Author Interviews, JAMA, Prostate Cancer, Race/Ethnic Diversity, UCLA / 03.01.2022

MedicalResearch.com Interview with: Ting Martin Ma, MD, PhD Resident Physician Amar U. Kishan, MD Assistant Professor, Department of Radiation Oncology Vice-Chair of Clinical and Translational Research Department of Radiation Oncology at UCLA MedicalResearch.com: What is the background for this study? Response: We know from epidemiologic studies that  Black men are more likely to be diagnosed with and die of prostate cancer than White men. Recent studies hinted that Black men had better oncological outcome (such as prostate cancer specific mortality and overall survival) responding to systemic therapy for advanced prostate cancer (e.g. cancer that has spread or metastasized to other parts of the body). The question we were trying to answer in this study is: is there a difference in outcomes between Black and White men with localized prostate cancer (cancer that has not spread) receiving definitive radiotherapy enrolled in clinical trials?  (more…)
Author Interviews, Eating Disorders, Exercise - Fitness, JAMA, Pediatrics / 31.12.2021

MedicalResearch.com Interview with: Sean C. Rose, MD Child Neurology Nationwide Children’s Hospital The Ohio State University, Columbus MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is conflicting evidence regarding the association between repetitive head impacts during youth contact sports and worse neurocognitive outcomes.   Most research has been conducted in older adults, while the research in children is mostly limited to 1-2 sports seasons. (more…)
Author Interviews, Diabetes, JAMA, Race/Ethnic Diversity, University of Pennsylvania / 20.12.2021

MedicalResearch.com Interview with: Lauren A. Eberly, MD, MPH Clinical Fellow, Cardiovascular Medicine Perelman School of Medicine Cardiovascular Division, Perelman School of Medicine Center for Cardiovascular Outcomes, Quality, and Evaluative Research, Cardiovascular Center for Health Equity and Social Justice, Leonard Davis Institute of Health Economics University of Pennsylvania, Philadelphia MedicalResearch.com: What is the background for this study? Response: Racial inequities are pervasive in our country, and cardiovascular therapeutics with proven benefit have been shown to be underutilized among Black and Latinx patients. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a recommended treatment option for glycemic control in patients with diabetes, have recently emerged as a cardioprotective therapy as multiple large randomized clinical trials have shown they prevent cardiovascular events among patients with Type 2 Diabetes (T2D), particularly patients with established atherosclerotic cardiovascular disease (ASCVD). Given this, they are now recommended therapy for patients with diabetes and established or high risk of ASCVD. Given the known inequitable utilization of other therapies, along with the known higher burden of diabetes and cardiovascular disease among Black patients, the aim of this study was to evaluate the uptake of GLP-1 RA as well as for inequities in utilization. (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Social Issues, Transplantation / 14.12.2021

MedicalResearch.com Interview with: Rebecca Thorsness, PhD Research Associate Department of Health Services, Policy, and Practice Brown University School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2019, the President signed the Advancing American Kidney Health executive order, which included provisions to increase the use of home dialysis and kidney transplant for Americans living with kidney failure. To carry out this vision, the Centers for Medicare & Medicaid Services (CMS) developed the ESRD Treatment Choices (ETC) payment model, which uses financial incentives and penalties to incentivize dialysis facilities to pursue home dialysis or kidney transplant for their patients. Transplant and home dialysis are optimal care for people with kidney failure, but there are social and clinical reasons that patients with high social risk (such as those exposed to racism, poverty, or housing instability) may not be candidates for these treatments. This means that facilities which serve a large number of patients with high social risk might be disproportionately penalized by this new payment model. Using data immediately prior to the implementation of the ETC model, we found that dialysis facilities that serve high proportions of patients with high social risk have lower rates of home dialysis and kidney transplantation than facilities that care for lower proportions of such patients. (more…)
Author Interviews, JAMA, Opiods, University of Pennsylvania / 14.12.2021

MedicalResearch.com Interview with: Ashish Thakrar, MD Internal Medicine & Addiction Medicine National Clinician Scholars Program University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: About 1.8 million Americans are currently incarcerated, more than any other country in the world per capita. Of those 1.8 million, about 1 in 7 suffers from opioid addiction, putting them at high risk of overdose and death, particularly in the weeks following release. Opioid use disorder is a treatable condition, particularly with the medications buprenorphine or methadone, but historically, prisons and jails have not offered treatment. Over the past five years, a few states and municipalities have enacted policies to provide access for OUD treatment. We examined whether these policies were actually improving access to treatment.  (more…)
Aging, Alzheimer's - Dementia, Author Interviews, Blood Pressure - Hypertension, JAMA / 14.12.2021

MedicalResearch.com Interview with: Jan Willem van Dalen, PhD Department of Neurology Donders Institute for Brain, Behaviour and Cognition Radboud University Medical Centre Nijmegen Department of Neurology The Netherlands3Department of Public and Occupational Health Amsterdam UMC, University of Amsterdam, Amsterdam   MedicalResearch.com: What is the background for this study? Response: Although high systolic blood pressure in midlife has consistently been reported as a condition that increases the risk of developing dementia in old age, reports regarding this relationship in older people have been inconsistent. One potential reason for this, is that the relationship between systolic blood pressure and dementia in later life may be U-shaped, meaning that both individuals with low and with high systolic blood pressure are at increased incident dementia risk. This study combined data from several longitudinal cohort studies specifically designed to study incident dementia in older people, to investigate whether these U-shaped relationships exist, and in which age ranges they appear. We included more than 16,500 people aged 60 and older, with over 2,700 incident dementia cases. Also, we aimed to investigate whether these observational associations might be caused by confounding, differences in mortality, or result from opposite relationships between certain subgroups of individuals. (more…)
Author Interviews, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, JAMA / 13.12.2021

MedicalResearch.com Interview with: Liise-anne Pirofski, M.D. Mitrani Professor of Biomedical Research Chief, Division of Infectious Diseases Albert Einstein College of Medicine and Montefiore Medical Center Liise-anne Pirofski, MD on behalf of lead authors Mila Ortigoza MD, PhD, Assistant professor at NYU Langone Health and Hyunah Yoon MD, Assistant Professor, Albert Einstein Medical Center and the CONTAIN COVID-19 trial authors and team MedicalResearch.com: What is the background for this study? Response: The study was designed to determine the efficacy of COVID-19 convalescent plasma (CCP) in hospitalized patients with COVID-19. It was designed and launched in New York City in April 2020 during the height of the first COVID-19 pandemic wave and later extended to sites in Miami, Houston, and other regions affected by subsequent waves of the pandemic. At that time, there were no validated therapeutic options for COVID-19, and there was clinical equipoise for CCP use in hospitalized patients. COVID-19 convalescent plasma was considered worthy of investigation because of the historical success of convalescent plasma in prior pandemics and epidemics dating to the beginning of the 20th century, and importantly, biological plausibility because convalescent plasma contains antibodies to agents from which people have recovered, and case series and observational studies showing signals of CCP efficacy in patients with COVID-19. The trial was designed to focus on patients with moderate to severe COVID-19 who required supplemental oxygen, but not mechanical intubation. At the time the trial was designed, hospitals in New York City were overwhelmed with severely and critically ill patients with COVID-19, an entirely new disease about which more and more was learned over the 11 months the trial was conducted.  (more…)
Author Interviews, Cost of Health Care, JAMA, Medicare / 12.12.2021

MedicalResearch.com Interview with: Jeanne Madden, PhD Associate Professor Department of Pharmacy and Health Systems Sciences School of Pharmacy and Pharmaceutical Sciences Bouvé College of Health Science Northeastern University MedicalResearch.com: What is the background for this study? Response: Medicare is the US public insurance program mainly serving people 65 years and older, but also some younger adults who have long-term disabling conditions. As such, on average, the Medicare population bears a heavy burden of illness and has high health care needs, compared to the general US population. The under-65 group for the most part has quite low incomes, while the older group represents a wide spectrum, from poor to well-off. Medicare beneficiaries also differ a great deal in terms of whether they have access to supplemental insurance that can help with patient cost-sharing requirements. I’m referring to Medicaid assistance, or a self-purchased Medigap plan, or retiree health benefits, etc. The cost-sharing requirements in traditional Medicare are substantial — e.g., 20% for doctor visits — and there is no annual cap on patient out-of-pocket spending. That’s in contrast to commercial insurance and Medicare Advantage managed care plans — all of those have an annual cap on patient out-of-pocket costs. There’s a good amount of existing research on whether people in Medicare can afford their drugs, and on the affordability of medical care among younger groups such as working-aged uninsured people and those in ACA exchange plans. But there hasn’t been much research into medical care affordability among older Americans. (more…)
Author Interviews, Dental Research, JAMA, Pediatrics, USPSTF / 10.12.2021

MedicalResearch.com Interview with: Michael Cabana, M.D., M.A., M.P.H Professor of Pediatrics Albert Einstein College of Medicine. Physician-in-chief , Children's Hospital at Montefiore Chair of the Department of Pediatrics Albert Einstein College of Medicine Member, U.S. Preventive Services Task Force  MedicalResearch.com: What is the background for this study and recommendation statement?  Response: Dental caries, also known as cavities or tooth decay, is the most common chronic disease in children in the United States and can develop in any child whose teeth have come in. Many young children under five years old do not visit a dentist, so the Task Force reviewed the latest evidence on how primary care clinicians can help prevent tooth decay in young children. The Task Force’s research led to two important findings: all young children whose teeth have come in should have fluoride varnish applied by their clinician, and all children six months and older whose water supply doesn’t contain enough fluoride should receive fluoride supplements. Both approaches can help prevent cavities in kids. The Task Force also determined that there is not enough evidence to recommend for or against screening for tooth decay in the primary care setting for children under five. This is consistent with the Task Force’s 2014 recommendation on dental caries. (more…)
Author Interviews, Gender Differences, JAMA / 09.12.2021

MedicalResearch.com Interview with: Christopher J. D. Wallis, MD, PhD Assistant Professor, Division of Urology University of Toronto Urologic Oncologist, Division of Urology Mount Sinai Hospital and University Health Network MedicalResearch.com: What is the background for this study? Response: Previous research has shown that female and male physicians communicate differently with patients. Further, there is evidence that female physicians, including surgeons, spend more time with patients. This, coupled with evidence that female patients may experience disparities in the management of their pain, led us to consider that communication differences may underpin differences in surgical outcomes previously noted (eg. Wallis et al, BMJ 2017) between male and female physicians. We postulated that there may be a differential association between surgeon sex and patient sex in behaviours that would translate into clinically important outcomes. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Ophthalmology / 06.12.2021

MedicalResearch.com Interview with: Cecilia S. Lee, MD, MS Associate Professor,Director, Clinical Research Department of Ophthalmology Harborview Medical Center University of Washington Seattle, WA MedicalResearch.com: What is the background for this study? Response: Cataract is a natural aging process of the eye and affects the majority of older adults who are at risk for dementia. Sensory loss, including vision and hearing, is of interest to the research community as a possible risk factor for dementia, and also as a potential point of intervention. Because cataract surgery improves visual function, we hypothesized that older people who undergo cataract surgery may have a decreased risk of developing Alzheimer disease and dementia. We used the longitudinal data from an ongoing, prospective, community based cohort, Adult Changes in Thought (ACT) study. The ACT study includes over 5000 participants to date who are dementia free at recruitment and followed until they develop Alzheimer disease or dementia. We had access to their extensive medical history including comprehensive ophthalmology visit data. We investigated whether cataract surgery was associated with a decreased risk of developing Alzheimer disease and dementia.  (more…)
Author Interviews, JAMA, Johns Hopkins, Weight Research / 25.11.2021

MedicalResearch.com Interview with: Alejandra Ellison-Barnes, MD MPH General Internal Medicine Johns Hopkins Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Emerging adulthood is a unique period of development that ultimately leads to the formation of adult identity, but how this stage contributes to obesity is relatively understudied. The prevalence of obesity has been increasing in the United States population as a whole, and we wanted to know how mean body mass index and the prevalence of obesity have changed over the past several decades specifically among emerging adults. We found that among emerging adults aged 18 through 25, mean BMI has increased from 23.1 kg/m2 in 1976-1980 to 27.7 kg/m2 in 2017-2018. In the same period, the prevalence of obesity increased from 6.2% to 32.7%. (more…)
Author Interviews, JAMA, Mayo Clinic, Race/Ethnic Diversity, USPSTF / 20.11.2021

MedicalResearch.com Interview with: Chyke A. Doubeni, M.D., M.P.H. Member of the U.S. Preventive Services Task Force since 2017 Director, the Mayo Clinic Center Health Equity and Community Engagement Research Department of Family Medicine Mayo Clinic in Rochester, MN  MedicalResearch.com: What is the background for this study? What are the main findings? Response: People who experience systemic racism generally have shorter life expectancies and experience more health problems. Racism can increase the chances of getting preventable conditions, limit access to health information, and restrict access to actual preventive care. To confront these issues and promote antiracism and health equity, the Task Force commissioned a review of the evidence around how systemic racism currently undermines preventive healthcare. Based on that review, the Task Force has developed an initial set of strategies to reduce the effects of systemic racism, which includes prioritizing topics that are likely to advance health equity, assessing the Task Force’s language to ensure it is culturally appropriate, and calling for more research in people of color.  (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, University of Pennsylvania / 18.11.2021

MedicalResearch.com Interview with: Ashwin Nathan, MD, MSHP Assistant Professor, Medicine, Perelman School of Medicine Interventional Cardiologist Hospital of the University of Pennsylvania and at the Corporal Michael C. Crescenz VA Medical Center in Philadelphia Penn Cardiovascular Outcomes, Quality & Evaluative Research Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: We found that the rates of TAVR were lower in areas with higher proportions of Black, Hispanic and socioeconomically disadvantaged patients. Inequities in access in areas with higher proportions of Black and Hispanic patients existed despite adjusting for socioeconomic status. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lipids / 16.11.2021

MedicalResearch.com Interview with: Nicholas A. Marston, MD, MPH Thrombolysis in Myocardial Infarction (TIMI) Study Group Brigham and Women’s Hospital Harvard Medical School Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: There has been recent debate about how much of lipid-associated cardiovascular risk is from LDL cholesterol versus triglycerides. However, genetic studies suggest that apolipoprotein B is actually the primary driver of atherosclerotic risk. Since there is exactly one apoB lipoprotein on each lipid particle (LDL, IDL, VLDL), its measurement is a surrgate for the total number of apoB-containing lipoproteins. So in this study, we asked the question: Do common measures of cholesterol concentration, triglyceride concentration, or their ratio carry predictive value for cardiovascular risk beyond the number of apo-B containing lipoproteins? (more…)
Author Interviews, Coffee, Heart Disease, JAMA, OBGYNE / 09.11.2021

MedicalResearch.com Interview with: Stefanie N. Hinkle, PhD Assistant Professor Department of Biostatistics Epidemiology and Informatics Perelman School of Medicine University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: Over 80% of U.S. women of reproductive age consume caffeine daily.While most women decrease consumption after becoming pregnant, many continue to consume caffeine throughout pregnancy. The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women limit their caffeine consumption to <200 mg/d out of an abundance of caution due to potential associations with pregnancy loss and fetal growth restriction at higher intakes. There remains limited data on associations with maternal cardiometabolic outcomes in pregnancy.   (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Vaccine Studies / 04.11.2021

MedicalResearch.com Interview with: Rani Elwy, PhD Bridge Quality Enhancement Research Initiative Program, Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System Bedford, Massachusetts Department of Psychiatry and Human Behavior, Alpert Medical School Brown University, Providence, Rhode Island  MedicalResearch.com: What is the background for this study? Response: The VA operates a very robust, embedded quality improvement and implementation science program, of which our team is involved. As the VA was one of the first US healthcare systems to rollout COVID-19 vaccination programs, we were asked to evaluate these efforts in real-time, to provide input to VA healthcare leaders on what was going well and what could be improved. This survey reported in JAMA Network Open is one of the quality improvement efforts we engaged in. (more…)
Author Interviews, Infections, JAMA, Multiple Sclerosis, Neurological Disorders / 27.10.2021

MedicalResearch.com Interview with: Prof. Scott Montgomery Professor of medical science (clinical epidemiology) Örebro University, Sweden Director of Clinical Epidemiology and Biostatistics Örebro University Hospital, Sweden MedicalResearch.com: What is the background for this study? Response: Infections have been linked with increased risk of subsequent multiple sclerosis (MS), but it has been suggested this may be because the genetic or other family characteristics of people who go on to develop MS have a more severe response to infections: the infections would be more likely to be recorded in those who would subsequently develop MS, rather than being risk factors for the disease. To address this issue, we performed a large study of 2,492,980 people living in Sweden, and 5,867 of them had a diagnosis of MS after age 20 years. We identified who had a hospital diagnosis of infectious mononucleosis (caused by Epstein-Barr virus, EBV infection, and also known as glandular fever or the kissing disease). The new study was different from other studies of infection and MS risk, as it compared siblings in the same families. Siblings share much of their genetic make-up and have similar family lives. If glandular fever is associated with later MS when siblings are compared, then it is unlikely that the association is caused by genetics or other family characteristics that make infections worse in people more likely to develop future MS. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Surgical Research / 27.10.2021

MedicalResearch.com Interview with: Joel S. Weissman, PhD Deputy Director/Chief Scientific Officer Center for Surgery and Public Health Brigham and Women's Hospital/Harvard Medical School Professor of Surgery (Health Policy) Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Over time, the military health system has been shifting care for its soldiers and their families away from big military treatment facilities (MTFs), allowing soldiers and their families to get care from civilian hospitals.  But this has had an unintended consequence.  Unfortunately, it means that military surgeons are getting fewer cases, and they are worried about maintaining their skills as surgeons.  But some surgeries count more than others to help prepare the surgeon for battlefield casualties.  (more…)
Author Interviews, Cannabis, JAMA, Pediatrics / 25.10.2021

MedicalResearch.com Interview with: Carmen Lim BSc(Hons), MSc, CStat PhD Candidate National Centre for Youth Substance Use Research Faculty of Health and Behavioural Sciences The University of Queensland Brisbane Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: This review has systematically summarized the trends and products used for cannabis vaping using 17 studies published globally between Jan 1, 2003 and August 19, 2020. The pooled prevalence has increased for lifetime use (6.1% in 2013 to 13.6% in 2020), past-year use (7.2% in 2017 to 13.2% in 2020) and past-month use (1.6% in 2013 to 8.4% in 2020). Adolescents' preference for cannabis products may be shifting from less potent products (e.g., herbal cannabis) to highly potent vape oil and concentrates. (more…)
Author Interviews, Cost of Health Care, JAMA, Lung Cancer, Stanford, USPSTF / 24.10.2021

MedicalResearch.com Interview with: Summer S Han, PhD Assistant Professor Quantitative Sciences Unit Stanford Center for Biomedical Informatics Research (BMIR) Neurosurgery and Medicine Stanford University School of Medicine Stanford, CA 94304  MedicalResearch.com: What is the background for this study? Response: The US Preventive Services Task Force (USPSTF) issued their 2021 recommendation on lung cancer screening lowering the start age from 55 to 50 years and the minimum pack-year criterion from 30 to 20, relative to the 2013 recommendations. Although costs are expected to increase with the expanded screening eligibility, it is unknown if the new guidelines for lung cancer screening are cost-effective. (more…)
Author Interviews, Cognitive Issues, COVID -19 Coronavirus, JAMA, Occupational Health / 24.10.2021

MedicalResearch.com Interview with: Jacqueline H. Becker, Ph.D. Clinical Neuropsychologist Associate Scientist Division of General Internal Medicine Icahn School of Medicine at Mount Sinai  MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study leverages data being collected through the ongoing Mount Sinai Health System Post-COVID-19 Registry, which is led by Dr. Juan Wisnivesky, Professor of Medicine and Chief of the Division of General Internal Medicine at the Icahn School of Medicine at Mount Sinai and senior author of the study. Our study concluded that there may be long-term cognitive repercussions from COVID-19 that impact individuals in various age groups and across the spectrum of disease severity, although the frequency of cognitive impairment was highest among patients who were previously hospitalized for COVID-19.  (more…)
Author Interviews, COVID -19 Coronavirus, JAMA / 22.10.2021

MedicalResearch.com Interview with: Destin Groff, BA Ashley Sun BA Department of Surgery and Paddy Ssentongo MD PhD Department of Public Health Sciences Center for Neural Engineering Department of Engineering, Science and Mechanics The Pennsylvania State University, State College Penn State College of Medicine and Milton S. Hershey Medical Center Hershey, Pennsylvania  MedicalResearch.com: What is the background for this study? Response: Most people who get sick from COVID-19 will survive. However, the burden of long-term consequences among the survivors is not well-characterized. That is what inspired this study.  MedicalResearch.com: What are the main findings? Response: After compiling data from 57 studies involving 250,351 unvaccinated individuals, our study shows that more than half of those worldwide who have been diagnosed with COVID-19 experience six months after recovering. The most common sequelae involve functional mobility impairments, pulmonary abnormalities, and mental health disorders, including memory deficits, concentration difficulty, post-traumatic stress disorders, depression, and anxiety. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Cost of Health Care, JAMA / 20.10.2021

MedicalResearch.com Interview with: Anita Katharina Wagner, PharmD, MPH, DrPH Associate Professor of Population Medicine Director, Ethics Program, Point32Health (parent company of Harvard Pilgrim Health Care and Tufts Health Plan) Co-Director, HMS Fellowship in Health Policy and Insurance Research Co-Director, Center for Cancer Policy and Program Evaluation (CarPE) Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The expectation for new cancer drugs is that they help patients live better longer. Increasingly more cancer drugs are approved without documented quality of life or overall survival benefits.   At the same time, cancer drug prices are rising.  We studied use of and spending on selected new cancer drugs among patients with employer-sponsored health insurance. We found that among 37348 patients who received one or more of 44 oral targeted cancer drugs, the proportion of patients who received a drug without documented overall survival benefit increased from 13% in 2011 to 59% in 2018.  By 2018, spending on drugs without documented overall survival benefit accounted for 52% of the $3.5 million spend on the 44 drugs since 2011. (more…)
Author Interviews, JAMA, Race/Ethnic Diversity, Surgical Research, Weight Research / 18.10.2021

MedicalResearch.com Interview with: Amresh D. Hanchate, PhD Professor, Department of Social Sciences and Health Policy Director, Program in Health Services Research Division of Public Health Sciences Wake Forest School of Medicine Medical Center Boulevard Winston-Salem, NC  27157-1063 MedicalResearch.com: What is the background for this study? Response: There is strong evidence of increase in access to outpatient physicians among low income individuals who gained Medicaid following changes initiated with the Affordable Care Act. But there is little evidence of whether Medicaid expansion has similarly resulted in increased use of elective inpatient procedures. Bariatric surgery is a particularly important service to study, as the number of adults with severe obesity continues to grow in the United States, and this is the most effective available treatment. Additionally, bariatric procedures are primarily performed among the age group targeted by Affordable Care Act expansions (18-64), and there is a lot of evidence that only a small fraction of eligible uninsured patients are having surgery.  (more…)
Author Interviews, JAMA, OBGYNE, USPSTF / 06.10.2021

MedicalResearch.com Interview with: Aaron B. Caughey, M.D., M.P.P., M.P.H., Ph.D. Professor and ChairDepartment of Obstetrics and Gynecology Associate dean for Women’s Health Research and Policy Oregon Health & Science University in Portland, OR. Founder and Chair, Centers for Disease Control and Prevention–funded Oregon Perinatal Collaborative MedicalResearch.com: What is the background for this study? What are the main findings? Response: Preeclampsia is one of the most serious health problems that can occur during pregnancy. It can lead to preterm birth, and in some cases even death of the pregnant person and their baby. The Task Force looked at the latest available evidence and found that low-dose aspirin can help prevent preeclampsia in pregnant people who are at highest risk, and it can also protect their babies. This new final recommendation is consistent with the Task Force’s 2014 recommendation statement and has the potential to save many lives.  (more…)
Author Interviews, CDC, Emergency Care, JAMA / 06.10.2021

MedicalResearch.com Interview with: Dr. Daniel S.  Budnitz MD MPH CAPT, USPHS Division of Healthcare Quality Promotion Director, Centers for Disease Control and Prevention’s Medication Safety Program Atlanta, Georgia  MedicalResearch.com: What is the background for this study?  Response: Medications are generally safe when used as prescribed or as directed on the label, but there can be risks in taking any medication. Adverse drug events are harms resulting from the use of medication. The risk of adverse drug events is highest among older adults and very young children. Older adults have higher risks because they typically take more medications and are more likely to have underlying medical conditions. Very young children have higher risks because they often find and ingest medications meant for others. Previous studies of medication safety have focused on harm from medications when taken for therapeutic reasons. Separate studies have focused on harm from specific types of non-therapeutic use (taking medications for recreational use or self-harm). This study examined the number of emergency department (ED) visits that resulted when people who took medications for any reason – as directed by a clinician or for other reasons, including recreational use or intentional self-harm.  (more…)
Author Interviews, Biomarkers, Heart Disease, JAMA, Technology / 05.10.2021

MedicalResearch.com Interview with: Pinar Zorlutuna, PhD Sheehan Family Collegiate Professor of Engineering Aerospace and Mechanical Engineering Chemical and Biomolecular Engineering (Concurrent) Bioengineering Graduate Program University of Notre Dame  MedicalResearch.com: What is the background for this study? Response: Acute myocardial infarction (AMI) is the primary cause of death among cardiovascular diseases. The current clinical standard of diagnosis combines echocardiogram (ECG) and several circulating protein biomarkers from plasma. In their current state, both are incapable of distinguishing between patients with and without complete coronary occlusion, unless additional invasive testing is implemented, and both have significant false positive rates. MicroRNAs (miRNAs) have shown great potential as rapid and discriminating biomarkers for acute myocardial infarction (AMI) diagnosis. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Stroke / 30.09.2021

MedicalResearch.com Interview with: Daniel E. Singer, MD Professor of Medicine, Harvard Medical School Professor in the Department of Epidemiology Harvard T.H. Chan School of Public Health Division of General Internal Medicine Massachusetts General Hospital Boston, MA, 02114 MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) raises the risk of ischemic stroke 4-5-fold and this risk is largely reversible by oral anticoagulants (OAC). These facts are part of the core knowledge of internal medicine and the basis of multiple guidelines. They are based on studies of patients with persistent or predominantly “heavy burden” paroxysmal AF completed in the 1990s. More recent studies using cardiac implantable devices (CIEDs: implantable defibrillators, pacemakers, etc) which have the capacity to monitor heart rhythm continuously have found that many older patients have brief, often undiagnosed, episodes of AF. Several of these studies have found that strokes occur during periods of sinus rhythm temporally distant from a preceding episode of AF. This has led to a widespread suspicion that AF is not a direct causal risk factor but a risk “marker” indicating the presence of other truly causal features like a diseased left atrium (atrial myopathy). If the risk marker hypothesis is correct, then long-term anticoagulation is needed even for brief and rare episodes of AF (assuming the patient’ s CHA2DS2-VASc score is high enough). The key problem with prior prospective studies using CIEDs was that only a small number of strokes were observed leading to inadequate statistical power. Our study addressed this power problem by linking the very large Optum electronic health record database which could identify ischemic strokes with the Medtronic CareLink database of long-term, continuous heart rhythm records of patients with CIEDs. We ended up studying 891 individuals who had an ischemic stroke and had 120 days of continuous heart monitoring prior to the stroke. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Kidney Disease, Transplantation / 27.09.2021

MedicalResearch.com Interview with: Joel T. Adler, MD, MPH Department of Surgery, Brigham and Women’s Hospital Center for Surgery and Public Health Brigham and Women’s Hospital Boston, Massachusetts  MedicalResearch.com: What is the background for this study? Response: For patients who require renal replacement therapy for failed kidneys, kidney transplantation increased length of life and improves quality of life.  For many of these patients, their dialysis centers are the source of referral for evaluation for transplantation.  These dialysis centers have a number of publicly-reported quality measures, but they largely focus on the provision of dialysis care and not how often the centers’ patients undergo a kidney transplant.  Because these higher-rated facilities provide better dialysis care, we wanted to know if that benefit also spilled over into higher transplant listing rates. (more…)