Author Interviews, Cost of Health Care, Education, JAMA / 14.11.2017
More Lab Tests Ordered At Teaching vs Non-Teaching Hospitals
MedicalResearch.com Interview with:
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Victoria Valencia[/caption]
Victoria Valencia, MPH
Assistant Director for Healthcare Value
Dell Medical SchoolThe University of Texas at Austin
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We were surprised to find that despite the common anecdote that resident physicians in teaching environments order more lab tests, there was a lack of empirical data to support the claim that more lab tests are ordered for patients at teaching hospitals than at non-teaching hospitals. Our study of 43,329 patients with pneumonia or cellulitis across 96 hospitals in the state of Texas found that major teaching hospitals order significantly more lab tests than non-teaching hospitals. We found this to be true no matter how we looked at the data, including when restricting to the least sick patients in our dataset. We also found that major teaching hospitals that ordered more labs for pneumonia tended to also more labs for cellulitis, indicating there is some effect from the environment of the teaching hospital that affects lab ordering overall.
Victoria Valencia[/caption]
Victoria Valencia, MPH
Assistant Director for Healthcare Value
Dell Medical SchoolThe University of Texas at Austin
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We were surprised to find that despite the common anecdote that resident physicians in teaching environments order more lab tests, there was a lack of empirical data to support the claim that more lab tests are ordered for patients at teaching hospitals than at non-teaching hospitals. Our study of 43,329 patients with pneumonia or cellulitis across 96 hospitals in the state of Texas found that major teaching hospitals order significantly more lab tests than non-teaching hospitals. We found this to be true no matter how we looked at the data, including when restricting to the least sick patients in our dataset. We also found that major teaching hospitals that ordered more labs for pneumonia tended to also more labs for cellulitis, indicating there is some effect from the environment of the teaching hospital that affects lab ordering overall.




















Dr. Sara Brownell[/caption]
Sara E. Brownell PhD
School of Life Sciences
Arizona State University
Tempe, AZ
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Brownell: Our group has been broadly interested in gender biases in introductory biology
since we published a study that showed that women underperform on course
exams and under participate in whole class discussions compared to men
(http://www.lifescied.org/content/13/3/478.full). We were curious why women
might be under performing on these course exams so in this new study, we
examined characteristics of the exams to see if that had an impact. What we
found was that women and men perform equally on questions that test basic
memorization. However, when questions tested more higher-level critical
thinking skills, women were not scoring as high as men. This happened even
when we took into account the academic ability of the students - women and men
who had the same ability coming into the class. We also found that students
from lower socioeconomic statuses also underperformed on these higher-level
critical thinking questions compared to students from higher socioeconomic
statuses, again even when we took into account academic ability.
Dr-Daniel Benjamin[/caption]
Dr. Daniel J. Benjamin PhD
Associate Professor (Research), USC, 2015-present
Associate Professor (with tenure), Cornell, 2013-2015
Assistant Professor, Cornell University, 2007-2013
Research Associate, NBER, 2013-present
Faculty Research Fellow, NBER, 2009-2013
MedicalResearch.com: What is the background for this study?
Dr. Benjamin: Educational attainment is primarily determined by environmental factors, but decades of twin and family studies have found that genetic factors also play a role, accounting for at least 20% of variation in educational attainment across individuals. This finding implies that there are genetic variants associated statistically with more educational attainment (people who carry these variants will tend on average to complete more formal education) and genetic variants associated statistically with less educational attainment (people who carry these variants will tend on average to complete less formal education). But none of these genetic variants had been identified until our 2013 paper on educational attainment. That paper, which studied a sample of roughly 100,000 individuals, identified 3 genetic variants associated with educational attainment, each of which has a very small effect. In the current paper, we expanded our sample to roughly 300,000 individuals, with the goal of learning much more about the genetic factors correlated with educational attainment.