Author Interviews, Health Care Systems, JAMA, Primary Care / 18.09.2019

MedicalResearch.com Interview with: Deborah Korenstein, MD FACP General internist and Chief, General Internal Medicine Memorial Sloan Kettering Cancer Center  MedicalResearch.com: What is the background for this study? Response: Executive physicals are 1 to 2-day comprehensive health assessments offering disease screening and preventive testing. Large companies can arrange for these evaluations for senior executives. They are often offered by prestigious academic medical centers, but can also be located in less formal settings like spas. They generally include a set of tests that sometimes vary based on patient characteristics. Any tests that are done in response to from findings from executive physicals are billed to health insurance companies. A single 2008 paper described executive physicals and criticized them for being non-evidence based. Since then, executive physicals have grown in popularity, but their nature and impact have not been described. We set out to describe included services and cost of executive physicals at top academic medical centers. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Genetic Research, Infections, JAMA / 17.09.2019

MedicalResearch.com Interview with: QiPing Feng, PhD Division of Clinical Pharmacology Department of Medicine Vanderbilt University Medical Center Nashville, Tennessee MedicalResearch.com: What is the background for this study? Response: Sepsis is one of the leading causes of hospital mortality. Yet, there are no specific effective treatments for it. Recent information suggests that drugs that inhibit proprotein convertase subtilisin kexin type 9 (PCSK9) could have potential as a new treatment for sepsis. We used a genetic approach to test if variation in PCSK9 affected the risk of sepsis. In patients admitted to hospital with infection, neither variants in the PCSK9 gene nor predicted expression of PCSK9 were associated with risk of sepsis or poorer outcomes after sepsis.  (more…)
Author Interviews, Gender Differences, HPV / 16.09.2019

MedicalResearch.com Interview with: Dr. Ashish A. Deshmukh UT Health School of Public Health Houston MedicalResearch.com: What is the background for this study? Response: The HPV vaccination is recommended for females and males for prevention of 6 cancers (cervical, oropharyngeal, anal, penile, vaginal, and vulvar). Nearly 43,000 HPV-associated cancer cases are diagnosed every year in the US. Yet, it is extremely unfortunate and something that continues to bother us that HPV vaccination coverage remains low (50% in 2018) in the US and completion rate is nearly 5% lower in boys. Different from some industrialized nations where vaccination policy is school-based, vaccination policy in the US is clinic-based and parents are generally responsible for making vaccination decisions for their children. Generally, there are two main factors that drive parents’ decision-making: (1) how much knowledge they have of HPV and (2) recommendation from a healthcare professional. We analyzed the National Cancer Institute’s Health Information National Trend Survey (HINTS) of over 6000 participants focusing on their knowledge of HPV and HPV vaccination and whether participants received any vaccination recommendation from their health care provider.  (more…)
Author Interviews, Breast Cancer, JAMA, USPSTF / 12.09.2019

MedicalResearch.com Interview with: Dr. Carol Mangione, M.D., M.S.P.H., F.A.C.P. Division Chief of General Internal Medicine and Health Services Research Professor of Medicine Barbara A. Levey, MD, and Gerald S. Levey, MD, endowed chair in Medicine David Geffen School of Medicine University of California Los Angeles Professor of public health at the UCLA Fielding School of Public Health.  MedicalResearch.com: What is the background for this study? Response: We all want to find better ways to help prevent breast cancer, a disease that impacts the lives of too many women in the United States each year. Fortunately, the Task Force found there are steps that women at increased risk can take to reduce their chances of developing breast cancer. (more…)
Author Interviews, Emergency Care, JAMA, Race/Ethnic Diversity / 09.09.2019

MedicalResearch.com Interview with: Amresh D Hanchate, PhD Research Assistant Professor Department of Medicine, School of Medicine Boston University MedicalResearch.com: What is the background for this study? Response: National guidelines require EMS transportation to the nearest suitable hospital. To what extent this occurs and whether this varies by the race and ethnicity of the patient is unknown since there is little to no prior research on destination patterns of EMS-transported patients to hospitals. (more…)
Author Interviews, Heart Disease, JAMA, Occupational Health / 07.09.2019

MedicalResearch.com Interview with: Rachel Zeig-Owens, Dr.P.H., MPH FDNY Research Assistant Professor Albert Einstein Medical Center MedicalResearch.com: What are the main findings? Response: We found that the most exposed members, those who arrived first at the World Trade Center (WTC ) site—when the air-borne dust was thickest—have a 44% increased risk of cardiovascular disease (CVD) compared to those who arrived later in the day. This is a level risk that was similar to other known risk factors for CVD.  (more…)
Author Interviews, Cost of Health Care, JAMA, Medical Imaging, UCSF / 05.09.2019

MedicalResearch.com Interview with: Rebecca Smith-Bindman, MD Professor, Department of Radiology and Biomedical Imaging, Epidemiology and Biostatistics Philip R. Lee Institute for Health Policy Studies University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: Medical imaging increased rapidly from 2000 to 2006. The rise in imaging can be attributed to improvements in technical aspects of imaging, strong physician and patient demand, and strong financial incentives. While imaging contributes to accurate disease diagnosis and improved treatment, imaging can also increase costs and patient harms, such as incidental findings, overdiagnosis, anxiety, and radiation exposure associated with increased risk of cancer. Potential overuse of diagnostic testing has been addressed by the American Board of Internal Medicine Foundation’s Choosing Wisely Campaign and initiatives by payers to reduce imaging through payment reductions, but there remains uncertainty in the impact of these initiatives on imaging rates.The objective of our study was to evaluate recent trends in medical imaging. Our study assessed imaging from 2000 through 2016 among individuals enrolled in diverse U.S. integrated healthcare systems and among individuals residing in Ontario, Canada and assessed changes in medical imaging utilization over time by country, health system, and patient demographic factors. (more…)
ADHD, Author Interviews, Autism, JAMA, OBGYNE / 30.08.2019

MedicalResearch.com Interview with: Tianyang Zhang, MSc Centre for Psychiatry Research, Department of Clinical Neuroscience Stockholm Health Care Services, Stockholm County Council Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm, Sweden MedicalResearch.com: What is the background for this study? Response: We know that births by caesarean delivery are linked to several negative health outcomes in the children, such as obesity, asthma, allergy, and type 1 diabetes. However, the association between c-section and neurodevelopmental and psychiatric disorders has been less studied. In addition, it is unclear whether the extent of this association is different if a caesarean section is performed planned in advance or urgently due to medical reasons during a delivery. (more…)
Author Interviews, Breast Cancer, Cancer Research, Genetic Research, JAMA, Ovarian Cancer, USPSTF / 28.08.2019

MedicalResearch.com Interview with: Dr. Carol Mangione, M.D., M.S.P.H., F.A.C.P. Division Chief of General Internal Medicine and Health Services Research Professor of Medicine Barbara A. Levey, MD, and Gerald S. Levey, MD, endowed chair in Medicine David Geffen School of Medicine University of California, Los Angeles (UCLA) Professor of public health at the UCLA Fielding School of Public Health.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Every year, too many American women are faced with the challenge of dealing with a cancer diagnosis related to potentially harmful mutations of the BRCA1 and BRCA2 genes.  However, the Task Force found that there are several steps women can take to determine if they’re potentially at increased risk for BRCA gene mutations – and if genetic counseling and BRCA testing are needed. It is important to note that while some women can benefit from risk assessment, counseling, and testing, these services are not for everyone. (more…)
Author Interviews, Education, JAMA, Opiods, Social Issues / 28.08.2019

MedicalResearch.com Interview with: Isaac Sasson, PhD Department of Sociology and Anthropology and the Herczeg Institute on Aging Tel Aviv University Tel Aviv, Israel MedicalResearch.com: What is the background for this study? Response: Life expectancy at birth in the United States has been declining steadily since 2014, which is very unusual for a high-income country in times of peace. In fact, the last time that life expectancy declined in the US was in the early 1990s, and only briefly. Studies from the past few years have shown that the rise in mortality is concentrated among middle-aged Americans and particularly the lower socioeconomic classes. Our study analyzed over 4.6 million death records in 2010 and 2017 to understand which causes of death account for the rise in mortality among white and black non-Hispanic US adults. In addition, given the substantial socioeconomic inequality in health in the US, we broke down our results by level of education, which is a good proxy for socioeconomic status. Essentially, our goal was to measure how many years of life were lost, on average, to each cause of death across different social groups.  (more…)
Author Interviews, Brain Injury, Erectile Dysfunction, JAMA / 26.08.2019

MedicalResearch.com Interview with: Rachel Grashow PhD Research Associate Department of Environmental Health Football Players Health Study at Harvard University Harvard T.H. Chan  MedicalResearch.com: What is the background for this study? Response: It has been previously shown in small studies of boxers and military personnel that traumatic brain injuries can damage the pituitary gland, which serves as the "master controller" of hormone function in the brain. These studies on individuals at risk for repeated head injury found that hits on the head caused deficiencies in certain hormones, such as growth hormone and testosterone, which could have downstream effects on sexual function. Only one large study was conducted that used Taiwanese health insurance data and looked at single traumatic brain injuries and risk of erectile function (ED). In that study, men who experienced a single severe TBI were more than twice as like to report ED after their injury. In light of these findings, important questions remain regarding whether multiple head injuries are associated with pituitary or sexual dysfunction in a large population with other ED-related health issues. The Football Players Health Study at Harvard University asked former NFL players to fill out a questionnaire that interrogated demographic factors, football-related exposures and current health conditions. Specifically, we asked participants to self-report the frequency of ten different concussion symptoms experienced during professional play, as well as whether a clinician had ever recommended or prescribed medication for low testosterone or ED.   (more…)
Author Interviews, JAMA, Kidney Disease, Transplantation / 26.08.2019

MedicalResearch.com Interview with: Alexandre Loupy, MD PhD Nephrologist, Department of Nephrology & Kidney Transplantation Necker Hospital, Paris Head of the Paris Transplant Group (Inserm)  MedicalResearch.com: What is the background for this study? Response: The lack of organs for kidney transplantation is a major public health problem across the world, due to its attributable mortality and excess cost to healthcare systems while waitlisted patients are maintained on chronic dialysis. Nearly 5,000 people in the US and 3,500 people in Europe die each year while waiting for a kidney transplant. Yet in the US, over 3,500 donated kidneys are discarded annually, representing almost 18% of the available organs, while the discard rate in France is only 6,8%, though these countries have similar organ allocation systems and offer the same treatments to patients after transplant. We thus compared the use of donated kidneys in the US to France from 2004-2014 in much more depth, using a new approach based on validated analytic methods and computer simulation.  (more…)
Author Interviews, Global Health, Heart Disease, Mental Health Research / 21.08.2019

MedicalResearch.com Interview with: Lasse Brandt, M.D. and Jonathan Henssler, M.D. Charité University Medicine Berlin, Germany MedicalResearch.com: What is the background for this study? Response: Migration has increased globally and the effect of migration on health is highly relevant for clinicians, particularly in mental health. There is no increase in the risk for nonaffective psychosis in the home countries of migrants, so environmental factors could be of key importance. Refugees are often subjected to inhuman conditions. While migration has repeatedly been identified and confirmed as a risk factor for psychosis, the impact of refugee experience on this risk of psychosis was unclear.  (more…)
Author Interviews, Hospital Acquired, JAMA / 20.08.2019

MedicalResearch.com Interview with: Todd Campbell Lee MD MPH FACP FIDSA Consultant in Internal Medicine and Infectious Diseases Director, MI4 Clinical Trials Platform Associate Professor of Medicine, McGill University Montreal, Quebec  MedicalResearch.com: What is the background for this study? Response: For a number of years people have been advocating for a move towards single-patient rooms in hospital design.  This was articulately argued for in an opinion piece by Detsky and Etchells in 2008 (https://jamanetwork.com/journals/jama/article-abstract/182433) as being important for a move to safe and patient-centered design. One of the major selling points has always been a reduction in the risk of nosocomial, or hospital-associated, infections given reduced opportunities for contamination between patients; however, only a few studies have specifically looked at this issue.  Overall, despite some strong work, many of these studies were limited by only looking at specific units, over limited periods of time,  and using before-after comparisons which did not account for change over time either within or outside of the institution. We knew that in 2015 our old hospital would close and within the same day all patients would be moved to a brand new hospital with 100% single patient rooms -- most of which have a private bathroom for patients and a separate hand-washing sink for staff.  So in 2014, we designed this study, obtained ethics review, and then waited patiently for several years to pass after the move so that we could rigorously evaluate the impact.  We looked at monthly rates of vancomycin-resistant Enterococcus (VRE) colonizations and infections, methicillin-resistant Staphylococcus aureus (MRSA) colonization and infections, and Clostridium (now Clostrideroides) difficile infections (CDI). We chose these because we had good long term data on their rates and because we could compare the rates over time before and after the move and contrast them with the province of Quebec as a whole. (more…)
Author Interviews, Cognitive Issues, End of Life Care, Gender Differences, JAMA / 16.08.2019

MedicalResearch.com Interview with: Dr. Nathan Stall, MD Geriatrician and Research fellow Women’s College Research Institute       Dr. Paula Rochon, MD, MPH, FRCPC Periatrician and Vice-President of Research Women’s College Hospital     MedicalResearch.com: What is the background for this study? Response: The advanced stages of the dementia are characterized by profound memory impairment, an inability to recognize family, minimal verbal communication, loss of ambulatory abilities, and an inability to perform basic activities of daily living. Nursing homes become a common site of care for people living with advanced dementia, who have a median survival of 1.3 years. In the advanced stages of the disease, the focus of care should generally be on maximizing quality of life. Our study examined the frequency and sex-based differences in burdensome interventions received by nursing home residents with advanced dementia at the very end of life. Burdensome interventions include a variety of treatment and procedures that are often avoidable, may not improve comfort, and are frequently distressing to residents and their families. We found that in the last 30 days of life, nearly one in 10 nursing home residents visited an emergency department, more than one in five were hospitalized, and one in seven died in an acute care setting. In addition, almost one in 10 residents received life-threatening critical care; more than one in four were physically restrained; and more than one in three received antibiotics. (more…)
Author Interviews, Breast Cancer, JAMA, UCLA / 12.08.2019

MedicalResearch.com Interview with: Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLA  MedicalResearch.com: What is the background for this study? What are the main findings?
  • A pathologist makes the diagnosis of breast cancer versus non-cancer after reviewing the biopsy specimen. Breast biopsies are performed on millions of women each year and It is critical to get a correct diagnosis so that we can guide patients to the most effective treatments.
  • Our prior work (Elmore et al. 2015 JAMA) found significant levels of disagreement among pathologists when they interpreted the same breast biopsy specimen. We also found that pathologists would disagree with their own interpretations of breast biopsies when they where shown the same biopsy specimen a year later.
  • In this study, 240 breast biopsy images were fed into a computer, training it to recognize patterns associated with several types of breast lesions, ranging from benign (noncancerous) to invasive breast cancer. We compared the computer readings to independent diagnoses made by 87 practicing U.S. pathologists and found that while our artificial intelligence program came close to performing as well as human doctors in differentiating cancer from non-cancer, the AI program outperformed doctors when differentiating ductal carcinoma in situ (DCIS) from atypia, which is considered the greatest diagnostic challenge.
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Author Interviews, Dental Research, JAMA, OBGYNE, Pediatrics, Vitamin D / 06.08.2019

MedicalResearch.com Interview with: Hans Bisgaard, DMSc, MD Head of COPSAC, Professor Professor of Pediatrics, University of Copenhagen Founder and Head of the Copenhagen Prospective Studies on Asthma in Childhood; Gentofte Hospital, University of Copenhagen and Naestved Hospital MedicalResearch.com: What is the background for this study? Response: Enamel defects is a global health challenges affecting typically 1/3 of school children and more in some regions. It leads to break down of the teeth and caries later on. MedicalResearch.com: What are the main findings? Response: Supplementation with high-dose vitamin D compared to standard dose in the third pregnancy trimester in a mother child cohort of 588 pairs lead to a significant reduction of enamel defects. Enamel defects was found in 28% of children by age 6 after standard dose of vitamin D supplementation (400 i.u.), compared to 15% after 7-fold higher dose vitamin D.  (more…)
Author Interviews, Cost of Health Care, JAMA, NYU, Ophthalmology, Pharmaceutical Companies / 02.08.2019

MedicalResearch.com Interview with: Cassandra L. Thiel, PhD Assistant Professor NYU Langone School of Medicine Department of Population Health NYU Wagner Graduate School of Public Service NYU Tandon School of Engineering MedicalResearch.com: What is the background for this study? Response: Most healthcare professionals and researchers are aware that the healthcare sector makes up about 18% of the US Gross Domestic Product. What many do not realize is that all of that economic activity results in sizable resource consumption and environmental emissions. The healthcare industry is responsible for 10% of the US’s greenhouse gas (GHG) emissions and 9% of air pollutants.1 Sustainability in healthcare is a developing field of research and practice, and my lab offers data and information by quantifying resource use and emissions of healthcare delivery. We started looking at cataract surgery a few years ago, in part because operating rooms (ORs) typically represent the largest portion of spending and garbage generation in a hospital.2,3 Cataract surgeries are interesting because they are one of the most common surgeries performed in the world. In the US, we spend $6.8 billion on them each year. Any changes we can make to individual cases would have much larger, global impacts. I studied cataract surgeries at a world-renowned, high-volume eye surgery center in India and helped validate that clinical care could be designed in a way that was effective, cost-efficient, and resource efficient. Compared to the same procedure in the UK, this surgery center generates only 5% of the carbon emissions (with the same outcomes).2 This site’s standard policy is to multi-dose their eye drops, or use them on multiple patients until the bottle was empty. As such, the site generated very little waste. Returning to the US, I observed cataract cases and heard the complaints of OR staff that they had to throw out many partially used or unused pharmaceuticals. In reviewing the literature, we could not find a study that quantified how much we were throwing away and what it cost us to do so. We, therefore, set up a study to look at this particular issue. (more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, JAMA, Ophthalmology / 01.08.2019

MedicalResearch.com Interview with: Daejoon Alex Hwang, PhD Instructor in Ophthalmology Investigator, Schepens Eye Research Institute of Mass. Eye and Ear Harvard Medical School MedicalResearch.com: What is the background for this study?   Response: Yellow night driving glasses are sold with promises to reduce headlight glare from oncoming traffic and help aging individuals see better at night. Despite a 1997 ruling by the Federal Trade Commission against one company’s claims, the products still remain popular online. We tested three commercially available yellow lens night driving glasses and compare their effectiveness with clear lens glasses on our novel headlight glare simulator in the driving simulator. (more…)
Author Interviews, Endocrinology, Hormone Therapy, JAMA, Schizophrenia / 01.08.2019

MedicalResearch.com Interview with: Mark Weiser, M.D. Associate Director for Treatment Trials The Stanley Medical Research Institute Kensington, MD 20895 MedicalResearch.com: What is the background for this study? Response: Over the years many theories have been proposed explaining schizophrenia, and studies tested compounds based on these theories.  Some showed improvement in symptoms, but these positive findings were often not later replicated, and the theory discarded. Over the past 15 years several studies performed in Australia by Dr. Jayshri Kulkarni (Molecular psychiatry. 2015;20(6):695) showed positive effects of estrogen patches on symptoms in women with schizophrenia. (more…)
Author Interviews, Gastrointestinal Disease, JAMA, Outcomes & Safety, Surgical Research / 31.07.2019

MedicalResearch.com Interview with: Ninh T. Nguyen, MD Department of Surgery University of California Irvine Medical Center Orange, California MedicalResearch.com: What is the background for this study? Response: The US World & News Report publishes each year on top ranked hospitals for specific specialties. These ratings are promoted nationally and used by patients and physicians in making decisions about where to receive care for challenging conditions or common elective procedures. Bariatric, colorectal and hiatal hernia procedures are common gastrointestinal operations being performed at most hospitals. Seeking care for these operations specifically at top 50 ranked hospitals can pose significant logistic and financial constraints for most patients. The objective of this study was to determine whether top ranked hospitals (RHs) in Gastroenterology & GI Surgery (GGS) have improved outcomes for advanced laparoscopic abdominal surgery compared to non-ranked hospitals (NRHs). (more…)
Author Interviews, Exercise - Fitness, JAMA, Lifestyle & Health / 31.07.2019

MedicalResearch.com Interview with: Wei Bao, MD, PhD Assistant Professor, Department of Epidemiology College of Public Health, University of Iowa Iowa City, IA 52242  and Yang Du University of Iowa MedicalResearch.com: What is the background for this study? Response: In 2008, the US Department of Health and Human Services released the first federal Physical Activity Guidelines for Americans, which recommended that people should do at least 150 minutes moderate- to vigorous-intensity aerobic activity. This key recommendation has been reaffirmed in the 2018 recently updated Physical Activity Guidelines for Americans. In addition, the new 2018 Guidelines for the first time discussed health risks of sedentary behaviors. Insufficient physical activity and long sitting time have long been recognized as risk factors for major chronic diseases and mortality. Therefore, we were curious whether there have been a significant changes in adherence to the Physical Activity Guidelines in US adults since the release of the first edition of the federal guidelines in 2008 and whether sedentary behavior in US adults changed during the same period. (more…)
Author Interviews, Coffee, Hepatitis - Liver Disease, JAMA, OBGYNE, Pediatrics / 30.07.2019

MedicalResearch.com Interview with: Prof Hui Wang PhD Wuhan University China MedicalResearch.com: What is the background for this study? What are the main findings? Response: We started our work in the adverse outcome of maternal caffeine intake during pregnancy about 15 years ago. Then, we found that prenatal caffeine intake could result in nonalcoholic fatty liver disease in the offspring. However, the underlying mechanism was unclear. So, we start the current work, and found that hat maternal caffeine intake disrupts liver development before and after birth, which might be the trigger of the adult non-alcoholic fatty liver disease in the offspring rats. Moreover, we further found that the fetal programming of liver glucocorticoid – insulin like growth factor 1 axis, a new endocrine axis first reported by our team, might participate in such process.  (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA, Stroke / 29.07.2019

MedicalResearch.com Interview with: "Blood Pressure Monitor" by Medisave UK is licensed under CC BY 2.0Kazuo Kitagawa, MD PhD Department of Neurology Tokyo Women's Medical University Tokyo, Japan MedicalResearch.com: What is the background for this study? What are the main findings Response:   Reduction in blood pressure (BP) reduces the rates of recurrent stroke, but the optimum BP target remained unclear. The results of RESPECT Study together with up-dated meta-analysis showed the benefit of intensive blood pressure lowering (<130/80 mmHg) compared with standard BP lowering (<140/90 mmHg).  (more…)
Author Interviews, Cost of Health Care, JAMA / 28.07.2019

MedicalResearch.com Interview with: blood-tests-lab-testsRenuka S Bindraban, MD and Prabath W. B. Nanayakkara, MD, PhD Section of Acute Medicine Department of Internal Medicine Amsterdam Public Health Research Institute Amsterdam UMC Vrije Universiteit Amsterdam, Amsterdam, the Netherland  MedicalResearch.com: What is the background for this study? Response: It is well known that a significant portion of healthcare activities is considered of low-value. Eliminating such low-value care is often targeted in efforts to both contain rapidly increasing healthcare costs as well as maintain high-quality care. In this context, our study focused on reducing unnecessary laboratory testing. In 2008, our study group performed a multifaceted intervention aimed at reducing unnecessary diagnostic testing at the Internal Medicine department of the Amsterdam University Medical Center, location Vrije Universiteit (VU). In the ‘Reduction of Unnecessary Diagnostics Through Attitude Change of the Caregivers’, we implemented this successful intervention in the Internal Medicine departments of four large teaching hospitals in the Netherlands. The intervention included creating awareness through education and feedback, intensified supervision of residents, and changes in order entry systems. (more…)
Author Interviews, JAMA, Menopause, Weight Research / 25.07.2019

MedicalResearch.com Interview with: Yangbo Sun  MD, PhD Department of Epidemiology University of Iowa Wei Bao, MD, PhD Assistant Professor, Department of Epidemiology College of Public Health, University of Iowa Iowa City, IA 52242 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obesity has become a serious health problem in the United States. Body mass index (BMI) which is calculated as weight (kg)/height (m)2, is the standard measure used to define obesity in clinical and public health guidelines. However, BMI does not distinguish body shape or body fat distribution. Meanwhile central obesity, characterized by relatively high abdominal fat distribution, has been associated with higher risk of mortality, independent of BMI. So for example, two persons with the same BMI of 24 which is considered as “normal weight”, might have different abdominal fat distribution, thus they might be facing different risk of developing disease and mortality. In the most recent obesity management guidelines, measuring central obesity was recommended among people who are either overweight or have class I obesity (BMI 25.0-34.9 kg/m2), but not among people of normal weight. This might send those people with normal weight but with high abdominal fat as well as those public and clinical professionals a wrong message that these people are free of any particular obesity-related risk, while in fact, they are at elevated risk of mortality and might need risk reduction interventions, such as lifestyle modifications and other interventions. So we did this study to evaluate the mortality risk among this neglected group of people. We found that women with normal weight central obesity were at increased risk of mortality. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, ENT, Surgical Research / 25.07.2019

MedicalResearch.com Interview with: Vinay K. Rathi, MD Otolaryngology Resident | Massachusetts Eye and Ear Project Manager | Partners Ambulatory Care MBA Candidate | Harvard Business School  MedicalResearch.com: What is the background for this study?  Response: This study is a secondary subgroup analysis that follows on the heels of a recently published study in The New England Journal of Medicine (NEJM) examining physician reimbursement for surgical procedures in the Medicare Physician Fee Schedule (PFS), which both public and private insurers use to determine payment rates for clinician services. Although it is widely understood that physician time (i.e., the amount of physician time required to perform a procedure) is perhaps the most important factor used to determine payment rates, the Centers for Medicare and Medicaid Services (CMS) has historically relied upon limited and potentially biased survey data to estimate physician time. Leveraging time data from American College of Surgeons National Quality Improvement Program, the authors of the recent NEJM study demonstrated that CMS does not appear to systematically misestimate intraoperative times, but there are substantial discrepancies that may result in over- or undercompensation for certain procedures and specialties. (more…)
Author Interviews, Hepatitis - Liver Disease, JAMA, OBGYNE, USPSTF / 24.07.2019

MedicalResearch.com Interview with: Melissa Simon, M.D., M.P.H.  George H. Gardner Professor of Clinical Gynecology Vice Chair of Clinical Research, Department of Obstetrics and Gynecology Professor of Preventive Medicine and Medical Social Sciences Northwestern University Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hepatitis B is a viral infection of the liver caused by the hepatitis B virus, or HBV. HBV causes liver disease, which can be either a mild, short-term illness, or a serious, lifelong issue. The U.S. Preventive Services Task Force has reaffirmed its 2009 recommendation that clinicians screen all pregnant people for HBV at their first prenatal visit. This is an A recommendation. (more…)
Author Interviews, JAMA, Johns Hopkins, OBGYNE, Race/Ethnic Diversity / 20.07.2019

MedicalResearch.com Interview with: Alison Gemmill, PhD Assistant Professor Johns Hopkins Bloomberg School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A growing body of evidence suggests that the circumstances surrounding the 2016 presidential election may have had a uniquely negative impact on the health of U.S. Latino population. Few studies, however, have evaluated the population health implications of the election for Latina mothers and their children. We used national data and methods that control for temporal patterning to test the hypothesis that preterm birth rose above otherwise expected levels among Latina women in the U.S. following the election of Donald Trump. We find that the number of preterm births among Latina women increased above expected levels following the election. Specifically, we find 3.5 percent more preterm births among Latinas than projected for nine months following election. (more…)