Our findings are reassuring to women of reproductive age, contemporary combined oral contraceptives (which generally contain lower doses of oestrogen and newer progestogens) are still associated with a reduced risk of ovarian cancer....
MedicalResearch.com Interview with: [caption id="attachment_44905" align="alignleft" width="200"] Dr. Morieri[/caption] Mario Luca Morieri MD Section on Genetics and Epidemiology, Research Division, Joslin Diabetes Center Department of Medicine, Harvard Medical School, Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Coronary artery disease (CAD) is one of the most important complications...
MedicalResearch.com Interview with: [caption id="attachment_44776" align="alignleft" width="200"] Dr. McCoy[/caption] Thomas McCoy, M.D. Assistant Professor of Psychiatry Massachusetts General Hospital Psychiatry Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Response: Big data has the potential to transform how we care for patients but comes with risks of big breaches. My co-author and I use health records...
Dr. Okubo[/caption]
Masashi Okubo, MD.
Clinical Instructor of Emergency Medicine
Research Fellow
Department of Emergency Medicine
University of Pittsburgh
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Out-of-hospital cardiac arrest (OHCA) is a major public health problem, annually affecting over 350,000 individuals in the US with low survival rate, 11.4% among those who were treated by emergency medical services (EMS). Prior studies showed a 5-fold difference (3.0% to 16.3%) in survival to hospital discharge between 10 study sites in North America (US and Canada) and 6.5-fold difference (3.4% to 22.0%) between 132 US counties after OHCA.
However, it was unclear how much patient outcome after OHCA differ between EMS agencies which play a critical role in OHCA care. Among 43,656 adults treated for Out-of-hospital cardiac arrest by 112 EMS agencies in North America, we found that survival to hospital discharge differed from 0% to 28.9% between EMS agencies. There was a median difference of 56% in the odds of survival to hospital discharge for patients with similar characteristics between any 2 randomly selected EMS agencies, after adjusting for known measured sources of variability.
Prof. Sanders[/caption]
Professor Prash Sanders
Director, Centre for Heart Rhythm Disorders
NHMRC Practitioner Fellow,
Knapman-NHF Chair of Cardiology Research,
University of Adelaide | SAHMRI
Director, Cardiac Electrophysiology & Pacing,
Royal Adelaide Hospital
MedicalResearch.com: What is the background for this study?
Response: CLINICALLY WE HAVE HAD SOME PATIENTS WHO HAVE SURVIVED SUDDEN DEATH EPISODES AND HAVE NOTED THAT THEY HAD MITRAL VALVE PROLAPSE. THIS STIMULATED US TO UNDERTAKE A REVIEW OF THE LITERATURE.
Dr. Joao Xavier[/caption]
Joao Xavier PhD
Associate Faculty Member | Computational & Systems Biology
Memorial Sloan Kettering Cancer Center
New York, NY 10065
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our team at Memorial Sloan Kettering has been investigating the intestinal microbiota of patients receiving bone marrow transplantations for more than eight years now. We have found through several studies that these patients lose important healthy bacteria from their microbiota, and that these losses are mostly caused by the antibiotics given as prophylaxis or to treat infections.
We also found that the drastic changes in the microbiota composition, especially the intestinal dominations by bacteria such as Enterococcus, increase the risk of transplant-related complications and lowered patient survival.
We aimed to determine the feasibility of autologous microbiota transplant (auto-FMT) as a way to reconstitute lost bacteria. This randomized study found that indeed auto-FMT could reconstitute important microbial groups to patients.
Dr. Kelkar[/caption]
Dr. Amar Kelkar MD
Clinical Fellow
Division of Hematology & Oncology, Department of Medicine
University of Florida College of Medicine, UF Health Shands Hospital
MedicalResearch.com: What is the background for this study? What are synthetic cannabinoids?
Response: Starting in March 2018, patients began reporting to hospitals and clinics with unexplained and prolonged bleeding symptoms, first in Chicago, Illinois, and then spreading to Peoria, Illinois and elsewhere. This gained a lot of press because the initial identifying factor was that all the patients had reported recent use of synthetic cannabinoids. As the matter was studied further, it was determined that these patients were likely exposed to an anticoagulant poison mixed in with the synthetic cannabinoids.
Synthetic cannabinoids are lab-derived illicit drugs that target the cannabinoid receptors that are also targeted by marijuana. They go by many names including synthetic marijuana, K2, and Spice.
Raghav Tripathi[/caption]
Raghav Tripathi, MPH
Case Western Reserve University
MD Candidate, Class of 2021
MedicalResearch.com: Why did you decide to perform this study?
Response: Differences in the impact of dermatologic conditions on different groups have been of interest to our research group for a long time. Previously, our group had found differences in time to treatment for patients with different skin cancers. Beyond this, we had found differences in mortality and incidence of various skin conditions (controlling for other factors) in different racial groups/ethnicities, socioeconomic groups, demographic groups, and across the rural-urban continuum.
The goal of this study was to investigate socioeconomic and demographic differences in utilization of outpatient dermatologic care across the United States. As demographics throughout the country become more diverse, understanding differences in utilization of dermatologic care is integral to developing policy approaches to increasing access to care across the country.
Thomas J Moore[/caption]
Thomas J Moore AB
Senior Scientist Institute for Safe Medication Practices
Lecturer, Department of Epidemiology and Biostatistics
The George Washington University
Milken Institute of Public Health
Alexandria, VA 22314
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Howard[/caption]
Prof. David H. Howard PhD
Department of Health Policy and Management
Emory University
Atlanta, GA 30322
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is a lot of skepticism that physicians respond to evidence, especially when trials report that widely-used, separately-reimbursed procedures are not effective.
Physicians are reluctant to abandon treatments. This study shows that in the case of knee arthroscopy, evidence has made a difference. The use of knee arthroscopy declined by 23% in Florida between 2002 and 2015. This change occurred despite increases in the prevalence of osteoarthritis.
Andrea Gruneir, PhD
Department of Family Medicine
University of Alberta
Edmonton, AB Canada
MedicalResearch.com: What is the background for this study?
Response: Hospital readmissions – when a patient is discharged from hospital but then returns to hospital in a short period of time – are known to be a problem, both for the patients and for the larger health system. Hospital readmissions have received considerable attention and there have been a number of initiatives to try to reduce them, but with mixed success. Older adults are among the most vulnerable group for hospital readmission. Older adults are also the largest users of continuing care services, such as home care and long-term care homes (also known as nursing homes). Yet, few large studies have really considered how older adults with different pathways through hospital compare on the risk of hospital readmission.
In our study, we take a population-level approach and use health administrative data to create a large cohort of older adults who were hospitalized in Ontario between 2008 and 2015. For each of the 701,527 patients in our study, we identified where they received care before the hospitalization (in the community or in long-term care) and where they received care after discharge (in the community, in the community with home care, or in long-term care).
Dr. Haarbauer-Krupa[/caption]
Juliet Haarbauer-Krupa, PhD
Senior Health Scientist
Division of Unintentional Injury Prevention
CDC
MedicalResearch.com: What is the background for this study?
Dr. Johns[/caption]
Michelle M Johns, MPH, PhD
Health Scientist
Division of Adolescent and School Health
CDC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Gender nonconformity is an under-researched area of adolescent health that is often linked to negative health outcomes. To address this gap, we analyzed Youth Risk Behavior Survey data to describe the associations between gender nonconformity and risk behaviors, including mental distress, and substance use.
Gender nonconformity was associated with feeling sad and hopeless, as well as suicidal thoughts and/or behaviors among female and male students. In addition, gender nonconformity was strongly associated with substance use among male students.
Dr. Hess[/caption]
Erik P. Hess MD MSc
Professor and Vice Chair for Research
Department of Emergency Medicine
UAB Medicine
he University of Alabama at Birmingham
Birmingham Alabama 35249
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: 450,000 children present to U.S emergency departments each year for evaluation of head trauma. Physicians obtain head computed tomography (CT) scans in 37%-50% of these patients, with less than 10% showing evidence of traumatic brain injury and only 0.2% that require neurosurgical treatment.
In order to avoid unnecessary CT scans and to limit radiation exposure, the Pediatric Emergency Care Applied Research Network (PECARN) developed clinical prediction rules that consist of 6 readily available factors that can be assessed from the history and physical examination. If none of these risk factors are present, a CT scan is not indicated.
If either of 2 high risk factors such as signs of a skull fracture are present, CT scanning is indicated.
If 1 or 2 non-high risk factors are present, then either CT scanning or observation are recommended, depending on considerations such as parental preference, clinician experience and/or symptom progression.
In this study we designed a parent decision aid, “Head CT Choice” to educate the parent about the difference between a concussion – which does not show up on a CT scan – and a more serious brain injury causing bleeding in or around the brain. The decision aid also shows parents their child’s risk for a serious brain injury – less than 1% risk in the majority of patients in our trial – what to observe their child at home for should they opt not to obtain a CT scan, and the advantages and disadvantages of CT scanning versus home observation.
In our trial, we did not observe a difference in the rate of head CT scans obtained in the ED but did find that parents who were engaged in shared decision-making using Head CT Choice were more knowledgeable about their child’s risk for serious brain injury, has less difficulty making the decision because they were clearer about the advantages and disadvantages of the diagnostic options, and were more involved in decision-making by their physician. Parents also less frequently sought additional testing for their child within 1 week of the emergency department visit.
Fudi Wang, M.D., Ph.D.
Qiushi Chair Professor
Nutrition Discovery Innovation Center
School of Public Health/School of Medicine
Zhejiang University
Hangzhou China
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Parkinson disease (PD) is the second most common neurodegenerative disease affecting approximately 10 million people around the world. To date, the cause of PD remains poorly understood. It is reported that 90% PD cases have no identifiable genetic cause. What’s worse, few therapeutic advances for the treatment of PD have been made in the past decades. Nevertheless, growing prospective longitudinal studies shed lights on the potential beneficial effect of lifestyle factors on reducing the risk of developing Parkinson disease. In this study, we performed a a dose-response meta-analysis of more than half a million participants.
We found that physical activity, particularly moderate to vigorous physical activity, could significantly reduce PD risk.
Dr. Murray[/caption]
Michael F. Murray, MD, FACMG, FACP
Director for Clinical Operations in the Center for Genomic Health
Yale School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Population screening for the cancer risk associated with the BRCA1 and BRCA2 genes has been suggested by some. We screened a cohort of about 50,000 adult patient volunteers at Geisinger Health System in Pennsylvania for this risk.
Dr. Cohen[/caption]
Eyal Cohen, MD, MSc, FRCP(C)
Associate Scientist and Program Head (interim), Child Health Evaluative Sciences
Research Institute, The Hospital for Sick Children
Staff Physician, Division of Paediatric Medicine, The Hospital for Sick Children
Professor, Paediatrics and Health Policy
Management & Evaluation
The University of Toronto
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Having a child with a major birth defect can be a life-changing and stressful event for the child's mother. This stress may be associated with higher risk of premature cardiovascular disease.
We found that mothers of infants born with a major birth defect had a 15% higher risk of premature cardiovascular disease that a comparison group of mothers. The risk was more pronounced, rising to 37% among mothers who gave birth to a more severely affected infant (and infant born with major birth defects affecting more than one organ system). The risk was apparent even within the first 10 years after the birth of the child.
Dr. Kishan[/caption]
Amar U. Kishan, MD
Assistant Professor
Department of Radiation Oncology
University of California, Los Angeles
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Three large randomized trials demonstrated an overall survival (OS) benefit when androgen deprivation therapy (ADT) is combined with radiotherapy (RT) for high-risk prostate cancer (PCa). The duration of ADT in these seminal studies ranged from six months to lifelong. Because ADT has multiple attendant adverse effects--including bone loss, altered metabolism, diminished muscle mass, gynecomastia, hot flashes, and possibly increased cardiovascular events--shortening the duration of ADT without compromising oncologic effectiveness has been an area of active study. Five trials have compared various durations of ADT, reaching conflicting conclusions with respect to overall survival outcomes, with some suggesting an improvement with longer durations of ADT and others failing to show a uniform survival benefit.
Most of these trials have amalgamated Gleason grade group 4 (Gleason score 8) PCa with Gleason grade group (GG) 5 (Gleason score 9-10) PCa. Emerging data indicate that GS 9-10 PCa constitutes a distinct subset of high-risk PCa with inferior outcomes and earlier progression than GS 8 disease. With the knowledge that GS 9-10 PCas constitute a distinct, more aggressive form of PCa, one might hypothesize that longer durations of ADT may be more advantageous in both augmenting local control and controlling potential micrometastatic disease. Alternatively, as GS 9-10 lesions by definition contain highly de-differentiated Gleason pattern 5 disease foci and may proceed to a castrate-resistant state more rapidly, one may also hypothesize that GS 9-10 lesions are less responsive to ADT, and longer durations may be counter-productive.
In order to identify differences in the impact of ADT duration on clinical outcomes of patients with GG 4 and GG 5 PCa, we performed an individual patient-level meta-analysis of six randomized trials. Our working hypothesis was that longer durations of ADT would offer significant survival benefits in both groups.
Howa Yeung, MD
Assistant Professor of Dermatology
Emory University School of Medicine
Atlanta, GA 30322
MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by actinic keratoses?
Response: Actinic keratoses are common precancerous skin lesions caused by sun exposure. Because actinic keratoses may develop into skin cancers such as squamous cell carcinoma and basal cell carcinoma, they are often treated by various destructive methods. We used Medicare Part B billing claims to estimate the number and cost of treated actinic keratoses from 2007 to 2015.
MedicalResearch.com: What are the main findings?
Response: While the number of Medicare Part B beneficiaries increased only moderately, the number of actinic keratoses treated by destruction rose from 29.7 million in 2007 to 35.6 million in 2015. Medicare paid an average annual amount of $413.1 million for actinic keratosis destruction from 2007 to 2015. Independently billing non-physician clinicians, including advanced practice registered nurses and physician assistants, are treating an increasing proportion of actinic keratosis, peaking at 13.5% in 2015.
MedicalResearch.com: What should readers take away from your report?
Response: Readers should understand that the burden of actinic keratosis treatment is increasing in the Medicare population. There is also an increasing proportion of actinic keratoses being treated by advanced practice registered nurses and physician assistants.
MedicalResearch.com Interview with: [caption id="attachment_44703" align="alignleft" width="122"] Dr. Sher[/caption] Dr. David Sher MD MPH Radiation Oncology, Harold C. Simmons Comprehensive Cancer Center UTSouthwestern Medical Center Associate Senior Editor International Journal of Radiation Oncology MedicalResearch.com: What is the background for this study? Response: The prevalence of oropharyngeal cancer is rising rapidly, and the two primary therapeutic approaches –...
Knud Josefsen, senior researcher
Bartholin Institute, Rigshospitalet,
Copenhagen K, Denmark
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In a large population of pregnant women, we found that the risk of the offspring being diagnosed with type 1 diabetes before the age of 15.6 years (the follow up period) was doubled in the group of women ingesting the highest amounts of gluten (20-66 g/day) versus the group of women ingesting the lowest amounts of gluten (0-7 g/day). For every additional 10 grams of gluten ingested, the risk for type 1 diabetes in the child increased by a factor of 1.31.
It the sense that it was a hypothesis that we specifically tested, we were not surprised. We had seen in animal experiments that a gluten-free diet during pregnancy protected the offspring from diabetes, and we wanted to see if we could prove the same pattern in humans. There could be many reasons why we would not be able to show the association, even if it was there (sample size, low quality data, covariates we could not correct for and so on), but we were off course pleasantly surprised that we found the association that we were looking for, in particular because it is quite robust
Dr. Lotta[/caption]
Luca A. Lotta, MD, PhD
Senior Clinical Investigator
MRC Epidemiology Unit
University of Cambridge
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Doubeni[/caption]
Chyke Doubeni, M.D., M.P.H.
Harrison McCrea Dickson, M.D. and Clifford C. Baker, M.D. Presidential Professor
Associate Professor of Epidemiology
Senior scholar, Center for Clinical Epidemiology and Biostatistics
University of Pennsylvania School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Obesity is an important public health issue that affects nearly 4 in 10 American adults. It increases the risk for many chronic health conditions as well as premature death from diabetes, coronary heart disease, various types of cancer, and other conditions. As such, it was important for the U.S. Preventive Services Task Force to review the current evidence and update the recommendation on this topic.
Based on a review of the most recent studies, we found that intensive, multicomponent behavioral interventions are safe and effective. They can help people lose weight, maintain their weight loss, and reduce the risk of obesity-related conditions such as diabetes in people with high blood sugar. Therefore, the Task Force is recommending that clinicians offer or refer adults with a body mass index, or BMI, of 30 kg/m2 or higher to these behavioral interventions.
Professor Phyo Kyaw Myint MBBS MD FRCP(Edin) FRCP(Lond)
Clinical Chair in Medicine of Old Age
Academic Lead: Ageing Clinical & Experimental Research &
Director of Clinical Academic Training Development
The Lead Academic, Aberdeen Clinical Academic Training (ACAT) Programmes
School of Medicine, Medical Sciences & Nutrition
College of Life Sciences & Medicine, University of Aberdeen
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: While Mediterranean Diet has been linked to reduced stroke risk it remains unclear
(1) its impact on populations within non-Mediterranean countries;
(2) its specific impact on different gender;
(3) the effect observed when using more robust dietary assessments; and (4) which specific components of the diet are most protective.
We therefore studied more than 23 thousand men and women (mainly British Caucasian) aged 40 years or older in Norfolk, UK as part of EPIC-Norfolk study and we found that the greater adherence to Mediterranean dietary pattern is linked to a significant reduction in stroke risk in women but not in men. This benefit was seen across the whole middle and older age population (particularly for women) regardless of their existing risk factors such as high blood pressure.
Rik Ossenkoppele -PhD
Lund University & VU University Medical Center
Oskar Hansson - Lund University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: [18F]flortaucipir is a relatively novel PET tracer that can be used to detect tau pathology in the living human brain. Previous studies have shown a robust signal in patients with Alzheimer’s disease, but in patients with other types of dementia the signal was more variable.
We aimed to assess the ability of [18F]flortaucipir PET to distinguish Alzheimer’s disease from other neurodegenerative disease in more than 700 study participants. T
he main finding was that [18F]flortaucipir discriminated Alzheimer’s disease patients from patients with other neurodegenerative diseases with high accuracy. Furthermore, [18F]flortaucipir PET outperformed established MRI markers and showed higher specificity than amyloid-β PET.
MedicalResearch.com Interview with: [caption id="attachment_44637" align="alignleft" width="128"] Dr. Carnahan Craig[/caption] Dr. Sarah J.Carnahan Craig PhD Postdoctoral Scholar Makova Lab Biology Department Center for Medical Genomics Penn State University MedicalResearch.com: What is the background for this study? Response: This study stems from a long standing collaboration with pediatrician, Ian Paul at Penn State Hershey Medical School (and a co-author...
Dr. Cannon[/caption]
Richard B. Cannon, MD
Division of Otolaryngology–Head and Neck Surgery
School of Medicine
University of Utah, Salt Lake City
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The Patient Protection and Affordable Care Act (ACA) is a nationwide effort to reduce the number of uninsured individuals in the United States and increase access to health care. This legislation is commonly debated and objective data is needed to evaluate its impact. As a head and neck cancer surgeon, I sought to evaluate how the ACA had specifically influenced my patients. Main findings below:
MedicalResearch.com: What should readers take away from your report?
Response: This population-based study found an increase in the percentage of patients enrolled in Medicaid and private insurance and a large decrease in the rates of uninsured patients after implementation of the Patient Protection and Affordable Care Act (ACA). This change was only seen in states that adopted the Medicaid expansion in 2014. The decrease in the rate of uninsured patients was significant, 6.2% before versus 3.0% after. Patients who were uninsured prior to the Patient Protection and Affordable Care Act had poorer survival outcomes.
Dr Ruth Blackburn PhD
UKRI Innovation Fellow
UCL Institute of Health Informatics
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In England one child in every classroom is admitted to hospital with an adversity related injury (i.e. violence, intentional self-injury, or drug or alcohol misuse) between the ages of 10 and 19 years. These young people are more likely than their classmates to be re-admitted to hospital or to die within 10 years.
We investigated how the rate of hospital admissions with an adversity related injury has changed over time among young people aged 10-24 years, using administrative data for National Health Service hospitals in England.
We found that between 2012 and 2016, rates of admission with an adversity related injury (including intentional self-injury) increased steeply for girls, with the biggest increase (6% per year) among 15-19 year olds. During the same time period, rates of admission with an adversity related injury decreased in boys aged 15-24 years (4-5% per year) but increased slightly for 10-14 year olds (3% per year).
Dr. Tsirigos[/caption]
Aristotelis Tsirigos, Ph.D.
Associate Professor of Pathology
Director, Applied Bioinformatics Laboratories
New York University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Pathologists routinely examine slides made from tumor samples to diagnose cancer types. We studied whether an AI algorithm can achieve the same task with high accuracy. Indeed, we show that such an algorithm can achieve an accuracy of ~97%, slightly better than individual pathologists.
In addition, we demonstrated that AI can be used to predict genes that are mutated in these tumors, a task that pathologists cannot do. Although the accuracy for some genes is as high as 86%, there is still room for improvement. This will come from collecting more training data and also from improvement in the annotations of the slides by expert pathologists.