JAMA

11 Sep

Posted at 13:17h in Author Interviews, Emory, Health Care Systems, JAMA, Kidney Disease, Transplantation
 A retraction and replacement have been issued due to a major coding error that resulted in the reporting of incorrect data in this study surrounding the difference in transplant rates between for-profit and non-profit dialysis centers. Please see link below:

Bauchner H, Flanagin A, Fontanarosa PB. Correcting the Scientific Record—Retraction and Replacement of a Report on Dialysis Ownership and Access to Kidney Transplantation. JAMA. 2020;323(15):1455. doi:10.1001/jama.2020.4368

MedicalResearch.com Interview with: [caption id="attachment_51140" align="alignleft" width="122"]Rachel Patzer, PhD, MPH Associate Professor Director, Health Services Research Center Department of Medicine Department of Surgery Emory University School of Medicine Dr. Patzer[/caption] Rachel Patzer, PhD, MPH Associate Professor Director, Health Services Research Center Department of Medicine Department of Surgery Emory University School of Medicine   MedicalResearch.com: What is the background for this study? Response: We know that historically, for-profit dialysis facilities have been shown to have lower rates of kidney transplantation than patients who receive treatment in non-profit dialysis facilities. However, these studies are outdated, and did not examine access to living donor transplantation or include the entirety of the end-stage kidney disease population 

10 Sep

Posted at 10:55h in Author Interviews, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_51215" align="alignleft" width="200"]Nariman Sepehrvand, MD Research Associate & PhD Candidate Canadian VIGOUR Centre, and Department of Medicine, University of Alberta, Edmonton, Canada Dr. Sepehrvand[/caption] Nariman Sepehrvand, MD Research Associate & PhD Candidate Canadian VIGOUR Centre, and Department of Medicine, University of Alberta, Edmonton, Canada Medical Research: Can you tell us a little bit about the background of this study? Dr. Sepehrvand: As you know the traditional randomized clinical trials (RCT) have been criticized from time to time for the lack of generalizability, high costs and lengthy processes. Pragmatic trials with the primary goal of informing patients, clinicians, healthcare administrators and policy-makers about the effectiveness of biomedical and behavioral interventions have the potential to address those shortcomings by enrolling a population representative of the populations in which the intervention will be eventually applied to and by streamlining and simplifying the trial-related procedures. We knew about the challenges that trialists encounter in the design and implementation of pragmatic trials, so we were wondering how pragmatic or explanatory are cardiovascular (CV) RCTs and if there has been any change over time!

09 Sep

Posted at 18:09h in Author Interviews, Biomarkers, JAMA, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_28740" align="alignleft" width="200"]Elizabeth D. Kantor, PhD MPH Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center NY, NY Dr. Elizabeth D. Kantor[/caption] Elizabeth D. Kantor, PhD MPH Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center NY, NY MedicalResearch.com: What is the background for this study? Response: There has been recent interest in understanding how exposures in childhood and adolescence relate to later-life health outcomes. Although inflammation is thought to play a role in the etiology of various diseases, little is known about the long-term implications of inflammation in early life. We therefore sought to evaluate how erythrocyte sedimentation rate (ESR), a marker of inflammation, measured among ostensibly healthy men in late adolescence, relates to subsequent cause-specific mortality. We found that men with high inflammation in late adolescence experienced increased mortality due to cancer and cardiovascular disease.

09 Sep

Posted at 17:30h in Author Interviews, Emergency Care, JAMA, Race/Ethnic Diversity
MedicalResearch.com Interview with: [caption id="attachment_51209" align="alignleft" width="142"]Amresh D Hanchate, PhD Research Assistant Professor Department of Medicine, School of Medicine Boston University Dr. Hanchate[/caption] Amresh D Hanchate, PhD Research Assistant Professor Department of Medicine, School of Medicine Boston University MedicalResearch.com: What is the background for this study? Response: National guidelines require EMS transportation to the nearest suitable hospital. To what extent this occurs and whether this varies by the race and ethnicity of the patient is unknown since there is little to no prior research on destination patterns of EMS-transported patients to hospitals.

07 Sep

Posted at 21:41h in Author Interviews, Heart Disease, JAMA, Occupational Health
MedicalResearch.com Interview with: [caption id="attachment_51143" align="alignleft" width="155"]Rachel Zeig-Owens, Dr.P.H., MPH FDNY  Research Assistant Professor Albert Einstein Medical Center Dr. Zeig-Owens[/caption] Rachel Zeig-Owens, Dr.P.H., MPH FDNY Research Assistant Professor Albert Einstein Medical Center MedicalResearch.com: What are the main findings? Response: We found that the most exposed members, those who arrived first at the World Trade Center (WTC ) site—when the air-borne dust was thickest—have a 44% increased risk of cardiovascular disease (CVD) compared to those who arrived later in the day. This is a level risk that was similar to other known risk factors for CVD. 

06 Sep

Posted at 13:49h in Author Interviews, Cost of Health Care, JAMA, Medicare
MedicalResearch.com Interview with: [caption id="attachment_51121" align="alignleft" width="99"]Md Momotazur Rahman PhD Associate Professor of Health Services, Policy and Practice Dr. Rahman[/caption] Md Momotazur Rahman PhD Associate Professor of Health Services, Policy and Practice [caption id="attachment_51158" align="alignleft" width="125"] Margot Schwartz[/caption] Margot Schwartz MPH Doctoral program Brown University MedicalResearch.com: What is the background for this study? Response: Although one third of Medicare beneficiaries are currently enrolled in Medicare Advantage (MA), it is difficult to assess the quality of healthcare providers that serve MA beneficiaries, or to compare them to providers that serve Traditional Medicare (TM) beneficiaries. While Medicare Advantage plans are required to cover the same minimum healthcare services as TM, MA beneficiaries receive care from their plan’s network of preferred providers, while TM beneficiaries may select any Medicare-certified provider. The objective of this study is to compare the quality of Home health Agencies (HHAs) that serve Medicare Advantage and TM beneficiaries. Approximately 3.5 million Medicare beneficiaries receive home health care annually.  

05 Sep

Posted at 11:50h in Author Interviews, Cost of Health Care, JAMA, Medical Imaging, UCSF
MedicalResearch.com Interview with: [caption id="attachment_51136" align="alignleft" width="150"]Rebecca Smith-Bindman, MD Professor, Department of Radiology and Biomedical Imaging, Epidemiology and Biostatistics Philip R. Lee Institute for Health Policy Studies University of California, San Francisco Dr. Smith-Bindman[/caption] Rebecca Smith-Bindman, MD Professor, Department of Radiology and Biomedical Imaging, Epidemiology and Biostatistics Philip R. Lee Institute for Health Policy Studies University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: Medical imaging increased rapidly from 2000 to 2006. The rise in imaging can be attributed to improvements in technical aspects of imaging, strong physician and patient demand, and strong financial incentives. While imaging contributes to accurate disease diagnosis and improved treatment, imaging can also increase costs and patient harms, such as incidental findings, overdiagnosis, anxiety, and radiation exposure associated with increased risk of cancer. Potential overuse of diagnostic testing has been addressed by the American Board of Internal Medicine Foundation’s Choosing Wisely Campaign and initiatives by payers to reduce imaging through payment reductions, but there remains uncertainty in the impact of these initiatives on imaging rates.The objective of our study was to evaluate recent trends in medical imaging. Our study assessed imaging from 2000 through 2016 among individuals enrolled in diverse U.S. integrated healthcare systems and among individuals residing in Ontario, Canada and assessed changes in medical imaging utilization over time by country, health system, and patient demographic factors.

30 Aug

Posted at 23:10h in ADHD, Author Interviews, Autism, JAMA, OBGYNE
MedicalResearch.com Interview with: Tianyang Zhang, MSc Centre for Psychiatry Research, Department of Clinical Neuroscience Stockholm Health Care Services, Stockholm County Council Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm, Sweden MedicalResearch.com: What is the background for this study? Response: We know that births by caesarean delivery are linked to several negative health outcomes in the children, such as obesity, asthma, allergy, and type 1 diabetes. However, the association between c-section and neurodevelopmental and psychiatric disorders has been less studied. In addition, it is unclear whether the extent of this association is different if a caesarean section is performed planned in advance or urgently due to medical reasons during a delivery.

30 Aug

Posted at 18:19h in Author Interviews, JAMA, Opiods, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_51102" align="alignleft" width="150"]Dr. Hannah T. Neprash, PhD Assistant Professor, Division of Health Policy and Management School of Public Health University of Minnesota Dr. Neprash[/caption] Dr. Hannah T. Neprash, PhD Assistant Professor, Division of Health Policy and Management School of Public Health University of Minnesota  MedicalResearch.com: What is the background for this study? Response: Physicians play a pivotal role in the opioid epidemic and it's important to understand what factors that drive opioid prescribing. Variation in opioid prescribing across physicians has been well-documented, but there’s very little research on variation within physicians…which is surprising, given the widespread concern about time pressure and cognitive fatigue having a potentially detrimental effect on the quality of care provided by physicians.

28 Aug

Posted at 20:25h in Author Interviews, Breast Cancer, Cancer Research, Genetic Research, JAMA, Ovarian Cancer, USPSTF
MedicalResearch.com Interview with: [caption id="attachment_46135" align="alignleft" width="200"]Dr. Carol Mangione M.D., M.S.P.H., F.A.C.P Ronald Reagan UCLA Medical Center Division Chief of General Internal Medicine and Health Services Research Professor of Medicine. Barbara A. Levey, MD, and Gerald S. Levey, MD Endowed chair in medicine David Geffen School of Medicine University of California Dr. Mangione[/caption] Dr. Carol Mangione, M.D., M.S.P.H., F.A.C.P. Division Chief of General Internal Medicine and Health Services Research Professor of Medicine Barbara A. Levey, MD, and Gerald S. Levey, MD, endowed chair in Medicine David Geffen School of Medicine University of California, Los Angeles (UCLA) Professor of public health at the UCLA Fielding School of Public Health.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Every year, too many American women are faced with the challenge of dealing with a cancer diagnosis related to potentially harmful mutations of the BRCA1 and BRCA2 genes.  However, the Task Force found that there are several steps women can take to determine if they’re potentially at increased risk for BRCA gene mutations – and if genetic counseling and BRCA testing are needed. It is important to note that while some women can benefit from risk assessment, counseling, and testing, these services are not for everyone.

28 Aug

Posted at 19:21h in Author Interviews, Brigham & Women's - Harvard, JAMA, Medicare
MedicalResearch.com Interview with: [caption id="attachment_51047" align="alignleft" width="128"]Jose F. Figueroa, MD, MPH Instructor , Harvard Medical School, Department of Medicine Brigham and Women’s Hospital Dr. Figueroa[/caption] Jose F. Figueroa, MD, MPH Instructor , Harvard Medical School, Department of Medicine Brigham and Women’s Hospital  MedicalResearch.com: What is the background for this study? Response: Hospitalizations related to ambulatory-care sensitive conditions are widely considered a key measure of access to high-quality ambulatory care. It is included as a quality measure in many national value-based care programs. To date, we do not really know whether rates of these avoidable hospitalizations are meaningfully improving for Medicare beneficiaries over time.

28 Aug

Posted at 19:17h in Author Interviews, Education, JAMA, Opiods, Social Issues
MedicalResearch.com Interview with: [caption id="attachment_51077" align="alignleft" width="180"]Isaac Sasson, PhD Department of Sociology and Anthropology and the Herczeg Institute on Aging Tel Aviv University Tel Aviv, Israel Dr. Sasson[/caption] Isaac Sasson, PhD Department of Sociology and Anthropology and the Herczeg Institute on Aging Tel Aviv University Tel Aviv, Israel MedicalResearch.com: What is the background for this study? Response: Life expectancy at birth in the United States has been declining steadily since 2014, which is very unusual for a high-income country in times of peace. In fact, the last time that life expectancy declined in the US was in the early 1990s, and only briefly. Studies from the past few years have shown that the rise in mortality is concentrated among middle-aged Americans and particularly the lower socioeconomic classes. Our study analyzed over 4.6 million death records in 2010 and 2017 to understand which causes of death account for the rise in mortality among white and black non-Hispanic US adults. In addition, given the substantial socioeconomic inequality in health in the US, we broke down our results by level of education, which is a good proxy for socioeconomic status. Essentially, our goal was to measure how many years of life were lost, on average, to each cause of death across different social groups. 

26 Aug

Posted at 16:14h in Author Interviews, Brain Injury, Erectile Dysfunction, JAMA
MedicalResearch.com Interview with: [caption id="attachment_51050" align="alignleft" width="200"]Rachel Grashow PhD Research Associate Department of Environmental Health Football Players Health Study at Harvard University Harvard T.H. Chan Dr. Grashow[/caption] Rachel Grashow PhD Research Associate Department of Environmental Health Football Players Health Study at Harvard University Harvard T.H. Chan  MedicalResearch.com: What is the background for this study? Response: It has been previously shown in small studies of boxers and military personnel that traumatic brain injuries can damage the pituitary gland, which serves as the "master controller" of hormone function in the brain. These studies on individuals at risk for repeated head injury found that hits on the head caused deficiencies in certain hormones, such as growth hormone and testosterone, which could have downstream effects on sexual function. Only one large study was conducted that used Taiwanese health insurance data and looked at single traumatic brain injuries and risk of erectile function (ED). In that study, men who experienced a single severe TBI were more than twice as like to report ED after their injury. In light of these findings, important questions remain regarding whether multiple head injuries are associated with pituitary or sexual dysfunction in a large population with other ED-related health issues. The Football Players Health Study at Harvard University asked former NFL players to fill out a questionnaire that interrogated demographic factors, football-related exposures and current health conditions. Specifically, we asked participants to self-report the frequency of ten different concussion symptoms experienced during professional play, as well as whether a clinician had ever recommended or prescribed medication for low testosterone or ED.  

26 Aug

Posted at 16:11h in Author Interviews, JAMA, Kidney Disease, Transplantation
MedicalResearch.com Interview with: [caption id="attachment_51066" align="alignleft" width="186"]Alexandre Loupy, MD PhD Necker Hospital Head of team at National institute of Medical research (Inserm) Prof. Loupy[/caption] Alexandre Loupy, MD PhD Nephrologist, Department of Nephrology & Kidney Transplantation Necker Hospital, Paris Head of the Paris Transplant Group (Inserm)  MedicalResearch.com: What is the background for this study? Response: The lack of organs for kidney transplantation is a major public health problem across the world, due to its attributable mortality and excess cost to healthcare systems while waitlisted patients are maintained on chronic dialysis. Nearly 5,000 people in the US and 3,500 people in Europe die each year while waiting for a kidney transplant. Yet in the US, over 3,500 donated kidneys are discarded annually, representing almost 18% of the available organs, while the discard rate in France is only 6,8%, though these countries have similar organ allocation systems and offer the same treatments to patients after transplant. We thus compared the use of donated kidneys in the US to France from 2004-2014 in much more depth, using a new approach based on validated analytic methods and computer simulation. 

23 Aug

Posted at 16:52h in Alzheimer's - Dementia, Author Interviews, JAMA, Mental Health Research, Sleep Disorders
MedicalResearch.com Interview with: Chenlu Gao, MA Graduate Student Department of Psychology and Neuroscience Baylor University Michael Scullin, PhD Assistant Professor Department of Psychology and Neuroscience Baylor University  MedicalResearch.com: What is the background for this study? Response: According to the World Alzheimer Report, dementia affects 50 million adults worldwide, and this number is expected to approach 131 million by 2050. Dementia patients often require assistance with daily activities from caregivers. The Alzheimer’s Association reported that, in the United States, 16 million caregivers spend on average 21.9 hours per week providing care for patients with dementia. Being a caregiver is stressful, which not only challenges emotional, cognitive, and physical health, but is also associated with shorter and poorer sleep at night. If a caregiver cannot obtain restorative sleep at night, their quality of life and their abilities to perform the caregiving role can be compromised. For example, sleep loss may jeopardize caregivers’ memory, causing them to forget medications or medical appointments for the patients. Sleep loss can also impair immune functions, causing the caregivers to suffer from illnesses. In the long-term, sleep loss is associated with cortical thinning and accumulation of beta-amyloid and tau, which increase the risks of dementia. Undoubtedly, there is a need to systematically study whether caregivers sleep less or worse during the night and whether we can improve their sleep quality through low-cost behavioral interventions. To answer these questions, we systematically reviewed and meta-analyzed 35 studies with data from 3,268 caregivers of dementia patients.    

23 Aug

Posted at 11:00h in Author Interviews, Cancer Research, JAMA
MedicalResearch.com Interview with: [caption id="attachment_51041" align="alignleft" width="200"]Prof. Dr. Lukas Flatz MD Institute of Immunobiology Kantonsspital St Gallen, St Gallen Switzerland Prof. Flatz[/caption] Prof. Dr. Lukas Flatz MD Institute of Immunobiology Kantonsspital St Gallen, St Gallen Switzerland MedicalResearch.com: What is the background for this study? Response: Toxicity is an important limiting factor of treatment with checkpoint inhibitors. We aimed in investigating the relationship between immune-related adverse events during anti-PD-1 therapy and tumor mutational burden by comparing large scale surveillance data of irAEs with the median tumor mutational burden across multiple cancer types.

21 Aug

Posted at 17:16h in Author Interviews, Diabetes, JAMA, PTSD
MedicalResearch.com Interview with: [caption id="attachment_50945" align="alignleft" width="174"]Jeff Scherrer, Ph.D. Associate professor; Research director Department of Family and Community Medicine Saint Louis University Center for Health Outcomes Research Dr. Jeff Scherrer[/caption] Jeff Scherrer, Ph.D. Associate professor; Research director Department of Family and Community Medicine Saint Louis University Center for Health Outcomes Research  MedicalResearch.com: What is the background for this study? Response: This study was part of a larger NIH grant to determine if PTSD is associated with poor health behaviors and subsequently whether PTSD remains an independent risk factor for diabetes and heart disease.  Our second focus of the grant was to measure if those patients who experience clinically meaningful PTSD improvement have improved health behaviors (e.g. seeking help to lose weight) and a lower risk for diabetes and heart disease. The rationale for this study of PTSD improvement and lower risk for diabetes is supported from other investigators' findings that PTSD treatment completion is often followed by improvement in sleep, depression, pain and general physical complaints and lower blood pressure.  Because we have found the association between PTSD and incident diabetes is largely explained by obesity, depression and other comorbid conditions that are more common in patients with vs. without PTSD, we hypothesized that improvements in PTSD would be associated with lower risk of diabetes either directly or due to improvements in these comorbid diabetes risk factors.

20 Aug

Posted at 11:56h in Author Interviews, Hospital Acquired, JAMA
MedicalResearch.com Interview with: [caption id="attachment_50892" align="alignleft" width="176"]Todd Campbell Lee MD MPH FACP FIDSA Consultant in Internal Medicine and Infectious Diseases Director, MI4 Clinical Trials Platform Associate Professor of Medicine, McGill University Montreal, Quebec Dr. Todd Lee[/caption] Todd Campbell Lee MD MPH FACP FIDSA Consultant in Internal Medicine and Infectious Diseases Director, MI4 Clinical Trials Platform Associate Professor of Medicine, McGill University Montreal, Quebec  MedicalResearch.com: What is the background for this study? Response: For a number of years people have been advocating for a move towards single-patient rooms in hospital design.  This was articulately argued for in an opinion piece by Detsky and Etchells in 2008 (https://jamanetwork.com/journals/jama/article-abstract/182433) as being important for a move to safe and patient-centered design. One of the major selling points has always been a reduction in the risk of nosocomial, or hospital-associated, infections given reduced opportunities for contamination between patients; however, only a few studies have specifically looked at this issue.  Overall, despite some strong work, many of these studies were limited by only looking at specific units, over limited periods of time,  and using before-after comparisons which did not account for change over time either within or outside of the institution. We knew that in 2015 our old hospital would close and within the same day all patients would be moved to a brand new hospital with 100% single patient rooms -- most of which have a private bathroom for patients and a separate hand-washing sink for staff.  So in 2014, we designed this study, obtained ethics review, and then waited patiently for several years to pass after the move so that we could rigorously evaluate the impact.  We looked at monthly rates of vancomycin-resistant Enterococcus (VRE) colonizations and infections, methicillin-resistant Staphylococcus aureus (MRSA) colonization and infections, and Clostridium (now Clostrideroides) difficile infections (CDI). We chose these because we had good long term data on their rates and because we could compare the rates over time before and after the move and contrast them with the province of Quebec as a whole.

19 Aug

Posted at 15:13h in Author Interviews, Dental Research, JAMA, Mental Health Research, Mineral Metabolism, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_50911" align="alignleft" width="200"]Rivka Green, MA Doctoral Candidate Clinical Developmental Neuropsychology York University Rivka Green[/caption] Rivka Green, MA Doctoral Candidate Clinical Developmental Neuropsychology York University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We conducted a study on 512 mother-child pairs from 6 major cities across Canada, about half of whom lived in a region that receives fluoridated water. We found that prenatal fluoride exposure was associated with lower IQ scores in 3-4 year old children.

16 Aug

Posted at 19:37h in Author Interviews, Cognitive Issues, End of Life Care, Gender Differences, JAMA
MedicalResearch.com Interview with: [caption id="attachment_50851" align="alignleft" width="142"]Dr. Nathan Stall, MD Geriatrician and Research fellow Women’s College Research Institute Dr. Stall[/caption] Dr. Nathan Stall, MD Geriatrician and Research fellow Women’s College Research Institute   [caption id="attachment_50852" align="alignleft" width="133"]Dr. Paula Rochon, MD, MPH, FRCPC Periatrician and Vice-President of Research Women’s College Hospital Dr. Rochon[/caption]     Dr. Paula Rochon, MD, MPH, FRCPC Periatrician and Vice-President of Research Women’s College Hospital     MedicalResearch.com: What is the background for this study? Response: The advanced stages of the dementia are characterized by profound memory impairment, an inability to recognize family, minimal verbal communication, loss of ambulatory abilities, and an inability to perform basic activities of daily living. Nursing homes become a common site of care for people living with advanced dementia, who have a median survival of 1.3 years. In the advanced stages of the disease, the focus of care should generally be on maximizing quality of life. Our study examined the frequency and sex-based differences in burdensome interventions received by nursing home residents with advanced dementia at the very end of life. Burdensome interventions include a variety of treatment and procedures that are often avoidable, may not improve comfort, and are frequently distressing to residents and their families. We found that in the last 30 days of life, nearly one in 10 nursing home residents visited an emergency department, more than one in five were hospitalized, and one in seven died in an acute care setting. In addition, almost one in 10 residents received life-threatening critical care; more than one in four were physically restrained; and more than one in three received antibiotics.

15 Aug

Posted at 14:15h in Author Interviews, JAMA, Outcomes & Safety, Surgical Research, University of Michigan
MedicalResearch.com Interview with: [caption id="attachment_50705" align="alignleft" width="160"]Kyle Sheetz, MD, MSc Research Fellow Center for Healthcare Outcomes and Policy University of Michigan Dr. Sheetz[/caption] Kyle Sheetz, MD, MSc Research Fellow Center for Healthcare Outcomes and Policy University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Various patient safety organizations and clinical societies continue to advocate for volume thresholds as a means to improve the short-term safety and overall effectiveness of high risk cancer surgeries in the United States. We asked two questions with this study: 1) What proportion of U.S. hospitals meet discretionary volume standards? 2) Do these standards differentiate hospitals based on short-term safety outcomes (mortality and complications)? We found that a relatively low proportion of hospitals meet even modest volume standards put forth by the Leapfrog Group. These standards did not differentiate hospitals based on outcomes for 3 of 4 high risk cancer operations reported by the Leapfrog Group. However, using higher thresholds, we were able to demonstrate a significant relationship between higher hospital volume and better outcomes, which has been reported numerous times.

14 Aug

Posted at 16:42h in Author Interviews, JAMA, Mayo Clinic, Pancreatic, USPSTF
MedicalResearch.com Interview with: [caption id="attachment_50834" align="alignleft" width="138"]Dr. Chyke A. Doubeni, M.D., M.P.H. Dr. Doubeni is a family physician and The inaugural director of the Mayo Clinic Center for Health Equity and Community Engagement Research Dr. Doubeni[/caption] Dr. Chyke A. Doubeni, M.D., M.P.H. Dr. Doubeni is a family physician and The inaugural director of the Mayo Clinic Center for Health Equity and Community Engagement Research MedicalResearch.com: What is the background for this study? Response: The U.S. Preventive Services Task Force uses systematic review of existing research to make recommendations on clinical preventive services that are delivered in primary care, with the goal to promote and improve health for all Americans. Although pancreatic cancer is an uncommon condition in the general population, it is often deadly. Pancreatic cancer is now the third most common cause of cancer death in the United States, and could become the second leading cause if current trends continue. The vast majority of people with pancreatic cancer are diagnosed at a late stage and, unfortunately, even when caught early enough when surgery could be most effective, only a little over one-third of patients survive beyond five years.

14 Aug

Posted at 15:21h in Author Interviews, Blood Pressure - Hypertension, Duke, Heart Disease, JAMA, Race/Ethnic Diversity
MedicalResearch.com Interview with: [caption id="attachment_50729" align="alignleft" width="200"]Yuichiro Yano MD Assistant Professor in Family Medicine and Community Health Duke University  Dr. Yano[/caption] Yuichiro Yano MD Assistant Professor in Family Medicine and Community Health Duke University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: African Americans are disproportionally affected by hypertension-related cardiovascular disease compared with other racial/ethnic groups in the United States and have higher blood pressure levels inside and outside the clinic than whites and Asians. However, little is known, among African Americans, regarding whether higher mean blood pressure measured outside of the clinic setting on 24-hour ambulatory blood pressure monitoring is associated with an increased risk for cardiovascular disease events, independent of blood pressure measured in the clinic setting.

14 Aug

Posted at 15:19h in Author Interviews, Heart Disease, JAMA, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_50819" align="alignleft" width="177"]Dr Juan Pablo Kaski MD(Res) FRCP FESC Director of the GOSH Centre for Inherited Cardiovascular Diseases Great Ormond Street Hospital, University College London Institute of Cardiovascular Science, London, UK Dr. Kaski[/caption] Dr Juan Pablo Kaski MD(Res) FRCP FESC Director of the GOSH Centre for Inherited Cardiovascular Diseases Great Ormond Street Hospital, University College London Institute of Cardiovascular Science, London, UK  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Hypertrophic Cardiomyopathy?  Response: Hypertrophic cardiomyopathy (HCM) is a genetic condition characterised by abnormal thickening of the muscle of the heart and can affect people of all ages. It is associated with an increased risk of sudden cardiac death (SCD) and, in the last few years, a clinical risk tool that estimates the 5-year risk of SCD in adults with HCM has been developed. However, there are no similar risk models in children, where risk stratification has traditionally been based on clinical risk factors extrapolated from the adult population. We have recently shown that this approach does not discriminate risk well in children, and so the aim of this study was to develop a new risk tool to provide an individualised risk of SCD in children with HCM. 

13 Aug

Posted at 16:58h in Author Interviews, Environmental Risks, JAMA, NIH, Pulmonary Disease
MedicalResearch.com Interview with: [caption id="attachment_50697" align="alignleft" width="150"]Joel Kaufman, MD, MPH, Professor   Environmental & Occupational Health Sciences, Medicine, and Epidemiology University of Washington Prof. Kaufman[/caption] Joel Kaufman, MD, MPH, Professor   Environmental & Occupational Health Sciences, Medicine, and Epidemiology University of Washington  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Increasingly, it is recognized that chronic lung diseases like emphysema occur in nonsmokers and rates of these diseases are continuing to increase.  We really need to understand what’s causing chronic lung disease. Air pollutants are known to make disease worse in people with prior lung disease, but little is known about whether long-term exposure to air pollutants can cause chronic lung disease. We found that higher residential concentrations of air pollutants—especially ozone and traffic-related air pollutants—are associated with changes in the lung—emphysema-like changes in the lung.  The associations were strong and suggest that air pollution may be an important contributor to chronic lung disease. 

12 Aug

Posted at 23:59h in Author Interviews, Breast Cancer, JAMA, UCLA
MedicalResearch.com Interview with: [caption id="attachment_50709" align="alignleft" width="200"]Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLA Dr. Elmore[/caption] Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLA  MedicalResearch.com: What is the background for this study? What are the main findings?
  • A pathologist makes the diagnosis of breast cancer versus non-cancer after reviewing the biopsy specimen. Breast biopsies are performed on millions of women each year and It is critical to get a correct diagnosis so that we can guide patients to the most effective treatments.
  • Our prior work (Elmore et al. 2015 JAMA) found significant levels of disagreement among pathologists when they interpreted the same breast biopsy specimen. We also found that pathologists would disagree with their own interpretations of breast biopsies when they where shown the same biopsy specimen a year later.
  • In this study, 240 breast biopsy images were fed into a computer, training it to recognize patterns associated with several types of breast lesions, ranging from benign (noncancerous) to invasive breast cancer. We compared the computer readings to independent diagnoses made by 87 practicing U.S. pathologists and found that while our artificial intelligence program came close to performing as well as human doctors in differentiating cancer from non-cancer, the AI program outperformed doctors when differentiating ductal carcinoma in situ (DCIS) from atypia, which is considered the greatest diagnostic challenge.

12 Aug

Posted at 19:34h in Author Interviews, Diabetes, JAMA
MedicalResearch.com Interview with: [caption id="attachment_50615" align="alignleft" width="180"]Pooyan Kazemian, Ph.D. Instructor in Medicine Massachusetts General Hospital Dr. Kazemian[/caption] Pooyan Kazemian, Ph.D. Instructor in Medicine Massachusetts General Hospital  MedicalResearch.com: What is the background for this study? Response: Advances in diabetes care can meaningfully improve outcomes only if they effectively reach the populations at risk. However, it is not known if recent innovations in diabetes treatment and care models have reached the United States population at risk.

09 Aug

Posted at 18:13h in Author Interviews, JAMA, Orthopedics, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_50635" align="alignleft" width="200"]Dr Ahmed Elhakeem PhD Senior Research Associate in Epidemiology University of Bristol Dr. Elhakeem[/caption] Dr Ahmed Elhakeem PhD Senior Research Associate in Epidemiology University of Bristol MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that the denser (stronger) your bones are, the less likely they are to break (fracture). We also have reliable evidence that later maturing adolescents tend on average to have lower bone density than their earlier maturing peers. We wanted to find out how the timing of puberty might influence the development of bone density throughout adolescence and into early adult life. We did this by following up a large group of young people born in the early 90s around Bristol, UK that took part in a unique study (the Children of the 90s study) that included repeated density scans over a 15-year period from age ten to 25. We found that those later maturing adolescents that got their growth spurt at an older age tended to catch-up to some degree to their earlier maturing peers during puberty however, they continued on average to have lower bone density than average for several years into adulthood.

07 Aug

Posted at 20:54h in Author Interviews, Cancer Research, JAMA, MRI, Prostate Cancer
MedicalResearch.com Interview with: Dr Martha Elwenspoek PhD Research Associate in Epidemiology and Health Services Research NIHR CLAHRC West, Bristol MedicalResearch.com: What is the background for this study? Response: Prostate cancer is one of the most common cancers in men. Prostate cancer is usually diagnosed by taking 10 to 14 systematic samples from the prostate guided by ultrasound. However, these biopsies are unpleasant for patients, can miss cancer even when it’s present, can misclassify the severity of the cancer, and can cause side effects, such as bleeding and infection. If biopsies could be targeted better, men wouldn’t have to undergo so many and there would be less risk of getting a misleading result. Multiparametric MRI (mpMRI) scans are sometimes used before doing a biopsy to help diagnose prostate cancer, and while this approach is now being recommended by the UK National Institute for Clinical Excellence (NICE) their use isn’t widespread.