Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lung Cancer, Supplements, USPSTF / 30.06.2022

MedicalResearch.com Interview with: Michael J. Barry, M.D Director of the Informed Medical Decisions Program Health Decision Sciences Center Massachusetts General Hospital. Professor of medicine at Harvard Medical School Dr. Barry was appointed as Vice Chair of USPSTF in March 2021. He previously served as a member from January 2017 through December 2020.   MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: The Task Force looked at the use of vitamin and mineral supplementation specifically for the prevention of heart disease, stroke, and cancer. We found that there is not enough evidence to recommend for or against taking multivitamin supplements, nor the use of single or paired nutrient supplements, to prevent these conditions. However, we do know that you should not take vitamin E or beta-carotene for this purpose. (more…)
Author Interviews, Breast Cancer, JAMA, Mammograms, Medical Imaging, UCSF / 15.06.2022

MedicalResearch.com Interview with: Karla Kerlikowske, MD. Professor, Departments of Medicine and Epidemiology/Biostatistics, Cancer Center Program Membership. Breast Oncology UCSF MedicalResearch.com:  What is the background for this study?  Response: Digital breast tomosynthesis (DBT) was developed with the expectation it would improve detection of breast cancer in women with dense breasts and decrease false-positive results. DBT is now available at most breast screening centers. (more…)
Author Interviews, Cancer Research, JAMA, Race/Ethnic Diversity / 10.06.2022

MedicalResearch.com Interview with: Marquita W. Lewis-Thames, PhD (she/her/Dr.) Assistant Professor, Department of Medical Social Science Center for Community Health, Member Researcher Assistant Directors of Community Outreach and Engagement, Robert H. Lurie Comprehensive Cancer Center Feinberg School of Medicine, Northwestern University MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response: Incidence, mortality, and survivorship provide a comprehensive description of cancer for a group of people. Differences in cancer incidence and mortality trends by rural-urban status and race and ethnicity are well documented, but urban-rural cancer survivorship trends by race and ethnicity are unknown. To this end, we examined almost 40 years of racial and ethnic differences by rural-urban status for 5-year survival of patients with lung, prostate, breast, and colorectal cancers. Using a nationwide epidemiological assessment of 1975-2011 data from the SEER database, we found that 5-year cancer-specific survival trends increased for all cancer types and race and ethnic groups, regardless of rural or urban status. Generally, rural, and non-Hispanic Black cancer patients had worse survival outcomes than others. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA / 09.06.2022

MedicalResearch.com Interview with: Benjamin N. Rome MD Instructor, Harvard Medical School Internal Medicine Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital MedicalResearch.com:  What is the background for this study? What are the main findings?  Response: Manufacturers of brand-name drugs are granted periods, free from direct competition, during which they can set and raise prices as they choose. We found that the prices for newly marketed brand-name drugs increased by 20% per year from 2008 to 2021. In 2020 and 2021, nearly half of new drugs were launched at a price greater than $150,000 per year, compared with 9% of drugs in 2008-2013. These dramatic trends are only partly explained by changes in the types of drugs coming to market. (more…)
Author Interviews, Gout, JAMA, Kidney Disease / 06.06.2022

MedicalResearch.com Interview with: Csaba P Kovesdy MD FASN Fred Hatch Professor of Medicine Director, Clinical Outcomes and Clinical Trials Program Division of Nephrology, University of Tennessee Health Science Center Nephrology Section Chief, Memphis VA Medical Center Memphis TN, 38163 MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response: Hyperuricemia has unfavorable metabolic effects and has been associated with higher risk of progressive kidney disease and mortality. Despite this, earlier clinical trials have failed to prove a beneficial impact on kidney disease progression from uric acid lowering therapy in patients with preexisting CKD. The effect of uric acid lowering therapy on the development of new onset CKD in patients with normal kidney function has not been well studied. In our large observational study we did not find a beneficial association between newly initiated uric acid lowering therapy (the majority of which was in the form of allopurinol). On the contrary, uric acid lowering therapy was associated with a slightly higher risk of new onset low eGFR and new onset albuminuria, especially in patients with less elevated baseline serum acid levels. (more…)
Author Interviews, JAMA, Ophthalmology, USPSTF / 02.06.2022

MedicalResearch.com Interview with: Katrina Donahue, M.D., M.P.H. Professor and vice chair of research Department of Family Medicine University of North Carolina at Chapel Hill Dr. Donohue is a family physician and senior research fellow Cecil G. Sheps Center for Health Services Research Dr. Donahue joined the U.S. Preventive Services Task Force in January 2020. MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response: Impaired vision and glaucoma are serious and common conditions facing millions of people nationwide that can affect a person’s independence and quality of life. These recommendations looked at how primary care clinicians can help people who have not noticed any problems with their vision. Unfortunately, there is not enough evidence available to make a recommendation for or against screening adults for glaucoma or older adults for impaired vision in the primary care setting. (more…)
Author Interviews, Education, Fertility, JAMA / 20.05.2022

MedicalResearch.com Interview with: Kathryn S. Smith, BS M.D. Candidate, Class of 2023 Northwestern University Feinberg School of Medicine Chicago, Illinois MedicalResearch.com:  What is the background for this study  Response: There are studies that show women in medicine do not achieve promotion at the same rate as men and that only a minority of women are in the upper levels of leadership such as Department Chairs and Medical School Deans. Since peak fertility coincides with peak career building years, we wanted to explore themes related to career advancement, physician burnout and ultimately whether women were being held back from their potential by the burden of fertility, family building, childcare, and household responsibilities. (more…)
Author Interviews, JAMA, Race/Ethnic Diversity / 16.05.2022

MedicalResearch.com Interview with: Susannah G. Rowe, MD, MPH Office of Equity, Vitality and Inclusion Boston University Medical Group Boston Medical Center Boston University School of Medicine Boston, Massachusetts MedicalResearch.com:  What is the background for this study?  Response: We wanted to learn how frequently mistreatment occurs for clinicians at work and how it impacts their occupational well-being. We began to see more anecdotal reports of workplace mistreatment of clinicians even before the pandemic. In the extraordinarily stressful environment we are currently experiencing, with people feeling exhausted and emotionally threadbare on some level, the problem appears to be growing. We also predicted that the burden of mistreatment would not borne be equally. It has often been said that we are all in the same storm but in different boats – some of us are riding out the storm in comfortable ocean liners, while others are paddling in canoes without life jackets. What we are learning, though, is that we are not in fact experiencing the same storm. For example, the increasing intolerance and erosion of public civility we have seen in recent years might show up as minor annoyances for some of us, and actual threats of violence for others depending in large part on our gender and racialized identities. Our relationship to privilege and oppression affects our experiences, creating protections or additional burdens, so when studying clinician occupational well-being, it seemed important to consider how these disparities play out in the workplace.  (more…)
Author Interviews, Cancer Research, JAMA, NIH, Race/Ethnic Diversity / 05.05.2022

MedicalResearch.com Interview with: Megan Clarke, Ph.D., M.H.S., Earl Stadtman Investigator Division of Cancer Epidemiology and Genetics National Cancer Institute MedicalResearch.com:  What is the background for this study? 
  • Through our prior work, we have demonstrated that uterine cancer incidence rates have been significantly increasing in the U.S. from 2003 to 2015 and that these increases were primarily driven by rising rates of aggressive (non-endometrioid) subtypes of this cancer. We observed that rates of these aggressive cancers increased among all women and were more than twice as high among Non-Hispanic Black women compared to other racial and ethnic groups. Factors explaining these trends, as well as the disproportionately higher rates of these aggressive subtypes among non-Hispanic Black women, remain unclear, in part because risk factors are poorly understood.
  • In addition to differences in incidence rates by race and ethnicity, we have also observed strong disparities in our prior studies, with Non-Hispanic Black women having substantially lower 5-year survival, regardless of subtype or stage at diagnosis, compared to other racial and ethnic populations.
  • The next logical step, and the focus of the current study, was to evaluate how increases in the incidence of aggressive, non-endometrioid uterine cancer affects racial disparities and rates of death from uterine cancer.
(more…)
Author Interviews, Heart Disease, JAMA / 04.05.2022

MedicalResearch.com Interview with: Gbenga Ogedegbe, MD, MPH Dr. Adolph & Margaret Berger Professor of Population Health Director, Division of Health & Behavior Director Center for Healthful Behavior Change Department of Population Health NYU Langone Health NYU School of Medicine Member of the U.S. Preventive Services Task Force MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Heart disease and stroke are the leading causes of mortality in the United States, accounting for more than one in four deaths. Taking a daily aspirin may help prevent a first heart attack or stroke in some people, but it can also cause some harm, like internal bleeding. The decision on whether or not to start taking a daily aspirin should be based primarily on age, but cardiovascular disease risk, a person’s chances of bleeding, and other factors should also be taken into account. (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA, OBGYNE / 04.05.2022

MedicalResearch.com Interview with: Richard McManus MA PhD MBBS FRCGP FRCP Professor of Primary Care Dr. McManus chairs the Blood Pressure Monitoring Working Party of the British Hypertension Society Nuffield Department of Primary Care Health Sciences  MedicalResearch.com:  What is the background for this study?  Response: About one in ten people who are pregnant develop high blood pressure and almost half of these go onto to have pre-eclampsia. Many pregnant women and individuals are already measuring their own blood pressure – well over half of those with high blood pressure in a recent large survey in the UK but until recently there were no data to support this. (more…)
Author Interviews, COVID -19 Coronavirus, Hearing Loss, JAMA / 04.05.2022

MedicalResearch.com Interview with: Archelle Georgiou, MD Chief Health Officer for Starkey Starkey Hearing Technologies Eden Prairie, Minnesota MedicalResearch.com:  What is the background for this study?  Response: In August 2021, Starkey introduced a vaccination incentive program for employees in the U.S. to provide education on COVID-19 and encourage vaccinations. The program encouraged employees to watch and acknowledge online educational information and report their vaccination status. Those fully vaccinated and who submitted proof of vaccination by September 2021, including employees who were vaccinated prior to the incentive announcement, received $1,000.  (more…)
Author Interviews, Cancer Research, JAMA, Race/Ethnic Diversity, Radiology / 27.04.2022

MedicalResearch.com Interview with: Leticia Nogueira, PhD, MPH Senior Principal Scientist, Health Services Research American Cancer Society, Inc. Kennesaw, GA 30144 MedicalResearch.com:  What is the background for this study?  Response: Proton Beam Therapy (PBT) can deliver higher dose of radiation to the tumor with less damage to surrounding healthy cells. Therefore, PBT is potentially superior to photon-based radiation therapy to treat tumors with complex anatomy, surrounded by sensitive tissues, or for treating childhood cancer (where long-term side effects of radiation therapy are a main concern). However, PBT can cost twice as much as photon-based radiation therapy.  (more…)
Author Interviews, JAMA, Mental Health Research, Pediatrics, Social Issues / 13.04.2022

MedicalResearch.com Interview with: Regina Triplett, M.D., M.S. Developmental Neuroscience Post-Doctoral Research Scholar Department of Neurology Washington University in St. Louis, MO  MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response: This is an ongoing, longitudinal, prospective study of 399 pairs of mothers studied throughout pregnancy and their infants, designed to investigate exposure to early life adversity (prenatal poverty and stress) on infant brain development and behavior in early childhood. We examined measures of maternal socioeconomic status including neighborhood factors and stress/mental health during pregnancy in relation to data from infant brain MRI scans conducted in the first weeks after birth. We found that poverty during pregnancy is associated with reduced size and folding of infant brains. We found these associations across the whole brain and not specific to one region. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA / 13.04.2022

MedicalResearch.com Interview with: Cheng-Ying Ho, MD, PhD Associate Professor Department of Pathology Johns Hopkins University School of Medicine MedicalResearch.com:  What is the background for this study?  Response: Smell loss is one of the most common symptoms of COVID-19 infection. The mechanism of COVID-19-related smell loss is unclear. Previous studies mainly focused on the effect of the viral infection on the lining of the nasal cavity. We went a step beyond to examine the olfactory bulb, a region that transmits smell-related signals to the brain.  (more…)
Author Interviews, Dermatology, JAMA, Melanoma, University of Pittsburgh / 08.04.2022

MedicalResearch.com Interview with: Laura Ferris, M.D., Ph.D. Professor of Dermatology Director of clinical trials for UPMC Department of Dermatology University of Pittsburgh School of Medicine MedicalResearch.com:  What is the background for this study?  Response: In this quality initiative at UPMC (a large academic and community health system in Western PA and surrounding areas) Primary Care Physicians were trained to perform annual skin cancer screening examinations of their patients who were aged 35 years and older at routine medical visits. Over a 5-year period more than 595,000 patients who were eligible to be screened were seen by a UPMC PCP and about 24% of them were screened. We compared the number and thickness (an important indicator of prognosis) of the melanomas diagnosed in those patients who were screened to those who were not screened. (more…)
Abuse and Neglect, Author Interviews, Dermatology, JAMA, Pediatrics / 27.03.2022

MedicalResearch.com Interview with: Aaron Drucker MD, ScM, FRCPC Division of Dermatology, Department of Medicine, Women’s College Hospital Scientist, Women’s College Research Institute Assistant Professor, Department of Medicin and Institute of Health Policy, Management and Evaluation University of Toronto Adjunct Scientist, ICES  MedicalResearch.com:  What is the background for this study?  What are the main findings?   Response: Because atopic dermatitis is a chronic condition that is common in children, parents and physicians often wonder if it will affect overall child well-being, including their growth parameters. Previous studies were mostly cross-sectional, so we conducted a longitudinal study to follow children over time. We found that although young children with atopic dermatitis were somewhat shorter with higher BMI than children without atopic dermatitis, these differences were small and attenuated as children grew older. (more…)
Author Interviews, JAMA, Mental Health Research, USPSTF, Weight Research / 23.03.2022

MedicalResearch.com Interview with: Lori Pbert, Ph.D Professor, Department of Population and Quantitative Health Sciences Associate chief of the Division of Preventive and Behavioral Medicine Founder and Director of the Center for Tobacco Treatment Research and Training University of Massachusetts Medical School Dr. Pbert joined the U.S. Preventive Services Task Force in January 2019 MedicalResearch.com:  What is the background for this study?  Response: This is the first time that the Task Force has looked at the evidence around screening for eating disorders. It was important to address this topic because of the serious harm that these conditions can cause to people’s physical and mental health, and the tremendous toll eating disorders have on individuals and families. MedicalResearch.com:  What are the main findings? Response: After reviewing the limited available research, we determined there is not enough evidence to recommend for or against screening teens and adults for eating disorders in adolescents and adults who do not have signs or symptoms of an eating disorder or concerns about their eating. It’s important to note that this recommendation is not for people who are showing signs or symptoms of eating disorders, like rapid weight loss or gain, slow heart rate, delayed puberty, or a disruption of menstruation, or for those expressing concern about their eating. (more…)
Author Interviews, Education, JAMA, Surgical Research, Technology / 22.03.2022

MedicalResearch.com Interview with: Ali M. Fazlollahi, MSc, McGill Medicine Class of 2025 Neurosurgical Simulation and Artificial Intelligence Learning Centre Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital Faculty of Medicine and Health Sciences McGill University, Montreal, Canada MedicalResearch.com:  What is the background for this study?  Response: COVID-19 disrupted hands on surgical exposure of medical students and academic centres around the world had to quickly adapt to teaching technical skills remotely. At the same time, advances in artificial intelligence (AI) allowed researchers at the Neurosurgical Simulation and Artificial Intelligence Learning Centre to develop an intelligent tutoring system that evaluates performance and provides high-quality personalized feedback to students. Because this is the first AI system capable of providing surgical instructions in simulation, we sought to evaluate its effectiveness compared with learning from expert human instructors who provided coaching remotely. (more…)
Author Interviews, Education, JAMA, Race/Ethnic Diversity, Social Issues / 15.03.2022

MedicalResearch.com Interview with: Arman A. Shahriar Medical Student, University of Minnesota Medical School Research Consultant, HealthPartners Institute Minneapolis, MinnesotaArman A. Shahriar Medical Student, University of Minnesota Medical School Research Consultant, HealthPartners Institute Minneapolis, Minnesota

  MedicalResearch.com:  What is the background for this study?  Response: In recent years there has been a significant focus on the diversity of medical students, but to date, most work has focused on ‘visible’ forms of diversity; such as race, ethnicity and gender. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Kidney Disease / 15.03.2022

MedicalResearch.com Interview with: Susan P. Y. Wong, MD MS Assistant Professor Division of Nephrology University of Washington VA Puget Sound Health Care System  MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Very little is known about the care and outcomes of patients who reach the end stages of kidney disease and do not pursue dialysis. We conducted a systematic review of longitudinal studies on patients with advanced kidney disease who forgo dialysis to determine their long-term outcomes. We found that many patients survived several years and experienced sustained quality of life until late in the illness course. However, use of acute care services was common and there was a high degree of variability in access to supportive care services near the end of life. (more…)
Anesthesiology, Author Interviews, Columbia, JAMA, OBGYNE / 28.02.2022

MedicalResearch.com Interview with: Jean Guglielminotti MD,PhD Assistant Professor of Anesthesiology Columbia University Irving Medical Center New York 10032  MedicalResearch.com:  What is the background for this study?  Response: An old study (2004-2006) conducted in France suggested that epidural analgesia during childbirth resulted in a decreased risk of postpartum hemorrhage, the first cause of preventable maternal morbidity and mortality. We believed it was important to replicate this study in the United States, because of the advances in obstetric and anesthesia care practices during the last 15 years, and because of the marked differences in the health care systems between the United States and France. (more…)
Author Interviews, JAMA, OBGYNE, STD / 16.02.2022

MedicalResearch.com Interview with: Irene A. Stafford, M.S., M.D. Associate Professor Associate Program Director Maternal - Fetal Medicine Fellowship Department of Obstetrics and Gynecology Division of Maternal Fetal Medicine McGovern Medical School at UTHealth Houston MedicalResearch.com:  What is the background for this study? Response: We have observed disproportionately high-rates syphilis in the US over the last several years, and here in Texas. As this is now leading to health alerts in our cities, it is key we bring attention to this infection regarding risks to the pregnant patient and her fetus. Syphilis carries a nearly 40% neonatal mortality rate, so testing and treating is key in preventing this devastating neonatal infection. We need to encourage and offer testing at intake to pregnancy care, and any time a patient desires to be tested for STI.   (more…)
Author Interviews, JAMA, Pediatrics / 16.02.2022

MedicalResearch.com Interview with: Izzuddin M Aris, PhD Assistant Professor Department of Population Medicine, Harvard Medical School Division of Chronic Disease Research Across the Lifecourse Harvard Pilgrim Health Care Institute Boston, MA MedicalResearch.com:  What is the background for this study?  Response: Puberty is a key stage during child development. Previous research indicates that children in the United States are entering puberty at younger ages. These children may be in danger of developing certain diseases, such as type 2 diabetes, later in life. A better understanding of how early life factors affect puberty development is important for combating earlier puberty onset. . (more…)
Author Interviews, Cost of Health Care, COVID -19 Coronavirus, JAMA / 15.02.2022

MedicalResearch.com Interview with: Kao-Ping Chua, MD, PhD Assistant Professor, Department of Pediatrics Assistant Professor, Health Management and Policy School of Public Health University of Michigan MedicalResearch.com:  What is the background for this study? Response: In 2020, most insurers waived the cost of COVID-19 hospitalization for patients. In early 2021, many major insurers started to abandon those waivers. By August 2021, the vast majority of insurers had started billing patients for COVID-19 hospitalizations again. (more…)
Author Interviews, Environmental Risks, JAMA, OBGYNE, Pediatrics / 04.02.2022

MedicalResearch.com Interview with: Anders Hviid M.Sc.,Dr.Med.Sci. Head of Department (acting), Professor of Pharmacoepidemiology, Department of Epidemiology Research Statens Serum Institut MedicalResearch.com:  What is the background for this study?  Response: An unusually low number of extremely preterm births have been observed in some countries during the initial covid-19 lockdowns. We speculated that this could be because of fewer infections, reduced activity levels, less stress etc. These are also factors that change with the seasons, and we hypothesized that extremely preterm birth might be associated with seasonality. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, NYU / 03.02.2022

MedicalResearch.com Interview with: Andrea B. Troxel, ScD (she/her/hers) Professor and Director, Division of Biostatistics Department of Population Health NYU Grossman School of Medicine NYU Langone Health MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: This study represents an international collaboration across four continents and six countries, to pool information from studies in different patient populations to generate robust information about the possible benefits of convalescent plasma in treating COVID-19. Because the study was so large and the methods so rigorous, we were able to show that while CP doesn’t benefit all patients, it may have positive effects in certain subgroups. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics, Respiratory, Yale / 03.02.2022

MedicalResearch.com Interview with: Thomas Murray MD PhD Associate Professor, Yale School of Medicine Department of Pediatrics, Infectious Disease and Global Health Associate Medical Director, Infection Prevention Yale New Haven Children's Hospital MedicalResearch.com:  What is the background for this study?  Response: This study was performed by Yale- CARES (Children and Adults Research in Early Education Study Team) a multidisciplinary group of researchers that are interested in learning how the COVID-19 pandemic has impacted early child care programs in the US including the effects on both the children and those who care for them in this setting. This is important because when child care programs close it becomes very difficult for working families to find safe, affordable alternative care. We surveyed over 6000 child care workers from across the US in May/June 2020 with a follow up survey in May/June 2021. This includes both center based and home based child care programs. One question we were interested in was what things they were doing in their programs to reduce the risk of COVID-19. We then asked whether their program closed at any time in that year because of COVID-19. (more…)
Author Interviews, Heart Disease, JAMA, NYU, USPSTF / 02.02.2022

MedicalResearch.com Interview with: Gbenga Ogedegbe, MD, MPH Dr. Adolph & Margaret Berger Professor of Population Health Director, Division of Health & Behavior Director Center for Healthful Behavior Change Department of Population Health NYU Langone Health NYU School of Medicine Member of the U.S. Preventive Services Task Force MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response: Atrial Fibrillation (AFib) is the most common type of irregular heartbeat and a major risk factor for stroke, and it often goes undetected. For this recommendation, the Task Force evaluated whether screening adults over the age of 50 who do not have any signs or symptoms of AFib can help prevent strokes. In its evidence review, Task Force expanded its scope to include a search for studies on portable and wearable devices such as smartphones and fitness trackers in addition to electrocardiography (ECG). Despite this consideration, the Task Force found insufficient evidence to recommend for or against screening for AFib. This is consistent with the Task Force’s 2018 recommendation. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA / 28.01.2022

MedicalResearch.com Interview with: Eva Petkova, PhD Professor, NYU School of Medicine Department of Population Health Division of Biostatistics Department of Child and Adolescent Psychiatry, New York, NY 10016 Senior Scientist, Nathan Kline Institute of Psychiatric Research, Orangeburg, NY 10962 MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: The COMPILE study is based on real-time collection of individual patient data from 8 international completed, terminated early and ongoing randomized clinical trials testing the efficacy of convalescent plasma for the treatment of hospitalized patients with COVID-19. Recruitment covered the period from March 2020 to March 2021 in Asia, Europe, North and South America. Total of 2369 patients were enrolled and data from 2341 patients were used in the analysis. COMPILE, the largest study of convalescent plasma for hospitalized COVID-19 patients to date, provided robust information on a diverse patient population, which allowed rigorous evaluation of questions related to convalescent plasma efficacy. The main findings are that convalescent plasma might have only a moderate efficacy on average, but that there is a huge heterogeneity in the benefits for individual patients. (more…)