Author Interviews, JAMA, Kidney Disease, Medicare / 10.04.2020

MedicalResearch.com Interview with: Lead and Senior coauthors contributing to this interview: Abby Hoffman, BA is a Pre-Doctoral Fellow in Population Health Sciences at Duke University and a PhD Candidate in Health Policy and Management University of North Carolina at Chapel Hill. Virginia Wang, PhD, MSPH is an Associate Professor in the Department of Population Health Sciences, Associate Director of the Center for Health Innovation and Outcomes Research, and Core Faculty in the Margolis Center for Health Policy at Duke University and Investigator at the Durham VA HSR&D Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT).   MedicalResearch.com: What is the background for this study? Response: It is well established that healthcare providers are sensitive to changes in price, though their behavioral response varies. Dialysis facilities are particularly responsive to changes in Medicare reimbursement. Many dialysis patients are eligible for Medicare regardless of age, but dialysis facilities generally receive significantly higher reimbursement from private insurers than from Medicare. In 2011, Medicare implemented a new prospective bundled payment for dialysis that was expected to decrease Medicare payment and reduce overall revenues flowing into facilities. Then the Affordable Care Act (ACA) rules against refusing to insure patients for preexisting conditions and the 2014 ACA Marketplace provided an additional avenue for patients to purchase private insurance. As a result of these policies, dialysis facilities had a strong motivation and opportunity to increase the share of patients with private insurance coverage. We were interested in understanding whether dialysis facilities were shifting their payer mix away from Medicare, possibly in response to these policy changes.  (more…)
Addiction, Author Interviews, Cannabis / 10.04.2020

MedicalResearch.com Interview with: Anees Bahji, MD PGY5, Department of Psychiatry, Queen’s University M.Sc. Candidate, Department of Public Health Sciences, Queen’s University Kingston, ON, Canada MedicalResearch.com: What is the background for this study?
  • There has been much speculation into the existence of a withdrawal syndrome involving cannabis much like withdrawal syndromes from opioids or alcohol. Our goal for this study was to estimate the prevalence of cannabis withdrawal syndrome (CWS) and to identify any risk factors for CWS.
  • There has been a lot of research into cannabis withdrawal syndrome (CWS) in the past. A big part of this review involved understanding where the CWS field is in terms of the shared understanding on its epidemiology and physiology.
  • To that end, we were not surprised to find that the prevalence of cannabis withdrawal syndrome was high. However, we found that some of the characteristics of CWS are consistent with other substance use disorders, which really serves to legitimize the decision to classify CWS and cannabis use disorders as psychiatric conditions.
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Accidents & Violence, Author Interviews, JAMA, Johns Hopkins, Pediatrics / 07.04.2020

MedicalResearch.com Interview with: Johnathon P. Ehsani, PhD Assistant Professor Johns Hopkins School of Public Health MedicalResearch.com: What is the background for this study? Response: Car crashes are the leading cause of death and disability for young people. So, what can parents do during the learner stage of licensing to reduce their teenagers’ crash risk during independent driving? The learner stage is a brief window of opportunity to influence the safety of their teenager. This is when teenagers are required to practice driving under the supervision of a licensed adult – typically mom or dad. Once teenagers get their license to start driving on their own, their crash risk increases - but parents have fewer chances to intervene at that point.  (more…)
Author Interviews, Cost of Health Care, JAMA, Opiods / 01.04.2020

MedicalResearch.com Interview with: Aparna Soni PhD, Assistant Professor Department of Public Administration and Policy School of Public Affairs American University Washington, DC MedicalResearch.com: What is the background for this study? Response: The United States is in the midst of an opioid epidemic. Opioids are responsible for nearly 50,000 deaths per year and present a substantial financial burden on hospitals. The rate of opioids-related hospital events has tripled since 2005. We are particularly concerned about rising hospitalizations because they may stem from a lack of access to treatment for individuals with opioid use disorder. Medication-assisted treatment is effective in treating opioid use disorder but can be unaffordable for people without health insurance. (more…)
Author Interviews, Orthopedics, Surgical Research / 23.03.2020

MedicalResearch.com Interview with: Pincus MD PhD Division of Orthopaedic Surgery, Department of Surgery University of Toronto Sunnybrook Health Sciences Centre, Division of Orthopaedic Surgery ICES, Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? Response: Controversy exists among arthroplasty surgeons and patients about the best surgical approach for total hip arthroplasty (THA) - one of the most common operations performed worldwide. In the last few years, the direct anterior approach has become increasingly popular compared to posterior and lateral approaches, partially as a result of advertising to patients.  We sought to determine whether a direct anterior surgical approach was associated with lower surgical complications compared to lateral and posterior approaches. (more…)
Author Interviews, Gastrointestinal Disease, JAMA, Orthopedics, Pediatrics / 17.03.2020

MedicalResearch.com Interview with: Yun-Han Wang, PhD Student Karolinska Institute MedicalResearch.com: What is the background for this study? Response: Proton pump inhibitor (PPI) use has been linked to increased risk of fracture in adults. Despite an increasing trend in prescription of PPIs in children, there is scarce evidence regarding this safety concern in pediatric patients. (more…)
Author Interviews, Colon Cancer, JAMA, Weight Research / 13.03.2020

MedicalResearch.com Interview with: Dr Laurent Bailly MD, PhD Département de Santé Publique, CHU Nice, Hôpital Archet 1. Niveau1 NICE France  MedicalResearch.com: What is the background for this study? Response: Obesity is known to increase cancer incidence and notably colorectal cancer incidence. Bariatric surgery is an effective treatment of obesity however the association of this surgery with the colorectal cancer remained controversial. We used the French National Health Insurance Information System to conduct a nationwide retrospective cohort study, between 2009 and 2018, of patients hospitalized in France with a diagnosis of obesity. We followed more than 1 million obese individuals aged 50 to 75 years and free of colorectal cancer at baseline, some of them did undergo bariatric surgery and others did not. (more…)
Author Interviews, Hepatitis - Liver Disease, JAMA, USPSTF / 12.03.2020

MedicalResearch.com Interview with: Dr. Michael Barry MD Director of the Informed Medical Decisions Program Health Decision Sciences Center at Massachusetts General Hospital Physician at Massachusetts General Hospital Professor of Medicine,Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hepatitis C affects more people today than ever before, many of whom are younger. If left untreated, it can cause serious, lifelong health problems due to liver damage. The good news is that hepatitis C infection is both preventable and treatable, with recent evidence showing that new treatments for adults are highly effective. Knowing this, we’ve broadened our guidelines to recommend screening for hepatitis C in all adults between the ages of 18 and 79. (more…)
Author Interviews, Cost of Health Care, JAMA, NIH, Social Issues / 12.03.2020

MedicalResearch.com Interview with: Dr. Adan Z. Becerra PhD Senior Epidemiologist for the  NIH Social and Scientific Systems Washington, District Of Columbia MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that disparities in insurance coverage by immigration status exist in the United States such that immigrants compared to nonimmigrants are less likely to have insurance. However, most studies have been cross sectional with few studies investigating long term trajectories of insurance coverage over time. We addressed this gap in the literature by following a cohort of adults for 24 years from before until after reaching Medicare age-eligibility. (more…)
Author Interviews, Breast Cancer, Genetic Research, JAMA, Stanford / 12.03.2020

MedicalResearch.com Interview with: Allison W. Kurian, M.D., M.Sc. Associate Professor of Medicine (Oncology) and of Epidemiology and Population Health Director, Women’s Clinical Cancer Genetics Program Stanford University School of Medicine Stanford, CA 94305-5405 MedicalResearch.com: What is the background for this study? Response: Genetic testing is increasingly relevant for the care of cancer patients. However, little was known about the prevalence of inherited mutations in cancer susceptibility genes among the most common group of women with breast cancer: those diagnosed after menopause and without a strong family history of cancer.  (more…)
Author Interviews, Cost of Health Care / 10.03.2020

MedicalResearch.com Interview with: Olivier Wouters, Ph.D. Assistant Professor of Health Policy Department of Health Policy London School of Economics and Political Science London MedicalResearch.com: What is the background for this study? Response: Although both Democrats and Republicans consider lowering prescription drug prices a priority, lobbyists and campaign donors in the pharmaceutical industry may counteract efforts by federal and state governments to decrease these costs. In this study, I tracked every dollar spent by the pharmaceutical and health product industry on lobbying and campaign contributions in the US from 1999 to 2018. These data were obtained from the Center for Responsive Politics and the National Institute on Money in Politics—two non-profit, non-partisan US organizations.  (more…)
Alzheimer's - Dementia, Author Interviews, USPSTF / 04.03.2020

MedicalResearch.com Interview with: Chyke A. Doubeni, M.D., M.P.H. Director, the Mayo Clinic Center Health Equity and Community Engagement Research Department of Family Medicine Mayo Clinic in Rochester, MN MedicalResearch.com: What is the background for this study? Response: Cognitive impairment is a serious public health problem that affects millions of Americans as they age; it can lead to frustrating challenges that impact their everyday lives, such as trouble remembering, learning new things, or organizing their thoughts. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmaceutical Companies / 04.03.2020

MedicalResearch.com Interview with: Olivier Wouters, Ph.D. Assistant Professor of Health Policy Department of Health Policy (COW 2.06) London School of Economics and Political Science MedicalResearch.com: What is the background for this study? What are the main findings? Response: Drug companies often point to high research and development costs as justification for the rising prices of new medicines. Yet most prior analyses of research and development costs have been based on confidential data voluntarily supplied by drug companies to researchers with financial ties to the industry. Independent teams have not been able to verify those findings. (more…)
Author Interviews, Fertility, Heart Disease, JAMA, OBGYNE / 27.02.2020

MedicalResearch.com Interview with: Shi Wu Wen PhD Senior Scientist, Clinical Epidemiology Program Professor, Department of Obstetrics & Gynecology University of Ottawa MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that having a baby as a result of using assisted procedures such as IVF nearly doubles the chance that a baby will have heart problems. (more…)
Author Interviews, Gastrointestinal Disease, JAMA, Microbiome / 25.02.2020

MedicalResearch.com Interview with: Drs. R.P.J. Willems  |  Arts-onderzoeker Medische Microbiologie en Infectiepreventie Amsterdam MedicalResearch.com: What is the background for this study? Does your study refer to both PPIs and H2-blockers?  Response: There is mixed evidence on the associated risk of colonization and infection with multidrug-resistant microorganisms with acid suppressive therapy. We therefore aimed to investigate current literature in order to determine whether acid suppressants facilitate intestinal colonization with multidrug-resistant microorganisms. We included studies on PPIs, H2 blockers and antacids. (more…)
Aging, Author Interviews, Cannabis, Geriatrics, JAMA, NYU / 24.02.2020

MedicalResearch.com Interview with: Benjamin H. Han, MD MPH Assistant Professor Division of Geriatric Medicine and Palliative Care New York University School of Medicine MedicalResearch.com: What is the background for this study? Response: In the past, the prevalence of cannabis use (both for recreational and for medicinal purposes) was very low among adults age 65 and older. As a reference, the national prevalence rate of past-year cannabis use among adults age 65 and older in 2006-2007 was 0.4%, it has increased dramatically since then. (more…)
Author Interviews, Education, Gender Differences, JAMA, Race/Ethnic Diversity, Yale / 24.02.2020

MedicalResearch.com Interview with: Katherine A. Hill, BA, BS Yale School of Medicine New Haven, Connecticut MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that mistreatment is a common and damaging experience for medical students. However, there is little research on whether the prevalence of medical student mistreatment varies by demographic factors such as student sex, race/ethnicity, and sexual orientation.  (more…)
Author Interviews, JAMA, Surgical Research / 23.02.2020

MedicalResearch.com Interview with: Paulina Salminen MD PhD Chief and Professor of surgery Turku University, Finland MedicalResearch.com: What is the background for this study? Response: Appendectomy has been the standard treatment for uncomplicated acute appendicitis and currently one of the most commonly performed surgical procedures. We now know that there are two different forms of acute appendicitis: the more common milder uncomplicated acute appendicitis and the more severe complicated acute appendicitis. While the complicated form is primarily still treated surgically, in recent years evidence from randomised trials and meta-analyses show that antibiotics are a safe and efficient treatment of uncomplicated acute appendicitis  also at long-term follow-up. Quality of life (QOL) and patient satisfaction after antibiotic therapy or appendectomy for uncomplicated acute appendicitis have been studied previously in a pediatric population but not in an adult population. Our aim was to compare long-term quality of life and patient satisfaction after antibiotic therapy and appendectomy for the treatment of uncomplicated acute appendicitis in patients enrolled in the original APPAC trial. (more…)
Aging, Author Interviews, Cost of Health Care, JAMA, University of Michigan / 10.02.2020

MedicalResearch.com Interview with: Renuka Tipirneni, MD, MSc, FACP Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine Divisions of General Medicine and Hospital Medicine and Institute for Healthcare Policy & Innovation Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? Response: While U.S. adults age 50-64 previously had more limited options for health insurance before Medicare at age 65, the Affordable Care Act expanded the number of options, including Marketplace plans (e.g., through HealthCare.gov) and Medicaid. This expanded set of options may complicate decisions about health insurance near retirement. In addition, several policy challenges to the Affordable Care Act may add uncertainty to the decision-making process. (more…)
Author Interviews, C. difficile, Health Care Systems, Hospital Acquired, JAMA / 06.02.2020

MedicalResearch.com Interview with: Valerie Vaughn MD, MSc Assistant Professor of Medicine; Hospital Medicine VA Ann Arbor Healthcare System and University of Michigan Medical School @ValerieVaughnMD MedicalResearch.com: What is the background for this study? Response: Health care-associated infection are a major patient safety problem. Fortunately, they can often be prevented through key practices. The Department of Veterans Affairs has been an early adopters of these key strategies through a combination of policies, directives, and initiatives which have aimed to reduce health care-associated infection. No one had previously looked across infections to see whether key infection prevention practices are being used in the VA. (more…)
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Pediatrics / 03.02.2020

MedicalResearch.com Interview with: Dr. Jonathan R. Skirko, MD , MHPA, MPH Assistant professor Division of Pediatric Otolaryngology University of Utah Health  MedicalResearch.com: What is the background for this study? Response: Obstructive sleep apnea is a common problem that that impacts the lives of many people. Understanding treatment effectiveness is important and Health-State Utility is a standardized way of assessing quality of life.  Before this study, we didn't have a way of measuring quality of life in this population in this important way. You have to accurately measure something before you can improve it. (more…)
Author Interviews, Hip Fractures, JAMA, Orthopedics / 31.01.2020

MedicalResearch.com Interview with: Alison M. Cogan, PhD, OTR/L Polytrauma/TBI Advanced Fellow Washington DC VA Medical Center Washington DC MedicalResearch.com: What is the background for this study? Response: Medicare is shifting from a volume- to value-based payment for postacute care services, in which value is determined by patient characteristics and functional outcomes. Matching therapy time and length of stay (LOS) to patient needs is critical to optimize functional outcomes and manage costs. The objective of this study was to investigate the association among therapy time, LOS, and functional outcomes for patients following hip fracture surgery. This retrospective cohort study analyzed data on patients from 4 inpatient rehabilitation facilities and 7 skilled nursing facilities in the eastern and midwestern United States. Participants were patients aged 65 years or older who received inpatient rehabilitation services for hip fracture and had Medicare fee-for-service as their primary payer. We categorized patients into nine recovery groups based on low, medium, and high therapy minutes per day and low, medium, or high rate of functional gain per day. We measured the groups for functional mobility independence and self-care capabilities at the time each patient was discharged. (more…)
Author Interviews, Health Care Systems, JAMA / 30.01.2020

MedicalResearch.com Interview with: Coleman Drake, PhD Assistant Professor, Health Policy and Management Pitt Public Health Affiliate faculty member Medicaid Research Center and Center for Pharmaceutical Policy and Prescribing MedicalResearch.com: What is the background for this study? Response: The religious directives of Catholic hospitals prohibit the provision of many forms of contraception. To examine how Catholic hospitals restrict access to reproductive health services, we examined the market share of Catholic hospitals in every county in the continental US. We found that nearly 40% of women of reproductive-aged women live in counties with high or dominant Catholic hospital market share. We also examined whether the networks of Health Insurance Marketplace (i.e., Obamacare) plans direct their enrollees toward or away from Catholic hospitals, and thus reproductive health services.  (more…)
Author Interviews, JAMA, Pediatrics, Weight Research / 29.01.2020

MedicalResearch.com Interview with: Dr. Carol Chelimo PhD Research Fellow Dept. of Paediatrics, School of Medicine University of Auckland MedicalResearch.com: What is the background for this study? Response: New Zealand has the third highest prevalence of obesity among Organisation for Economic Co-operation and Development countries. Pediatric obesity is associated with development of cardiovascular risk factors in later life, such as type 2 diabetes, hypertension, dyslipidemia, and metabolic syndrome. Antibiotic exposures in early life may affect weight by altering the gut microbiota, potentially increasing the risk of childhood obesity. The overall aim of this research was to examine whether repeated antibiotic exposure by age 48 months is associated with higher body mass index (BMI) at age 54 months. Specifically, it evaluates whether the number, timing (age), and type of antibiotic exposures are associated with a higher body mass and an increased likelihood of overweight and obesity. This work incorporates antibiotic exposure during pregnancy (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Gastrointestinal Disease, JAMA / 17.01.2020

MedicalResearch.com Interview with: Dr. Paul Young MBChB, BSc (Hons), FCICM Medical Director of the Wakefield Hospital ICU Head of the Intensive Care Research Unit Wellington Hospital MedicalResearch.com: What is the background for this study? Response: Proton pump inhibitors (PPIs) are among the most widely prescribed drugs in the intensive care unit (ICU) in the world.   Many, if not most, prescriptions of PPIs in the ICU are for stress ulcer prophylaxis.  Although PPIs are used most widely for this indication, histamine-2 receptor blockers (H2RBs) are used in preference to PPIs in some ICUs.  This practice variation, which appears to be largely dependent on clinician preference rather than based on patient-specific factors, has continued for decades.  The PPIs vs. H2RBs for Ulcer Prophylaxis Therapy in the Intensive Care Unit (PEPTIC) trial results raise the possibility that PPIs, the most commonly used medicines for stress ulcer prophylaxis, may be responsible for a clinically important increase in the risk of death that, in global health terms could equate to many tens of 1000s of deaths per year. (more…)
Author Interviews, Nutrition, Supplements, UCSD / 14.01.2020

MedicalResearch.com Interview with: Kellogg Parsons, MD, MHS Professor of Urology Moores UC San Diego Comprehensive Cancer Center MedicalResearch.com: What is the background for this study? Response: Clinical guidelines for prostate cancer, circulated widely in the public domain, endorse the consumption of diets high in micronutrient-enriched vegetables. Drawing on expert opinion, epidemiological studies, and small preclinical experiments, these recommendations propose that vegetable-enriched diets may decrease cancer progression and death among prostate cancer survivors. However, data from randomized clinical trials focused on actionable clinical endpoints has been lacking. We utilized a specific behavioral intervention, grounded in the field of social psychology, to “nudge” patients with prostate cancer toward healthier food choices. The intervention is telephone-based, like a call center: patient-focused, convenient, and simple. (more…)
Author Interviews, JAMA, Surgical Research, Technology, University of Michigan / 13.01.2020

MedicalResearch.com Interview with: Kyle Sheetz, MD Clinical Year 4 Resident, General Surgery Michigan Medicine MedicalResearch.com: What is the background for this study? Response: There are concerns that robotic surgery is increasing for common surgical procedures with limited evidence and unclear clinical benefit. Prior studies describing the use of robotic surgery relied upon claims or billing data to identify robotic operations from laparoscopic or open ones. This may lead to inaccuracies as claims data may not provide specific codes for robotic operations. (more…)
Author Interviews, Breast Cancer, Cost of Health Care, JAMA, Race/Ethnic Diversity / 09.01.2020

MedicalResearch.com Interview with: Naomi Y Ko, MD Director, Inpatient Medical Operations Assistant Professor of Medicine, Department of Medicine Boston University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is to help understand the association between risk of more advanced cancer in racial minorities and insurance.   (more…)
Author Interviews, Biomarkers, Heart Disease, JAMA, UCLA / 09.01.2020

MedicalResearch.com Interview with: Olujimi A. Ajijola, MD, PhD Neurocardiology Research Center of Excellence Cardiac Arrhythmia Center University of California, Los Angeles MedicalResearch.com: What is the background for this study? Response: It hadn’t been understood why some people with basic heart failure might live longer than others despite receiving the same medications and medical device therapy. Through this research we set out to determine whether a biomarker of the nervous system could help explain the difference. This study revealed a biomarker that can specifically predict which patients with “stable” heart failure have a higher risk of dying within one to three years. (more…)