Author Interviews, Geriatrics, JAMA, Surgical Research / 24.05.2017

MedicalResearch.com Interview with: Cheryl Chia-Hui Chen, RN, DNSc Vice Dean for Student Affairs Professor of Nursing National Taiwan University Nurse Supervisor at National Taiwan University Hospital Taipei, Taiwan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Older patients undergoing abdominal surgery often experience preventable delirium, which greatly influences their postoperative recovery and hospital length of stay. The modified Hospital Elder Life Program (mHELP) utilizes nurses to reduce postoperative delirium and LOS among older patients undergoing abdominal surgery for resection of malignant tumor. The mHELP consisted of 3 protocols: oral and nutritional assistance, early mobilization, and orienting communication, researchers say. Researchers at the National Taiwan University Hospital randomly assigned 377 patients undergoing abdominal surgery for a malignant tumor to an intervention (n = 197) or usual care (n = 180). Postoperative delirium occurred in 6.6 percent of mHELP participants vs 15.1 percent of control individuals (odds of delirium reduced by 56 percent). Intervention group participants received the mHELP for a median of 7 days, and they had a median LOS that was two days shorter (12 vs 14 days). (more…)
Author Interviews, Geriatrics, JAMA, NYU, Primary Care / 22.05.2017

MedicalResearch.com Interview with: Benjamin Han, MD, MPH Assistant professor Departments of Medicine-Division of Geriatric Medicine and Palliative Care, and Population Health NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are an increasing number of older adults being prescribed statins for primary prevention, but the evidence for the benefit for older adults is unclear. Our study finds that in the ALLHAT-LLT clinical trial, there were no benefits in either all-cause mortality or cardiovascular outcomes for older adults who did not have any evidence of cardiovascular disease at baseline. (more…)
Author Interviews, JAMA, Tobacco / 22.05.2017

MedicalResearch.com Interview with: Reto Auer, MD, MAS Institute of Primary Health Care (BIHAM), University of Bern, Bern, Department of Ambulatory Care and Community Medicine University of Lausanne, Lausanne, Switzerland MedicalResearch.com: What is the background for this study? Response: When the tobacco industry began to promote new “heat-not-burn” (HNB) tobacco cigarettes as a “safer” alternative to traditional cigarettes, we wanted to find out if their claims were true. Philip Morris International (PMI) created an HBN called IQOS® (I-Quit-Ordinary-Smoking). IQOS® uses tobacco sticks soaked in propylene glycol, which are inserted into a holder and heated to a maximum of 350°C. PMI claims that because its HNBs don’t combust, they emit far fewer harmful chemicals than conventional cigarettes. We decided to test their claims. (more…)
Author Interviews, Heart Disease, JAMA / 21.05.2017

MedicalResearch.com Interview with: Dr. Gregory Roth MD MPH Division of Cardiology, Department of Medicine Institute for Health Metrics and Evaluation University of Washington, Seattle MedicalResearch.com: What is the background for this study? Response: My colleagues and I at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, evaluated and analyzed mortality rates from cardiovascular diseases (CVD) on the county level from throughout the United States. We obtained the data from: The National Center for Health Statistics and population counts from the U.S. Census Bureau, the National Center for Health Statistics, and the Human Mortality Database. This data ranged from 1980 through 2014. (more…)
Abuse and Neglect, JAMA, Surgical Research, Weight Research / 18.05.2017

MedicalResearch.com Interview with: Andrew Ibrahim, M.D., M.Sc Institute for HealthCare Policy and Innovation University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: The laparoscopic gastric band was approved by the FDA in 2001 and widely adopted for the surgical treatment of morbid obesity. Reported rates of reoperation to revise or remove the device ranged from 4 to 60 percent in small scale studies, but no population estimates in the United States existed. In a review of Medicare Claims data between 2006 and 2013, we observed that reoperation was common with 18% of patients requiring at least one reoperation. More over, we found that on average, patients who did need a reoperation often underwent an average of 3.8 additional procedures. Taken together, nearly half (47%) of the $470 million paid by Medicare for device related procedures was for reoperations. (more…)
AHRQ, Author Interviews, JAMA, Outcomes & Safety / 18.05.2017

MedicalResearch.com Interview with: John Oliver DeLancey, MD, MPH Resident, Department of Urology Research Fellow, Surgical Outcomes and Quality Improvement Center Northwestern University Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: We initially looked at the star ratings for hospitals that we considered to provide excellent care, and it did not seem that this was reflected in the star ratings. Therefore, we sought to examine which factors were associated with the likelihood of receiving a high or low star rating. When we examined these associations, we found that academic and community hospitals, who reported nearly all of the measures included, had disproportionally lower star ratings than Critical Access or Specialty hospitals, who reported on average about half of the measures used to generate the star ratings. (more…)
Author Interviews, Emergency Care, JAMA, Stroke / 18.05.2017

MedicalResearch.com Interview with: Ryan A. McTaggart M.D. Assistant Professor of Diagnostic Imaging, Neurology, and Neurosurgery @mobilestroke4U Warren Alpert School of Medicine Brown University Rhode Island Hospital MedicalResearch.com: What is the background for this study? Response: Stroke is the #1 cause of disability and 5th leading cause of death. Mechanical thrombectomy (direct mechanical removal of the obstructing blood clot) is a dramatically effective treatment for the most devastating of all acute ischemic strokes – emergency large vessel occlusion (ELVO). Access to this treatment can be optimized with the use of 1) mobile stroke unit technology, 2) changing our Emergency medical services triage algorithms so that stroke matches that of trauma (using field severity to transport the right patient, to the right hospital, the first time, whenever possible), and 3) improving in-hospital processes at Primary Stroke Centers (PSCs) so that patients with suspected ELVO who present to a PSC (a hospital that does not offer mechanical thrombectomy) do not get left behind and untreated. This study reflects an effort to address and improve the third item. (more…)
Alzheimer's - Dementia, Author Interviews, Depression, JAMA / 18.05.2017

MedicalResearch.com Interview with: Archana Singh-Manoux, PhD Research Professor (Directeur de Recherche) Epidemiology of ageing & age-related diseases INSERM  France Honorary Professor University College London, UK  MedicalResearch.com: What is the background for this study? Response: Depressive symptoms are common in dementia patients. Previous studies, based on older adults, show depressive symptoms in late life to be associated with an increased risk of dementia. These studies do not allow conclusions to be drawn on the causal nature of the association between depressive symptoms and dementia. (more…)
Accidents & Violence, Author Interviews, JAMA, Surgical Research / 17.05.2017

MedicalResearch.com Interview with: Alan Cook, MD, FACS Director, Trauma Research Program Chandler Regional Medical Center Clinical Assistant Professor, Department of Surgery University of Arizona College of Medicine - Phoenix Chandler, AZ 85224 and Frederick B. Rogers MD, MS, FACS Trauma Surgeon Lancaster General Health/Penn Medicine Adjunct Professor of Surgery University of Pennsylvania College of Medicine Department of Surgery MedicalResearch.com: What is the background for this study? What are the main findings? Response: The morbidity and mortality from pulmonary emboli (PE) are considerable. They range in severity from a problem amenable to outpatient medical management to fatal. Trauma patients are often ineligible for chemoprophylaxis due to the risk for life-threatening bleeding. Yet traumatic injury can increase a person’s likelihood of having a pulmonary embolus via an array of mechanical and humoral pathways. The vena cava filter (VCF) offered the possibility of PE prophylaxis for patients otherwise vulnerable to PE risk. Use of VCF grew and the rate of use increased even more after the introduction of the retrievable VCF. Our study sought to determine if any temporal variation in VCF use has occurred and investigate if an contemporaneous change in the diagnosis of PE has taken place. We used three databases to allow a telescoping window of observation from a single state, Pennsylvania (PTOS), to a convenience of sample of trauma centers across the country (NTDB), and finally a national, population-based sample of all hospital discharges in the US (NIS). A temporal trend was observed in all three datasets with differing magnitudes and time points of change. The variation of vena cava filter use was most pronounced in the PTOS and least dramatic in the NIS, The rate of PE was essentially unchanged during the same period. (more…)
Author Interviews, JAMA, Thyroid / 15.05.2017

MedicalResearch.com Interview with: Dr. C. Seth Landefeld MD U.S. Preventive Services Task Force and Chairman of the department of Medicine and Spencer Chair in Medical Science Leadership University of Alabama at Birmingham (UAB) School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Thyroid cancer is rare in the United States, and the evidence shows that screening for it leads to an increase in new diagnoses without affecting the number of people who die from it. This is because screening people without signs or symptoms for thyroid cancer often identifies small or slow-growing tumors that might never affect a person during their lifetime. After reviewing the evidence, the Task Force found little evidence on the benefits of screening for thyroid cancer and considerable evidence that treatment, which is often unnecessary, can cause significant harms. Additionally, in places where universal screening has been implemented, it hasn’t helped people live longer, healthier lives. (more…)
ADHD, Author Interviews, JAMA, Karolinski Institute / 11.05.2017

MedicalResearch.com Interview with: Zheng Chang PhD MSc Department of Medical Epidemiology and Biostatistics (MEB) Karolinska Institutet Stockholm Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: About 1.25 million people worldwide die annually because of motor vehicle crashes (MVCs). ADHD is a prevalent neurodevelopmental disorder with symptoms that include poor sustained attention, impaired impulse control and hyperactivity. ADHD affects 5 percent to 7 percent of children and adolescent and for many people it persists into adulthood. Prior studies have suggested people with ADHD are more likely to experience MVCs. Pharmacotherapy is a first-line treatment for the condition and rates of ADHD medication prescribing have increased over the last decade in the United States and in other countries. Among the more than 2.3 million patients with ADHD (average age 32.5), we found patients with ADHD had a higher risk of an MVC than a control group of people without ADHD. The use of medication in patients with ADHD was associated with reduced risk for motor vehicle crashes in both male and female patients. (more…)
Author Interviews, Immunotherapy, JAMA, Melanoma / 10.05.2017

MedicalResearch.com Interview with: Yasuhiro Nakamura, M.D., Ph.D. Associate Professor Department of Skin Oncology/Dermatology Comprehensive Cancer Center Saitama Medical University International Medical Center Hidaka, Saitama MedicalResearch.com: What is the background for this study? What are the main findings? Response: Regressing nevi, which are frequently associated with halo phenomenon, occur in approximately 1% of the general population. In patients with melanoma, spontaneous or treatment-related depigmentation of the skin (vitiligo) is sometimes observed. Although humoral and cellular immune responses may play a crucial role in their development, immune reactions to benign melanocytic nevi (BMN) without a halo are extremely rare in both the general population and in patients with melanoma. This publication reports a rare case with multiple metastatic melanomas who showed a remarkable clinical response to nivolumab with a simultaneous prominent immune reaction to multiple BMN without halo phenomenon. This rare phenomenon may be associated with dramatic efficacy of nivolumab in melanoma patients. (more…)
Author Interviews, JAMA, Ophthalmology / 08.05.2017

MedicalResearch.com Interview with: John H Kempen, MD, PhD Protocol Chair, MUST Trial Follow-up Study; Vice Chair, MUST Research Group Director of Epidemiology for Ophthalmology, Massachusetts Eye and Ear Harvard Medical School Editor-in-Chief, Ophthalmic Epidemiology President, Sight for Souls MedicalResearch.com: What is the background for this study? Response: Uveitis is about the fifth leading cause of blindness in the united states.  Among types of uveitis, intermediate, posterior and panuveitis are the leading causes of blindness.  Before 2005, systemic therapy with corticosteroids—supplemented when indicated with immunosuppressive drugs (most of the time)—was the primary treatment recommended for these conditions.  With approval of the fluocinolone acetonide implant in 2005 for intermediate, posterior and panuveitis, it became unclear which of the alternative treatment approaches should be the treatment of choice. The multicenter uveitis steroid treatment (must) trial was initiated in 2005 to directly compare the alternative treatments.  Systemic therapy was administered using high dose prednisone followed by tapering of corticosteroids to maintenance doses of 10 mg/day or less (generally 7.5 mg/day or less) or to zero; this was supplemented by immunosuppressive corticosteroid-sparing drugs in 88% of participants.  Implant therapy was done by initial quieting of the anterior chamber of the eye with topical, injected or systemic corticosteroids followed by surgical implant placement within 28 days (first eye) and 56 days (second eye if it was indicated).  After this, systemic corticosteroids and immunosuppressive drugs were tapered off. (more…)
Author Interviews, JAMA, Ophthalmology, Pediatrics / 05.05.2017

MedicalResearch.com Interview with: Rohit Varma, MD, MPH Executive Director - USC Roski Eye Institute and Dean of the Keck School of Medicine of USC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Visual impairment in early childhood has profound impact on a child’s development. It can significantly impair development of visual, motor, and cognitive function1-3 and lead to adverse psychosocial consequences. There has been a lack of accurate data characterizing the current and expected numbers of visual impairment cases among preschool children in the United States from 2015 to 2060. The number of preschool children with visual impairment is projected to increase by 26% in 2060. And 69% of these visual impairment will result from simple uncorrected refractive error such hyperopia and myopia, which can be prevented or treated by low-cost refractive correction. (more…)
Author Interviews, Heart Disease, JAMA, Kidney Disease, Surgical Research / 04.05.2017

MedicalResearch.com Interview with: Nirat Beohar, MD Vice-Chief of Cardiology Director Cardiac Catheterization Laboratory Director Structural Heart Disease Program Director Interventional Cardiology Fellowship program Cardiac Catheterization Laboratory Columbia University Division of Cardiology, Mount Sinai Medical Center Miami Beach, Miami, FL 33140 MedicalResearch.com: What is the background for this study? Response: Nirat Beohar MD, Director of the Cardiovascular Catheterization Laboratory and Vice-Chief of Cardiology at the Columbia University Division of Cardiology at the Mount Sinai Medical Center and co-authors report the effect of trans-catheter aortic valve replacement (TAVR) on subsequent renal function and outcomes in high-risk and inoperable patients presenting with baseline renal dysfunction (eGFR < 60 ml/min/1.73 m2). This was a sub-study of patients undergoing TAVR in the PARTNER 1 trial and continued access registry that was conducted in 25 centers in the United States and Canada. (more…)
Author Interviews, JAMA, Pharmacology, UCLA / 03.05.2017

MedicalResearch.com Interview with: Ian Larkin, PhD Assistant Professor of Strategy UCLA Anderson School of Management MedicalResearch.com: What is the background for this study? Response: The study examined whether restrictions put in by medical centers on salesperson visits to physicians, known as “detailing,” affected subsequent physician prescribing behavior. Detailing represents the most prominent form of pharmaceutical marketing. Detailing visits allow the sharing of scientific information, but they also often involve small gifts for physicians and their staff, such as meals. Pharmaceutical companies incur far greater expenditures on detailing visits than they do on direct-to-consumer marketing, or even on research and development of new drugs. Specifically, the study examined detailing restrictions put into place by 19 academic medical centers (AMCs) in five states in the U.S. It compared changes in prescribing by thousands of AMC physicians whose practices limited typical elements of detailing visits, such as provisions of meals and educational gifts, to a carefully matched control group of similar physicians practicing in the same geographic regions but not subject to such detailing restrictions. The study, which included more than 25,000 physicians and all 262 drugs in eight major drug classes — from statins to sleep aids to antidepressants, representing more than $60 billion in aggregate sales in the United States — was, to date, by far the most comprehensive to examine the impact of detailing restrictions. The comprehensive and quasi-experimental methodology, which compared prescribing behavior before and after implementation of policies, and which included a large matched control group of physicians not subject to policy changes, was an important innovation relative to prior research. The study used prescription data from CVS Caremark, one of the largest pharmacy benefit managers in the United States. (more…)
Author Interviews, JAMA, Opiods, Pain Research, Surgical Research / 03.05.2017

MedicalResearch.com Interview with: Chad M. Brummett, M.D. Associate Professor Director, Clinical Anesthesia Research Director, Pain Research Department of Anesthesiology Division of Pain Medicine University of Michigan Medical School Ann Arbor, MI  48109  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The opioid epidemic has received tremendous attention in recent years, but most of the focus has been on chronic pain, opioid abuse and overdose. Far less attention has been paid to the importance of acute care prescribing (e.g. surgical pain) in patients that are not chronic opioid users. We found that 5-6% of patients not using opioids prior to surgery continued to fill prescriptions for opioids long after what would be considered normal surgical recovery. Moreover, the rates of new chronic use did not differ between patients having major and minor surgeries, suggesting that patients continue to use these pain medications for something other than simply pain from surgery. Building on other work by our group, and the few additional studies done on the topic to date, these data suggest that pain medications written for surgery are a major cause of new chronic opioid use for millions of Americans each year. (more…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 02.05.2017

MedicalResearch.com Interview with: Dr. PJ Devereaux MD, PhD, FRCP(C) Director of the Division of Cardiolog Scientific Leader of the Anesthesiology, Perioperative Medicine and Surgical Research Group at the Population Health Research Institute Professor and University Scholar in the Departments of Health Research Methods, Evidence, and Impact and Medicine McMaster University MedicalResearch.com: What is the background for this study? Response: Although the majority of patients undergoing noncardiac surgery benefit from surgery and do well, even when a small proportion of these patients have a serious complication it represents a major population issue. A recent publication in JAMA Cardiology established that >5 million Americans age ≥45 years undergo major in-patient noncardiac surgery annually, and 1.3% of these patients die in the hospital. This means 65,000 of these patients die, and cardiovascular causes are a dominant cause. (more…)
Author Interviews, JAMA, Pain Research, Pharmacology, UT Southwestern / 01.05.2017

MedicalResearch.com Interview with: Una Makris MD, MSc Clinical Investigator at the VA North Texas Health System VA North Texas Health Care System Assistant Professor at UT Southwestern Medical Center Departments on Internal Medicine and Clinical Sciences Dr. Makris is a Rheumatologist, clinically, and spends the majority of time focused on clinical research investigating how to improve outcomes for adults with back pain. MedicalResearch.com: What is the background for this study? Response: Back pain is the most common type of musculoskeletal (MSK) pain. We know that expenditures for back pain exceed $100 billion each year (and this was in 2005). Back pain results in tremendous disability (including reduced mobility) and impaired quality of life (not exclusive to physical consequences, but also including important psychosocial repercussions). We also know that statins are prescribed very often, and frequently in younger populations who are active. Some reports suggest that statins may have a protective effect on  musculoskeletal conditions such as back pain. (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA, OBGYNE / 01.05.2017

MedicalResearch.com Interview with: Dr. Maureen Phipps, USPTS Task Force member Department chair and Chace-Joukowsky professor of obstetrics and gynecology Assistant dean for teaching and research on women's health Warren Alpert Medical School of Brown University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Preeclampsia, which includes high blood pressure after 20 weeks of pregnancy, is one of the most serious health problems affecting pregnant women. After reviewing the evidence, the Task Force found the benefits of screening for preeclampsia outweighed the harms and recommended screening pregnant women for preeclampsia with blood pressure measurements throughout pregnancy. The evidence showed mothers and their babies are likely to benefit from screening, as screening leads to treatment that reduces their risk of severe complications, including death. (more…)
ADHD, Author Interviews, Education, Gender Differences, JAMA, Pediatrics / 01.05.2017

MedicalResearch.com Interview with: Professor Jill Pell MD Director of Institute (Institute of Health and Wellbeing) Associate (School of Medicine, Dentistry and Nursing) University of Glasgow MedicalResearch.com: What is the background for this study? Response: The novelty of our study lies in its scale and scope. In terms of scope, it reported on six educational outcomes and three health outcomes in the same group of children. In terms of scale, it is the first study of a whole country to compare educational outcomes of children with treated ADHD with their unaffected peers and is more than 20 times larger than previous studies on similar educational outcomes. The only previous countrywide study on health outcomes, included only children with very severe ADHD who were in psychiatric hospitals. (more…)
Author Interviews, JAMA, Macular Degeneration, Ophthalmology, Primary Care / 01.05.2017

MedicalResearch.com Interview with: David C Neely, MD The University of Alabama at Birmingham MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study examined the prevalence of eyes with age-related macular degeneration (AMD) in patients seen in primary eye care clinics who purportedly have normal macular health. Approximately 25.0% of eyes deemed to be normal based on dilated eye examination by primary eye care providers had macular characteristics that indicated age-related macular degeneration. (more…)
Accidents & Violence, Author Interviews, JAMA, Mental Health Research, Surgical Research / 30.04.2017

MedicalResearch.com Interview with: Elinore J. Kaufman, MD, MSHP Department of Surgery, New York Presbyterian Hospital Weill Cornell Medicine New York, New York MedicalResearch.com: What is the background for this study? What are the main findings? Response: Deaths of civilians in contact with police have recently gained national public and policy attention. However, we know very little about nonfatal injuries, which far outnumber deaths. MedicalResearch.com: What should readers take away from your report? Response: Nonfatal injuries are much more pervasive than law enforcement-associated deaths, and rates have remained stable over several years, at approximately 51,000 emergency department visits and hospitalizations each year. These injuries primarily affect young men, and mental illness is a common theme. As a physician, my goal is always to get to zero preventable injuries. (more…)
Author Interviews, Dermatology, JAMA, Melanoma, Technology / 27.04.2017

MedicalResearch.com Interview with: Laura Korb Ferris, MD, PhD Associate Professor, University of Pittsburgh Clinical and Translational Science Institute Director of Clinical Trials Department of Dermatology University of Pittsburgh Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: We found that a non-invasive adhesive patch applied to the skin over a pigmented skin lesion allowed us to capture enough genetic material from the lesion to analyze and predict if that lesion is likely to be melanoma, meaning a biopsy is warranted, or if it is likely benign, meaning the patient would not need a skin biopsy. In this study, we asked dermatologists to use their clinical judgement to decide if they would recommend biopsying a skin lesion based on photos and information about the lesion and the patients, such as the patient's age, personal and family history of skin cancer, and if the lesion was new or changing. We then provided them the read out of the gene test and asked them how this influence their decision. We found that with this test result, dermatologists were more accurate in their decision making, meaning they were more likely to recommend biopsy of melanomas and less likely to biopsy harmless moles than they were without the test. This is important as it means this test has the potential to reduce the number of unnecessary skin biopsies performed, saving patients from undergoing a procedure and having a scar as a result, without increasing the risk of missing a melanoma. (more…)
Addiction, Author Interviews, Cannabis, JAMA / 27.04.2017

MedicalResearch.com Interview with: Deborah S. Hasin, Ph.D. Professor of Epidemiology Columbia University New York, New York 10032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Among adults, the prevalence of cannabis use and cannabis use disorders has increased in recent years. Concerns have been raised that for various reasons, medical marijuana laws would promote use of cannabis and consequently, cannabis-related consequences. Many studies show that this didn't happen among adolescents, but very little was known about the relationship between medical marijuana laws and adults. Using data from three surveys spanning the years 1991-2013, the study findings suggested that medical marijuana laws did play a role in increasing rates of cannabis use and cannabis use disorders. (more…)
Author Interviews, HIV, JAMA, Pediatrics, Sexual Health / 25.04.2017

MedicalResearch.com Interview with: Robin Lin Miller, Ph.D. Professor, Ecological-Community Psychology Co-Director, MA in Program Evaluation Chair, Graduate Program in Ecological-Community Psychology Michigan State University East Lansing, MI 48824 MedicalResearch.com: What is the background for this study? Response: We wanted to identify promising strategies for providing access to HIV-testing for gay and bisexual male youth. We were especially interested in testing strategies to reach gay and bisexual male youth of color, as they bear a disproportionate burden of the HIV epidemic and are the least likely to be aware of their HIV status. We also wanted to explore approaches to successfully link these youth with HIV-negative test results to diverse HIV prevention services, including pre-exposure prophylaxis, when warranted. Although some argue that the ideal place to test adolescents and young adults is via emergency rooms and in routine medical care visits, we found that we were able test many more youth with previously undiagnosed HIV-infection through intensive, targeted community outreach efforts. We also tested a much higher proportion of young men of color through targeted outreach. (more…)
Author Interviews, JAMA, Mental Health Research, Pediatrics / 25.04.2017

MedicalResearch.com Interview with: Dr. Yongfu Yu, PhD Department of Clinical Epidemiology Aarhus University Hospital Aarhus, Denmark MedicalResearch.com: What is the background for this study? Response: Bereavement by the death of a close relative is ranked as one of the most severe life events and it is likely to cause psychological stress regardless of coping mechanisms. An increased risk of mortality and adverse health outcomes has been observed among the bereaved spouses, parents, and children. It is estimated that nearly 8% of individuals in the US experienced a sibling death in childhood but much less is known about its health consequences. Sibling relationship tends to be the longest and the most intimate in family thus the death of a sibling can be a devastating life event, especially when this event happens at early ages. However, to our knowledge, no study has investigated the effects of sibling death in childhood on subsequent mortality in bereaved siblings with a long follow-up time. (more…)
Author Interviews, JAMA, Prostate Cancer, UCSF / 24.04.2017

MedicalResearch.com Interview with: Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S. Lee Goldman, MD, endowed chair in medicine and professor of medicine and of epidemiology and biostatistics University of California, San Francisco Chair of the U.S. Preventive Services Task Force MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prostate cancer is one of the most common cancers to affect men, and the Task Force believes all men should be aware of the benefits and harms of screening for prostate cancer. Prostate cancer screening with PSA testing can help men reduce their chance of dying of prostate cancer or of having metastatic cancer. These are important benefits but occur in a small number of men. There are risks associated with screening, specifically overdiagnosis and overtreatment with surgery and radiation that can have important side effects like impotence and incontinence. Since the release of our 2012 recommendation, new evidence has emerged that increased the Task Force’s confidence in the benefits of screening, which include reducing the risk of metastatic cancer (a cancer that spreads) and reducing the chance of dying from prostate cancer. This draft recommendation also reflects new evidence on the use of active surveillance in men with low-risk prostate cancers that may help mitigate some of the harms in these men by allowing some men with low risk cancer to delay or avoid surgery or radiation. Therefore, in our new 2017 draft recommendation, the Task Force encourages men ages 55 to 69 to make an individual decision about whether to be screened after a conversation with their clinician about the potential benefits and harms. For men age 70 years and older, the potential benefits do not outweigh the harms, and these men should not be screened for prostate cancer. (more…)
Author Interviews, Education, JAMA, Outcomes & Safety, Surgical Research / 24.04.2017

MedicalResearch.com Interview with: Haggi Mazeh, MD, FACS Endocrine and General Surgery Department of Surgery Hadassah-Hebrew University Medical Center, Mount Scopus Jerusalem, Israel 91240 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The level of operating room autonomy given to surgical residents varies greatly between different institutions and different countries. On one hand, providing residents the opportunity to operate alone augments their confidence and their sense of responsibility, possibly accelerating their learning process. On the other hand, it may be argued that the presence of a senior general surgeon in every operation is a safer approach. Before 2012, a large proportion of appendectomies at our institution were performed by surgical residents alone. After 2012, our institutional policy changed to require the presence of a senior general surgeon in every appendectomy case. This unique situation provided us the opportunity to compare the outcomes of appendectomies performed by residents alone to those performed in the presence of a senior general surgeon. Our study demonstrated no difference in the complication rates between the two groups of patients. However, surgeries performed in the presence of senior general surgeons were significantly shorter than those performed by residents. (more…)