this safety concern in pediatric patients. (more…)
Author Interviews, JAMA, Pediatrics, Weight Research / 16.03.2020

MedicalResearch.com Interview with: Ashlesha Datar, PhD Senior Economist Director of Program on Children & Families USC Dornsife Center for Economic and Social Research (CESR) University of Southern California  MedicalResearch.com: What is the background for this study? Response: Prior research, including our own work, has suggested that there might be some kind of social contagion or social transmission in obesity. So we wanted to explore that avenue further. In the present study, we showed teens in military families a set of human body figures with varying body sizes and asked them to choose the figure that best captured their ideal body size. (more…)
Author Interviews, Cancer Research, JAMA / 13.03.2020

MedicalResearch.com Interview with: Alyson Haslam, PhD Nutritional Epidemiologist Center for Indigenous Health Research and Policy Oklahoma State University MedicalResearch.com: What is the background for this study? Response: Checkpoint inhibitor drugs for the treatment of cancers have received a lot of attention in recent years because of their ability to induce responses in certain tumors. To quantify the eligibility and response of these drugs in the US population, we published an article about a year ago (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2732329). Since that publication, there were several confirmatory studies that failed to show a benefit in important outcomes such as overall survival or progression-free survival, and the US FDA made some revisions to certain checkpoint inhibitor drug labels. This prompted us to re-evaluate the eligibility of these drugs. (more…)
Author Interviews, Colon Cancer, JAMA, Weight Research / 13.03.2020

MedicalResearch.com Interview with: Dr Laurent Bailly MD, PhD Département de Santé Publique, CHU Nice, Hôpital Archet 1. Niveau1 NICE France  MedicalResearch.com: What is the background for this study? Response: Obesity is known to increase cancer incidence and notably colorectal cancer incidence. Bariatric surgery is an effective treatment of obesity however the association of this surgery with the colorectal cancer remained controversial. We used the French National Health Insurance Information System to conduct a nationwide retrospective cohort study, between 2009 and 2018, of patients hospitalized in France with a diagnosis of obesity. We followed more than 1 million obese individuals aged 50 to 75 years and free of colorectal cancer at baseline, some of them did undergo bariatric surgery and others did not. (more…)
Author Interviews, Hepatitis - Liver Disease, JAMA, USPSTF / 12.03.2020

MedicalResearch.com Interview with: Dr. Michael Barry MD Director of the Informed Medical Decisions Program Health Decision Sciences Center at Massachusetts General Hospital Physician at Massachusetts General Hospital Professor of Medicine,Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hepatitis C affects more people today than ever before, many of whom are younger. If left untreated, it can cause serious, lifelong health problems due to liver damage. The good news is that hepatitis C infection is both preventable and treatable, with recent evidence showing that new treatments for adults are highly effective. Knowing this, we’ve broadened our guidelines to recommend screening for hepatitis C in all adults between the ages of 18 and 79. (more…)
Author Interviews, Cost of Health Care, JAMA, NIH, Social Issues / 12.03.2020

MedicalResearch.com Interview with: Dr. Adan Z. Becerra PhD Senior Epidemiologist for the  NIH Social and Scientific Systems Washington, District Of Columbia MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that disparities in insurance coverage by immigration status exist in the United States such that immigrants compared to nonimmigrants are less likely to have insurance. However, most studies have been cross sectional with few studies investigating long term trajectories of insurance coverage over time. We addressed this gap in the literature by following a cohort of adults for 24 years from before until after reaching Medicare age-eligibility. (more…)
Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Cost of Health Care, Geriatrics, JAMA, Medicare / 12.03.2020

MedicalResearch.com Interview with: Rishi K. Wadhera, MD Harvard Medical Faculty Physicians Cardiovasular Diseases Beth Israel Deaconess Medical Center  MedicalResearch.com: What is the background for this study? Response: In the U.S., income inequality has steadily increased over the last several decades. Given widening inequities, there has been significant concern about the health outcomes of older Americans who experience poverty, particularly because prior studies have shown a strong link between socioeconomic status and health. In this study, we evaluated how health outcomes for low-income older adults who are dually enrolled in both Medicare and Medicaid have changed since the early 2000’s, and whether disparities have narrowed or widened over time compared with more affluent older adults who are solely enrolled in Medicare (non-dually enrolled). (more…)
Author Interviews, Breast Cancer, Genetic Research, JAMA, Stanford / 12.03.2020

MedicalResearch.com Interview with: Allison W. Kurian, M.D., M.Sc. Associate Professor of Medicine (Oncology) and of Epidemiology and Population Health Director, Women’s Clinical Cancer Genetics Program Stanford University School of Medicine Stanford, CA 94305-5405 MedicalResearch.com: What is the background for this study? Response: Genetic testing is increasingly relevant for the care of cancer patients. However, little was known about the prevalence of inherited mutations in cancer susceptibility genes among the most common group of women with breast cancer: those diagnosed after menopause and without a strong family history of cancer.  (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Nutrition, Social Issues / 09.03.2020

MedicalResearch.com Interview with: Alon Peltz, MD MBA MHS  Department of Population Medicine Harvard Pilgrim Health Care Institute MedicalResearch.com: What is the background for this study? Response: Thank you for taking an interest in our study. This study represented a collaboration between investigators from Harvard Medical School and Boston University School of Medicine. SNAP is an important U.S. federal aid program that serves nearly 40 million persons annually with well-established health, nutrition, and financial benefits. Families can be eligible for the SNAP program under “federal” rules or “categorical eligibility” rules that extend SNAP support to otherwise ineligible families who receive benefits under certain social assistance programs, such as Temporary Assistance for Needy Families. In July 2019, the U.S. Department of Agriculture proposed new SNAP policies that would limit qualifications via the categorical eligibility route. Although these new policies have not been finalized, it is estimated that 1 in 10 U.S. families currently participating in SNAP may lose their benefits. We wanted to investigate the potential ramifications of these changes to help inform policymakers of the vulnerabilities of the families who receive SNAP benefits and may be at risk for disenrollment if the proposed policies are implemented. (more…)
Author Interviews, Compliance, Electronic Records, JAMA, University of Pennsylvania / 05.03.2020

MedicalResearch.com Interview with: Alexander C. Fanaroff, MD, MHS Assistant Professor of Medicine, Division of Cardiovascular Medicine University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: This is a secondary analysis of the ARTEMIS, a cluster randomized trial of copayment assistance for P2Y12 inhibitors in patients that had myocardial infarction. One of the primary endpoints of ARTEMIS was persistence with P2Y12 inhibitors: Did the patient continue to take a P2Y12 inhibitor over the entire 1 year following MI? In ARTEMIS, we captured persistence data in two ways, patient report and pharmacy fill records. What we did in this study was to look at the agreement between persistence as measured by these two methods. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmaceutical Companies / 04.03.2020

MedicalResearch.com Interview with: Olivier Wouters, Ph.D. Assistant Professor of Health Policy Department of Health Policy (COW 2.06) London School of Economics and Political Science MedicalResearch.com: What is the background for this study? What are the main findings? Response: Drug companies often point to high research and development costs as justification for the rising prices of new medicines. Yet most prior analyses of research and development costs have been based on confidential data voluntarily supplied by drug companies to researchers with financial ties to the industry. Independent teams have not been able to verify those findings. (more…)
Author Interviews, Cost of Health Care, JAMA, University of Pittsburgh / 04.03.2020

MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy MedicalResearch.com: What is the background for this study? Response: Prior research found that list prices of drugs more than doubled in the last decade. However, because prior research was based on list prices, it did not account for manufacturer discounts, which have also increased in the past few years. We leveraged net pricing data from the investment firm SSR health to estimate increases in drug prices after accounting for discounts. (more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, JAMA, Pediatrics / 03.03.2020

MedicalResearch.com Interview with: Hooman Azad First author and a 3rd year medical student Feinberg School of Medicine Northwestern University Eric Fleegler, MD MPH FAAP Senior author and Pediatric Emergency Physician Boston Children’s Hospital Assistant Professor of Pediatrics and Emergency Medicine Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Pediatric firearm violence is a public health crisis. The firearm fatality rate has increased by >50% over the past 10 years. Over our 26-year study period (1991-2016), 13,697 children under the age of 15 died at the hands of a firearm. Laws have been employed to try to reduce these deaths, and Child Access Prevention (CAP) laws, which aim to hold parents liable for the safe storage of their firearms, were passed in 25 states between 1989-2000. No new state passed a CAP laws after the year 2000. Child Access Prevention laws come in two flavors – recklessness laws that hold firearm owners liable for directly providing firearms to a minor, and negligence laws that hold the firearm owner liable for the unsafe storage of firearms with variability in how storage is defined and what penalties are imposed. (more…)
Addiction, Author Interviews, JAMA, Pediatrics / 02.03.2020

MedicalResearch.com Interview with: Karl Alcover, PhD Postdoctoral Research Associate Behavioral Health Innovations Washington State University MedicalResearch.com: What is the background for this study? Response: It has been a public health focus to prevent early exposure to drugs. Our paper shows that the average age of initiation of drug use among adolescents and young adults has been increasing from 2004 to 2017. We found that 12 of 18 drugs (including alcohol and tobacco products) had statistically increasing average ages of initiation. To our knowledge, no studies have documented these findings. We think this is great news because delaying initiation of drugs prevents early exposure, which we know is associated with various long-term negative health outcomes. Also, these promising trends may serve as initial evidence that prevention strategies, especially those that focus on adolescents and young adults, are working. (more…)
Author Interviews, JAMA, Mental Health Research / 28.02.2020

MedicalResearch.com Interview with: Dr. Aristotle Voineskos MD, PhD, FRCPC Director, Slaight Family Centre for Youth in Transition and Head, Kimel Family Translational Imaging-Genetics Laboratory Campbell Family Mental Health Research Institute CAMH University of Toronto MedicalResearch.com: What is the background for this study? Response: Uncontrolled studies in humans have shown conflicting results regarding effects of antipsychotic medications on brain structure. Recent studies in animals (e.g. rats and non-human primates) show that these medications may be associated with brain volume loss. To date, our knowledge of the effects of antipsychotic medications on brain structure in humans have been limited by the lack of a double-blind, randomized, placebo-controlled trial with brain imaging. Ours is the first such study. It is considered unethical to do such a study in people with schizophrenia, because of the life-saving benefits of these medications in this illness. However, in people with depression also experiencing psychosis, it was possible to do such a study once people experienced remission from their illness. (more…)
Aging, Author Interviews, JAMA / 27.02.2020

MedicalResearch.com Interview with: Dr. Konstantin G. Arbeev, PhD Associate Research Professor Biodemography of Aging Research Unit (BARU) Social Science Research Institute (SSRI) Duke University Dr. Abraham Aviv, MD Department Pediatrics Director, The Center of Human Development and Aging Rutgers New Jersey Medical School MedicalResearch.com: What is the background for this study? Response: A body of research has shown that having comparatively short leukocyte telomere length (LTL) is associated with increased risk of death in adults.    (more…)
Author Interviews, Fertility, Heart Disease, JAMA, OBGYNE / 27.02.2020

MedicalResearch.com Interview with: Shi Wu Wen PhD Senior Scientist, Clinical Epidemiology Program Professor, Department of Obstetrics & Gynecology University of Ottawa MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that having a baby as a result of using assisted procedures such as IVF nearly doubles the chance that a baby will have heart problems. (more…)
Author Interviews, Gastrointestinal Disease, JAMA, Microbiome / 25.02.2020

MedicalResearch.com Interview with: Drs. R.P.J. Willems  |  Arts-onderzoeker Medische Microbiologie en Infectiepreventie Amsterdam MedicalResearch.com: What is the background for this study? Does your study refer to both PPIs and H2-blockers?  Response: There is mixed evidence on the associated risk of colonization and infection with multidrug-resistant microorganisms with acid suppressive therapy. We therefore aimed to investigate current literature in order to determine whether acid suppressants facilitate intestinal colonization with multidrug-resistant microorganisms. We included studies on PPIs, H2 blockers and antacids. (more…)
Aging, Author Interviews, Cannabis, Geriatrics, JAMA, NYU / 24.02.2020

MedicalResearch.com Interview with: Benjamin H. Han, MD MPH Assistant Professor Division of Geriatric Medicine and Palliative Care New York University School of Medicine MedicalResearch.com: What is the background for this study? Response: In the past, the prevalence of cannabis use (both for recreational and for medicinal purposes) was very low among adults age 65 and older. As a reference, the national prevalence rate of past-year cannabis use among adults age 65 and older in 2006-2007 was 0.4%, it has increased dramatically since then. (more…)
Author Interviews, Education, Gender Differences, JAMA, Race/Ethnic Diversity, Yale / 24.02.2020

MedicalResearch.com Interview with: Katherine A. Hill, BA, BS Yale School of Medicine New Haven, Connecticut MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that mistreatment is a common and damaging experience for medical students. However, there is little research on whether the prevalence of medical student mistreatment varies by demographic factors such as student sex, race/ethnicity, and sexual orientation.  (more…)
Author Interviews, Health Care Systems, Heart Disease, JAMA, Medicare / 24.02.2020

MedicalResearch.com Interview with: Rishi K. Wadhera, MD Beth Israel Deaconess Medical Center Harvard Medical Faculty Physicians MedicalResearch.com: What is the background for this study? Response: In recent years, the Centers for Medicare and Medicaid Services has implemented nationally mandated value-based programs to incentivize hospitals to deliver higher quality care. The Hospital Readmissions Reduction Program (HRRP), for example, has financially penalized hospitals over $2.5 billion to date for high 30-day readmission rates. In addition, the Value-Based Purchasing Program (VBP) rewards or penalizes hospitals based on their performance on multiple domains of care.  Both programs have focused on cardiovascular care. The evidence to date, however, suggests that these programs have not improved health outcomes, and there is growing concern that they may disproportionately penalize hospitals that care for sick and poor patients, rather than for poor quality care. (more…)
Author Interviews, JAMA, Surgical Research / 23.02.2020

MedicalResearch.com Interview with: Paulina Salminen MD PhD Chief and Professor of surgery Turku University, Finland MedicalResearch.com: What is the background for this study? Response: Appendectomy has been the standard treatment for uncomplicated acute appendicitis and currently one of the most commonly performed surgical procedures. We now know that there are two different forms of acute appendicitis: the more common milder uncomplicated acute appendicitis and the more severe complicated acute appendicitis. While the complicated form is primarily still treated surgically, in recent years evidence from randomised trials and meta-analyses show that antibiotics are a safe and efficient treatment of uncomplicated acute appendicitis  also at long-term follow-up. Quality of life (QOL) and patient satisfaction after antibiotic therapy or appendectomy for uncomplicated acute appendicitis have been studied previously in a pediatric population but not in an adult population. Our aim was to compare long-term quality of life and patient satisfaction after antibiotic therapy and appendectomy for the treatment of uncomplicated acute appendicitis in patients enrolled in the original APPAC trial. (more…)
Author Interviews, Cancer Research, Cost of Health Care, JAMA, University of Pennsylvania / 20.02.2020

MedicalResearch.com Interview with: Samuel Takvorian, MD, MS Instructor in the Division of Hematology and Oncology LDI Associate Professor University of Pennsylvania Perelman School of Medicine MedicalResearch.com: What is the background for this study? Response: The Affordable Care Act’s Medicaid expansions have been associated with improved access to care, affordability, and for certain surgical and medical conditions, health outcomes. However, studies have also suggested unintended consequences such as lengthened wait times, and there is continued debate about the overall impact of the expansions. (more…)
Author Interviews, Cancer Research, Dermatology, JAMA / 19.02.2020

MedicalResearch.com Interview with: Nikolai Dyrberg Loft MD, Ph.D.-fellow Department of Dermatology and Allergy Gentofte Hospital Hellerup MedicalResearch.com: What is the background for this study? Response: Epidemiological studies examining the association between psoriasis or psoriatic arthritis and cancer have reported conflicting results. Some studies report an increased risk of cancer in individuals with psoriasis or psoriatic arthritis and others do not. Whether individuals with psoriasis or psoriatic arthritis have an increased risk of cancer is important as this might help guiding in clinical practice. In order to determine if there is an increased risk of cancer and the magnitude of this risk, a systematic review of the literature and meta-analysis is needed.  (more…)