Author Interviews, JAMA, Melanoma, Technology, UCSF / 01.04.2015

Maria L. Wei, M.D., Ph.D. Associate Professor of Dermatology Director, Melanoma Surveillance Clinic Multidisciplinary Melanoma Program University of California, San Francisco Staff Physician Veterans Affairs Medical Center, San FranciscoMedicalResearch.com Interview with: Maria L. Wei, M.D., Ph.D. Associate Professor of Dermatology Director, Melanoma Surveillance Clinic Multidisciplinary Melanoma Program University of California, San Francisco Staff Physician Veterans Affairs Medical Center, San Francisco Medical Research: What is the background for this study? Dr. Wei: Effective physician-patient communication is essential for optimal medical care. There are now many methods available to notify patients of their biopsy results: a clinic visit (the method traditionally preferred by patients), a telephone call, secure online patient portals to access medical charts, email and texts. In addition, there is variability from state to state in the guidelines regulating the release of biopsy results online. Until recently, some states did not allow the on-line release of biopsy results. There have been few systematic studies on patient preferences for communication of biopsy results. (more…)
Author Interviews, Duke, Personalized Medicine, Technology / 27.03.2015

Ryan Jeffrey Shaw, PhD, MS, RN Assistant Professor School of Nursing Center for Health Informatics Center for Precision Medicine Duke University MedicalResearch.com Interview with: Ryan Jeffrey Shaw, PhD, MS, RN Assistant Professor School of Nursing Center for Health Informatics Center for Precision Medicine Duke University Medical Research: What is the background for this study? What are the main findings? Dr. Shaw: Primary care delivery revolves around a series of episodes, rather than functioning as a continuum. When patients come to a clinic data on their health is collected as a single data point. This model neglects potentially meaningful data from patients’ daily lives and results in less informed treatment and scheduling of follow-up visits. Lack of meaningful data further blinds clinicians to patients’ health outside of the clinic and can contribute to unnecessary emergency department visits and hospitalizations. Personalized care through mobile health technologies inspires the transition from isolated snapshots based on serial visits to real time and trended data. By using technologies from cell phones to wearable sensors, providers have the ability to monitor patients and families outside of the traditional office visit. (more…)
Author Interviews, Compliance, Technology / 05.03.2015

MedicalResearch.com Interview with: Avinash Pandey, the study author, is a high school student who conducted this study under the guidance of his mentor, Niteesh K. Choudhry., M.D., Ph.D., executive director of the Center for Healthcare Delivery Sciences, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass. Medical Research: What is the background for this study? What are the main findings? Response: Numerous studies have demonstrated that there is poor adherence to medications in cardiac patients (coronary artery disease patients, CAD). Despite the fact that non-adherence to these medications can have serious consequences on long-term health like disease progression, increased risk of cardiac events and premature mortality, many patients consistently miss their medications and many stop their medications only months after they are prescribed. This non-compliance leads to high costs for the health care system and more potentially preventable cardiac events. Studies suggest, that for the vast majority of patients, non-adherence to medications is not intentional. A significant portion simply forget to take their medications. Although many systems are available today to reduce medication non-adherence, like pill boxes and blisterpacks, these have demonstrated limited effect on medication adherence. Other systems may be expensive to purchase and cumbersome to use or of limited availability. With the proliferation of cellphones, text message reminders could represent a simple, cost-effective method to improve adherence to medications. This research began as a high school science fair project 4 years ago and has evolved into a large ongoing assessment of the impact of mobile technologies on adherence to evidence based therapies and lifestyle interventions in a broad cross-section of cardiovascular patients and those at risk for cardiovascular disease. The current report examines the impact of an automated computer program which sends free, personalized text messages to remind patients to adhere to their medications. 30 CAD patients were recruited from a single centre cardiac practice, in this 2 month cross-over study. Patients were randomized to either receive text message reminders in the first month or the second month. Adherence of each patient was compared between months. Text message reminders were shown to significantly impact medication adherence. Patients missed on average 60% less doses when receiving text message reminders. These numbers were even greater when looking at pre-specified groups identified in previous studies to be at high risk of medication non-adherence, including depression patients, dementia patients, elderly patients, and patients with less than 12 years of education. All patients improved with text message reminders but those with the lowest adherence improved the most. Although this study did not examine clinical outcomes, the text message reminder system appears to be a simple and widely applicable method to improve adherence to medications. The system is free to operate and represents no cost for patients receiving messages. Thus it could be implemented at an individual level or by physicians and clinics to improve patient adherence to medications. (more…)
Author Interviews, Lancet, Surgical Research, Technology / 26.02.2015

MedicalResearch.com Interview with: Aidan Roche MBBS, PhD, BEng and Prof Oskar C Aszmann MD Director of the Christian Doppler Laboratory for Restoration of Extremity Function Division of Plastic and Reconstructive Surgery Department of Surgery Medical University of Vienna, Vienna, Austria Medical Research: What is the background for this study? What are the main findings? Response: The study was prompted by lack of techniques to restore hand function in patients with global plexopathies with avulsion of the lower roots. In simple terms, this is a tearing injury to parts of the brachial plexus. The brachial plexus is a complex junction of nerves that leaves the spinal cord and supplies the arm. If this junction of nerves is severely damaged, information cannot reach the hand to control it or to receive sensation from it.  In some of these cases, traditional reconstructive surgical techniques are only able to restore shoulder and elbow function, not the hand itself. In severe cases, this might leave the patient with a useless hand.  In previous clinical studies with existing amputees, advancing research has shown that good prosthetic control can be achieved by selectively transferring nerves. However, our study differs as our patients had intact, but functionless hands. The innovation here was to selectively transfer nerves and muscles to create useable signals for prosthetic control. Together with a comprehensive rehabilitation regime, followed by elective amputation, this formed the bionic reconstruction process. The main finding is that all three patients had excellent hand function restored through bionic reconstruction (as measured by the uniform improvement in all patients in the clinical outcome scores of the Action Research Arm Test, the Disability of Arm, Shoulder and Hand Questionairre, and the Southampton Hand Assessment Procedure and reported in detail in The Lancet). (more…)
Author Interviews, Infections, Technology / 09.02.2015

MedicalResearch.com Interview with: Tassaneewan Laksanasopin PhD Candidate Molecular and Microscale Bioengineering Lab Columbia University Medical Research: What is the background for this study? What are the main findings? Response: We miniaturized and integrated all components needed for blood test (similar to ELISA) to be run on a smartphone accessory for point-of-care testing of infectious diseases.  The device simultaneously detects three infectious disease markers for HIV, treponemal syphilis and nontreponemal syphilis from a finger prick of blood in just 15 minutes.  In a blinded experiment in three health clinics in Rwanda, local health care workers obtained diagnostic results from 96 patients enrolled in prevention of mother-to-child transmission and voluntary counseling programs.  The test performance from our triplexed test was 92-100% sensitivity and 79-92% specificity compared to the gold standard of lab-based HIV ELISA, Treponema pallidum haemagglutination and rapid plasma reagin.  Importantly, patient preference for the dongle was 97% compared to lab-based tests, with most pointing to the convenience of obtaining quick results with a single finger prick.  This work suggests coupling microfluidics with recent advances in consumer electronics can make certain lab-based diagnostics accessible to almost any population with access to smartphones. (more…)
Technology / 06.02.2015

MedicalResearch.com Interview with: Gautam M. Shah Vice President of Product Management at VoceraMedicalResearch.com Interview with: Gautam M. Shah Vice President of Product Management at Vocera MedicalResearch.com Editor’s Note: Vocera announced on February 5, 2015, it will “provide a cloud-based secure text messaging solution as a benefit to all of its U.S. healthcare customers, at no additional cost, for use by any of their affiliated healthcare providers. Vocera Secure Texting will connect seamlessly with Vocera Communication Systems installed in over 800 U.S. hospitals” (Vocera press release). Mr. Shah, from Vocera, answers some questions regarding this new technology for the readers of MedicalResearch.com below. MedicalResearch: What is the background for this technology? Mr. Shah: The Vocera Secure Texting solution is a cloud-based, secure, HIPAA-compliant texting application that seamlessly integrates with the Vocera Communication System.  The solution will allow physicians to securely communicate with all members of their patient's care team, while helping hospital CIOs improve security associated with protecting personal health information (PHI). MedicalResearch: How will this texting method facilitate communication among health care providers? Mr. Shah: This solution is being offered to all of our 800+ U.S. hospital customers at no cost, and to new customers for a nominal fee. Vocera Secure Texting will connect seamlessly with our award-winning communication system to enable physicians to securely text care teams and improve care coordination, operational efficiencies, and patient experience. What’s unique about Vocera Secure Texting is that it combines the convenience physicians need with the security health systems require. Our new secure texting app will be easy to use and provide a HIPAA-compliant alternative to SMS, as well as basic communication and collaboration capabilities for physicians and care teams. (more…)
Author Interviews, Brain Injury, Technology / 05.02.2015

Uzma Samadani, M.D., Ph.D. Assistant Professor; Departments of Neuroscience and Physiology NYU Langone Medical CenterMedicalResearch.com Interview with: Uzma Samadani, M.D., Ph.D. Assistant Professor Departments of Neuroscience and Physiology NYU Langone Medical Center Medical Research: What is the background for this study? What are the main findings? Dr. Samadani: Research dating back as early as 3,500 years ago suggests the eyes serve as a window into the brain, with disconjugate eye movements -- eyes rotating in different directions -- considered a principal marker for head trauma. Current estimates suggest up to 90 percent of patients with concussions or blast injuries exhibit dysfunction in their eye movements. We wanted to find a way to objectively track and analyze eye movements following a head injury to measure injury severity and replace the current “state of the art” method of asking a patient to follow along with a finger. CT-scans and MRIs may not necessarily reveal concussion or traumatic brain injury (TBI) in the absence of structural damage, presenting a need for a diagnostic measure of head injury severity. In a study published earlier this year in the Journal of Neurosurgery, my team at the NYU Cohen Veterans Center tested our novel eye-tracking technology on military veterans, and found our device and tracking algorithm could reveal edema in the brain as a potential biomarker for assessing brain function and monitoring recovery in people with head injuries. Our latest paper, published January 29 in Journal of Neurotrauma, looked at a civilian population of patients admitted to the Bellevue Medical Center emergency department in New York City, with whom the NYU School of Medicine has an affiliation agreement. We compared 64 healthy control subjects to 75 patients who had experienced trauma that brought them to emergency department. We tracked and compared the movements of patients' pupils for over 200 seconds while watching a music video. We found that 13 trauma patients who had hit their heads and had CT scans showing new brain damage, as well as 39 trauma patients who had hit their heads and had normal CT scans, had significantly less ability to coordinate their eye movements than normal, uninjured control subjects. Twenty-three trauma subjects who had bodily or extremity injuries but did not require head CT scans had similar abilities to coordinate eye movements as normal uninjured controls. Among patients who had hit their heads and had normal CT scans, most were slightly worse at 1-2 weeks after the injury, and subsequently recovered about one month after the injury. Among all trauma patients, the severity of concussive symptoms correlated with severity of disconjugacy. (more…)
Author Interviews, Dengue, Technology / 31.01.2015

MedicalResearch.com Interview with: Professor Jackie Ying Institute of Bioengineering and Nanotechnology The Nanos, Singapore Medical Research: What is the background for this study? What are the main findings? Response: The Institute of Bioengineering and Nanotechnology (IBN) has developed a paper-based disposable device that will allow dengue-specific antibodies to be detected easily from saliva within 20 minutes. Currently, dengue infection is diagnosed in the laboratory by testing the patient’s blood sample for the presence of dengue antigens or antibodies. IBN’s device, on the other hand, is capable of detecting IgG, a dengue-specific antibody found at the onset of secondary infections, directly from saliva in one step. Unlike blood samples, saliva can be collected easily and painlessly for rapid point-of-care diagnostics. However, unlike other body fluids, it cannot be applied directly to commercially available test kits as it would cause the sensor nanoparticles to stick haphazardly to the test strip. In addition, conventional paper-based tests are not designed to handle the larger sample volume of saliva required. As described in the journal Lab on a Chip, the IBN researchers used an innovative stacking flow design to overcome key challenges faced by existing lateral flow devices, which are not designed to handle large volume of saliva samples. In IBN’s device, different flow paths are created for samples and reagents through a multiple stacked system. This allows the saliva sample to flow separately through a fiber glass matrix, which removes the substances that would interfere with the nanoparticle-based sensing system before it mixes with the sensor nanoparticles. IBN’s device configuration also helps to regulate the flow in the test strip, generating uniform test lines for more accurate results. (more…)
Asthma, Author Interviews, Compliance, Lancet, Technology / 30.01.2015

Amy Chan BPharm(Hons) RegPharmNZ MPS ANZCP Pharmacist / PhD candidate Department of Paediatrics Auckland Hospital Faculty of Medical & Health Sciences University of Auckland Auckland, New ZealandMedicalResearch.com Interview with: Amy Chan   BPharm(Hons) RegPharmNZ  MPS  ANZCP Pharmacist / PhD candidate Department of Paediatrics Auckland Hospital Faculty of Medical & Health Sciences University of Auckland  Auckland, New Zealand Medical Research: What is the background for this study? What are the main findings? Response: Asthma is one of the most common childhood conditions, affecting 1 in 4 children in New Zealand.  Although there are many effective medications available for asthma, of which the most important are inhaled corticosteroids, asthma control remains suboptimal due to poor adherence.  In children, adherence to regular preventive asthma therapy is about 50%, and can be as low as 30%.  Our randomised controlled trial looked at use of an electronic monitoring device with an in-built audiovisual reminder to see if it improved adherence and asthma control.  We recruited 220 children aged between 6-15yrs, who presented to the emergency department with asthma and randomised them to receive the device either with the audiovisual function enabled or disabled.  It found that those who received the audiovisual reminder (the intervention arm) took a median of 84% of their inhaled corticosteroids compared to just 30% in those who did not receive the reminder (control arm).  This equates to a 180% improvement in adherence.  We found significant improvements also in asthma control (including reduced asthma symptoms and increased participation in daily activities) and a reduction in reliever use from 17.4% to 9.5% in those who received the reminder. (more…)
Author Interviews, Technology / 16.01.2015

Moe Alsumidaie MBA MSF President & Chief Scientific Officer Annex ClinicalMedicalResearch.com Interview with: Moe Alsumidaie MBA MSF President & Chief Scientific Officer Annex Clinical   MedicalResearch: What is the background for this study? Response: SUMMARY: A real-world case study measuring the impact of Short Messaging System (SMS) or “Text Messaging” on clinical trial patient recruitment using an interactive two-way patient engagement platform by Mosio, Inc., which provides clinical research services designed to increase patient recruitment, engagement and retention, found that use of text messaging alone can be an effective means of patient engagement that results in clinical trial patient enrollment. Patient recruitment, retention and medication adherence continue to be challenges in conducting effective clinical trials. While clinical trials often rely on email recruitment, recent studies suggest that only 22% of emails are read.1 Alternatively, 98% of text messages are read1 and 90% of text messages are read within the first three minutes of receipt.2 Recent research has evaluated the impact of Short Messaging System (SMS) or “Text Messaging” in healthcare settings, such as appointment reminders and medication adherence. Results have demonstrated that SMS intervention significantly improved patient behavioral outcomes: patients who received SMS reminders were more likely to show up to appointments on time,3 and patients who received SMS reminders were more adherent to medications.4 However, only limited research is available on the effect of SMS on clinical trial subject enrollment. Johnson County Clin-Trials (JCCT), a clinical research facility that specializes in executing 10-15 vaccine clinical trials per year, was facing issues with enrolling patients rapidly in a tight time frame using email. To access a more effective strategy to better engage patients, JCCT employed two-way SMS/text messaging solutions, and this study assessed the impact of SMS/text messaging on patient recruitment and enrollment. (more…)
Author Interviews, Cancer Research, Technology / 12.01.2015

Oleh Taratula, Ph. D. Assistant Professor of Pharmaceutics Department of Pharmaceutical Sciences College of Pharmacy Oregon State University Corvallis, OR 97331-3507MedicalResearch.com Interview with: Oleh Taratula, Ph. D. Assistant Professor of Pharmaceutics Department of Pharmaceutical Sciences College of Pharmacy Oregon State University Corvallis, OR 97331-3507 Medical Research: What is the background for this study? What are the main findings? Dr. Taratula: Our research group is focused on the development of novel nanotechnology-based approaches to treat different cancers, including ovarian cancer. For many cancers, surgery is a first choice of treatment. For example, only optimal surgical resection of most abdominal metastases can significantly reduce ovarian cancer recurrence and, therefore, improve patient survival. However, it is challenging to remove most of the cancer tumors and residual cancer cells eventually may lead to cancer relapse. Therefore, our aim is to develop a nanomedicine platform, which could help surgeons achieve maximal tumor resection, using the intraoperative guidance with real-time near infrared (NIR) fluorescence signal. Moreover, we expect that the same nanoplatform could further enhance surgical outcomes by combinatorial phototherapy to be performed intraoperatively after tumor resection to eradicate unresected cancer cells. Our data published in Nanoscale is the first step towards our main goal. At this point, by utilizing naphthalocyanine, we have developed a single-agent-based nanomedicine platform capable of both NIR fluorescence imaging and combinatorial phototherapy. Naphthalocyanine is a commercially available compound, but its potential clinical application is limited by low water solubility and aggregation. Especially, aggregation diminishes the imaging ability and phototherapeutic efficacy of this compound. To address these shortcomings, we discovered that the loading of naphthalocyanine into the dendrimers significantly enhances water solubility, prevents aggregation and preserves imaging and therapeutic abilities. Our data demonstrated that naphthalocyanine-based nanoplatform can generate a NIR fluorescence signal in the cancer tumors, required for elimination of autofluorescence from healthy tissue and body fluids. Furthermore, our results also indicated that the developed nanoplatform is an efficient therapeutic agent which, upon exposure to NIR light, destroys chemotherapy-resistant ovarian cancer tumors by producing both heat and toxic reactive oxygen species. Finally, many organic fluorophores, including naphthalocyanine, can undergo photobleaching under exposure to light, which could be misinterpreted as a lack of fluorescence signal during the surgery. We demonstrated that the dendrimer encapsulated naphthalocyanine exhibits extremely high photostability and could overcome the above mentioned issue. (more…)
Author Interviews, Education, Technology / 12.01.2015

MedicalResearch.com Interview with: Živa Cotič Research Assistant & PhD Student,Global eHealth Unit Imperial College London and A/Prof Josip Car Director of Health Services and Outcomes Research Programme Lee Kong Chian School of Medicine, Director of Global eHealth Unit School of Public Health, Imperial College London Medical Research: What is the background for this study? What are the main findings? Response: The Department of Health Workforce in collaboration with the Department of Knowledge, Ethics and Research at the World Health Organization commissioned the report to provide countries with evidence to inform and guide the adoption of innovative, technology enabled models into health professional education. The report aims to address complex challenges of 21st century global workforce development through eLearning, which has been recognised as key to building more effective health education and a stronger, better qualified workforce. Global workforce development is one of the most pressing global health issues. The World Health Organization estimates the shortage of the health workforce at approximately 7.2 million health workers, with an expected increase to 12.9 million by 2035. The magnitude of the health workforce challenges the health care systems are facing require both greater investment and more effective and strategic use of available resources. The findings of the report suggest that eLearning could be equivalent to traditional forms of learning in regard to knowledge and skill acquisition in health education. This information is crucial for policy makers and educators who are forming future education. (more…)
Author Interviews, Stroke, Technology / 15.12.2014

Dr. Emmanuel Tsekleves Senior Lecturer in Design Interactions ImaginationLancaster LICA |Lancaster UniversityMedicalResearch.com Interview with: Dr. Emmanuel Tsekleves Senior Lecturer in Design Interactions ImaginationLancaster LICA |Lancaster University Medical Research: What is the background for this study? What are the main findings Dr. Tsekleves: The study was influenced by the anecdotal use of the Nintendo Wii in therapy in NHS physiotherapy clinics back in 2010/11. This led to the need for conducting a study with therapists and patients (33 questionnaires and 10 interviews were completed) to explore the current use of the Nintendo Wii console technology in physical rehabilitation programmes across four NHS Trusts in London. The study revealed that although respondents felt the Wii helped with rehabilitation, over half of them  reported difficulty using equipment (such as using the hand-held remote controls). Therapists believed use of standard Wii was limited due to the high level of dexterity, movement and coordination necessary to operate the system. Adapting Nintendo Wii To Enhance Stroke Rehabilitation The results of the aforementioned study informed the development of a personalised stroke treatment, using adapted Wii technology, for arm re-education post-stroke (that is reported in the article http://informahealthcare.com/doi/abs/10.3109/17483107.2014.981874). The developed system was tested for acceptability with three stroke survivors with differing levels of disability. Participants reported an overwhelming connection with the system and avatar. A two-week, single case study with a long-term stroke survivor showed positive changes in all four outcome measures employed (Fugl-Meyer Assessment, Nine Hole Peg Test, Motor Activity Log – Amount of Use  sub-scale] and the Modified Ashworth Scale), with the participant reporting better wrist control and greater functional use. Activities, which were deemed too challenging or too easy were associated with lower scores of enjoyment/motivation, highlighting the need for activities to be individually calibrated. (more…)
Author Interviews, PLoS, Technology / 04.09.2014

Giulio Ruffini PhD Starlab Barcelona Neuroelectrics Barcelona Barcelona, Spain.MedicalResearch.com Interview with: Giulio Ruffini PhD Starlab Barcelona Neuroelectrics Barcelona Barcelona, Spain. Medical Research: What are the main findings of the study? Dr. Ruffini: We demonstrated that it is possible to transmit information directly from a brain to another one, without intervention of the peripheral nervous system (PNS) - e.g., the senses. By hyperinteraction we mean this: the technologically mediated transmission of information directly from one brain to another, bypassing our senses or effectors (all which require the intervention of the PNS). (more…)