Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Medicare / 11.01.2024

MedicalResearch.com Interview with: Kalli Koukounas, MPH Ph.D. Student, Health Services Research Brown University School of Public Health Providence, RI MedicalResearch.com: What is the background for this study? Response:  On Jan. 1st, 2021, the Centers for Medicare and Medicaid Services (CMS) implemented the End-Stage Renal Disease Treatment Choices (ETC) Model, one of the largest randomized tests of pay-for-performance incentives ever conducted in the US. The goal of the model was to enhance the use of home dialysis and kidney transplant or waitlisting among kidney failure patients in traditional Medicare. The model randomly assigned approximately 30% of US dialysis facilities and nephrologists to receive financial incentives, ranging from bonuses of 4% to penalties of 5%, based on their patients’ use of home dialysis and kidney transplant/waitlisiting. The payment adjustments apply to all Medicare-based reimbursement for dialysis services. Prior research has demonstrated that dialysis facilities that disproportionately serve populations with high social risk have lower use of home dialysis and kidney transplant, raising concerns that these sites may fare poorly in the payment model. Using data released by CMS, we examined the first year of ETC model performance and financial penalties across dialysis facilities, stratified by the measured social risk of the facilities’ incident patients. (more…)
Author Interviews, Gender Differences / 03.01.2024

MedicalResearch.com Interview with: Christian Carbe, PhD Department of Medical Educatio Geisinger Commonwealth School of Medicine Scranton, PA 18509   MedicalResearch.com: What is the background for this study? Response: Transgender patients often experience pronounced healthcare disparities compared to their cisgender counterparts. Disparities in the treatment of transgender patients resulting from deficiencies in cultural competency perpetuate poor health outcomes, such as suicide, substance misuse, depression, harassment, and victimization. Individuals within the transgender community often face systemic barriers within the medical field, including a lack of comprehensive access to health insurance, discrimination from providers, and incompetent provider training in transgender-specific health needs. This report evaluated the changes in knowledge, attitudes, and beliefs of the psychosocial and medical needs of the transgender community among first-year undergraduate medical students that attended the Northeastern Pennsylvania Trans Health Conference. Our broader goal is to develop and refine longitudinal interventions to improve skills and sensitivity of future physicians to provide compassionate and competent gender diverse and transgender healthcare. (more…)
Author Interviews, COVID -19 Coronavirus, Race/Ethnic Diversity, Vaccine Studies / 10.02.2023

MedicalResearch.com Interview with: Kenya Colvin, MBS Department of Medical Education Scranton, PA MedicalResearch.com:  What is the background for this study?  Response: Vaccine hesitancy is a major driver of COVID-19 vaccination disparities between minority and non-Hispanic White communities. Our goal was to understand what factors influenced vaccine hesitancy among individuals in Eastern Pennsylvania to identify more effective ways to promote vaccine uptake within minority communities. (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…)
ASCO, Author Interviews, Breast Cancer, Cancer Research, Race/Ethnic Diversity / 09.06.2022

MedicalResearch.com Interview with: Sachi Singhal, MD Department of Medicine Crozer Chester Medical Center Upland, PA MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: This study focuses on analysing the National Inpatient Sample for patients with breast cancer, their breakdown by race, gender and US regions, and their mortality per sub-group. The main findings are that African Americans, especially AA women are at significantly increased odds of dying from metastatic breast cancer in the United States. (more…)
Author Interviews, Breast Cancer, Cancer Research, Race/Ethnic Diversity, Vitamin D / 26.04.2022

MedicalResearch.com Interview with: Katie M. O’Brien PhD Chronic Disease Epidemiology Group National Institute of Environmental Health Sciences MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Vitamin D may protect against breast cancer. Although women of color have lower average vitamin D levels than non-Hispanic White women, few studies have considered the role of race/ethnicity. In a sample of self-identified Black/African American and Hispanic/Latina women, we observed that vitamin D concentrations measured in blood were inversely associated with breast cancer, particularly among Latinas. These findings indicate that vitamin D may protect against breast cancer, including among racial/ethnic groups with low average circulating levels. (more…)
Alzheimer's - Dementia, Author Interviews, Race/Ethnic Diversity, UCSF / 20.04.2022

MedicalResearch.com Interview with: Erica Kornblith, PhD Assistant Professor, Psychiatry UCSF Weill Institute for Neurosciences MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response: As the population of the United States grows more diverse and dementia is a serious public health concern, we hoped to understand whether differences in dementia risk exist based on race or ethnicity.  Older studies have shown that Black and Hispanic folks have higher risk of dementia, perhaps due to medical risk factors, diagnostic bias, lack of equal access to health care and education, or the health effects of racism, among other factors.  However, these older studies have been small or limited geographically or by only studying a few race and ethnicity groups. Our study used a nationwide sample of almost two million older Veterans who all had access to care through the Veterans Health Administration (VHA), and we examined 5 race or ethnicity groups: American Indians or Alaska Natives, Asians, Blacks, Hispanics, and Whites. Our results show that dementia risk is higher for Black and Hispanic Veterans compared to white Veterans, even when education and medical factors are considered. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Race/Ethnic Diversity, Social Issues / 03.02.2022

MedicalResearch.com Interview with: Xing Gao, MPH, lead author and doctoral candidate in Dr. Mujahid's research group Mahasin Mujahid, MS, PhD, FAHA Lillian E. I. and Dudley J. Aldous Chair in the School of Public Health Associate Professor of Epidemiology Director, Epidemiology & Biostatistics Master of Public Health Program UC Berkeley, School of Public Health MedicalResearch.com:  What is the background for this study?  What are the main findings?
  • ​​Hypertension is a major risk factor for cardiovascular diseases, and persistent racial and ethnic inequities in hypertension remain an urgent public health challenge.
  • Public health researchers need a more nuanced understanding of how structural factors contribute to these inequities, which has a direct application to improving the cardiovascular health of marginalized populations.
  • This study examined associations between racial residential segregation, a product of historical and contemporary racially discriminatory policies, and hypertension in a multi-racial cohort of middle-aged and older adults. 
(more…)
Author Interviews, JAMA, Prostate Cancer, Race/Ethnic Diversity, UCLA / 03.01.2022

MedicalResearch.com Interview with: Ting Martin Ma, MD, PhD Resident Physician Amar U. Kishan, MD Assistant Professor, Department of Radiation Oncology Vice-Chair of Clinical and Translational Research Department of Radiation Oncology at UCLA MedicalResearch.com: What is the background for this study? Response: We know from epidemiologic studies that  Black men are more likely to be diagnosed with and die of prostate cancer than White men. Recent studies hinted that Black men had better oncological outcome (such as prostate cancer specific mortality and overall survival) responding to systemic therapy for advanced prostate cancer (e.g. cancer that has spread or metastasized to other parts of the body). The question we were trying to answer in this study is: is there a difference in outcomes between Black and White men with localized prostate cancer (cancer that has not spread) receiving definitive radiotherapy enrolled in clinical trials?  (more…)
Author Interviews, Diabetes, JAMA, Race/Ethnic Diversity, University of Pennsylvania / 20.12.2021

MedicalResearch.com Interview with: Lauren A. Eberly, MD, MPH Clinical Fellow, Cardiovascular Medicine Perelman School of Medicine Cardiovascular Division, Perelman School of Medicine Center for Cardiovascular Outcomes, Quality, and Evaluative Research, Cardiovascular Center for Health Equity and Social Justice, Leonard Davis Institute of Health Economics University of Pennsylvania, Philadelphia MedicalResearch.com: What is the background for this study? Response: Racial inequities are pervasive in our country, and cardiovascular therapeutics with proven benefit have been shown to be underutilized among Black and Latinx patients. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a recommended treatment option for glycemic control in patients with diabetes, have recently emerged as a cardioprotective therapy as multiple large randomized clinical trials have shown they prevent cardiovascular events among patients with Type 2 Diabetes (T2D), particularly patients with established atherosclerotic cardiovascular disease (ASCVD). Given this, they are now recommended therapy for patients with diabetes and established or high risk of ASCVD. Given the known inequitable utilization of other therapies, along with the known higher burden of diabetes and cardiovascular disease among Black patients, the aim of this study was to evaluate the uptake of GLP-1 RA as well as for inequities in utilization. (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, University of Pennsylvania / 18.11.2021

MedicalResearch.com Interview with: Ashwin Nathan, MD, MSHP Assistant Professor, Medicine, Perelman School of Medicine Interventional Cardiologist Hospital of the University of Pennsylvania and at the Corporal Michael C. Crescenz VA Medical Center in Philadelphia Penn Cardiovascular Outcomes, Quality & Evaluative Research Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: We found that the rates of TAVR were lower in areas with higher proportions of Black, Hispanic and socioeconomically disadvantaged patients. Inequities in access in areas with higher proportions of Black and Hispanic patients existed despite adjusting for socioeconomic status. (more…)
Author Interviews, HIV, Infections, Vanderbilt / 02.10.2021

MedicalResearch.com Interview with: Rachael Pellegrino, MD Vanderbilt University Medical Center MedicalResearch.com: What is the background for this study? Response: We know that HIV care and outcomes have dramatically improved over the last 20 years, but disparities still exist at each step of the HIV care continuum, which can ultimately lead to differences in mortality rates. In addition to assessing trends and disparities in mortality, we wanted to look at differences in premature mortality, which has not been widely studied in the HIV population in the US. This concept serves to emphasize and quantify the time lost by death at an early age as an important measurement of the impact of diseases and can expose disparities that are not apparent in the mortality rates alone. (more…)
Author Interviews, JAMA, Primary Care, Social Issues / 13.09.2021

MedicalResearch.com Interview with: Karina W. Davidson, Ph.D., M.A.Sc. Professor of Behavioral Medicine Zucker School of Medicine at Hofstra University/Northwell Health Chairperson, USPSTF MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The social and economic conditions in someone’s life, such as whether or not they have secure food, housing, or transportation, can affect their health in multiple ways. As part of our commitment to improving health equity, the U.S. Preventive Services Task Force took two key steps. We both thoroughly reviewed the existing research around screening and interventions for social risk factors, and audited our own portfolio of recommendation statements to determine how and how often social risks have been considered in the past. This information serves as a benchmark and foundation for our ongoing work to further advance health equity through our methods and recommendations. (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, JAMA, Race/Ethnic Diversity / 13.09.2021

MedicalResearch.com Interview with: Megan B. Cole, PhD, MPH Assistant Professor | Dept. of Health Law, Policy, & Management Co-Director | BU Medicaid Policy Lab Boston University School of Public Health Boston, MA 02118 MedicalResearch.com: What is the background for this study? Response: Under the Affordable Care Act, states were given the option to expand Medicaid eligibility to nonelderly adults with incomes up to 138% of the federal poverty level, where in January 2014, 25 states plus Washington, DC expanded eligibility, with 13 additional states expanding thereafter. State Medicaid expansion decisions were particularly consequential for federally qualified health centers (FQHCs), which serve nearly 30 million low-income, disproportionately uninsured patients across the US. We know from earlier work that in the shorter-term, Medicaid expansion was associated with improvements in quality of care process measures and FQHC service capacity. However, we conducted the first known nationally representative study to examine how Medicaid expansion impacted key chronic disease outcome measures at FQHCs over the longer-term by looking at changes five years after implementation, including changes by race/ethnicity.  (more…)
Addiction, Author Interviews, Opiods, Race/Ethnic Diversity / 10.09.2021

John A. Furst BS Geisinger Commonwealth School of Medicine MedicalResearch.com: What is the background for this study? Response: Methadone is an evidence-based pharmacotherapy for opioid detoxification, maintenance therapy, and pain management. However, accessibility of this treatment remains variable across much of the country. Methadone for the treatment of opioid use disorder (OUD) is exclusively provided by federally regulated opioid treatment programs (OTPs) and has provoked significant community-based and legal controversy regarding its role in the management of this condition. This has created disparities related to the distribution and access of methadone throughout the United States (U.S.). The goal of this study1 was to highlight the most recent pharmacoepidemiologic trends associated with methadone in the face of unique restrictions at the local, state, and federal levels. (more…)
Author Interviews, Columbia, JAMA, Race/Ethnic Diversity, Telemedicine / 29.07.2021

MedicalResearch.com Interview with: Steffie Woolhandler MD MPH, FACP Professor of Public health and Health Policy CUNY School of Public Health at Hunter College Co-founder and board member Physicians for a National Health Program MedicalResearch.com: What is the background for this study? What are the main findings? Response:   We analzyed a national database of healthcare utilization. We found racial disparities exist in use of specialist MD services by Black- and Native-Americans relative to White-Americans, despite their greater needs.  Hispanic- and Asian-Americans also receive specialist care at low rates.   (more…)
Author Interviews, Cancer Research, COVID -19 Coronavirus, JAMA, Prostate Cancer, Race/Ethnic Diversity / 23.07.2021

MedicalResearch.com Interview with: Andres F. Correa, MD Assistant Professor Department of Surgical Oncology, and Adrien Bernstein, MD Second Year Urologic Oncology Fellow Fox Chase Cancer Center MedicalResearch.com: What is the background for this study? Response: Unfortunately, it has been well-established that historically Black Americans experience increased cancer specific mortality compared to white patients. In prostate cancer specifically studies have shown that when access to care is equitable this gap resolves. This suggests that biological factors are not driving these differences but rather the result of the complex interplay of social determinants and systemic inequities in our healthcare system. Early in the pandemic, multiple studies demonstrated that minority communities disproportionately shouldered poor COVID-19 outcomes.  On March 13th 2020, the American College of Surgeons recommended against elective procedures; however, the definition of an elective oncologic case was left to the discretion of the provider. As prostate cancer treatment can be safely deferred up to a year follow diagnosis, management of prostate cancer during the initial lockdown period of the COVID-19 Pandemic provided a useful analysis of the differential restrictions placed on non-emergent health care during the Pandemic. (more…)
Author Interviews, JAMA, Kidney Disease, Race/Ethnic Diversity, UCSF / 17.07.2021

MedicalResearch.com Interview with: Chi-yuan Hsu, MD, MSc (he/him/his) Professor and Division Chief Division of Nephrology University of California, San Francisco San Francisco, CA 94143-0532 MedicalResearch.com: What is the background for this study? Response: There has been a great deal of controversy recently about how race should be considered in medicine, including its use in estimating kidney function (e.g. https://jamanetwork.com/journals/jama/fullarticle/2769035).  A recent paper published in JAMA Network Open by Zelnick et al suggested that removing the race coefficient improves the accuracy of estimating kidney function (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775076) in the Chronic Renal Insufficiency Cohort, a NIH-funded study (www.cristudy.org). We are core investigators of the Chronic Renal Insufficiency Cohort Study and were not involved in the Zelnick’s study that was based on a public use dataset.  Because we were surprised by the methodological approach they took and the conclusion they came to, we implemented our own analysis of the data. (more…)
Author Interviews, Cancer Research, CDC, Emory, Gender Differences, Race/Ethnic Diversity / 08.07.2021

MedicalResearch.com Interview with: Farhad Islami, MD PHD Scientific Director, Cancer Disparity Research American Cancer Society MedicalResearch.com: What is the background for this study? Response: The Centers for Disease Control and Prevention (CDC), the American Cancer Society (ACS), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) have collaborated annually since 1998 to provide updated information about cancer occurrence and trends by cancer type, sex, age group, and racial/ethnic group in the United States. In this year’s report, we focus on national cancer statistics and highlight trends in stage-specific survival for melanoma of the skin, the first cancer for which effective immune checkpoint inhibitors were developed. (more…)
Author Interviews, Cancer Research, Colon Cancer, JAMA, USPSTF / 26.05.2021

MedicalResearch.com Interview with: Martha Kubik, Ph.D., R.N. Professor and Director School of Nursing College of Health and Human Services George Mason University MedicalResearch.com: What is the background for this study? Response: Colorectal cancer is the third leading cause of cancer deaths in the United States, yet about a quarter of people ages 50 to 75 have never been screened for this devastating disease. Fortunately, we know that screening for colorectal cancer is effective and saves lives. New science about colorectal cancer in people younger than 50 years old has enabled us to expand our previous guidelines to recommend that all adults ages 45 to 75 be screened for colorectal cancer to reduce their risk of dying from this disease.  (more…)
Author Interviews, Breast Cancer, JAMA, Race/Ethnic Diversity / 17.05.2021

MedicalResearch.com Interview with: Ying Liu, MD, PhD Assistant Professor Washington University School of Medicine Department of Surgery, Division of Public Health Sciences St. Louis, MO MedicalResearch.com: What is the background for this study? Response: Non-Hispanic African American women experience a disproportional burden of poor breast cancer outcomes than non-Hispanic White women, which is associated with a higher incidence of triple-negative breast cancer (TNBC), more advanced stages at diagnosis, and lower treatment adherence. However, the differences in clinical treatment and outcomes between African American women with TNBC and their White counterparts have not been well defined. (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease, JACC, Social Issues / 12.05.2021

MedicalResearch.com Interview with: Kobina Hagan MBBS, MPH Postdoctoral Fellow Center for Outcomes Research, Houston Methodist Research Institute MedicalResearch.com: What is the background for this study? Response: Before the COVID-19 vaccination roll-out, risk mitigation guidelines including respiratory hygiene, social distancing, and job flexibility, were the most effective preventive measures against coronavirus transmission. Social determinants of health scholarships had identified social circumstances to limit adherence to these mitigation guidelines. Individuals with underlying cardiovascular disease are identified as high-risk phenotypes for severe COVID-19 outcomes. In addition, research efforts during the early and middle waves of the pandemic had identified coronavirus exposure risk as a greater mediator of the observed COVID-19 disparities, compared to clinical susceptibility from comorbidities. Yet, population-based evidence on the practice of these mitigation guidelines in this high-risk group were lacking. Consequently, we believed there was a need to robustly characterize COVID-19 risk mitigation practices among adults with cardiovascular disease in the nation. The COVID-19 Household Impact Survey was a survey conducted by the National Opinion Research Center at the University of Chicago, to provide statistics about health, economic security, and social dynamics of the US adult household population nationwide and for 18 geographic areas (10 states, 8 metropolitan statistical areas) between April and June 2020. This survey complemented the Household Pulse Survey by the Census Bureau. In this study we described the COVID-19 risk mitigation practices among patients with CVD and evaluated the association between cumulative social determinants of health burden (a measure of social adversity) and adherence these measures.  (more…)
Asthma, Author Interviews, Brigham & Women's - Harvard, Race/Ethnic Diversity / 09.05.2021

MedicalResearch.com Interview with: Justin Salciccioli, MBBS, MA Research Fellow in Medicine Elliot Israel, MD Professor of Medicine, Harvard Medical School Pulmonary and Critical CareRheumatologyMedicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Asthma attacks account for almost 50% of the cost of asthma care, which costs $80 billion each year in the United States. Asthma is more severe in African-American/Black and Hispanic/Latinx patients, with these groups having double the rates of attacks and hospitalizations as the general population. The PREPARE study is an ongoing national clinical trial for African American/Black and Hispanic/Latinx adults with moderate-to-severe asthma from different U.S. cities in which reporting of asthma control and asthma exacerbations was monitored entirely remotely. With the arrival of the Covid19 pandemic, several studies suggested that asthma exacerbations may have decreased during the pandemic. However, multiple reports have suggested people were avoiding health services because of the pandemic, making it difficult to tell whether exacerbations truly decreased or whether people were simply avoiding their doctors. This is the first study done to assess asthma exacerbations before and during the pandemic that is unlikely to be impacted by patient healthcare avoidance. (more…)
Author Interviews, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, Race/Ethnic Diversity / 13.04.2021

MedicalResearch.com Interview with: Michael H. Lazar MD Jeffrey H Jennings, MD Pulmonary and Critical Care specialists Henry Ford Hospital Detroit Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Persons of color who are infected with COVID-19 have a higher incidence of hospitalization and death when compared to white patients.  However, it was previously unknown if there was a difference in outcomes based upon race in patients who are sick enough to be treated in an intensive care unit (ICU). Our study found that race made no difference in ICU outcomes. MedicalResearch.com: What should readers take away from your report? Response: Lack of racial differences in survival and other meaningful outcomes in the intensive care unit may be related to the highly protocolized nature of care and experience of the critical care team. (more…)