Author Interviews, Dermatology, Environmental Risks, FDA, JAMA / 06.05.2019

MedicalResearch.com Interview with: David Strauss, MD, PhD Director, Division of Applied Regulatory Science U.S. Food and Drug Administration Center for Drug Evaluation and Research MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is unknown whether most active ingredients in sunscreens are absorbed. FDA has provided guidance that sunscreen active ingredients with systemic absorption greater than 0.5 ng/mL or with safety concerns should undergo nonclinical toxicology assessment including systemic carcinogenicity and additional developmental and reproductive studies. This randomized clinical trial demonstrated systemic exposure of 4 commonly used sunscreen active ingredients on application of sunscreen products under maximal use conditions consistent with current sunscreen labeling. All 4 sunscreen active ingredients tested resulted in exposures exceeding 0.5 ng/mL.  (more…)
Allergies, Author Interviews, Immunotherapy, JAMA / 06.05.2019

MedicalResearch.com Interview with: Marcus S. Shaker, MD Associate Professor of Pediatrics Associate Professor of Community and Family Medicine Dartmouth-Hitchcock Medical Center MedicalResearch.com: What is the background for this study? Response: There are two peanut allergy treatments that are being evaluated for potential FDA approval—an orally administered treatment and an epicutaneous (skin based) treatment.  Both have tremendous potential benefit.  The focus of our study was to explore the range of health and economic benefits in terms of establishing pathways for how each therapy could be cost effective. We want to be clear that our purpose was not to suggest one therapy is or is not cost effective at present.  That would be a ridiculous statement to make regarding two treatments that not only lack FDA approval, but do not have established pricing.  Rather, we used preliminary inputs that are presently available to create as robust a model as we could to better determine the individual paths that would make them more or less cost-effective. (more…)
Author Interviews, Brigham & Women's - Harvard, Education, JAMA / 06.05.2019

MedicalResearch.com Interview with: Arabella L. Simpkin,  MD, MMSc Associate Director, Center for Educational Innovation and Scholarship, MGH Associate Program Director, Education and Curriculum, Internal Medicine Residency, MGH Instructor in Medicine, Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response: The academic health care environment has changed in unprecedented ways over several decades, with mounting evidence that faculty are becoming increasingly more unhappy, dissatisfied, and burnt out in their work. Concern for faculty wellbeing is high, with much speculation about causes of burnout. Comprehending what affects satisfaction at work in academic health care centers is critically important to stem this epidemic of discontent. For physicians, satisfaction has been reported to be associated with quality of care delivered, particularly as measured by patient satisfaction; faculty retention and job satisfaction are intricately linked, with dissatisfied physicians more likely to leave the profession and to discourage others from entering. Other industries that have suffered similar rises in employee discontent have found that demonstration of respect is the most important leadership behavior in improving employees satisfaction. To our knowledge this factor has not been looked at in healthcare professionals. To address this gap, we sought to determine key variables influencing satisfaction at work for faculty in a large academic medical center in the United States. (more…)
Author Interviews, JAMA, Pediatrics, Smoking / 06.05.2019

"E-Cigarette/Electronic Cigarette/E-Cigs/E-Liquid/Vaping/Cloud Chasing" by Vaping360 is licensed under CC BY 2.0 CC BY 2.0MedicalResearch.com Interview with:Jenny L. Carwile, ScD, MPH Department of Medicine Maine Medical Center Portland   MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Although e-cigarette aerosols are commonly perceived to be "harmless water vapors" they contain numerous potentially harmful chemicals including volatile organic compounds like formaldehyde, nicotine, heavy metals, and ultrafine particulates. Non-users can be exposed to these chemicals through secondhand exposure. We found that in the US 4.9% of adults who lived in a household with children were current e-cigarette users. (more…)
Author Interviews, Infections, JAMA / 01.05.2019

MedicalResearch.com Interview with: Nicholas B. DeFelice, PhD Department of Environmental Medicine & Public Health Icahn School of Medicine at Mount Sinai New York, New York MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Effective allocation of public health resources during an outbreak is complicated and often reactive. Thus, it is important that we develop quantitative tools that can accurately and rapidly forecast the progression of an outbreak and provide decision support. Recently, several advancements have been made in the realm of infectious disease forecasting: it is a field that is growing in exciting directions. However, for these forecasting tools to work in real time, we must understand how the forecasting apparatus and observational network work in real time to ensure they are sufficient to support accurate operational predictions. We previously showed that accurate and reliable forecasts of West Nile virus outbreaks can be made using surveillance data and a mathematical model representing the interactions between birds, mosquitoes and risk of human spillover. This model system was able to retrospectively forecast mosquito infection rates prior to the week of peak mosquito infection, and to forecast accurately the seasonal total number of human West Nile virus cases prior to when the majority of cases were reported. For this study, we were interested in the data flow process and the question of whether appropriate infrastructure is in place to support real time forecasting. If this forecast system were made operational in real time, public health officials would have an evidence-based decision-support tool to help 1) actively target control of infected mosquito populations (i.e., larviciding and adulticiding), 2) alert the public to future periods of elevated West Nile virus spillover transmission risk, and 3) identify when to intensify blood donor screening. (more…)
Alzheimer's - Dementia, Author Interviews, End of Life Care, JAMA, University of Pennsylvania / 30.04.2019

MedicalResearch.com Interview with: Emily Largent, PhD, JD, RN Assistant Professor, Medical Ethics and Health Policy Perelman School of Medicine Leonard Davis Institute of Health Economics University of Pennsylvania  MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  Public support for aid in dying in the United States is rapidly growing.  As a result, we’re now seeing debates about whether to expand access to aid-in-dying to new populations – such as people with Alzheimer’s disease – who wouldn’t be eligible under current laws. With those debates in mind, we asked currently healthy people who recently learned about their risk for developing Alzheimer’s disease dementia (i.e., due to the presence of amyloid, an Alzheimer’s disease biomarker) whether they would be interested in aid-in-dying. Our findings suggest that about 20% of individuals with elevated amyloid may be interested in aid-in-dying if they become cognitively impaired.   (more…)
Author Interviews, Cancer Research, Genetic Research, JAMA, Technology / 30.04.2019

MedicalResearch.com Interview with: Steven J.M. Jones, Professor, FRSC, FCAHS Co-Director & Head, Bioinformatics Genome Sciences Centre British Columbia Cancer Research Centre Vancouver, British Columbia, Canada and Jasleen Grewal, BSc.Genome Sciences CentreBritish Columbia Cancer Research CentreVancouver, British Columbia, CanadaJasleen Grewal, BSc. Genome Sciences Centre British Columbia Cancer Research Centre Vancouver, British Columbia, Canada MedicalResearch.com: What is the background for this study? Response: Cancer diagnosis requires manual analysis of tissue appearance, histology, and protein expression. However, there are certain types of cancers, known as cancers of unknown primary, that are difficult to diagnose based purely on their appearance and a small set of proteins. In our precision medicine oncogenomics program, we needed an accurate approach to confirm diagnosis of biopsied samples and determine candidate tumour types for where the primary site of the cancer was uncertain.  We developed a machine learning approach, trained on the gene expression data of over 10,688 individual tumours and healthy tissues, that has been able to achieve this task with high accuracy. Genome sequencing offers a high-resolution view of the biological landscape of cancers. RNA-Seq in particular quantifies how much each gene is expressed in a given sample. In this study, we used the entire transcriptome, spanning 17,688 genes in the human genome, to train a machine learning method for cancer diagnosis. The resultant method, SCOPE, takes in the entire transcriptome and outputs an interpretable confidence score from across a set of 40 different cancer types and 26 healthy tissues.  (more…)
Author Interviews, Cancer Research, JAMA, MD Anderson, Radiation Therapy / 30.04.2019

MedicalResearch.com Interview with: Quynh-Nhu Nguyen, MD Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This is the first non-spine bone metastases trial comparing higher dose single fraction radiotherapy vs multifraction standard fractionated radiotherapy for patients with painful bone metastases. The results of this trial demonstrated more durable pain relief and superior local control for patients treated in the higher dose(12 Gy-16 Gy)  single fraction RT compared to standard 30 Gy/10 fractions multifractionated regimen.  This trial supports the previous multiple randomized trials which recommend single fraction should be standard palliative radiotherapy regimen for bone metastases.  This trial is unique in that it addressed previous criticism that single fraction does not provide durable palliation with lower 8 gy single fraction and result in higher re-irradiation rates.  This trial on the contrary with the utilization of modern radiotherapy techniques, demonstrated we can safely and more effectively deliver a higher single fraction radiotherapy regimen for improvement in the quality of life for patients.  This higher dose should be the new standard single fraction regimen for patients who are functional and have a longer life expectancy.  (more…)
Author Interviews, Global Health, JAMA / 29.04.2019

MedicalResearch.com Interview with: Dr Barbara Mintzes PhD Associate Professor The University of Sydney Charles Perkins Centre and School of Pharmacy Faculty of Medicine and Health The University of Sydney MedicalResearch.com: What is the background for this study?   Response: When medicines are approved for marketing, the information available on rare serious harmful effects, longer-term effects, and outcomes in vulnerable populations is often limited. New serious safety concerns often arise when a medicine is already on the market. In many cases these can be  managed for example through dose reductions or avoiding prescribing to at-risk patients. Drug regulatory agencies such as the US FDA often issue safety warnings to let health professionals and the public know  about new evidence of potential harm and often to provide advice on how to avoid this. We were interested to know how consistent these warnings are between different countries. This is a research project funded by Australia’s National Health and Medical Research Council and the Canadian Institutes of Health Research. We examined warnings for medicines in Australia, Canada the US and the UK over a 10-year period, from 2007 to 2016 inclusive. We were looking at how often regulators issue the same warning if the drug is approved for marketing at the time.  (more…)
Author Interviews, Environmental Risks, Heart Disease, JAMA, Toxin Research / 29.04.2019

MedicalResearch.com Interview with: Monica Lind, PhD, Professor, Environmental toxicologist Occupational and Environmental Medicine Uppsala University Hospital Visiting adress: Dag Hammarskjölds väg 60 Uppsala Sweden MedicalResearch.com: What is the background for this study? Response: Previous studies in workers exposed to very high levels of polychlorinated biphenyls (PCBs) have suggested hazardous health effects. However, circulating PCB levels are detected in almost all indivuduals in industrialized countries, but the health effects of moderately elevated levels as seen in the general population are not well established. We investigated levels of PCBs in around 1,000 individuals, all aged 70 years, randomly chosen from the City of Uppsala, Sweden. (more…)
Author Interviews, JAMA, Opiods / 28.04.2019

MedicalResearch.com Interview with: Leah LaRue, PharmD, PMP Associate Director, Clinical Affairs Millennium Health MedicalResearch.com: What is the background for this study? Response: Drug overdose deaths continue to increase, despite the leveling off of prescription opioid use and policy changes limiting opioid prescribing. While fentanyl has garnered most of the attention, overdose deaths involving cocaine and methamphetamine also have increased markedly over the past few years. It is possible that those increases are due not just to those drugs, but to concomitant use with fentanyl. To better understand what is causing this rapid increase in overdose deaths, it is important to characterize the emerging combination of other illicit drugs with fentanyl, which increases the risk of overdose. The purpose of this study was to determine whether rates of the combination of nonprescribed fentanyl with cocaine or methamphetamine have changed in urine drug test (UDT) results through time. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Pediatrics, Weight Research / 26.04.2019

MedicalResearch.com Interview with: Vincent W. V. Jaddoe, MD, PhD Adjunct Professor of Epidemiology Department of Epidemiology MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Childhood body fat may be affected by patterns of fetal and infant weight change. Children born small for gestational age (SGA) tend to have infant growth acceleration, whereas those born large for gestational age (LGA) tend to have infant growth deceleration. Little is known about fetal and infant growth patterns affecting visceral, liver, and pericardial fat, which are strongly associated with cardiometabolic disease in later life. We assessed in a large population cohort study whether fetal and infant weight change was associated with not only general, but also organ fat at school age. We observed that fetal and infant weight change patterns were both associated with childhood body fat, but weight change patterns in infancy tended to have larger effects. Fetal growth restriction followed by infant growth acceleration was associated with increased visceral and liver fat.  (more…)
Author Interviews, Infections, JAMA, Pediatrics / 26.04.2019

MedicalResearch.com Interview with: Dr. Matthieu Domenech de Cellès PhD Biostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases Unit, Institut Pasteur, Inserm U1181, University of Versailles St-Quentin-en-Yvelines, Versailles, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most high-income countries now use acellular pertussis vaccines (called DTaP, which are sub-unit vaccines based on purified antigens of the bacterium Bordetella pertussis) to protect children against pertussis. Although clinical trials demonstrated the short-term effectiveness of DTaP vaccines, there was a growing concern that the duration of protection they conferred was not very long. Those concerns were mostly based on the results of a number of epidemiological studies, which showed that the relative risk of contracting pertussis increased substantially over time, typically by 20–40% every year since last vaccination. Although such increases seem high, it was not immediately obvious how to interpret them—the more so because pertussis epidemiology is complex. In our study, we developed mathematical models of pertussis epidemiology to try to understand what the results of recent epidemiological studies really meant about the effectiveness and the duration of protection of DTaP vaccines. The most interesting—and perhaps counterintuitive—finding of our study was that those results are fully consistent with highly effective DTaP vaccines, which confer long-term protection. This is a consequence of the fact that pertussis is highly contagious and that the immunity conferred by DTaP, though very high, is not perfect.    (more…)
Author Interviews, Infections, JAMA, Mental Health Research, Pediatrics / 25.04.2019

MedicalResearch.com Interview with: Lauren Breithaupt, PhD Department of Psychology George Mason University Fairfax, Virginia  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Our study provides novel insight into the relationship between the immune system and eating disorders characterized by chronic restriction (e.g., anorexia nervosa) and binge eating and/or purging (e.g., binge eating disorder, bulimia nervosa). These findings also add to the growing body of literature linking the immune systems broadly and mental disorders. We found that infections in early childhood were associated with an increased risk of anorexia nervosa, bulimia nervosa, and other eating disorders such as binge eating disorder in adolescence. These relationships appear to be both time and dose-dependent, meaning that the onset of eating disorder diagnosis is greatest in the first three months following the infection, and the more infections, the greater the risk.    (more…)
Author Interviews, Genetic Research, Heart Disease, JAMA, Lipids / 25.04.2019

MedicalResearch.com Interview with: Florian Kronenberg, MD Division of Genetic Epidemiology Department of Medical Genetics, Molecular and Clinical Pharmacology Medical University of Innsbruck, Innsbruck, Austria MedicalResearch.com: What is the background for this study? Response: Lp(a) is one of the most prevalent lipoprotein risk factors for cardiovascular disease. Roughly 20% of the general Caucasian population have concentrations above 50 mg/dL and the 10% with the highest concentrations have a 2 to 3-fold increased risk for myocardial infarction. There is strong evidence from genetic studies that high Lp(a) concentrations are causally related to cardiovascular outcomes. Until recently there was no drug available which lowers Lp(a) without any effects on other lipoproteins. This has recently changed by the development of drugs that block the production of Lp(a) in an impressive way. These drugs have to be studied in randomized controlled trials whether they not only lower Lp(a) concentrations but also cardiovascular outcomes. For the planning of such studies it is crucial to estimate the amount of Lp(a) lowering required to show a clinical benefit. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics, Race/Ethnic Diversity / 24.04.2019

MedicalResearch.com Interview with: Clare Brown, PhD Health Systems and Services Research University of Arkansas for Medical Sciences J. Mick Tilford, PhD, Professor and Chair Department of Health Policy and Management Fay W. Boozman College of Public Health University of Arkansas for Medical Science   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Prematurity and low birthweight are associated with increased risk of infant mortality as well as increased risk of chronic conditions throughout infancy and into adulthood. Non-Hispanic black infants are twice as likely to be born low birthweight (13.9% vs 7.0%) and 1.5 times as likely to be born prematurely (13.9% vs 9.1%) compared to non-Hispanic white infants. Under the Affordable Care Act (ACA), states may expand Medicaid to adults with household income levels at or below 138% of the federal poverty level, thus extending coverage to childless adults and improving continuity. Insurance gain may ultimately improve maternal health, increased use and earlier initiation of prenatal care services, and improved access to pregnancy planning resources. Our study aimed to evaluate whether there were changes in rates of low birthweight and preterm birth outcomes among states that expanded Medicaid versus states that did not expand Medicaid. (more…)
Author Interviews, Environmental Risks, JAMA, Pediatrics, Primary Care, Toxin Research, USPSTF / 23.04.2019

MedicalResearch.com Interview with: Alex H. Krist, MD, MPH Vice-Chairperson, U.S. Preventive Services Task Force Professor of family medicine and population healt Virginia Commonwealth University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Exposure to lead can have serious lifelong effects on the health and wellbeing of children. There is no safe level of lead exposure, so finding and removing any source of lead exposure is essential. In its review of the evidence, the Task Force found that more research is needed to determine what primary care clinicians can do to help prevent and treat the health problems that can result from lead exposure in childhood and pregnancy. (more…)
Author Interviews, Environmental Risks, JAMA, Lymphoma, Occupational Health, Toxin Research / 23.04.2019

MedicalResearch.com interview with: Sylvain Lamure, MD, Hematologist, Principal Investigator Pascale Fabbro-Peray, MD, PhD , Epidemiologist, Senior Investigator University of Montpellier, France MedicalResearch.com: What is the background for this study? Response: Occupational exposure to pesticides is a well-documented associated factor for non-Hodgkin lymphoma. The main biological mechanisms of both pesticides and chemotherapy are genotoxicity and reactive oxygen species generation. Cellular adaptation among patients exposed to low doses of genotoxic and oxidative compounds might hinder chemotherapy efficiency in lymphoma patients. T hus, we have investigated the association of occupational exposure with response to immunochemotherapy and survival in the subgroup of diffuse large B cell lymphoma, whose treatment is standardized. (more…)
Author Interviews, JAMA, Pediatrics, Sugar / 23.04.2019

MedicalResearch.com Interview with: Asher Y Rosinger, PhD, MPH Assistant Professor of Biobehavioral Health and Anthropology Director of the Water, Health, and Nutrition Laboratory Pennsylvania State University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sugar-sweetened beverage consumption has been linked to many negative health conditions, such as weight gain, dental caries, and type 2 diabetes. Previous research found that when you replace sugar-sweetened beverages (SSBs) with water intake then total energy intake goes down. We wanted to know how many calories from SSBs children consume when they drink water or not since sugar-sweetened beverages are often used as a replacement for water. SSB intake has been falling among children over the last 15 years, but there are still pockets and sub-populations that have high consumption levels. It is critical to identify which kids are particularly at risk for high SSB intake since this can lead to these negative health effects. Overall we found that kids that did not consume any plain water (from tap or bottled water) consumed almost twice as many calories and percent of total calories from sugar-sweetened beverages than kids that consumed water. And for the sample overall that translated to nearly 100 extra calories on a given day.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA, Radiation Therapy, Technology / 19.04.2019

MedicalResearch.com Interview with: Raymond H Mak, MD Radiation Oncology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? 
  • Lung cancer remains the most common cancer, and leading cause of cancer mortality, in the world and ~40-50% of lung cancer patients will need radiation therapy as part of their care
  • The accuracy and precision of lung tumor targeting by radiation oncologists can directly impact outcomes, since this key targeting task is critical for successful therapeutic radiation delivery.
  • An incorrectly delineated tumor may lead to inadequate dose at tumor margins during radiation therapy, which in turn decreases the likelihood of tumor control.
  • Multiple studies have shown significant inter-observer variation in tumor target design, even among expert radiation oncologists
  • Expertise in targeting lung tumors for radiation therapy may not be available to under-resourced health care settings
  • Some more information on the problem of lung cancer and the radiation therapy targeting task here:https://www.youtube.com/watch?v=An-YDBjFDV8&feature=youtu.be
(more…)
Author Interviews, Cancer Research, JAMA, Pain Research / 19.04.2019

MedicalResearch.com Interview with: Robert C. Miller, MD, MS, MBA Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida University of Maryland School of Medicine, Baltimore MedicalResearch.com: What is the background for this study? What are the main findings? Response: "Magic Mouthwash" is one of the most commonly prescribed medications for oral mucositis pain during cancer therapy, but there has not been good evidence in the past to support its use. This trial is the first large randomized controlled trial to demonstrate that both "Magic" mouthwash and doxepin rinse reduce patient reported pain during cancer therapy. (more…)
Author Interviews, Depression, Genetic Research, JAMA / 19.04.2019

MedicalResearch.com Interview with: Dr Kimberley Kendall MBBCh Wellcome Trust Clinical Research Fellow Professor James Walters MRC Centre for Neuropsychiatric Genetics and Genomics Professor, Division of Psychological Medicine and Clinical Neurosciences Cardiff University   MedicalResearch.com: What is the background for this study? Response: Copy number variants (CNVs) are the deletion or duplication of large sections of DNA. Large, rare CNVs have been shown to increase the risk of neurodevelopmental disorders including autism spectrum disorder (ASD), intellectual disability (ID), attention deficit/hyperactivity disorder (ADHD) and schizophrenia. However, the impact of these CNVs on risk of depression was unclear from the existing literature. (more…)
Author Interviews, Diabetes, JAMA, Technology / 18.04.2019

MedicalResearch.com Interview with: Associate Professor Josip Car MD, PhD, DIC, MSc, FFPH, FRCP (Edin)​ Associate Professor of Health Services Outcomes Research,​ Director, Health Services Outcomes Research Programme and Director Centre for Population Health Sciences Principal Investigator, Population Health & Living Laboratory  MedicalResearch.com: What is the background for this study? Response: In 2018, almost 8% of people with diabetes who owned a smartphone used a diabetes app to support self-management. Currently, most apps are not regulated by the US Food and Drug Administration (FDA). We downloaded and assessed 371 diabetes self-management apps, to see if they provided evidence-based decision support and patient education.  (more…)
Author Interviews, Education, JAMA, University of Pennsylvania / 16.04.2019

MedicalResearch.com Interview with: Krisda Chaiyachati, MD, MPH, MSHP Assistant Professor Medicine, Perelman School of Medicine Clinical Innovation Manager Penn's Center for Health Care Innovation Perelman School of Medicine Medical Director, Penn Medicine's FirstCall Virtual Care   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The United States spends more than $12 billion annually on training young doctors who have rates of burnout and depression at an alarmingly high rate. Yet, we have limited evidence as to what they are doing while training in the hospital. We sought to glimpse into how their day is spent. In the largest study to date, we observed 80 first-year internal medicine physicians (“interns”) for nearly 2200 hours across 194 work shifts at 6 different sites. Our research sought to understand what medical residents did by categorizing training activities into themes such as time spent in education or patient care.  (more…)
Author Interviews, Cost of Health Care, Hospital Readmissions, JAMA, Outcomes & Safety / 16.04.2019

MedicalResearch.com Interview with: Karen Joynt Maddox, MD, MPH Assistant Professor of Medicine Washington University Brown School of Social Work  MedicalResearch.com: What is the background for this study? Response: Medicare’s Hospital Readmissions Reduction Program has been controversial, in part because until 2019 it did not take social risk into account when judging hospitals’ performance. In the 21st Century Cures Act, Congress required that CMS change the program to judge hospitals only against other hospitals in their “peer group” based on the proportion of their patients who are poor. As a result, starting with fiscal year 2019, the HRRP divides hospitals into five peer groups and then assesses performance and assigns penalties.  (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, JAMA, Surgical Research / 16.04.2019

MedicalResearch.com Interview with: Nelya Melnitchouk, MD,MSc Director, Program in Peritoneal Surface Malignancy, HIPEC Dr. Melnitchouk is an associate surgeon at Brigham and Women’s Hospital (BWH) and Brigham and Women’s Faulkner Hospital (BWFH) and instructor of surgery at Harvard Medical School. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Current literature on women in surgery show that female physicians, particularly those in procedural specialties, face many challenges in balancing responsibilities between work and home. We hypothesized that these challenges may affect career satisfaction more negatively for physician mothers in procedural specialties than those in nonprocedural specialties. In our study, we found that physician mothers in procedural specialties who had more domestic responsibilities were more likely to report a desire to change careers than those in nonprocedural specialties.  (more…)
Author Interviews, JAMA, University of Pennsylvania / 14.04.2019

MedicalResearch.com Interview with: Genevieve P. Kanter, PhD Assistant Professor (Research) of Medicine Medical Ethics and Health Policy University of Pennsylvania Perelman School of Medicine Philadelphia, PA  19104-6021 MedicalResearch.com: What is the background for this study?   Response: Physicians frequently have financial relationships with pharmaceutical and medical device firms, but only recently has information on these financial ties been made available to the public. The Open Payments program, created by the Physician Payment Sunshine Act, has made this industry payments information available through a public website since 2014. Because transparent institutions are believed to engender greater public trust, public disclosure of industry payments could increase public trust in the medical profession, which may have been weakened by physicians' relationships with industry. On the other hand, Open Payments may have decreased public trust because of the focus of media reporting on physicians receiving the largest sums of money. We sought to investigate how Open Payments and the public disclosure of industry payments affected public trust in physicians and in the medical profession. We compared changes in trust among patients who lived in states where payments information had, by state statute, previously been made available, to changes in trust among patients who lived in states where this information became newly available through Open Payments. (more…)
Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease, JAMA, Johns Hopkins, Women's Heart Health / 14.04.2019

MedicalResearch.com Interview with: Erin D. Michos, MD, MHS, FACC, FAHA, FASE Associate Professor of Medicine and Epidemiology Associate Director of Preventive Cardiology Ciccarone Center for the Prevention of Heart Disease Johns Hopkins School of Medicine Victor Okunrintemi, MD, MPH Department of Internal Medicine East Carolina University Greenville, North Carolina  MedicalResearch.com: What is the background for this study?   Response: Women are less physically active than men on average, and the lack of regular physical activity has been associated with increased risk of cardiovascular disease and poorer health outcomes. Although recommendations encouraging regular physical activity has been in place for decades, we do not know how much of these recommendations are met, particularly among high risk women with established cardiovascular disease for secondary prevention. This study was therefore designed with the aim of describing the 10-year trends for the proportion of women with cardiovascular disease who do not meet these recommend physical activity levels, overall and by key sociodemographic groups, and the associated cost implications. (more…)
Author Interviews, Emergency Care, Global Health, JAMA / 12.04.2019

MedicalResearch.com Interview with: Margaret B. Greenwood-Ericksen MD, MSc Department of Emergency Medicine University of New Mexico Albuquerque, NM 87109 MedicalResearch.com: What is the background for this study?   Response: I’m an emergency physician, so I see first-hand how emergency department use patterns provide a lens into the status of health care delivery in the communities they serve. Troubling declines in the health of rural Americans coupled with rising rural hospital closures – with little access to alternative sites of care like urgent care – all led me to hypothesize that rural populations may be engaging with the health care system differently than their urban counterparts. Understanding the health care use of individuals in rural areas may yield insights into addressing rural health disparities. Further, this information may help healthcare systems and policymakers to make data-driven decisions informing new models of healthcare delivery for rural communities. (more…)
Author Interviews, Cancer Research, Health Care Systems, JAMA, Outcomes & Safety, Surgical Research, Yale / 12.04.2019

MedicalResearch.com Interview with: Daniel J. Boffa, MD Associate Professor of Thoracic Surgery Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prominent cancer hospitals have been sharing their brands with smaller hospitals in the community.  We conducted a series of nationally representative surveys and found that a significant proportion of the U.S. public assumes that the safety of care is the same at all hospitals that share the same respected brand.  In an effort to determine if safety was in fact the same, we examined complex surgical procedures in the Medicare database. We compared the chance of dying within 90 days of surgery between top-ranked hospitals, and the affiliate hospitals that share their brands.  When taking into account differences in patient age, health, and type of procedure, Medicare patients were 1.4 times more likely to die after surgery at the affiliate hospitals, compared to those having surgery at the top-ranked cancer hospitals. (more…)