Author Interviews, Beth Israel Deaconess, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity / 01.05.2020

MedicalResearch.com Interview with: Rishi Wadhera, MD, MPP, MPhil Instructor in Medicine at Harvard Medical School Cardiologist,Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: With more than a million confirmed cases of COVID-19 in the United States, there is growing concern that low-income communities and racial/ethnic minorities may be disproportionately shouldering the burden of the pandemic. New York City, which is comprised of 5 boroughs (Bronx, Brooklyn, Manhattan, Queens, and Staten Island) with unique demographic and socioeconomic characteristics, has emerged as the epicenter of the COVID-19 outbreak. (more…)
Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Cost of Health Care, Geriatrics, JAMA, Medicare / 12.03.2020

MedicalResearch.com Interview with: Rishi K. Wadhera, MD Harvard Medical Faculty Physicians Cardiovasular Diseases Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: In the U.S., income inequality has steadily increased over the last several decades. Given widening inequities, there has been significant concern about the health outcomes of older Americans who experience poverty, particularly because prior studies have shown a strong link between socioeconomic status and health. In this study, we evaluated how health outcomes for low-income older adults who are dually enrolled in both Medicare and Medicaid have changed since the early 2000’s, and whether disparities have narrowed or widened over time compared with more affluent older adults who are solely enrolled in Medicare (non-dually enrolled). (more…)
Author Interviews, Health Care Systems, Heart Disease, JAMA, Medicare / 24.02.2020

MedicalResearch.com Interview with: Rishi K. Wadhera, MD Beth Israel Deaconess Medical Center Harvard Medical Faculty Physicians MedicalResearch.com: What is the background for this study? Response: In recent years, the Centers for Medicare and Medicaid Services has implemented nationally mandated value-based programs to incentivize hospitals to deliver higher quality care. The Hospital Readmissions Reduction Program (HRRP), for example, has financially penalized hospitals over $2.5 billion to date for high 30-day readmission rates. In addition, the Value-Based Purchasing Program (VBP) rewards or penalizes hospitals based on their performance on multiple domains of care. Both programs have focused on cardiovascular care. The evidence to date, however, suggests that these programs have not improved health outcomes, and there is growing concern that they may disproportionately penalize hospitals that care for sick and poor patients, rather than for poor quality care. (more…)
Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Gout / 28.01.2020

MedicalResearch.com Interview with: Stephen P. Juraschek, MD, PhD Assistant Professor, Harvard Medical School Beth Israel Deaconess Medical Center Division of General Medicine, Section for Research Boston, MA 02215 MedicalResearch.com: What is the background for this study? Response: Gout is a common complication of blood pressure treatment. Furthermore, 75% of adults with gout have hypertension. There are several classes of medications uses to treat hypertension. While prior studies have reported that calcium channel blockers like amlodipine lower uric acid, its effects on gout risk compared to other common first-line antihypertensive agents are unknown. (more…)
Author Interviews, Beth Israel Deaconess, Emergency Care, Health Care Systems, JAMA / 05.11.2019

MedicalResearch.com Interview with: Laura Burke, MD, MPH Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston, MA 02215 Laura Burke, MD, MPH Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston, MA 02215 MedicalResearch.com: What is the background for this study? Response: There has been a lot of attention to the growing intensity and costs of emergency care, but relatively little study of how outcomes have changed in recent years for patients using the ED. We examined 30-day mortality rates for traditional Medicare beneficiaries age 65 and older using the emergency department (ED) from 2009-2016 and also examined how their rates of hospitalization have changed over time. (more…)
Author Interviews, Gastrointestinal Disease, Weight Research / 21.09.2019

MedicalResearch.com Interview with: Sarah Ballou, PhD Health Psychologist Division of Gastroenterology, Hepatology, and Nutrition Beth Israel Deaconess Medical Center Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obesity is known to be associated with an increased risk of gastrointestinal and liver diseases, but less is known about the relationship between obesity and constipation or diarrhea. We used a nationally representative sample of the US population to evaluate whether obesity was associated with abnormal bowel habits. We found that obese individuals were 60% more likely to have diarrhea, even after controlling for possible confounding factors such as dietary, lifestyle, psychological, and medical conditions. (more…)
Annals Thoracic Surgery, Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Geriatrics, Heart Disease, Primary Care / 23.07.2019

MedicalResearch.com Interview with: Christina C. Wee, MD, MPH Associate Professor of Medicine Harvard Medical School Director , Obesity Research Program Division of General Medicine Beth Israel Deaconess Medical Center (BIDMC) Associate Program Director, Internal Medicine Program, BIDMC Deputy Editor of the Annals of Internal Medicine MedicalResearch.com: What is the background for this study? Response: New research is showing that for many people without diagnosed heart disease, the risk of bleeding may outweigh the benefits of taking a daily aspirin particularly in adults over 70 years of age. The American Heart Association and the American College of Cardiology recently updated their guidelines and now explicitly recommend against aspirin use among those over the age of 70 who do not have existing heart disease or stroke. Our study found that in 2017, a quarter of adults aged 40 years or older without cardiovascular disease – approximately 29 million people – reported taking daily aspirin for prevention of heart disease. Of these, some 6.6. million people did so without a physician's recommendation. (more…)
Author Interviews, Beth Israel Deaconess, Blood Pressure - Hypertension, Salt-Sodium / 13.02.2019

MedicalResearch.com Interview with: Stephen P. Juraschek, MD, PhD Assistant Professor, Harvard Medical School Beth Israel Deaconess Medical Center Division of General Medicine, Section for Research Boston, MA 02215 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lightheadedness with standing is an important risk factor for falls. Sodium is often considered a treatment for lightheadedness with standing. We examined this in the setting of a monitored feeding study where adults ate each of 3 different sodium levels for 4 weeks at a time. Participants took 5 day breaks between sodium levels and ate the sodium levels in random order. We tested the hypothesis that lowering sodium would worsen how much lightheadedness the study participants reported. (more…)
Annals Internal Medicine, Author Interviews, Beth Israel Deaconess, Cost of Health Care, Heart Disease, Lipids / 02.01.2019

MedicalResearch.com Interview with: Dhruv S. Kazi, MD, MSc, MS Associate Director Richard A. and Susan F. Smith Center for Outcomes Research Boston MA 02215 Associate Director Cardiac Critical Care Unit Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The ODYSSEY Outcomes trial found that addition of alirocumab to statin therapy reduces the incidence of a composite of cardiovascular death, myocardial infarction, and stroke among patients with a recent history of a myocardial infarction and elevated low-density lipoprotein cholesterol. We modeled the cost-effectiveness of alirocumab and found that, at the March 2018 price of the drug, it would not be cost-effective (either relative to statin alone or statin + ezetimibe) for this indication. We found that a large price-reduction would be required to meet the cost-effectiveness threshold of $100,000 per quality-adjusted life year. Shortly after the preliminary findings of this study were released, both manufacturers of PCSK9 inhibitors announced large price reductions in order to improve access to these drugs. (more…)