Author Interviews, BMJ, Surgical Research / 15.10.2020

MedicalResearch.com Interview with: Sebastian Straube, BM BCh, MA (Oxon), DPhil Professor and Director, Division of Preventive Medicine, Department of Medicine University of Alberta Zone Section Chief, Occupational Medicine Edmonton Zone, Alberta Health Services Director, Foundation Course in Occupational Medicine surgery-aerosols-covid-19MedicalResearch.com: What is the background for this study?   Response: In view of the COVID-19 pandemic, medical procedures that generate aerosols require a higher grade of personal protective equipment, typically including filtering facepiece respirators (e.g. N95 masks). We wanted to know which procedures were aerosol-generating and would require such enhanced precautions. MedicalResearch.com: How did you approach that question? Response: We conducted a systematic review of the literature and aimed to find those procedures for which there is widespread agreement that they are aerosol-generating. We assembled a team of researchers with expertise in the subject matter as well as in systematic review methodology, and we searched widely for relevant guidelines, policy documents, and academic papers.
Author Interviews, Gender Differences, Surgical Research / 14.10.2020

MedicalResearch.com Interview with: [caption id="attachment_55646" align="alignleft" width="200"]Cassandra M. Kelleher, MD, FACS Dr. Kelleher[/caption] Cassandra M. Kelleher, MD, FACS Surgical Director, Fetal Care Program Surgical Director, NICU Quality and Safety Chair, Pediatric Surgery MGH eCare Clinical Informaticist Pediatric Surgery MassGeneral Hospital for Children Boston, MA MedicalResearch.com: What is the background for this study? Response: Only about one in five surgeons practicing in U.S. is female. Unemployment is virtually nonexistent among surgeons, but many female surgeons, as well as professional women in other fields, experience underemployment—the underuse of skills—according to the Federal Reserve Bank. Women in surgery talk among themselves about how they may be perceived as less confident or competent, and for those reasons they may have less opportunity to do exciting and challenging cases. We wondered if this was true, and if so, why?
Author Interviews, NEJM, OBGYNE, Surgical Research / 29.07.2020

MedicalResearch.com Interview with: Jane Daniels PhD Professor of Clinical Trials, Faculty of Medicine & Health Sciences School of Medicine University of Nottingham MedicalResearch.com: What is the background for this study? MedicalResearch.com: What are the main findings? [caption id="attachment_54976" align="alignleft" width="200"]One example of a large fibroid-Wikipedia image One example of a large fibroid-Wikipedia image[/caption] Response: Uterine fibroids are the most common non-cancerous tumour in women of childbearing age. They are associated with heavy bleeding, lower chances of having children and reduced quality of life. Traditional surgical options were either to remove the fibroids (myomectomy) or completely remove the womb. A newer approach, known as uterine artery embolization, involves blocking the blood supply to the fibroids in the womb. Fibroids may be associated with infertility and problems during pregnancy, including miscarriage and preterm birth. As more women are having children at a later age, fibroids are becoming more of an issue for them and safe and effective fertility sparing treatments are needed. Both treatments improve quality of life, but myomectomy will provide greater benefit to women on average. MedicalResearch.com: What should readers take away from your report? Response: This study is the largest to date comparing women treated with either myomectomy or uterine-artery embolization for their fibroids. It was completed in hospitals across the UK, and included a substantial number of women of African-Caribbean ethnicity, who are more likely have bothersome fibroids, so we can be confident that the findings are important and relevant. Women, including those desiring a future pregnancy, should be provided with the evidence generated by the FEMME trial to enable to make a fully informed decision regarding their fibroid treatment.
Author Interviews, Surgical Research / 29.07.2020

Rhinoplasty is a common plastic surgery procedure for people who want to alter the look of their nose. There are several versions of the procedure, including one that augments the nose by adding an implant. nose-plastic-surgery Some surgeons prefer to use human cartilage from the septum, ears, or ribs. But, other surgeons prefer to use synthetic implants made of either Gore-Tex or silicone. Before you get a nose job from the best rhinoplasty surgeons, it is important to know which material is best for you. Before you choose Gore-Tex or silicone, you should take time to talk to your surgeon and work together to pick the material that will give you the look you want. An augmentation rhinoplasty takes about 90 minutes, but the change to your face will last a lifetime.
  1. What is a silicone implant?
The silicone implant is easy to insert and easy to shape. It can also be removed if there are any problems. Surgeons like them as they offer a more noticeable lift to the bridge of the nose. Silicone implants need very small incisions, if they are done from the outside.
  1. What is a Gore-Tex implant?
Gore-Tex is porous, so it gives a less noticeable lift to the bridge as it merges with the tissues in the nose. Surgeons like to use Gore-Tex because it provides a natural look. Because Gore-Tex integrates with nasal tissue, it is more difficult to remove than a silicone implant.
Author Interviews, Surgical Research, Telemedicine / 17.07.2020

MedicalResearch.com Interview with: [caption id="attachment_54875" align="alignleft" width="200"]Leonardo Mattos, PhD Head of Biomedical Robotics Lab Advanced Robotics Department Istituto Italiano di Tecnologia Genova, Italy Dr. Mattos[/caption] Leonardo Mattos, PhD Head of Biomedical Robotics Lab Advanced Robotics Department Istituto Italiano di Tecnologia Genova, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have been working on robotic microsurgery for several years, and have developed robotic technology for it that is getting ready for use on humans. Then, 5G started to become a reality here in Italy, and we wanted to test if it could be used to enable remote telesurgery. So we joined forces with Vodafone Italia to realize this study and proof of concept demonstration. Telesurgery has been a dream for over 20 years, and has been demonstrated already back in 2001. However, the wide scale adoption of the technology has been limited by many factors, including the limited availability of surgical robots and the lack of a telecommunication network that is fast and reliable enough for such operation. Recent technological progress is changing this scenario, with surgical robots being used in hospitals around the world and high-performance telecommunications system becoming widely available. This study shows that telesurgery is now feasible using the newest 5G telecommunication networks, enabling us to consider a large scale adoption of the technology. 
Author Interviews, Dermatology, Stem Cells, Surgical Research / 01.06.2020

MedicalResearch.com Interview with: [caption id="attachment_54363" align="alignleft" width="200"]Charles-de-SáM.D., Ph.D. Rio de Janeiro, Brazil Dr. Charles-de-Sá[/caption] Charles-de-SáM.D., Ph.D. Rio de Janeiro, Brazil MedicalResearch.com: What is the background for this study? Response: Our clinical trial was based on our clinical skin observations in areas submitted to a lipotransfer previously, an ordinary practice in plastic surgery. These clinical observations lead us to investigate what will be the key element played in these findings. Our scientific support investigation addressed the Dardick1and Zuk, P2 studies, that demonstrated fibroblastic-like cells in adipose tissue with regenerative ability. Our clinical trial proposal is to investigate the adipose-derived stem cell (ADSC) role in the photoaged skin. The direct endpoint of the study was to assess the histological benefits provided by the subdermal ADSC injection. Mesenchymal stem cells were obtained from lipoaspirates, expanded in vitro, and introduced into the facial skin of 20 patients submitted after three to four months to a face-lifting surgery. In the retrieved skin, immunocytochemical and ultrastructural analysis quantified elastic matrix components, cathepsin-K, metalloprotease MMP-12, and the macrophage M2 markers: CD68, CD206 and heme-oxygenase-1.An overview of the trial steps is described in the infographic. 
Author Interviews, Gender Differences, JAMA, Surgical Research, University of Pittsburgh / 21.05.2020

MedicalResearch.com Interview with: [caption id="attachment_54289" align="alignleft" width="200"]Sara P. Myers, M.D., Ph.D. University of Pittsburgh School of Medicine Dr. Myers[/caption] Sara P. Myers, M.D., Ph.D. University of Pittsburgh School of Medicine  MedicalResearch.com: What is the background for this study? Response: Compared to other fields, medicine, and especially academic surgery and its subspecialties, trail with respect to gender diversity. Considering that these fields were traditionally male-dominated, two issues that may present ongoing challenges to the retention and promotion of women are pro-male bias and negative stereotypes about women. Training specific to pursuing a surgical career begins in residency, so it is important to understand how these issues affect motivation and achievement during this formative period. In our study we first evaluated the association between pro-male bias and research-related career engagement using a survey methodology, and then looked at whether evoking negative stereotypes about women was associated with reduced performance on a simulated technical skill assessment called the Fundamentals of Laparoscopic Surgery (FLS) assessment. 
Author Interviews, JAMA, Orthopedics, Race/Ethnic Diversity, Surgical Research / 19.05.2020

MedicalResearch.com Interview with: [caption id="attachment_54220" align="alignleft" width="200"]Alyson Cavanaugh, PT, PhD Joint Doctoral Program in Epidemiology University of California, San Diego/ San Diego State University  Dr. Cavanaugh[/caption] Alyson Cavanaugh, PT, PhD Joint Doctoral Program in Epidemiology University of California, San Diego/ San Diego State University MedicalResearch.com: What is the background for this study? Response: More than 700,000 total knee replacements are performed annually in the United States, but there is a racial disparity in outcomes after the surgery. If the knee replacement procedure is considered a highly effective treatment, why don't black women present with the same outcomes as whites? Physical function when going into surgery has a large impact on the potential functional outcomes after surgery. Our hypothesis was that black women were presenting to surgery with poorer physical function, which was contributing to poorer functional outcomes after surgery.
Author Interviews, JAMA, Surgical Research, Weight Research / 16.05.2020

MedicalResearch.com Interview with: [caption id="attachment_44215" align="alignleft" width="130"]Wei Bao, MD, PhD Assistant Professor, Epidemiology College of Public Health University of Iowa Dr. Wei Bao[/caption] Wei Bao, MD, PhD Assistant Professor Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242 and [caption id="attachment_50383" align="alignleft" width="128"]Yangbo Sun  MD, PhD Department of Epidemiology University of Iowa Dr. Yangbo Sun[/caption] Dr. Yangbo Sun, PhD (Former postdoc research scholar at University of Iowa) Tenure-track Assistant Professor The University of Tennessee Health Science Center.   MedicalResearch.com: What is the background for this study? Response: Obesity is a rising epidemic in the United States and worldwide. Bariatric surgery has been shown to be the most effective and durable treatment for clinically morbid obesity which is difficult to reverse through traditional approaches such as lifestyle intervention. There has been long-standing uncertainty and debate regarding the value of pre-operative weight loss as a requirement for bariatric surgery. Meanwhile, one of the major indicators for surgery outcomes is 30-day mortality after surgery, which is especially important for bariatric surgery because the vast majority of the patients undergoing bariatric surgery are voluntary and if the surgery were not performed, they are not supposed to die in short term. So far, the association of pre-operative weight loss with 30-day mortality after bariatric surgery remains unclear. Therefore, in this study, we examined the associations of pre-operative BMI and weight loss with 30-day mortality following bariatric surgery using a large database among ~500,000 patients who underwent bariatric surgery in the United States and Canada.
Author Interviews, Diabetes, JAMA, Surgical Research / 14.04.2020

MedicalResearch.com Interview with: [caption id="attachment_53895" align="alignleft" width="200"]Katherine Moll Reitz, MD General Surgery Resident University of Pittsburgh Dr. Reitz[/caption] Katherine Moll Reitz, MD General Surgery Resident University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: Surgical interventions both save lives and improve the quality of those lives each day. However, these same interventions and the recovery thereafter are a major physiologic stressor. Younger, more resilient patients tend to recover faster, with fewer postoperative complications when compared to older, frailer patients undergoing the same surgical treatments. Therefore, investigators at University of Pittsburgh and UPMC have begun focusing on prehabilitation in order to optimize at risk patients preoperatively. Just as an athlete would train for an upcoming event, prehabilitation (including smoking cessation, healthy eating, and physical activity increases) prepares or trains patients for their surgical intervention and can improve their postoperative outcomes. Currently, there is no medication available to aid in this training process, improving patients’ response to the physiologic stress of surgery. Therefore, we are interested in exploring potential safe, well tolerated medical therapies which can optimize patients as pharmacologic prehabilitation.
Author Interviews, Orthopedics, Surgical Research / 23.03.2020

MedicalResearch.com Interview with: [caption id="attachment_53608" align="alignleft" width="200"]Daniel Pincus MD PhD Division of Orthopaedic Surgery, Department of Surgery, University of Toronto Sunnybrook Health Sciences Centre, Division of Orthopaedic Surgery,  ICES, Toronto, Ontario, Canada Dr. Pincus[/caption] Pincus MD PhD Division of Orthopaedic Surgery, Department of Surgery University of Toronto Sunnybrook Health Sciences Centre, Division of Orthopaedic Surgery ICES, Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? Response: Controversy exists among arthroplasty surgeons and patients about the best surgical approach for total hip arthroplasty (THA) - one of the most common operations performed worldwide. In the last few years, the direct anterior approach has become increasingly popular compared to posterior and lateral approaches, partially as a result of advertising to patients.  We sought to determine whether a direct anterior surgical approach was associated with lower surgical complications compared to lateral and posterior approaches.
Author Interviews, Colon Cancer, JAMA, Weight Research / 13.03.2020

MedicalResearch.com Interview with: Dr Laurent Bailly MD, PhD Département de Santé Publique, CHU Nice, Hôpital Archet 1. Niveau1 NICE France  MedicalResearch.com: What is the background for this study? Response: Obesity is known to increase cancer incidence and notably colorectal cancer incidence. Bariatric surgery is an effective treatment of obesity however the association of this surgery with the colorectal cancer remained controversial. We used the French National Health Insurance Information System to conduct a nationwide retrospective cohort study, between 2009 and 2018, of patients hospitalized in France with a diagnosis of obesity. We followed more than 1 million obese individuals aged 50 to 75 years and free of colorectal cancer at baseline, some of them did undergo bariatric surgery and others did not.
Author Interviews, JAMA, Surgical Research / 23.02.2020

MedicalResearch.com Interview with: [caption id="attachment_53265" align="alignleft" width="200"]Paulina Salminen MD PhD Chief and Professor of surgery Turku University, Finland Dr. Salminen[/caption] Paulina Salminen MD PhD Chief and Professor of surgery Turku University, Finland MedicalResearch.com: What is the background for this study? Response: Appendectomy has been the standard treatment for uncomplicated acute appendicitis and currently one of the most commonly performed surgical procedures. We now know that there are two different forms of acute appendicitis: the more common milder uncomplicated acute appendicitis and the more severe complicated acute appendicitis. While the complicated form is primarily still treated surgically, in recent years evidence from randomised trials and meta-analyses show that antibiotics are a safe and efficient treatment of uncomplicated acute appendicitis  also at long-term follow-up. Quality of life (QOL) and patient satisfaction after antibiotic therapy or appendectomy for uncomplicated acute appendicitis have been studied previously in a pediatric population but not in an adult population. Our aim was to compare long-term quality of life and patient satisfaction after antibiotic therapy and appendectomy for the treatment of uncomplicated acute appendicitis in patients enrolled in the original APPAC trial.
Accidents & Violence, Author Interviews, Cost of Health Care, Surgical Research / 17.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52811" align="alignleft" width="200"]Juan P. Herrera-Escobar, MD, MPH Research Director, Long-term Outcomes in Trauma Center for Surgery and Public Health, Brigham and Women's Hospital Instructor in Surgery, Harvard Medical School Dr. Herrera-Escobar[/caption] Juan P. Herrera-Escobar, MD, MPH Research Director, Long-term Outcomes in Trauma Center for Surgery and Public Health, Brigham and Women's Hospital Instructor in Surgery, Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Firearm injuries are a pressing public health problem in the United States. Until now, most of the research on this problematic has focused on mortality, which of course is critical, but is only one piece of the story. For every person who dies from a firearm injury, three survive every year. As trauma systems continue to improve and save more lives every year, our attention should start shifting to the impact that firearm injuries have on survivors. 
Author Interviews, JAMA, Surgical Research, Weight Research / 15.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52800" align="alignleft" width="200"]Anita P. Courcoulas MD, MPH, FACS Anthony M. Harrison MD Chair and Professor of Surgery Chief, MIS Bariatric & General Surgery University of Pittsburgh Medical Center Dr. Courcoulas[/caption] Anita P. Courcoulas MD, MPH, FACS Anthony M. Harrison MD Chair and Professor of Surgery Chief, MIS Bariatric & General Surgery University of Pittsburgh Medical Center  MedicalResearch.com: What is the background for this study? Response: Fewer published studies in bariatric surgery address long term adverse outcomes or problems that can occur after different operations.  In addition, a lack of standardized reporting of potential adverse events limits the understanding of these issues. This paper results from one of the largest studies of bariatric surgery ever undertaken and includes both gastric bypass and gastric sleeve, the 2 most common operations performed in the U.S. and worldwide at the current time.  This study leverages large data sets from the electronic health record linked to insurance claims and death indices.  This is real-world data coming from a population-based cohort of 33,560 adults at 10 sites in 4 clinical data research networks throughout the U.S., so it may be different from data that accrues from a longitudinal observational study or randomized trial.  Patients and other important stakeholders in bariatric surgery were critical to the design, conduct, and dissemination of results from this study.
Author Interviews, JAMA, Surgical Research, Technology, University of Michigan / 13.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52750" align="alignleft" width="144"]Kyle Sheetz, MD Clinical Year 4 Resident, General Surgery Michigan Medicine Dr. Sheetz[/caption] Kyle Sheetz, MD Clinical Year 4 Resident, General Surgery Michigan Medicine MedicalResearch.com: What is the background for this study? Response: There are concerns that robotic surgery is increasing for common surgical procedures with limited evidence and unclear clinical benefit. Prior studies describing the use of robotic surgery relied upon claims or billing data to identify robotic operations from laparoscopic or open ones. This may lead to inaccuracies as claims data may not provide specific codes for robotic operations.
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, JAMA, Surgical Research / 08.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52688" align="alignleft" width="200"]Mehra Golshan, MD, MBA Dr. Abdul Mohsen & Sultana Al-Tuwaijri Distinguished Chair Surgical OncologyDirector of Breast Surgical Oncology Fellowship Associate Professor, Harvard Medical School Dr. Golshan[/caption] Mehra Golshan, MD, MBA Dr. Abdul Mohsen & Sultana Al-Tuwaijri Distinguished Chair Surgical OncologyDirector of Breast Surgical Oncology Fellowship Associate Professor, Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Triple negative breast cancer is an aggressive form of breast cancer that often requires chemotherapy. In this study we provided neoadjuvant chemotherapy with or without a PARP inhibitor and showed that many women who were originally ineligible for breast conservation (lumpectomy) became eligible after treatment. If lumpectomy was tried it was usually successful.  Many more women in the US compared to Europe and Asia chose mastectomy when lumpectomy was an option even when genetics is negative.
Author Interviews, Education, NEJM, Surgical Research / 31.10.2019

MedicalResearch.com Interview with: [caption id="attachment_51961" align="alignleft" width="99"]Ryan J. Ellis, MD MS General Surgery Resident Surgical Outcomes and Quality Improvement Center (SOQIC) Northwestern Medicine  Dr. Ellis[/caption] Ryan J. Ellis, MD MS General Surgery Resident Surgical Outcomes and Quality Improvement Center (SOQIC) Northwestern Medicine  MedicalResearch.com: What is the background for this study? Response: Burnout has emerged as a significant problem affecting the entire healthcare workforce and it has been likely to myriad downstream problems such as increases in medical errors, alcoholism, and depression. Despite the attention on clinician burnout, there are significant gaps in our understanding of how the workplace environment may lead to burnout. Moreover, there are particular concerns about the workplace environment in training, specifically with regards to abuse, discrimination, and harassment. We had the opportunity to survey all U.S. general surgery residents to comprehensively define the frequency of workplace mistreatment and its relationship with burnout and suicidal thoughts among surgical residents.
Author Interviews, Health Care Systems, Surgical Research / 19.09.2019

MedicalResearch.com Interview with: [caption id="attachment_51389" align="alignleft" width="170"]Gustav Tinghög, PhD Associate Professor Division of Economics                                                                              Department of Management and Engineering, IEI JEDI-lab: JUDGEMENT, EMOTION, DECISION and INTUITION  Linköping University Dr. TINGHÖG[/caption] Gustav Tinghög, PhD Associate Professor Division of Economics Department of Management and Engineering, IEI JEDI-lab: JUDGEMENT, EMOTION, DECISION and INTUITION Linköping University MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that when we get tired, we make decisions without engaging in cognitively demanding reasoning, and we postpone risky or uncertain choices. Previous studies have explored this idea of “decision fatigue” in relation to parole hearing outcomes, failure of health services workers to wash their hands, and the likelihood of physicians prescribing antibiotics. In our study we wanted to investigate how patient ordering affected decisions scheduled patients for orthpedic surgery (excluding acute cases)
Author Interviews, JAMA, Outcomes & Safety, Surgical Research, University of Michigan / 15.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50705" align="alignleft" width="160"]Kyle Sheetz, MD, MSc Research Fellow Center for Healthcare Outcomes and Policy University of Michigan Dr. Sheetz[/caption] Kyle Sheetz, MD, MSc Research Fellow Center for Healthcare Outcomes and Policy University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Various patient safety organizations and clinical societies continue to advocate for volume thresholds as a means to improve the short-term safety and overall effectiveness of high risk cancer surgeries in the United States. We asked two questions with this study: 1) What proportion of U.S. hospitals meet discretionary volume standards? 2) Do these standards differentiate hospitals based on short-term safety outcomes (mortality and complications)? We found that a relatively low proportion of hospitals meet even modest volume standards put forth by the Leapfrog Group. These standards did not differentiate hospitals based on outcomes for 3 of 4 high risk cancer operations reported by the Leapfrog Group. However, using higher thresholds, we were able to demonstrate a significant relationship between higher hospital volume and better outcomes, which has been reported numerous times.
Author Interviews, Opiods, Pediatrics, Surgical Research / 09.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50574" align="alignleft" width="140"]Kao-Ping Chua, M.D., Ph.D. Assistant Professor, Department of Pediatrics and Communicable Diseases Susan B. Meister Child Health Evaluation and Research Center University of Michigan Ann Arbor, Michigan Dr. Chua[/caption] Kao-Ping Chua, M.D., Ph.D. Assistant Professor, Department of Pediatrics and Communicable Diseases Susan B. Meister Child Health Evaluation and Research Center University of Michigan Ann Arbor, Michigan MedicalResearch.com: What is the background for this study?   Response: Tonsillectomy is one of the most common surgeries performed in children. It is also one of the most common reasons children are prescribed opioids, even though randomized trials suggest that non-opioids like ibuprofen are equally effective for pain control. We were interested in understanding whether it is possible to safely reduce opioid exposure after tonsillectomy in children without increasing the risk of complications such as emergency department visits for uncontrolled throat pain, which could lead to dehydration.
Author Interviews, Education, Gender Differences, JAMA, Surgical Research / 07.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50581" align="alignleft" width="86"]Maria S. Altieri, MD, MS Invasive surgery fellow Washington University, St. Louis, MO Dr. Altieri[/caption] Maria S. Altieri, MD, MS Invasive Surgery Stony Brook, NY MedicalResearch.com: What is the background for this study? What are the main findings? Response: For majority of residents, training years coincide with prime child bearing years.  Historically, surgical residency has not been conducive for having children, as it is one of the most demanding experiences, requiring long hours, high stress levels, and the acquisition of clinical and technical skills over a short period of time. However, with recent trends towards a more favorable work-life balance and the 80-hour work week, more male and female residents are having children or considering having children during training.  Thus, the topic of parental leave during residency is becoming more fundamental.  However, there is little research on the attitudes of residents towards their pregnant peers and parental leave. We wanted to examine the perceptions of surgical trainees towards parental leave and pregnancy during residency.  Through understanding the perceptions of current residents, obstacles could be identified which could lead to potential changes in policies that could help to normalize parenthood and parental leave during surgical training.   
Author Interviews, Gastrointestinal Disease, JAMA, Outcomes & Safety, Surgical Research / 31.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50510" align="alignleft" width="160"]Ninh T. Nguyen, MD Department of Surgery University of California Irvine Medical Center Orange, California Dr. Nguyen[/caption] Ninh T. Nguyen, MD Department of Surgery University of California Irvine Medical Center Orange, California MedicalResearch.com: What is the background for this study? Response: The US World & News Report publishes each year on top ranked hospitals for specific specialties. These ratings are promoted nationally and used by patients and physicians in making decisions about where to receive care for challenging conditions or common elective procedures. Bariatric, colorectal and hiatal hernia procedures are common gastrointestinal operations being performed at most hospitals. Seeking care for these operations specifically at top 50 ranked hospitals can pose significant logistic and financial constraints for most patients. The objective of this study was to determine whether top ranked hospitals (RHs) in Gastroenterology & GI Surgery (GGS) have improved outcomes for advanced laparoscopic abdominal surgery compared to non-ranked hospitals (NRHs).
Accidents & Violence, Author Interviews, JAMA / 26.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50426" align="alignleft" width="128"]Justin C. McCarty, DO, MPH General Surgery Resident, PGY-4 Department of Surgery | St. Elizabeth’s Medical Center Dr. McCarty[/caption] Justin C. McCarty, DO, MPH General Surgery Resident, PGY-4 Department of Surgery | St. Elizabeth’s Medical Center MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The main finding of the paper is that the assumption of the training that teaching how to apply one type of tourniquet translates to knowledge and understanding of how to apply any other tourniquet is questionable. I love the Stop the Bleed campaign and what it stands for but I believe that it is important that as it moves forward that there is continuous questioning of the educational curriculum and how it is delivered. Currently, I question whether the best interim method of teaching and empowering laypeople is to focus more on pressure and packing of wounds; a skill that is always fully translatable, doesn’t require anything other than a willing set of hands, and is incredibly effective, rather than tourniquets. A second question I have is whether existing tourniquets and the associated training are approaching the issue from the right angle since to me the device should be designed to not require training and continuous practice, but rather should be intuitive and simple to use, features lacking from all existing devices.  
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, ENT, Surgical Research / 25.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50402" align="alignleft" width="133"]Vinay K. Rathi, MD Otolaryngology Resident | Massachusetts Eye and Ear Project Manager | Partners Ambulatory Care MBA Candidate | Harvard Business School Dr. Rathi[/caption] Vinay K. Rathi, MD Otolaryngology Resident | Massachusetts Eye and Ear Project Manager | Partners Ambulatory Care MBA Candidate | Harvard Business School  MedicalResearch.com: What is the background for this study?  Response: This study is a secondary subgroup analysis that follows on the heels of a recently published study in The New England Journal of Medicine (NEJM) examining physician reimbursement for surgical procedures in the Medicare Physician Fee Schedule (PFS), which both public and private insurers use to determine payment rates for clinician services. Although it is widely understood that physician time (i.e., the amount of physician time required to perform a procedure) is perhaps the most important factor used to determine payment rates, the Centers for Medicare and Medicaid Services (CMS) has historically relied upon limited and potentially biased survey data to estimate physician time. Leveraging time data from American College of Surgeons National Quality Improvement Program, the authors of the recent NEJM study demonstrated that CMS does not appear to systematically misestimate intraoperative times, but there are substantial discrepancies that may result in over- or undercompensation for certain procedures and specialties.
Author Interviews, Cancer Research, ENT, JAMA, Surgical Research / 18.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50301" align="alignleft" width="129"]Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine Dr. Haymart[/caption] Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Thyroid cancer is a common malignancy with surgery considered one of the primary treatments. Complications from thyroid surgery can lead to long-term voice problems. However, few studies have used validated scales to quantify the impact of thyroid surgery on patient voice. Prior work has largely focused on single institution studies with high volume surgeons or claims data with reports of specific nerve injury. We surveyed a diverse cohort of patients affiliated with SEER sites Georgia and Los Angeles to identify the prevalence, severity and correlates of poor voice outcomes following surgery for differentiated thyroid cancer. We found that out of 2,325 patients 25.8% reported voice changes lasting greater than 3 months after surgery, 12.7% had abnormal voice per a validated voice scale (Voice Handicap Index- 10), and 4.7% reported a diagnosis of vocal fold motion impairment. We also identified patient factors associated with abnormal voice 2-4 years post op.
Author Interviews, Cancer Research, Outcomes & Safety, Surgical Research, Yale / 12.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50208" align="alignleft" width="160"]Daniel Boffa, MD Professor of Surgery Yale School of Medicine Dr. Boffa[/caption] Daniel Boffa, MD Professor of Surgery Yale School of Medicine  MedicalResearch.com: What is the background for this study? Response: We have previously demonstrated that top-ranked hospitals are significantly safer than their affiliates for complex cancer surgery (patients 1.4 times more likely to die after cancer surgery at affiliate hospitals).  A logical extension of this work was to compare affiliate hospitals to hospitals that were not affiliated with a top ranked hospital.
Author Interviews, Lancet, Neurology, Surgical Research / 05.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50105" align="alignleft" width="158"]Natasha van Zyl, MBChB (Cape Town), FRACS FRACS Plastic and Reconstructive Surgeon Melbourne, Australia  Dr Natasha van Zy[/caption] Dr. Natasha van Zyl, MBChB (Cape Town), FRACS FRACS Plastic and Reconstructive Surgeon Melbourne, Australia  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The estimated global incidence of spinal cord injury (SCI) from all causes is 40 to 80 new cases per million population per year which means that every year between 250 000 to 500 000 people worldwide suffer SCI (1)(chap 2 p 17). In Australia the age standardised, annual incident rate of persisting traumatic SCI for Australian residents aged 15 years and above is 11.8 cases per million.(2) Just over 50% of all spinal cord injuries  in Australia occur at the cervical level resulting in tetraplegia. (2) Cervical spinal cord injury is a devastating, life-changing injury impacting almost every aspect of a person’s work, family and social life. Although compared to many other health conditions it has a relatively low incidence, it is certainly a high cost health condition, with the lifetime cost per tetraplegia incident case estimated to be AU$9.5 million.(3) For those living with tetraplegia improvement in hand function is their highest ranked goal.(4) As such, reconstruction of upper extremity function in cervical spinal cord injury is a crucial component of the surgical rehabilitation of people with mid/low cervical spinal cord injury as it has the capacity to restore critical functions such as elbow extension, wrist extension, grasp, key pinch and release. Traditionally these functions have been reconstructed using tendon transfers, which move a functioning muscle to a new insertion site to recreate the function of a paralysed muscle.(5)
Author Interviews, CT Scanning, JAMA, Surgical Research, Technology / 21.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49894" align="alignleft" width="200"]Christian Krautz, MD Department of Surgery, Universitätsklinikum Erlangen Friedrich-Alexander-Universität Erlangen Nürnberg Erlangen, Germany Dr. Krautz[/caption] Christian Krautz, MD Department of Surgery, Universitätsklinikum Erlangen Friedrich-Alexander-Universität Erlangen Nürnberg Erlangen, Germany  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this preclinical study that included 720 case evaluations, visualization with Cinematic Rendering allowed a more correct and faster comprehension of the surgical anatomy compared to conventional CT imaging independent from the level of surgical experience. Therefore,Cinematic Rendering is a tool that may assist HPB surgeons with preoperative preparation and intraoperative guidance through an improved interpretation of computed tomography imaging data.
Author Interviews, Heart Disease, JAMA, Surgical Research / 16.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49721" align="alignleft" width="198"]Fausto Biancari, Professor of Surgery, University of Turku, Finland Professor of Cardiothoracic Surgery, University of Oulu, Finland Heart Center, T-Hospital, Hämeentie Turku, Finland Prof. Biancari[/caption] Fausto Biancari, MD, PhD Professor University of Turku and University Oulu, Finland MedicalResearch.com: What is the background for this study? Response: Current data is scarce regarding the short- and midterm benefit of transcatheter aortic valve replacement (TAVR) compared to surgical aortic valve replacement (SAVR) in low-risk patients with severe aortic valve stenosis. MedicalResearch.com: What are the main findings? Response: In this observational study on 2841 low-risk patients with aortic valve stenosis from the Finnish nationwide FinnValve registry, propensity score matching analysis showed similar 30-day and three-year survival after TAVR and SAVR.
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