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, Blood Pressure - Hypertension, JAMA, OBGYNE, USPSTF / 26.09.2023

MedicalResearch.com Interview with: Esa M. Davis, M.D., M.P.H , F.A.A.F.P Professor of Medicine and Family and Community Medicine Associate Vice President of Community Health and Senior Associate Dean of pPopulation Health and Community Medicine University of Maryland School of Medicine Dr. Davis joined the U.S. Preventive Services Task Force in January 2021 Esa M. Davis, M.D., M.P.H , F.A.A.F.P Professor of Medicine and Family and Community Medicine Associate Vice President of Community Health and Senior Associate Dean of pPopulation Health and Community Medicine University of Maryland School of Medicine Dr. Davis joined the U.S. Preventive Services Task Force in January 2021 MedicalResearch.com: What is the background for this study? Response: Hypertensive disorders of pregnancy, including gestational hypertension, preeclampsia, and eclampsia, are among the leading causes of serious complications and death for pregnant people in the United States. Pregnant women and pregnant people of all genders should have their blood pressure measured at each prenatal visit to help find and prevent serious health issues related to hypertensive disorders of pregnancy.  (more…)
Author Interviews, Dermatology, Melanoma, USPSTF / 27.04.2023

MedicalResearch.com Interview with: John M. Ruiz, Ph.D Associate Professor of Clinical Psychology Department of Psychology University of Arizona Dr. Ruiz is the incoming editor-in-chief of the American Psychological Association (APA) journal, Health Psychology Dr. Ruiz joined the U.S. Preventive Services Task Force in January 2022     MedicalResearch.com: What is the background for this study? What are the main findings? Response: Skin cancer is the most common type of cancer in the United States, but it often does not cause serious complications or death. The Task Force’s recommendation on screening for skin cancer focuses on the effectiveness of visual skin exams for children and adults who do not have any symptoms. When reviewing the latest research, we found that there is currently not enough evidence to tell us whether or not screening people without signs or symptoms is beneficial. This is an I statement. (more…)
Author Interviews, Blood Pressure - Hypertension, Personalized Medicine / 11.04.2023

MedicalResearch.com Interview with: Johan Sundström, MD, PhD Professor of Epidemiology at Uppsala University Professorial Fellow at The George Institute for Global Health Cardiologist at Uppsala University Hospital MedicalResearch.com: What is the background for this study? Response: High blood pressure, hypertension, is a growing global health challenge. Over the last 30 years, the number of people with hypertension has doubled, and it is estimated that around a third of adults aged 30-79 have the condition - a total of 1.28 billion people worldwide. Untreated hypertension can lead to kidney disease, heart disease, and stroke, accounting for 11.3 million deaths in 2021 alone. A small minority get their blood pressure under control with drug therapy, and some studies indicate that as little as half are taking their blood pressure medications as intended. Is this because the drugs' effectiveness and side effects differ between different individuals? If so, there would be a substantial risk that patients will not get their optimal medication on the first try, with poor blood pressure lowering and unnecessary side effects as a result. In a new clinical trial in Sweden, it was studied whether there is an optimal blood pressure medication for each person, and thus a potential for personalized blood pressure treatment. In the study, 280 people with high blood pressure tried out four different blood pressure drugs on several different occasions over a total of one year. (more…)
Author Interviews, Immunotherapy, Rheumatology / 29.03.2023

MedicalResearch.com Interview with: Siri Lillegraven MD MPH PhDVice director, REMEDY Center for treatment of Rheumatic and Musculoskeletal Diseases Leader, Unit for Clinical Research, Diakonhjemmet HospitalAssociate professor, Institute of Health and Society, Faculty of Medicine University of Oslo   MedicalResearch.com: What is the background for this study? Response: Rheumatoid arthritis, or RA, is a chronic disease, with joint inflammation as the primary manifestation. Due to advances in RA therapy and care, an increasing number of patients achieve sustained remission without joint damage progression and functional loss. For these patients, dose-reduction of disease modifying anti-rheumatic drugs (DMARDs), or complete withdrawal of therapy could be favorable due to potential reductions in adverse events, burden of taking medication, and healthcare costs. Current treatment recommendations suggest that tapering of conventional synthetic DMARDs could be considered in patients in sustained remission, but there is a lack of data to guide treatment decisions. (more…)
Author Interviews, Infections, JAMA, OBGYNE, Pediatrics / 08.03.2023

MedicalResearch.com Interview with: Anna Roca PhD MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine Fajara, The Gambia MedicalResearch.com: What is the background for this study? Response: Context specific interventions are needed to decrease the high burden of severe neonatal morbidity and mortality in sub-Saharan Africa. Severe bacterial infections are a main cause of neonatal mortality in the continent. Oral intra-partum azithromycin is a cheap intervention easily scalable. Before embarking on this trial, we conducted a proof-of-concept trial that showed the intervention reduced maternal and neonatal bacterial carriage of the most prevalent bacteria causing neonatal sepsis in the continent. (more…)
Alzheimer's - Dementia, Author Interviews, Genetic Research, Race/Ethnic Diversity, Stanford / 21.02.2023

MedicalResearch.com Interview with: Yann Le Guen, Ph.D. Assistant Director, Computational Biology Quantitative Sciences Unit Stanford Medicine MedicalResearch.com: What is the background for this study? Response: Apart from aging, the strongest contributing factor for late-onset Alzheimer’s disease is a specific allele of the APOE gene, which has three common alleles E2, E3, and E4. While E3 is the most common and considered as the reference, E2 is associated with decreased Alzheimer’s disease risk and E4 is associated with increased Alzheimer’s disease risk. Notably the prevalence of E4 among Alzheimer’s patient is high with about 60% of these carrying at least one E4 allele, while solely about 30% Americans carry one E4 allele. It’s worth emphasizing that individuals with an E4/E4 genotype have an exponential increased in their risk to develop AD (10 times as likely than the reference E3/E3 genotype), and individuals with an E3/E4 genotype have an intermediate risk. Though, most studies of Alzheimer’s disease genetic have been focused on European ancestry, this is beginning to change thanks to NIH’s efforts to fund more studies in non-European ancestry individuals. Our study built on these recent efforts to assess the Alzheimer disease risk associated with an APOE variant (R145C) present in about ~4% African Americans, but extremely rare in Europeans. (more…)
Aging, Alzheimer's - Dementia, Author Interviews, Hearing Loss, JAMA, Johns Hopkins / 10.01.2023

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle,   MedicalResearch.com Interview with: Alison R. Huang, PhD MPH Senior Research Associate Cochlear Center for Hearing & Public Health Department of Epidemiology Johns Hopkins Bloomberg School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hearing loss is a critical public health issue affecting two-thirds of older adults over 70 years old. There is growing understanding of a strong link between hearing loss and dementia, which impacts millions of Americans. Our main findings are that in a nationally representative sample of older adults in the United States from the National Health and Aging Trends Study, every 10 decibel increase in hearing loss was associated with 16% greater prevalence of dementia, such that prevalence of dementia in older adults with moderate or greater hearing loss was 61% higher than prevalence in those with normal hearing. We also found that in older adults with moderate or greater hearing loss, hearing aid use was associated with a 32% lower prevalence of dementia. (more…)
Author Interviews, Heart Disease, JAMA, Primary Care, Stroke, USPSTF / 06.09.2022

MedicalResearch.com Interview with: Katrina E. Donahue, M.D., M.P.H. Professor and Vice Chair of Research Chapel Hill Department of Family Medicine University of North Carolina Dr. Donahue joined the U.S. Preventive Services Task Force in January 2020. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart disease and stroke are the leading causes of death in the U.S. The Task Force found that people who are 40 to 75 years old and at high risk for heart disease should take a statin to help protect their health. People in this age group who are at increased risk but not high risk should make an individual decision with their healthcare professional about whether taking a statin is right for them. There is not enough research to determine whether statins are beneficial for people 76 years and older. (more…)
Author Interviews, Heart Disease, JAMA, Lifestyle & Health, USPSTF / 05.08.2022

MedicalResearch.com Interview with:

Lori Pbert, Ph.D Professor, Department of Population and Quantitative Health Sciences Associate chief of the Division of Preventive and Behavioral Medicine Founder and director of the Center for Tobacco Treatment Research and Training University of Massachusetts Chan Medical School Dr. Pbert joined the U.S. Preventive Services Task Force in January 2019

MedicalResearch.com: What is the background for this study? What are the main findings?

 

Response: Heart attacks and strokes are the number one killer of adults in the United States. Based on the evidence we reviewed, the Task Force found that some people would benefit from counseling interventions to support their cardiovascular health, however the overall benefits are small. For that reason, we continue to recommend that healthcare professionals decide together with their patients who do not have cardiovascular disease risk factors whether counseling interventions on healthy diet and physical activity might help them prevent heart attacks and strokes. This is a C grade recommendation. (more…)

Allergies, Author Interviews, JAMA, Pediatrics / 06.07.2022

MedicalResearch.com Interview with: Victoria Soriano PhD Research Assistant/Officer, Population Allergy University of Melbourne   MedicalResearch.com:  What is the background for this study?  Response: Peanut allergy is one of the most common childhood food allergies, and children rarely grow out of it. The only proven way to prevent peanut allergy is to give infants age-appropriate peanut products in the first year of life. We previously showed there was a dramatic increase in peanut introduction from 2007-11 to 2018-19, following changes to infant feeding guidelines. We wanted to know if earlier peanut introduction would reduce peanut allergy in the general population (in Melbourne, Australia). (more…)
Author Interviews, Breast Cancer, JAMA, Mammograms, Medical Imaging, UCSF / 15.06.2022

MedicalResearch.com Interview with: Karla Kerlikowske, MD. Professor, Departments of Medicine and Epidemiology/Biostatistics, Cancer Center Program Membership. Breast Oncology UCSF MedicalResearch.com:  What is the background for this study?  Response: Digital breast tomosynthesis (DBT) was developed with the expectation it would improve detection of breast cancer in women with dense breasts and decrease false-positive results. DBT is now available at most breast screening centers. (more…)
Author Interviews, JAMA, Ophthalmology, USPSTF / 02.06.2022

MedicalResearch.com Interview with: Katrina Donahue, M.D., M.P.H. Professor and vice chair of research Department of Family Medicine University of North Carolina at Chapel Hill Dr. Donohue is a family physician and senior research fellow Cecil G. Sheps Center for Health Services Research Dr. Donahue joined the U.S. Preventive Services Task Force in January 2020. MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response: Impaired vision and glaucoma are serious and common conditions facing millions of people nationwide that can affect a person’s independence and quality of life. These recommendations looked at how primary care clinicians can help people who have not noticed any problems with their vision. Unfortunately, there is not enough evidence available to make a recommendation for or against screening adults for glaucoma or older adults for impaired vision in the primary care setting. (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA, OBGYNE / 04.05.2022

MedicalResearch.com Interview with: Richard McManus MA PhD MBBS FRCGP FRCP Professor of Primary Care Dr. McManus chairs the Blood Pressure Monitoring Working Party of the British Hypertension Society Nuffield Department of Primary Care Health Sciences  MedicalResearch.com:  What is the background for this study?  Response: About one in ten people who are pregnant develop high blood pressure and almost half of these go onto to have pre-eclampsia. Many pregnant women and individuals are already measuring their own blood pressure – well over half of those with high blood pressure in a recent large survey in the UK but until recently there were no data to support this. (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…)
Author Interviews, CDC, COVID -19 Coronavirus, Emory, Heart Disease, JAMA / 25.01.2022

MedicalResearch.com Interview with: Matthew Oster, MD, MPH CDC COVID-19 Response CDC Center on Birth Defects and Developmental Disabilities Pediatric Cardiologist, Sibley Heart Center, Children’s Healthcare of Atlanta Emory University School of Medicine Emory University Rollins School of Public Health MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: More than 192 million people ages 12 years and older in the U.S. received at least one dose of mRNA COVID-19 vaccines from December 2020 through August 2021. From this population, VAERS (the Vaccine Adverse Event Reporting System) received 1,991 reports of myocarditis,  1,626 of which met the case definition of myocarditis. Rates of myocarditis were highest following the second dose of an mRNA vaccine among males aged 12–15 years (70.7 per million doses of Pfizer), 16-17 years (105.9 per million doses of Pfizer), and 18–47 years (52.4 and 56.3 per million doses of Pfizer and Moderna, respectively). Of those with myocarditis, the median age was 21 years and the median time from vaccination to symptom onset was two days. Males accounted for 82% of patients for whom sex was known. Approximately 96% were hospitalized, 87% of whose symptoms had gone away by the time they were discharged from the hospital. Non-steroidal anti-inflammatory drugs (589/676, 87%) were the most common treatment. (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Social Issues, Transplantation / 14.12.2021

MedicalResearch.com Interview with: Rebecca Thorsness, PhD Research Associate Department of Health Services, Policy, and Practice Brown University School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2019, the President signed the Advancing American Kidney Health executive order, which included provisions to increase the use of home dialysis and kidney transplant for Americans living with kidney failure. To carry out this vision, the Centers for Medicare & Medicaid Services (CMS) developed the ESRD Treatment Choices (ETC) payment model, which uses financial incentives and penalties to incentivize dialysis facilities to pursue home dialysis or kidney transplant for their patients. Transplant and home dialysis are optimal care for people with kidney failure, but there are social and clinical reasons that patients with high social risk (such as those exposed to racism, poverty, or housing instability) may not be candidates for these treatments. This means that facilities which serve a large number of patients with high social risk might be disproportionately penalized by this new payment model. Using data immediately prior to the implementation of the ETC model, we found that dialysis facilities that serve high proportions of patients with high social risk have lower rates of home dialysis and kidney transplantation than facilities that care for lower proportions of such patients. (more…)
Author Interviews, JAMA, Johns Hopkins, Weight Research / 25.11.2021

MedicalResearch.com Interview with: Alejandra Ellison-Barnes, MD MPH General Internal Medicine Johns Hopkins Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Emerging adulthood is a unique period of development that ultimately leads to the formation of adult identity, but how this stage contributes to obesity is relatively understudied. The prevalence of obesity has been increasing in the United States population as a whole, and we wanted to know how mean body mass index and the prevalence of obesity have changed over the past several decades specifically among emerging adults. We found that among emerging adults aged 18 through 25, mean BMI has increased from 23.1 kg/m2 in 1976-1980 to 27.7 kg/m2 in 2017-2018. In the same period, the prevalence of obesity increased from 6.2% to 32.7%. (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, CDC, Clots - Coagulation, COVID -19 Coronavirus, JAMA / 05.05.2021

MedicalResearch.com Interview with: Isaac See, MD Centers for Disease Control and Prevention COVID-19 Response Team Atlanta, Georgia MedicalResearch.com: What is the background for this study? Response: On February 27, 2021 the U.S. Food and Drug Administration (FDA) granted emergency use authorization for the Janssen/Johnson & Johnson (J&J) COVID-19 Vaccine in people 18 years of age or older in the United States.  The Janssen/J&J COVID-19 Vaccine uses a replication-deficient (i.e., cannot cause infections) human adenovirus vector.  In mid-March, the European Medicines Agency announced that they had conducted a preliminary investigation of cases of blood clots and low counts of blood cells called platelets in patients who had recently received the Oxford/AstraZeneca COVID-19 Vaccine, which uses a replication-deficient chimpanzee adenovirus vector.  This syndrome of blood clots and low platelet counts has been called thrombosis with thrombocytopenia syndrome, or TTS.  The European investigation showed that over 70% of their cases specifically involved blood clots in particular veins inside the brain, a condition caused cerebral venous sinus thrombosis (CVST), in addition to low platelet counts (thrombocytopenia is the medical term for low platelet counts). CVST is already a rare condition, and CVST with thrombocytopenia is even rarer.  By April 12, 2021, approximately 7 million doses of the Janssen/J&J COVID-19 Vaccine had been given in the United States, and six cases of CVST and thrombocytopenia after receipt of the Janssen/J&J COVID-19 Vaccine had been reported to the U.S. Vaccine Adverse Event Reporting System (VAERS), which is the U.S. national vaccine safety monitoring system.  The next day (April 13, 2021) CDC and FDA recommended a pause in use of the vaccine recommended to allow for further investigation of these events.  On April 23, 2021 data about the first 12 cases reported after authorization of the Janssen/J&J COVID-19 Vaccine were presented at an emergency meeting of the Advisory Committee on Immunization Practices (ACIP) to decide what to recommend regarding the Janssen COVID-19 vaccine.  The ACIP concluded that the benefits of resuming Janssen COVID-19 vaccination among persons aged 18 years or older outweighed the risks and reaffirmed its interim recommendation under the FDA’s Emergency Use Authorization.  The FDA’s Emergency Use Authorization includes a new warning for rare clotting events among women aged 18 to 49 years. Our report provides clinical details about these first reported 12 U.S. cases of CVST and thrombocytopenia following receipt of the Janssen COVID-19 Vaccine. (more…)
Author Interviews, Emory, Health Care Systems, JAMA, Kidney Disease, Transplantation / 11.09.2019

 A retraction and replacement have been issued due to a major coding error that resulted in the reporting of incorrect data in this study surrounding the difference in transplant rates between for-profit and non-profit dialysis centers. Please see link below:

Bauchner H, Flanagin A, Fontanarosa PB. Correcting the Scientific Record—Retraction and Replacement of a Report on Dialysis Ownership and Access to Kidney Transplantation. JAMA. 2020;323(15):1455. doi:10.1001/jama.2020.4368

MedicalResearch.com Interview with: Rachel Patzer, PhD, MPH Associate Professor Director, Health Services Research Center Department of Medicine Department of Surgery Emory University School of Medicine   MedicalResearch.com: What is the background for this study? Response: We know that historically, for-profit dialysis facilities have been shown to have lower rates of kidney transplantation than patients who receive treatment in non-profit dialysis facilities. However, these studies are outdated, and did not examine access to living donor transplantation or include the entirety of the end-stage kidney disease population  (more…)
Author Interviews, Heart Disease, JAMA / 19.03.2019

MedicalResearch.com Interview with: Dr. Carina Blomström-Lundqvist, MD Professor of Cardiology Department of Cardioloy Institution of Medical Science Uppsala, Sweden MedicalResearch.com: What is the background for this study?   Response: While all previous trials comparing atrial fibrillation (AF) ablation and antiarrhythmic drugs to our best knowledge have evaluated the efficacy of these treatments in terms of atrial fibrillation (AF) recurrences (with an AF episode of 30 seconds duration as standard primary endpoint) we wanted to use quality of Life (QoL) - general health - as primary endpoint, since the indication for treatment is improving QoL. This was important since, despite the fact that the indication for treatment is to improve (QoL) and reduce symptom, all prior trials have used 30 seconds AF episodes as standard primary endpoint, which if occurred it would be defined as a failed treatment. We also wanted to assess effects on various clinical outcome events. We know from registries such as ORBIT AF registry that around 60 % of AF patients have symptoms resulting in repeated hospitalisation visits in at least 30-40% of patients annually, and that only around 5 % of the AF population are being referred for AF ablation. Previous trials have used intermittent 24 hours Holter recordings whioch does not give the true AF burden (% of time in AF). We therefore also wanted to assess and compare treatments effects on true AF burden by implanting an implantable cardiac monitor (ICM) which continuosly records the heart rhythm. We would then be able to prove that improvement in QoL was directly related to a reduction in AF burden and that treatment differences in QoL was related to a difference in reduction in AF burden. We also wanted to study an AF population in their early AF disease state so that we could offer atrial fibrillation ablation to a broader AF population before their atria have become remodelled and too damaged for a pulmonary vein isolation to be effective.  (more…)