Alzheimer's - Dementia, Author Interviews, Cost of Health Care, Medicare, UCLA / 15.10.2024

MedicalResearch.com Interview with: [caption id="attachment_64014" align="alignleft" width="150"]Frank F. Zhou  |  he/himMD Candidate, Class of 2025 David Geffen School of Medicine at UCLA Frank F Zhou[/caption] Frank F. Zhou  |  he/him MD Candidate, Class of 2025 David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? What is Lecanemab used for?  How is it given to patients? Response: Lecanemab is a new infusion therapy for Alzheimer's disease. Its dosing is based on each patient's body weight (10 mg/kg every two weeks), but the drug is only available in 500 mg and 200 mg single-use vials, meaning that any leftover drug in vials must be thrown away. Given that lecanemab is expected to cost Medicare billions of dollars each year, we hypothesized that discarded drug could result in significant wasteful spending.
Aging, Author Interviews, Frailty, JAMA, Orthopedics / 16.05.2024

MedicalResearch.com Interview with: [caption id="attachment_61725" align="alignleft" width="150"]Chintan V. Dave PharmD, PhDAssistant Professor of Pharmacy and Epidemiology Assistant Director Rutgers Center for Pharmacoepidemiology and Treatment Science Academic Director Rutgers Center for Health Outcomes, Policy, and Economics Rutgers University New Brunswick, New Jersey Dr. Chintan Dave[/caption] Chintan V. Dave PharmD, PhD Assistant Professor of Pharmacy and Epidemiology Assistant Director Rutgers Center for Pharmacoepidemiology and Treatment Science Academic Director Rutgers Center for Health Outcomes, Policy, and Economics Rutgers University New Brunswick, New Jersey MedicalResearch.com: What is the background for this study? Response: Our study examined the association between initiation of an antihypertensive medication and its correlation with fracture risk among older nursing home veterans.
Accidents & Violence, Author Interviews, Environmental Risks / 25.03.2024

MedicalResearch.com Interview with: Donald A. Redelmeier, MD, MS(HSR); Canada Research Chair Medical Decision Sciences Professor of Medicine University of Toronto MedicalResearch.com: What is the background for this study? Response: The arrival of a solar eclipse attracts substantial public attention and superstitions about supernatural forces. We wondered whether the risk of solar retinopathy might not be the only health hazard since the celestial event leads to increases in driving and potentially increases in traffic deaths.
Author Interviews, Kidney Disease, Transplantation / 09.11.2023

MedicalResearch.com Interview with: Collective responses from study authors: MedicalResearch.com: What is the background for this study?
  • Patients with advanced chronic kidney disease (CKD) have the best chance for a longer and healthier life if they receive a kidney transplant.
  • However, due to many barriers, many eligible patients today will never receive a kidney transplant.
  • Advanced CKD care is provided by 26 chronic kidney disease (CKD) programs managed by a government funded provincial renal agency (the Ontario Renal Network)
  • Together these 26 programs treat ~ 24,000 patients each year
  • This care is provided by over 3400 nurses and 230 nephrologists
  • To patients approaching the need for dialysis and those receiving dialysis
  • Approximately half are transplant eligible
    • ~ 600 kidney transplants done in Ontario each year across 6 transplant centres
    • with approximately.30% of kidneys coming from living donors
Author Interviews, Blood Pressure - Hypertension, JAMA, Pediatrics / 08.08.2023

MedicalResearch.com Interview with: [caption id="attachment_60730" align="alignleft" width="160"]Tammy M. Brady, MD, PhD  (she/her/hers)Vice Chair for Clinical Research, Dept of Pediatrics Associate Director, Welch Center for Prevention, Epidemiology, and Clinical Research Associate Professor of Pediatrics, Division of Pediatric Nephrology Medical Director, Pediatric Hypertension Program Johns Hopkins University Baltimore, MD 21287 Dr. McLoughlin Brady[/caption] Tammy M. Brady, MD, PhD  (she/her/hers) Vice Chair for Clinical Research, Dept of Pediatrics Associate Director, Welch Center for Prevention, Epidemiology, and Clinical Research Associate Professor of Pediatrics, Division of Pediatric Nephrology Medical Director, Pediatric Hypertension Program Johns Hopkins University Baltimore, MD 21287     MedicalResearch.com: What is the background for this study? What are the main findings? Response: Accurate BP measurement is key to identification and treatment of hypertension which serves ultimately to prevent cardiovascular disease.  Our study describes substantial measurement error that can occur in a common office and home BP measurement scenario: use of a regular cuff size for all individuals regardless of arm size.  Many office triage measurements occur without individualized cuff selection and most home BP devices come with one cuff size – and our study shows that using a regular cuff size for people who have larger arms – those who require a large adult cuff or an extra-large adult cuff – can lead to blood pressure readings that are almost 5 and 20 mmHg greater than their actual BP, respectively.  Those require a small adult cuff can have BP readings that are almost 4 mmHg lower than their actual BP.
Author Interviews, Education, JAMA, Race/Ethnic Diversity, Yale / 01.08.2023

MedicalResearch.com Interview with: [caption id="attachment_60696" align="alignleft" width="133"]Mytien Nguyen Mytien Nguyen[/caption] Mytien Nguyen, MS Department of Immunobiology, Yale School of Medicine New Haven, Connecticut MedicalResearch.com: What is the background for this study? Response: Physician-scientists are critical for innovative translational research. Combined MD-PhD training programs are essential for developing physician-scientists. Although racial and ethnic diversity of MD-PhD matriculants has increased over the past decade, little is known about how attrition rates differ by race and ethnicity.
Author Interviews, General Medicine, Health Care Systems, Heart Disease, JAMA / 26.06.2023

MedicalResearch.com Interview with: [caption id="attachment_60551" align="alignleft" width="200"]Dan P. Ly, MD, PhD, MPPPhysician and an Assistant Professor Division of General Internal Medicine and Health Services Research David Geffen School of Medicine at UCLA Dr. Ly[/caption] Dan P. Ly, MD, PhD, MPP Physician and an Assistant Professor Division of General Internal Medicine and Health Services Research David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? Response: Cognitive biases, or ways of thinking that may deviate from rationality, are thought to influence physician decision-making, but there has been little large-scale evidence of their existence clinically. There is some large-scale evidence of the availability heuristic, under which the likelihood of an event is affected by how easily it comes to mind, but there’s little large scale evidence of other cognitive biases affecting physicians. 
Alzheimer's - Dementia, Author Interviews, Cost of Health Care, JAMA, UCLA / 20.05.2023

MedicalResearch.com Interview with: [caption id="attachment_60418" align="alignleft" width="100"]Julia Cave ArbanasProject Manager and Julia Cave Arbanas[/caption] Julia Cave Arbanas Project Manager and     John N. Mafi, MD, MPH Associate Professor of Medicine General Internal Medicine & Health Services Research David Geffen School of Medicine at UCLAJohn N. Mafi, MD, MPH Associate Professor of Medicine General Internal Medicine & Health Services Research David Geffen School of Medicine at UCLA   MedicalResearch.com: What is the background for this study? What is lecanemab used for and how well does it work? Response: Lecanemab is a treatment for mild cognitive impairment and mild dementia that was approved in January 2023 as part of the Food and Drug Administration’s (FDA) accelerated approval program. The results from a recent phase 3 clinical trial show a modest clinical benefit: the rate of cognitive decline by 27% in an 18-month study involving participants experiencing the early stage of Alzheimer’s, with an 0.45-point absolute difference in cognitive testing scores. However, due to the risk of brain swelling and bleeding (also known as amyloid-related imaging abnormalities), treatment with lecanemab involves frequent MRIs and neurology or geriatrics appointments to monitor for these abnormalities, which can be life threatening. So far, three patient deaths have potentially been tied to lecanemab. It is likely that the FDA will grant is lecanemab traditional approval later this year, prompting Medicare to reconsider its current coverage restrictions and potentially enabling widespread use.
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA / 29.03.2023

[caption id="attachment_60242" align="alignleft" width="150"]Kelly Potter Dr. Potter[/caption] MedicalResearch.com Interview with: Kelly Potter, PhD, RN, CNE T32 Postdoctoral Scholar CRISMA Center, Department of Critical Care Medicine University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: While it is well-recognized that survivors of critical illness often experience persistent problems with mental, cognitive, and physical health, very little is known about how these problems (collectively known as post-intensive care syndrome (PICS)) affect resumption of meaningful activities, such as driving.
Author Interviews, Cancer Research, Genetic Research, JAMA, Personalized Medicine, Vanderbilt / 18.03.2023

MedicalResearch.com Interview with: [caption id="attachment_60195" align="alignleft" width="143"]Jonathan Mosley, MD, PhDAssociate Professor Division of Clinical Pharmacology Departments of Internal Medicine and Biomedical Informatics Vanderbilt University Medical Center Dr. Mosley[/caption] Jonathan Mosley, MD, PhD Associate Professor Division of Clinical Pharmacology Departments of Internal Medicine and Biomedical Informatics Vanderbilt University Medical Center MedicalResearch.com: What is the background for this study? Response: Prostate cancer is an important source of morbidity and mortality among men. Earlier detection of disease is essential to reduce these adverse outcomes. Prostate cancer is heritable, and many single nucleotide polymorphisms (SNPs) associated with disease risk have been identified. Thus, there is considerable interest in using tools such as polygenic risk scores, which measure the burden of genetic risk variants an individual carries, to identify men at elevated risk of disease.
Author Interviews, Gender Differences, JAMA / 21.02.2023

MedicalResearch.com Interview with: [caption id="attachment_60052" align="alignleft" width="125"]Michael Liu, MPhilRhodes Scholar,MPhil in Evidence-Based Social Intervention and Policy Evaluation. Harvard Medical School Boston, Massachusetts Michael Liu[/caption] Michael Liu, MPhil Rhodes Scholar,MPhil in Evidence-Based Social Intervention and Policy Evaluation. Harvard Medical School Boston, Massachusetts   MedicalResearch.com: What is the background for this study? Response: Over the past few decades, research has shown that lesbian, gay, and bisexual (LGB) individuals have worse health outcomes and face unique challenges related to their experiences and costs of care. These disparities are driven by “minority stress” associated with belonging to a marginalized group. Such stressors erode health through a range of structural and interpersonal forces, including employment discrimination, family rejection, and internalized stigma One early analysis established national baseline estimates for LGB health outcomes using 2013-2014 National Health Interview Survey (NHIS) data. Since then, there have been substantial shifts in social policy and public opinion that may have differentially affected sexual minority subgroups. The US Supreme Court decision in Obergefell v. Hodges guaranteed the constitutional right to same-sex marriage across all states. Over the last decade, states have expanded rights and protections for LGB populations related to employment and housing discrimination, sexual orientation conversion efforts, HIV criminalization, and religious exemptions. Public support for LGB-related issues has also been increasing with more representation in media, uptake of LGB-affirming policies, and advocacy efforts. No studies have assessed national trends in health status or healthcare access among specific sexual minority subgroups amid the rapidly shifting sociocultural and policy landscape. Thus, we sought out to evaluate if and how health status and healthcare access have changed between 2013 and 2018 in the US among LGB adults, and whether differences relative to their heterosexual counterparts have changed over time.
Author Interviews, Cost of Health Care, JAMA / 19.12.2022

MedicalResearch.com Interview with: [caption id="attachment_59851" align="alignleft" width="125"]MedicalResearch.com Interview with:Anna L Goldman, MD, MPH, MPA Assistant Professor of Medicine Boston Medical Center MedicalResearch.com: What is the background for this study? Response: Experts on the healthcare labor market have long debated the existence and magnitude of a physician shortage. Physician work hours are a major contributor to physician supply issues, but little research is available on recent trends in work hours by physicians. In addition, no available studies have rigorously estimated changes in the physician workforce size during the pandemic. MedicalResearch.com: What are the main findings? Were there gender differences in hours worked? Response: The average hours worked per week by physicians decreased 7.6% in the two decades between 2001 and 2021. On average, physicians worked 52.6 hours per week in 2001-2003 and 48.6 hours per week in 2019-2021. This decrease did not appear to be caused by the COVID-19 pandemic, as the trend continued on the same steady trajectory that was present prior to the pandemic. The observed decreases were driven by reduced work hours among male physicians, full-time physicians, and younger physicians. Male physicians decreased work hours twice as much as female physicians. Physician mothers were the only group to increase weekly work hours, with a 3% increase over 20 years. Physician fathers, by contract, decreased work hours by 12%. The number of part-time physicians remained flat throughout the study period. Broadly decreasing trends in work hours were similarly present among non-physician holders of doctoral degrees, suggesting a broader trend among highly-educated professionals in their approach to work hours. The physician workforce grew by 32.9% over two decades, but then fell by 6.7% during the COVID-19 pandemic, or a drop of 1 in 14 physicians. The physicians who left the workforce during the pandemic were disproportionately white and from rural areas. Work hours generated by the physician workforce, as a whole, grew 7% over the study period, which was about half the rate of population growth in the same period (16.6%). This sluggish growth in physician workforce hours was entirely offset by large increases in the work hours contributed by nurse practitioners and physician assistants. When the clinician workforce was assessed as a whole (combining hours from physicians, nurse practitioners, and physician assistants), growth in total workforce hours was 21.4%, exceeding the population growth rate. MedicalResearch.com: What should readers take away from your report? • Physician weekly work hours fell 8% from 2001-2021, with a particularly large drop for physician fathers (-12%) vs. a small increase for physician mothers (+3%). • Because of this decline in hours, total weekly hours contributed by the physician workforce lagged far behind US population growth, an increase of 7% in work hours vs. 16.6% increase in US population. This gap was entirely offset by a large increase in nurse practitioner and physician assistant hours. • From 2019 to 2021, the physician workforce fell by 7%, which represents 1 in 14 physicians leaving the workforce during the COVID-19 pandemic. MedicalResearch.com: What recommendations do you have for future research as a results of this study? Response: Research on work hours in individual physician specialties is needed to better understand the distribution of work hour changes across the spectrum of physician types. Measurement of these trends can help predict burnout in specialties where hours may be lengthening vs. shortages in fields with rapidly decreasing work hours. MedicalResearch.com: Is there anything else you would like to add? Any disclosures? Response: Our findings may shed light on the high rates of burnout that has been identified among physician-mothers in other research. While increasing work hours among mothers may indicate progress on gender parity in terms of career engagement, this change may not have been sufficiently offset by a reduction in domestic responsibility. Further research should examine the balance of household duties as physician mothers spend an increasing amount of time at work. No disclosures. Citation: Changes in Physician Work Hours and Implications for Workforce Capacity and Work-Life Balance, 2001-2021 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. Dr. Goldman[/caption] Anna L. Goldman, M.D., M.P.A., M.P.H Assistant Professor of Medicine General Internal Medicine Boston University Chobanian & Avedisian School of Medicine   MedicalResearch.com: What is the background for this study? Response: Experts on the healthcare labor market have long debated the existence and magnitude of a physician shortage. Physician work hours are a major contributor to physician supply issues, but little research is available on recent trends in work hours by physicians.  In addition, no available studies have rigorously estimated changes in the physician workforce size during the pandemic.
Author Interviews, Emergency Care, JAMA / 03.08.2022

MedicalResearch.com Interview with: [caption id="attachment_59389" align="alignleft" width="150"]John A. Staples, MD, FRCPC, MPH Academic General Internist Vancouver General Hospital Clinical Assistant Professor at UBC Dr. Staples[/caption] John A. Staples, MD, FRCPC, MPH Academic General Internist Vancouver General Hospital Clinical Assistant Professor at UBC MedicalResearch.com:  What is the background for this study?    Response: As a hospital-based general internist, I often see patients in the emergency department after an episode of syncope. Syncope is a medical term for suddenly losing consciousness (the public generally knows this as “fainting”). As you can imagine, fainting out of the blue can be very unnerving. Patients and clinicians worry that it may happen again and wonder whether it’s safe to drive. The first time I was asked this question, I remember scouring the research literature for an answer and not finding any robust evidence to guide my advice to patients.
Author Interviews, Education, JAMA, Race/Ethnic Diversity, Social Issues, Yale / 15.07.2022

MedicalResearch.com Interview with: [caption id="attachment_59333" align="alignleft" width="92"]Mytien Nguyen, MS MD-PhD Program, Yale School of Medicine, New Haven, Connecticut Mytien Nguyen[/caption] Mytien Nguyen, MS MD-PhD Program, Yale School of Medicine, New Haven, Connecticut MedicalResearch.com:  What is the background for this study?  Response: It is well-recognized that diversity in the medical workforce is critical to improve health care access and achieve equity for neglected communities. Despite increased efforts to recruit diverse medical trainees, there remains a large chasm between the racial/ethnic and socioeconomic composition of the patient population and that of the physician workforce.
Alzheimer's - Dementia, Author Interviews, JAMA, Ophthalmology / 06.12.2021

MedicalResearch.com Interview with: [caption id="attachment_58453" align="alignleft" width="150"]Cecilia S. Lee, MD, MS Associate Professor,Director, Clinical Research Department of Ophthalmology Harborview Medical Center University of Washington Seattle, WA Dr. Lee[/caption] Cecilia S. Lee, MD, MS Associate Professor,Director, Clinical Research Department of Ophthalmology Harborview Medical Center University of Washington Seattle, WA MedicalResearch.com: What is the background for this study? Response: Cataract is a natural aging process of the eye and affects the majority of older adults who are at risk for dementia. Sensory loss, including vision and hearing, is of interest to the research community as a possible risk factor for dementia, and also as a potential point of intervention. Because cataract surgery improves visual function, we hypothesized that older people who undergo cataract surgery may have a decreased risk of developing Alzheimer disease and dementia. We used the longitudinal data from an ongoing, prospective, community based cohort, Adult Changes in Thought (ACT) study. The ACT study includes over 5000 participants to date who are dementia free at recruitment and followed until they develop Alzheimer disease or dementia. We had access to their extensive medical history including comprehensive ophthalmology visit data. We investigated whether cataract surgery was associated with a decreased risk of developing Alzheimer disease and dementia. 
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Cost of Health Care, JAMA / 20.10.2021

MedicalResearch.com Interview with: [caption id="attachment_58259" align="alignleft" width="200"]Anita Katharina Wagner, PharmD, MPH, DrPH Associate Professor of Population Medicine Director, Ethics Program, Point32Health (parent company of Harvard Pilgrim Health Care and Tufts Health Plan) Co-Director, HMS Fellowship in Health Policy and Insurance Research Co-Director, Center for Cancer Policy and Program Evaluation (CarPE) Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Dr. Wagner[/caption] Anita Katharina Wagner, PharmD, MPH, DrPH Associate Professor of Population Medicine Director, Ethics Program, Point32Health (parent company of Harvard Pilgrim Health Care and Tufts Health Plan) Co-Director, HMS Fellowship in Health Policy and Insurance Research Co-Director, Center for Cancer Policy and Program Evaluation (CarPE) Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The expectation for new cancer drugs is that they help patients live better longer. Increasingly more cancer drugs are approved without documented quality of life or overall survival benefits.   At the same time, cancer drug prices are rising.  We studied use of and spending on selected new cancer drugs among patients with employer-sponsored health insurance. We found that among 37348 patients who received one or more of 44 oral targeted cancer drugs, the proportion of patients who received a drug without documented overall survival benefit increased from 13% in 2011 to 59% in 2018.  By 2018, spending on drugs without documented overall survival benefit accounted for 52% of the $3.5 million spend on the 44 drugs since 2011.
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA / 17.09.2021

MedicalResearch.com Interview with: Hirotaka Kato, PhD Graduate School of Health Management Keio University  MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Physicians are increasingly engaging in clinical practice on a part-time basis, but little is known about the quality of care provided by these physicians. In this analysis of nationally representative data of the elderly patients admitted to hospitals, we found that patients treated by hospitalists who worked more clinical days per year had significantly lower 30-day mortality compared with patients treated by hospitalists working fewer clinical days, even after accounting for the differences in severity of illness. 
Anesthesiology, Author Interviews, Cost of Health Care, JAMA / 18.08.2021

MedicalResearch.com Interview with: [caption id="attachment_57937" align="alignleft" width="165"]Ambar La Forgia, PhD Assistant Professor of Health Policy & Management Columbia University Mailman School of Public Health Dr. La Forgia[/caption] Ambar La Forgia, PhD Assistant Professor of Health Policy & Management Columbia University Mailman School of Public Health MedicalResearch.com: What is the background for this study? Response: Over the past few years, there has been mounting pressure to protect consumers from surprise medical bills, which occur when a patient unknowingly receives care from an out-of-network practitioner at an in-network facility. In 2018, only six states had passed comprehensive surprise billing legislation, and by 2020, 17 states had passed legislation. In addition to protecting patients from financial liability for surprise medical bills, states adopted different methods for determining payments made by a patient’s insurer to the out-of-network practitioner. For example, some states, such as California and Florida, developed a payment standard that tied provider payments to median in-network rates, Medicare rates, or the usual and customary provider charges. Other states, such as New York, developed an independent dispute resolution process, which uses a third-party arbiter to resolve payment disputes between insurers and practitioners. However, little is known about how state laws influence the prices paid to out-of-network practitioners and whether spillovers existed to in-network prices. In this study, my co-authors and I study the association between the passage of surprise billing legislation in California, Florida, and New York, and prices paid to anesthesiologists in hospital outpatient departments and ambulatory surgery centers using commercial claims data from 2012-2017. We focused on anesthesiology because it is one of the specialties with the highest proportion of potential surprise bills since patients do not usually choose their anesthesiologist.
Allergies, Author Interviews, COVID -19 Coronavirus, JAMA, Vaccine Studies, Vanderbilt / 27.07.2021

MedicalResearch.com Interview with: [caption id="attachment_57827" align="alignleft" width="150"]Kimberly G. Blumenthal, MD, MSc Massachusetts General Hospital The Mongan Institute Boston, MA 02114 Dr. Blumenthal[/caption] Kimberly G. Blumenthal, MD, MSc Massachusetts General Hospital The Mongan Institute Boston, MA 02114 [caption id="attachment_57828" align="alignleft" width="100"]Matthew S. Krantz, MD Division of Allergy, Pulmonary and Critical Care Medicine Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Dr. Krantz[/caption] Matthew S. Krantz, MD Division of Allergy, Pulmonary and Critical Care Medicine Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee   MedicalResearch.com: What is the background for this study? Response: During the initial COVID-19 vaccine campaign with healthcare workers in December 2020, there was an unexpected higher than anticipated rate of immediate allergic reactions after Pfizer and Moderna mRNA vaccines.  This prompted both patient and provider concerns, particularly in those with underlying allergic histories, on the associated risks for immediate allergic reactions with the mRNA vaccines. Because of the significantly improved effectiveness of two doses of an mRNA vaccine compared to one dose, it was important to determine if those who experienced immediate allergic reaction symptoms after their first dose could go on to tolerate a second dose safely.   
Author Interviews, Brigham & Women's - Harvard, JAMA, Nutrition, Social Issues / 09.03.2020

MedicalResearch.com Interview with: [caption id="attachment_53418" align="alignleft" width="160"]Alon Peltz, MD MBA MHS  Department of Population Medicine Harvard Pilgrim Health Care Institute Dr. Peltz[/caption] Alon Peltz, MD MBA MHS  Department of Population Medicine Harvard Pilgrim Health Care Institute MedicalResearch.com: What is the background for this study? Response: Thank you for taking an interest in our study. This study represented a collaboration between investigators from Harvard Medical School and Boston University School of Medicine. SNAP is an important U.S. federal aid program that serves nearly 40 million persons annually with well-established health, nutrition, and financial benefits. Families can be eligible for the SNAP program under “federal” rules or “categorical eligibility” rules that extend SNAP support to otherwise ineligible families who receive benefits under certain social assistance programs, such as Temporary Assistance for Needy Families. In July 2019, the U.S. Department of Agriculture proposed new SNAP policies that would limit qualifications via the categorical eligibility route. Although these new policies have not been finalized, it is estimated that 1 in 10 U.S. families currently participating in SNAP may lose their benefits. We wanted to investigate the potential ramifications of these changes to help inform policymakers of the vulnerabilities of the families who receive SNAP benefits and may be at risk for disenrollment if the proposed policies are implemented.
Author Interviews, Blood Pressure - Hypertension, Columbia, Heart Disease, JAMA / 17.02.2020

MedicalResearch.com Interview with: [caption id="attachment_53185" align="alignleft" width="143"]George Hripcsak, MD, MS Vivian Beaumont Allen Professor of Biomedical Informatics  Chair, Department of Biomedical Informatics Columbia University Director, Medical Informatics Services NewYork-Presbyterian Hospital/Columbia Dr. Hripcsak[/caption] George Hripcsak, MD, MS Vivian Beaumont Allen Professor of Biomedical Informatics Chair, Department of Biomedical Informatics Columbia University Director, Medical Informatics Services NewYork-Presbyterian Hospital/Columbia MedicalResearch.com: What is the background for this study? Response: Diuretics are considered among the best drugs to treat hypertension, but there are no randomized studies to tell us which diuretic is best. Hydrochlorothiazide is the most frequently used diuretic for hypertension, but another drug, chlorthalidone, is gaining favor, with the most recent US hypertension guideline expressing a preference for it. Chlorthalidone is known to be longer acting and therefore perhaps more effective. Other (non-randomized) studies have been inconsistent, and some of them imply that chlorthalidone may be more effective. But other studies have shown that chlorthalidone may have more side effects.
Author Interviews, Geriatrics, Hip Fractures, JAMA, Orthopedics, Osteoporosis / 17.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49813" align="alignleft" width="132"]Kristine E. Ensrud MD MPH Professor of Medicine and Epidemiology and Community Health University of Minnesota Core Investigator, Center for Care Delivery and Outcomes Research Minneapolis VA Health Care System Dr. Ensrud[/caption] Kristine E. Ensrud MD MPH Professor of Medicine and Epidemiology and Community Health University of Minnesota Core Investigator, Center for Care Delivery and Outcomes Research Minneapolis VA Health Care System  MedicalResearch.com: What is the background for this study? Response: Women aged 80 years and older, a rapidly growing segment of the population, account for the majority of hip fractures in the United States. Hip fractures account for 72% of fracture-related health care expenditures and lead to significant morbidity and mortality. However, many late-life women at high risk of hip fracture are undiagnosed. Clinicians have difficulty identifying late-life women most likely to benefit from osteoporosis screening and interventions to prevent hip fracture in part due to concerns about comorbidity burden and prognosis in this patient population.
Author Interviews, Brigham & Women's - Harvard, Education, JAMA / 06.05.2019

MedicalResearch.com Interview with: [caption id="attachment_48973" align="alignleft" width="169"]Arabella L. Simpkin,  MD, MMScAssociate Director, Center for Educational Innovation and Scholarship, MGHAssociate Program Director, Education and Curriculum, Internal Medicine Residency, MGHInstructor in Medicine, Harvard Medical SchoolBoston, MA 02114 Dr. Simpkin[/caption] Arabella L. Simpkin,  MD, MMSc Associate Director, Center for Educational Innovation and Scholarship, MGH Associate Program Director, Education and Curriculum, Internal Medicine Residency, MGH Instructor in Medicine, Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response: The academic health care environment has changed in unprecedented ways over several decades, with mounting evidence that faculty are becoming increasingly more unhappy, dissatisfied, and burnt out in their work. Concern for faculty wellbeing is high, with much speculation about causes of burnout. Comprehending what affects satisfaction at work in academic health care centers is critically important to stem this epidemic of discontent. For physicians, satisfaction has been reported to be associated with quality of care delivered, particularly as measured by patient satisfaction; faculty retention and job satisfaction are intricately linked, with dissatisfied physicians more likely to leave the profession and to discourage others from entering. Other industries that have suffered similar rises in employee discontent have found that demonstration of respect is the most important leadership behavior in improving employees satisfaction. To our knowledge this factor has not been looked at in healthcare professionals. To address this gap, we sought to determine key variables influencing satisfaction at work for faculty in a large academic medical center in the United States.
Author Interviews, Education, JAMA, University of Pennsylvania / 16.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48540" align="alignleft" width="180"]Krisda Chaiyachati, MD, MPH, MSHPAssistant Professor , Medicine, Perelman School of MedicineClinical Innovation Manager, Penn's Center for Health Care InnovationPerelman School of MedicineMedical Director, Penn Medicine's FirstCall Virtual Care Dr. Chaiyachati[/caption] Krisda Chaiyachati, MD, MPH, MSHP Assistant Professor Medicine, Perelman School of Medicine Clinical Innovation Manager Penn's Center for Health Care Innovation Perelman School of Medicine Medical Director, Penn Medicine's FirstCall Virtual Care   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The United States spends more than $12 billion annually on training young doctors who have rates of burnout and depression at an alarmingly high rate. Yet, we have limited evidence as to what they are doing while training in the hospital. We sought to glimpse into how their day is spent. In the largest study to date, we observed 80 first-year internal medicine physicians (“interns”) for nearly 2200 hours across 194 work shifts at 6 different sites. Our research sought to understand what medical residents did by categorizing training activities into themes such as time spent in education or patient care. 
Author Interviews, End of Life Care, Health Care Systems, JAMA / 08.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48423" align="alignleft" width="143"]Cindy L. Cain, PhDAssistant ProfessorDepartment of SociologyUniversity of Alabama at BirminghamBirmingham, AL 35233  Dr. Cain[/caption] Cindy L. Cain, PhD Assistant Professor Department of Sociology University of Alabama at Birmingham Birmingham, AL 35233   MedicalResearch.com: What is the background for this study? What are the main findings? Response: The End of Life Option Act permits terminally ill Californians to request a prescription for medications that would hasten death, providing they meet all requirements of the law and follow the steps outlined by their health care provider. However, the law also allows health care providers and organizations to opt out of participating. Until now, we did not know how common it was for entire health care organizations to opt out. In this study, we found that 61% of the surveyed hospitals prohibited physician participation in the End of Life Option Act. Thirty-nine percent of hospitals did allow participation in the law; these participating hospitals were less likely to be religiously affiliated and more likely to be nonprofit.
Author Interviews, JAMA, Social Issues / 01.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48278" align="alignleft" width="200"]Rajan Sonik, PhD JD MPHResearch ScientistTucker-Seeley Research LabLeonard Davis School of GerontologyPostdoctoral Research FellowLeonard D. Schaeffer Center for Health Policy and EconomicsLeonard Davis School of GerontologyUniversity of Southern CaliforniaLos Angeles, CA 90089-3333 Dr. Sonik[/caption] Rajan Sonik, PhD JD MPH Research Scientist Tucker-Seeley Research Lab Leonard Davis School of Gerontology Postdoctoral Research Fellow Leonard D. Schaeffer Center for Health Policy and Economics Leonard Davis School of Gerontology University of Southern California Los Angeles, CA 90089-3333 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Not everyone who is eligible for public benefits like Supplemental Security Income (SSI) tries to receive them. One distinguishing factor is that those who apply for benefits disproportionately experience shocks (e.g., divorce, job loss, health problems) and sharp increases in material hardships (e.g., food insecurity, housing insecurity) shortly before applying. Typically, these increases in hardships are then partially—but not fully—alleviated by receipt of the public benefits. Given strong associations between these hardships and poor health outcomes, we wanted to examine whether health status might fluctuate before and after the receipt of public benefits as well. We examined SSI in particular given its focus on individuals with disabilities, keeping in mind the particular health vulnerabilities experienced by this population. In line with patterns previously observed for material hardships, we found in a nationally representative sample that the health status of eventual SSI recipients worsened significantly in the period prior to program entry. After enrollment began, the decline in health status stopped but was not fully reversed. In the paper, we discuss why these findings were more likely to be driven by changes in material hardship levels rather than changes in disability status.
Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Frailty, Heart Disease, Surgical Research / 05.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47274" align="alignleft" width="173"]Dae Hyun Kim, MD, MPH, ScD Assistant Professor of Medicine, Harvard Medical School Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center Dr. Dae Hyun Kim[/caption] Dae Hyun Kim, MD, MPH, ScD Assistant Professor of Medicine, Harvard Medical School Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The number of older adults undergoing aortic valve replacement is increasing.  Since these patients are at high risk for complications and functional decline due to preexisting multimorbidity and frailty, the latest guideline (Otto et al. J Am Coll Cardiol 2017;69:1313–46) emphasizes shared decision-making based on patient-centered outcomes.  Despite this recommendation, we witness many decision-making processes are cardio-centric—mainly informed by expected benefit in terms of cardiac-specific measures.  Many patients are not adequately informed about what their daily life would be like after the procedure. In this single-center prospective cohort study, we examined functional status trajectories via assessments of global functional status at 1, 3, 6, 9, and 12 months in 246 patients who underwent transcatheter and surgical aortic valve replacement.  We identified 5 clinically meaningful functional trajectories, ranging from high baseline function-early complete recovery to low baseline function-large and persistent decline.  We were able to predict most likely trajectory as well as best possible and worse possible trajectories using the preoperative frailty index.  Delirium and postoperative complications were also strongly associated with undesirable functional trajectories. 
Author Interviews, Gender Differences, JAMA, Mental Health Research, UCSF / 31.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47241" align="alignleft" width="142"]Christina Mangurian, MD MAS Professor Department of Psychiatry, Weill Institute for Neurosciences Center for Vulnerable Populations, University of California, San Francisco Dr. Mangurian[/caption] Christina Mangurian, MD MAS Professor Department of Psychiatry, Weill Institute for Neurosciences Center for Vulnerable Populations, University of California, San Francisco [caption id="attachment_47238" align="alignleft" width="150"]Veronica Yank, MD Division of General Internal Medicine Department of Medicine University of California, San Francisco Dr. Yank[/caption] Veronica Yank, MD Assistant Professor Division of General Internal Medicine Department of Medicine University of California San Francisco MedicalResearch.com: What is the background for this study? Response: This article is about the behavioral health and burnout consequences among physician mothers who are caring for seriously ill loved ones. Our work was inspired, in part, by some of the authors’ own experiences caring for loved ones with serious illnesses while also being physician mothers themselves.  We sought to determine the proportion of physician mothers with such caregiving responsibilities beyond their patients and children and the how these additional responsibilities affected the women’s health and practice.
Author Interviews, Cost of Health Care / 28.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47034" align="alignleft" width="200"]Sean Dickson, JD MPH Officer, Drug Spending Research Initiative The Pew Charitable Trusts Washington, DC 20004 Sean Dickson, JD MPH[/caption] Sean Dickson, JD MPH Officer, Drug Spending Research Initiative The Pew Charitable Trusts Washington, DC 20004 MedicalResearch.com: What is the background for this study? Response: Price increases on existing drugs are an ongoing challenge for patients and insurers, including government programs like Medicaid and Medicare. The Medicaid program requires drug manufacturers to provide a rebate that offsets price increases greater than inflation, but that rebate is capped once price increases exceed 433 percent above inflation. When these rebates are capped, manufacturers may find it more profitable to take very large price increases, raising costs for all payers. The Medicaid program has proposed removing the cap, and this study considers the effects of that proposal. 
Alzheimer's - Dementia, Author Interviews, Cost of Health Care, JAMA / 27.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46720" align="alignleft" width="200"]Lee A. Jennings, MD, MSHS Assistant Professor of Medicine Director, Oklahoma Healthy Aging Initiative Reynolds Department of Geriatric Medicine University of Oklahoma Health Sciences Center Oklahoma City, OK 73117 Dr. Jennings[/caption] Lee A. Jennings, MD, MSHS Assistant Professor of Medicine Director, Oklahoma Healthy Aging Initiative Reynolds Department of Geriatric Medicine University of Oklahoma Health Sciences Center Oklahoma City, OK 73117 MedicalResearch.com: What is the background for this study? Response: The research study focused on a novel model of care for persons living with Alzheimer’s disease and other types of dementia, the UCLA Alzheimer’s and Dementia Care Program. In the program, people with dementia and their caregivers meet with a nurse practitioner specializing in dementia care for a 90-minute in-person assessment and then receive a personalized dementia care plan that addresses the medical, mental health and social needs of both people. The nurse practitioners work collaboratively with the patient’s primary care provider and specialist physicians to implement the care plan, including adjustments as needs change over time. The research was designed to evaluate the costs of administering the program, as well as the health care services used by program participants, including hospitalizations, emergency room visits, hospital readmissions and long-term nursing home placement. A total of 1,083 Medicare beneficiaries with dementia were enrolled in the program and were followed for three years. The study compared them to a similar group of patients living in the same ZIP codes who did not participate in the program.