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Author Interviews, JAMA, OBGYNE, Pediatrics, Race/Ethnic Diversity / 24.04.2019

MedicalResearch.com Interview with: Clare Brown, PhD Health Systems and Services Research University of Arkansas for Medical Sciences J. Mick Tilford, PhD, Professor and Chair Department of Health Policy and Management Fay W. Boozman College of Public Health University of Arkansas for Medical Science   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Prematurity and low birthweight are associated with increased risk of infant mortality as well as increased risk of chronic conditions throughout infancy and into adulthood. Non-Hispanic black infants are twice as likely to be born low birthweight (13.9% vs 7.0%) and 1.5 times as likely to be born prematurely (13.9% vs 9.1%) compared to non-Hispanic white infants. Under the Affordable Care Act (ACA), states may expand Medicaid to adults with household income levels at or below 138% of the federal poverty level, thus extending coverage to childless adults and improving continuity. Insurance gain may ultimately improve maternal health, increased use and earlier initiation of prenatal care services, and improved access to pregnancy planning resources. Our study aimed to evaluate whether there were changes in rates of low birthweight and preterm birth outcomes among states that expanded Medicaid versus states that did not expand Medicaid. (more…)
Author Interviews, Melanoma, Pediatrics, Race/Ethnic Diversity, Stanford / 18.04.2019

MedicalResearch.com Interview with: Susan M. Swetter, MD Professor of Dermatology Director, Pigmented Lesion & Melanoma Program Physician Leader, Cancer Care Program in Cutaneous Oncology Stanford University Medical Center and Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The Stanford Pigmented Lesion and Melanoma and Program and Pediatric Dermatology Division participated in the long-term management of children, adolescents and young adults (<25 years of age) with melanoma and atypical melanocytic neoplasms, including atypical Spitz tumors (ASTs) that may be histopathologically challenging to differentiate from true melanoma. Over a 23-year period, we have observed increased racial-ethnic diversity in young patients with these diagnoses, especially in the presentation of young individuals with darker skin phenotypes and more clinically amelanotic (nonpigmented) lesions compared to patients with lighter skin.  (more…)
Author Interviews, Cancer Research, Race/Ethnic Diversity / 18.04.2019

MedicalResearch.com Interview with: Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303  MedicalResearch.com: What is the background for this study? Response: Despite a continuous decline in cervical cancer incidence rates, earlier studies reported an increase in cervical adenocarcinoma incidence rates. However, those reports had major limitations, as they did not account for changes in hysterectomy prevalence and used cancer occurrence data covering only 10%-12% of the U.S. population (which may not be representative of the entire population, especially racial/ethnic minorities). Further, the most recent study examined the trends by age and histology through 2010. We examined contemporary trends in cervical cancer incidence rates in the U.S. (1999-2015) by age, race/ethnicity, major histological subtypes, and stage at diagnosis using up-to-date nationwide data after accounting for hysterectomy prevalence. (more…)
Author Interviews, JAMA, Race/Ethnic Diversity, Surgical Research, Transplantation, Yale / 09.04.2019

MedicalResearch.com Interview with: Sanjay Kulkarni, MD MHCM FACS Associate Professor of Surgery & Medicine Surgical Director – Kidney Transplant Program Medical Director – Center for Living Organ Donors Scientific Director – Yale Transplant Research New Haven, CT 06410 MedicalResearch.com: What is the background for this study? Response: The kidney allocation system changed in December of 2014. The aim of the new system was to increase transplant in patients who were highly sensitized (difficult matches based on reactive antibodies) and to improve access to underserved populations. (more…)
Author Interviews, HIV, HPV, Race/Ethnic Diversity, STD, Vaccine Studies / 08.04.2019

MedicalResearch.com Interview with: Perry N Halkitis, PhD, MS, MPH Dean and Professor Department of Urban-Global Public Health Rutgers Public Health  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The rate of human papillomavirus (HPV) infection is high among young minority gay, bisexual, and other men who have sex with men despite the availability of a vaccine that can prevent the infection, a Rutgers School of Public Health study found. (more…)
Author Interviews, Cost of Health Care, General Medicine, Hospital Readmissions, JAMA, Race/Ethnic Diversity / 02.04.2019

MedicalResearch.com Interview with: Teryl K. Nuckols, MD Vice Chair, Clinical Research Director, Division of General Internal Medicine Cedars-Sinai Medical Center  MedicalResearch.com: What is the background for this study?   Response: Healthcare policymakers have long worried that value-based payment programs unfairly penalize hospitals treating many African-American patients, which could worsen health outcomes for this group. For example, policy experts have suspected that the Medicare Hospital Readmission Reduction Program unevenly punishes institutions caring for more vulnerable populations, including racial minorities. They've also feared that hospitals might be incentivized to not give patients the care they need to avoid readmissions. The study Investigators wanted to determine whether death rates following discharges increased among African-American and white patients 65 years and older after the Medicare Hospital Readmission Reduction Program started. (more…)
AACR, Author Interviews, Cancer Research, Dental Research, Pancreatic, Race/Ethnic Diversity / 28.03.2019

MedicalResearch.com Interview with: Julie R. Palmer, ScD Professor, Boston University School of Medicine Associate Director, Slone Epidemiology Center at Boston University Boston, MA 02118  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Since 1995, 59,000 African American women from all regions of the U.S. have participated in a Boston University research study of the health of Black women.  Study participants complete mailed or online questionnaires every two years. Our major goal is to identify modifiable risk factors for cancers and nonmalignant conditions that disproportionately affect African Americans (e.g., pancreatic cancer, early-onset breast cancer, type 2 diabetes, uterine fibroids).  The reasons for the higher incidence of pancreatic cancer in African Americans relative to non-Hispanic White women in the U.S. are unknown. I was aware that several recent studies in predominantly White populations had observed a higher incidence of pancreatic cancer in those who had reported poor oral health and wondered whether the higher prevalence of poor oral health among African Americans could play a role in their higher incidence of pancreatic cancer.  We had already asked about gum disease, periodontal disease, and adult tooth loss in several rounds of data collection. After rigorous analysis, we found that women who reported any adult tooth loss had about two times the risk of future development of pancreatic cancer compared with those who had no tooth loss and had never reported periodontal disease. The estimated risk was even greater for those who had lost five or more teeth. A similar association was observed for reports of periodontal disease, but the association was not statistically significant. (more…)
Author Interviews, Blood Pressure - Hypertension, NEJM, Race/Ethnic Diversity / 20.03.2019

MedicalResearch.com Interview with: Dike B. Ojji, M.D., Ph.D, FWACP, FACP Department of Medicine Faculty of Clinical Sciences University of Abuja MedicalResearch.com: What is the background for this study? Response: We decided to do this research because there were no large RCTs before now that have compared the efficacy of contemporary combination therapies among any black populations in spite of the high burden of hypertension and its complications (such as heart failure, cerebrovascular accident and chronic kidney) in this population, and also the fact that majority require 2 or more medications to control their blood pressure. (more…)
Author Interviews, Dermatology, Heart Disease, JAMA, Race/Ethnic Diversity / 04.03.2019

MedicalResearch.com Interview with: Francis Alenghat, MD, PhD Assistant Professor of Medicine Section of Cardiology University of Chicago MedicalResearch.com: What is the background for this study? What are the main findings? Response: Psoriasis has been associated with higher rates of atherosclerotic cardiovascular disease (ASCVD), potentially due to higher-than-normal levels of systemic inflammation. Whether this association varies by race was unknown. Also, it was unclear whether patients with psoriasis have more frequent ASCVD because of higher rates of traditional cardiovascular risk factors (smoking, diabetes, hypertension, hyperlipidemia) or because of components intrinsic to psoriasis itself. We found that, amongst a large population of patients with psoriasis, patients of both sexes and most ages had elevated ASCVD rates compared to those without psoriasis. Overall, African American patients with psoriasis had a 15% ASCVD prevalence, whereas it was 10% in white patients with psoriasis. Increased ASCVD associated with psoriasis occurred at earlier ages in African American patients compared to white patients. Traditional cardiovascular risk factors were common in patients with psoriasis and appeared to play a large role in the driving the higher rates of ASCVD in these patients, but even in patients with psoriasis but without any documented traditional risk factors, ASCVD rates were elevated compared to patients without psoriasis.  (more…)
Author Interviews, Compliance, Electronic Records, Lung Cancer, Race/Ethnic Diversity / 07.02.2019

MedicalResearch.com Interview with: Samuel Cykert, MD Professor of Medicine and Director of the Program on Health and Clinical Informatics UNC School of Medicine, and Associate Director for Medical Education, NC AHEC Program Chapel Hill, NC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Reports going as far back as the early 1990’s through reports published very recently show that Black patients with early stage, curable lung cancer are not treated with aggressive, curative treatments as often as White patients. These type of results have been shown in other cancers also. It’s particularly important for lung cancer because over 90% of these patients are  dead within 4 years if left untreated. In 2010, our group published a study in the Journal of the American Medical Association that showed that Black patients who had poor perceptions of communication (with their provider), who did not understand their prognosis with vs. without treatment, and who did not have a regular source of care ( a primary care doctor) were much less likely to get curative surgery. Also our results suggested that physicians who treated lung cancer seemed less willing to take the risk of aggressive treatments in treating Black patients (who they did not identify with as well) who had other significant illnesses. Because of the persisting disparities and our 2010 findings, we worked with a community group, the Greensboro Health Disparities Collaborative to consider potential solutions.  As these omissions were not overt or intentional because of race on the part of the patients or doctors, we came up with the idea that we needed transparency to shine light on treatment that wasn’t progressing and better communication to ensure that patients were deciding on good information and not acting on mistrust or false beliefs.  We also felt the need for accountability – the care teams needed to know how things were going with patients and they needed to know this according to race. To meet these specifications, we designed a system that received data from electronic health records about patients’ scheduled appointments and procedures. If a patient missed an appointment this umbrella system triggered a warning. When a warning was triggered, a nurse navigator trained specially on communication issues, re-engaged the patient to bring him/her back into care. In the system, we also programmed the timing of expected milestones in care, and if these treatment milestones were not reached in the designated time frame, a physician leader would re-engage the clinical team to consider the care options. Using this system that combined transparency through technology, essentially our real time warning registry, and humans who were accountable for the triggered warnings, care improved for both Black and White patients and the treatment disparity for Black patients was dramatically reduced. In terms of the numbers, at baseline, before the intervention, 79% of White patients completed treatment compared to 69% of Black patients. For the group who received the intervention, the rate of completed treatment for White patients was 95% and for Black patients 96.5%.  (more…)
Author Interviews / 11.12.2018

MedicalResearch.com Interview with:

Virginia J. Howard,PhD, FAHA, FSCT   
 Professor of Epidemiology
The University of Alabama at Birmingham

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

Response: This study comes from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national cohort study of 30,239 non-Hispanic black and white community-dwelling participants aged 45 years and older who lived in the 48 contiguous US states. 

REGARDS was designed to study risk factors for the development of stroke, with a focus on black and white comparisons as well as comparisons across geographic regions of the US.

(more…)
ADHD, Author Interviews, Pediatrics, Race/Ethnic Diversity / 05.12.2018

MedicalResearch.com Interview with: George J. DuPaul, PhD Department of Education and Human Services Lehigh University   Charles Barrett. Ph.D. School Psychologist Loudon County Virginia Public Schools   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous studies have shown that Black children are more likely to receive ratings that are more indicative of displaying externalizing behavior difficulties, including Attention Deficit Hyperactivity Disorder (ADHD).  However, many of these studies included teachers as the informants. Consistent with most teachers in the United States, raters have typically been White females.  For this reason, it is unclear if these outcomes would exist if the rater and child shared the same racial/ethnic background. Additionally, most research in the United States that involved cross-cultural comparisons has used White and Hispanic boys.  Few empirical studies have examined differences between Black and White boys. The present study sought to address several limitations in the field.  Most notably, cross-cultural comparisons between Black and White boys were included instead of Hispanic and White children.  Next, maternal figures, rather than teachers, were included as the informants. The present study was developed using a similar methodology that examined Hispanic and White boys’ behavior from the perspective of Hispanic and White teachers (Dominguez de Ramirez & Shapiro, 2005). In sum, we sought to determine if there were differences in how Black and White maternal figures rated Black and White boys who were demonstrating the same level/type of behavior (i.e., sub-clinical levels of ADHD).  Notably, although the boys’ behaviors were the same, maternal ratings were not identical. Specifically, using the ADHD Rating Scale, Fourth Edition (ARS-4), Black mothers assigned higher ratings to both Black and White boys. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA, NIH, Nutrition, Race/Ethnic Diversity, Salt-Sodium / 03.10.2018

MedicalResearch.com Interview with: Dr. George Howard DPH, for the research team Professor and Chair of Biostatistics University of Alabama at Birmingham MedicalResearch.com: What is the background for this study? What are the main findings? Response: Perhaps the most important distinction to draw for the readers is that this is not a paper about risk factors for hypertension, but rather a paper that looks for contributors to the black-white difference in the presence of hypertension.  This racial difference in hypertension is the single biggest contributor to the immense disparities in cardiovascular diseases (stroke, MI, etc.) that underpin the approximate 4-year difference in black-white life expectancy.  As such, this work is “going back upstream” to understand the causes that lead to blacks having a higher prevalence of hypertension than whites with hopes that changing this difference will lead to reductions in the black-white disparities in cardiovascular diseases and life expectancy.   This difference in the prevalence of hypertension is immense … in our national study of people over age 45, about 50% of whites have hypertension compared to about 70% of blacks … that is HUGE.   We think that changing this difference is (at least one of) the “holy grail” of disparities research. This study demonstrates that there are several “targets” where changes could be made to reduce the black-white difference in hypertension, and thereby the black-white difference in cardiovascular diseases and life expectancy; however, the most “potent” of these appears to be diet changes.   Even though we know what foods promote a heart healthy lifestyle, we still have major differences in terms of how that message is being adopted by various groups of Americans.  We can’t know from our data what about the Southern diet is driving these racial differences in hypertension but we can begin to design community based interventions that could possibly help to reduce these racial disparities through diet.  It is interested that diet more than being overweight was the biggest contributor to the racial disparities in hypertension.  This would suggest we might want to consider interventions to increase health foods in the diet while minimizing fried foods and processed meats. While this is not a clinical trial that “proves” that changes in diet will reduce the disparity in blood pressure, we consider the “message” of the paper to be good news, as the things that we found that contribute to this black-white difference are things that can be changed.   While it is always hard for individual people to change their diet, it can be done.   More importantly, over time we as a society have been changing what we eat … but we need to “double down” and try to change this faster.   Also, policy changes of play a role to gently make changes in these diet, where for example Great Britain has been making policy changes to slowly remove salt from the diet.   These changes are possible … and as such, we may see a day when the black-white differences in hypertension (and thereby CVD and death) may be reduced.  (more…)
Author Interviews, Dermatology, Gender Differences, JAMA, Race/Ethnic Diversity, Social Issues / 27.09.2018

MedicalResearch.com Interview with: Raghav Tripathi, MPH Case Western Reserve University MD Candidate, Class of 2021 MedicalResearch.com: Why did you decide to perform this study? Response: Differences in the impact of dermatologic conditions on different groups have been of interest to our research group for a long time. Previously, our group had found differences in time to treatment for patients with different skin cancers. Beyond this, we had found differences in mortality and incidence of various skin conditions (controlling for other factors) in different racial groups/ethnicities, socioeconomic groups, demographic groups, and across the rural-urban continuum. The goal of this study was to investigate socioeconomic and demographic differences in utilization of outpatient dermatologic care across the United States. As demographics throughout the country become more diverse, understanding differences in utilization of dermatologic care is integral to developing policy approaches to increasing access to care across the country.  (more…)
Accidents & Violence, Author Interviews, CDC, Race/Ethnic Diversity / 21.09.2018

MedicalResearch.com Interview with: Dr. Kameron Sheats PhD Licensed Psychologist; Behavioral Scientist Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? Response: This study updates literature on racial disparities in violence between black and white youth using data capturing different severity levels in violent outcomes such as homicide versus assault. This study also seeks to increase the understanding of the impact of these disparities by examining associations between disparities in childhood adversity (e.g., child abuse and neglect, exposure to violence, household challenges) and adult health conditions. (more…)
Author Interviews, Cancer Research, JAMA, Pediatrics / 20.08.2018

MedicalResearch.com Interview with: Rebecca D. Kehm, PhD Division of Epidemiology and Community Health University of Minnesota School of Public Health Minneapolis, MN   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Racial and ethnic differences in childhood cancer survival have long been known, and there has been some research indicating that SES could explain disparities. However, our study is the first to use statistical methods that put numbers to the relative contribution of SES to survival disparities for different types of childhood cancer. We set out to investigate whether racial and ethnic disparities in childhood cancer survival are attributed to underlying differences in socioeconomic status, defined as one’s social and economic position in relation to others based on income, education, and occupation, which scientists abbreviate as SES. Our findings provide evidence that SES does in fact contribute to racial and ethnic disparities in survival for some types of childhood cancer. Specifically, we found that SES accounted for 28-73% of the racial and ethnic survival disparity for acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, and non-Hodgkin lymphoma. However, SES did not significantly contribute to racial and ethnic disparities in survival for other types of childhood cancer including central nervous system tumors, soft tissue sarcomas, Hodgkin lymphoma, Wilms tumor, and germ cell tumors. These tumor-specific results help inform where to place resources to best reduce racial and ethnic survival disparities for each of the major types of childhood cancer. (more…)
AHA Journals, Author Interviews, Gender Differences, Geriatrics, Heart Disease / 25.07.2018

MedicalResearch.com Interview with: Quoc Dinh Nguyen, MD MA MPH Interniste-gériatre – Service de gériatrie Centre hospitalier de l’Université de Montréal – CHUM MedicalResearch.com: What is the background for this study? What are the main findings? Response: Randomized trials are the best evidence basis we have to treat patients. It is known for more than 20 years that older adults and women are disproportionately excluded from randomized trials in cardiology diseases. As the current US population is fast aging, we examined whether this underrepresentation improved or worsened in the last 20 years in the most influential studies published between 1996 and 2015. The main finding is that the women and older adults continue to be underrepresented in cardiology trials. Overall, the mean age was 63 years and the percentage of women was 29%. For coronary heart disease, women comprise 54% of the US population in need of treatment, yet are only 27% of the trial population. For heart failure, the median age of older adults in the US population is 70 years whereas it is only 64 years in the trial population. Our results indicate that the gap has very slowly narrowed in the last 2 decades. However, based on current trends, reaching proportionate enrollment would require between 3 and 9 decades. This persistent lack of representation has significant impacts on the ability of clinicians to provide evidenced based care for these segments of the population. Physicians and other health care professionals are forced to extrapolate study results from younger and male-predominant populations. This is problematic since we know that older adults and women may react differently to medications and to interventions.  (more…)
Addiction, Author Interviews, Opiods, Race/Ethnic Diversity / 26.06.2018

MedicalResearch.com Interview with: Bradley D. Stein MD PhD Senior Physician Policy Researcher Pittsburgh Office Rand Corporation MedicalResearch.com: What is the background for this study? Response: Increasing use of medication treatment for individuals with opioid use disorders, with medications like methadone and buprenorphine, is a critical piece of the nation’s response to the opioid crisis. Buprenorphine was approved by the FDA in 2002 for treatment of opioid use disorders, but there was little information about to what extent buprenrophine’s approval increased the number of Medicaid-enrollees who received medication treatment in the years following FDA approval nor to what extent receipt of such treatment was equitable across communities. (more…)
Author Interviews, Dermatology, Johns Hopkins / 15.06.2018

MedicalResearch.com Interview with: Dr. Shawn Kwatra MD Assistant Professor of Dermatology Johns Hopkins University School of Medicine  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by prurigo nodularis?  Response: Prurigo nodularis is a skin condition where patients develop extremely itchy nodules throughout the body. Little is known about why this happens or which groups of people are predisposed to develop this condition. MedicalResearch.com: What are the main findings? Response We found that prurigo nodularis disproportionately affects African-Americans as compared to the general population. Diabetes, Hepatitis C, chronic kidney disease, and HIV are also more common in patients with prurigo nodularis than the general population or patients with other inflammatory skin diseases studied, such as atopic dermatitis and psoriasis. We also found that people with prurigo nodularis are more likely to be depressed than patients with other inflammatory skin diseases, such as atopic dermatitis or psoriasis.  (more…)
Author Interviews, Duke, Heart Disease, JAMA, Lipids, Race/Ethnic Diversity, Statins / 14.06.2018

MedicalResearch.com Interview with: Michael G. Nanna, MD Fellow, Division of Cardiology Duke University Medical Center Durham, NC MedicalResearch.com: What is the background for this study? Response: We know that African Americans are at higher risk for cardiovascular disease than white patients. We also know that African American individuals have been less likely to receive statin therapy compared to white individuals in the past. However, the reasons underlying these racial differences in statin treatment are poorly understood. We set out to determine if African American individuals in contemporary practice are treated less aggressively than whites and, if so, we wanted to investigate potential reasons why this might be the case. (more…)
Accidents & Violence, Author Interviews, BMJ, Race/Ethnic Diversity / 08.05.2018

MedicalResearch.com Interview with: “police” by istolethetv is licensed under CC BY 2.0Anthony L. Bui, MPH M.D. Candidate, David Geffen School of Medicine at UCLA Matthew M. Coates, MPH Associate, Harvard Medical School, Department of Global Health and Social Medicine Ellicott C. Matthay, MPH Ph.D. Candidate, Division of Epidemiology, University of California, Berkeley School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Protests after recent deaths from encounters with law enforcement, the Black Lives Matter movement, and activism over social media platforms have raised the profile of the problem of police violence. Several studies have suggested that the public health community has a duty to address these deaths as a public health problem. These studies have also pointed out that although there is a lack of officially reported statistics on police violence, other journalistic and crowd-sourced efforts such as “The Counted” from The Guardian, FatalEncounters.org, U.S. Police Shootings Database, KilledbyPolice.net, and Mapping Police Violence have relatively complete documentation of deaths from police violence. To help frame the issue as a public health problem, we calculated years of life lost (YLLs) attributed to deaths from encounters with law enforcement. YLLs are, a metric that measures premature deaths, by age, gender, and race/ethnicity. To do this, we followed established methods, subtracting the age of each death from a corresponding standard life expectancy. For example, if an individual who died at age 25 had a life expectancy of 75, their YLL would be 50.  (more…)
Author Interviews, Opiods, Race/Ethnic Diversity, University of Michigan / 03.05.2018

MedicalResearch.com Interview with: Matthew A. Davis, MPH, PhD Assistant Professor Department of Systems, Populations and Leadership University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: The premise for the study was based on prior work that demonstrated that the likelihood of being prescribed an opioid differs according to a patient’s race and ethnicity.  Collectively this work has shown that Non-Hispanic Whites are more likely to receive opioids than other groups for pain. We decided to look at trends in the prescribing of different pain medications over the last 16 years to see if we could detect any differences in prescribing patterns among racial and ethnic groups.  To do so we used national health data for a large sample of Americans who live with significant pain. (more…)
Author Interviews, JAMA, Outcomes & Safety, Race/Ethnic Diversity, Surgical Research / 03.05.2018

MedicalResearch.com Interview with: Dr-Hillary-J-Mull Hillary J. Mull, PhD, MPP Center for Healthcare Organization and Implementation Research Veterans Affairs (VA) Boston Healthcare System Department of Surgery, Boston University School of Medicine Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: Little is known about outpatient procedures that can be considered invasive but are not conducted in a surgical operating room. These procedures are largely neglected by quality or patient safety surveillance programs, yet they are increasingly performed as technology improves and the U.S. population gets older. We assessed the rate of invasive procedures across five specialties, urology, podiatry, cardiology, interventional radiology and gastroenterology in the Veterans Health Administration between fiscal years 2012 and 2015. Our analysis included examining the rates of post procedure emergency department visits and hospitalizations within 14 days and the key patient, procedure or facility characteristics associated with these outcomes. We found varying rates of post procedure ED visits and hospitalizations across the specialties with podiatry accounting for a high volume of invasive outpatient care but the lowest rate of postoperative utilization (1.8%); in contrast, few of the procedures were in interventional radiology, but the postoperative utilization rate was the highest at 4.7%. In a series of logistic regression models predicting post procedure healthcare utilization for each specialty, we observed significantly higher odds of post procedural outcomes for African American patients compared to white patients. (more…)
Author Interviews, Education, Race/Ethnic Diversity, Social Issues / 07.03.2018

MedicalResearch.com Interview with: Patricia Louie, MA PhD Student, Department of Sociology University of Toronto Toronto, ON, Canada  MedicalResearch.com: What is the background for this study?   Response: While most physicians believe that they treat patients equally, research shows that racial inequality pervades the U.S. health care system (Feagin and Bennefield 2014; Williams 2012). Because these inequities persist even after demographic and other socio-economic differences are taken into consideration scholars have started to look at the representation of race in the medical curriculum. The idea is that medical curriculum creates both implicit and explicit connections between race and disease. We build on this body of work by investigating the representation of race (White, Black and Person of Color) and skin tone (light, medium and dark) in the images of four preclinical anatomy textbooks - Atlas of Human Anatomy, Bates’ Guide to Physical Examination & History Taking, Clinically Oriented Anatomy, and Gray’s Anatomy for Students.  Skin tone is important. The majority of medical imagery consists of decontextualized images of body parts where skin tone, which may be related to disease presentation, is the only phenotypical marker. If doctors associate light skin tones with White patients, this may also influence how doctors think about who is a “typical” patient, particularly for the type of disease that is shown in that image. (more…)
Author Interviews, Diabetes, JAMA, Race/Ethnic Diversity, Weight Research / 02.01.2018

MedicalResearch.com Interview with: Michael P. Bancks, PhD Northwestern University Chicago, Illinois  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that the disparity in diabetes between black and white youth and young adults is growing, but the reasons why are unclear. We also know that traditional risk factors for diabetes, such as obesity and low socioeconomic status, are more common among blacks as compared with whites. Our study describes how the unequal rates of these traditional diabetes risk factors explain or account for the higher rates of diabetes among blacks. (more…)
Author Interviews, Breast Cancer, Cancer, CDC, Race/Ethnic Diversity / 07.12.2017

MedicalResearch.com Interview with: “Family Weekend 2014-Breast Cancer Walk” by Nazareth College is licensed under CC BY 2.0Dr. Jacqueline Miller, MD Division of Cancer Prevention and Control CDC  MedicalResearch.com: What efforts have proven successful in reducing racial disparities like these? Response: While some racial disparities will exist due to differences in tumor types, improving early diagnosis and providing specific treatment based on tumor characteristics in a timely fashion would result in reducing breast cancer disparities. (more…)
Author Interviews, Cancer, CDC, Ovarian Cancer, Race/Ethnic Diversity / 06.12.2017

MedicalResearch.com Interview with: Dr. Sherri Stewart, PhD Division of Cancer Prevention and Control CDC MedicalResearch.com: What do women most need to know about ovarian cancer detection and treatment? Response: There is no effective test to detect ovarian cancer at an early stage where treatment is most likely to be effective.  Many women mistakenly believe that the Pap test can detect ovarian cancer, but it does not. The Pap test is recommended only for the detection of cervical cancer.  Recognizing early symptoms of ovarian cancer and seeking timely care may help lead to detection of the cancer at an earlier stage, where treatment is likely to be more effective.  Symptoms – such  as abdominal and back pain, feeling full quickly after eating, and frequent urination – are often present among women with ovarian cancer.  Women should talk with their doctors if they experience any of these symptoms for 2 weeks or longer and the symptoms persist or worsen. If a woman is diagnosed with ovarian cancer, she should seek treatment from a gynecologic oncologist, a physician specially trained to treat ovarian cancer.  Ovarian cancer patients who have been treated by gynecologic oncologists have been shown to survive longer than those treated by other physicians.           (more…)
Author Interviews, Cancer Research, CDC, Colon Cancer, Race/Ethnic Diversity / 06.12.2017

MedicalResearch.com Interview with: Dr. Arica White PhD MPH Division of Cancer Prevention and Control CDC MedicalResearch.com: What is the likelihood of reaching the 80% CRC screening rate goal by next year? Response: As of 2016, 67% of adults age 50-75 years reported being up-to-date with colorectal cancer screening. The 80% by 2018 initiative represented an aspirational goal that public health, non-profit, and community-based organizations will continue to strive for regardless of the outcome in 2018. (more…)