Health Newsfeed – Johns Hopkins Medicine Podcasts

The majority of cancer studies researchers attempted to repeat in a recent analysis were not reproducible, a recent paper found, with 59% of 50 attempts failing. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says trying to validate results is a laudable goal, but it’s very difficult to execute. A major issue is pressure on researchers to publish their findings.

Nelson: I do worry about publishing. If you look at the number of articles published, it’s really been continuing to go up. Things that are clearly inappropriate, plagiarism, it’s a little harder to do with the search tools that are present where you can go search out borrowed text. Occasionally you’ll see things published about the level and degree of fraud and misleading publications. There’s room for improvement, and I think one thing that this group should be lauded for was trying to take this on.   :28

Biomedical research is largely funded in the US and many other countries using public funds, so attempting some sort of oversight is certainly indicated. At Johns Hopkins, I’m Elizabeth Tracey.

What will the drop in cancer screenings teach us about overdiagnosis and overtreatment? Elizabeth Tracey reports

Colonoscopies, prostate biopsies, CT for lung cancer screening, all down as a result of the pandemic. More worrisome is the drop in cancer diagnosis. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says over the next several months what may be revealed is how many times cancers that weren’t going to cause a problem are detected.

Nelson: There’s always this concern around the use of screening techniques and technologies of an overdiagnosis. Once we find them then we find ourselves having to chase after and manage them, so this is in a sense a real world experiment. As the pandemic waxes and wanes, paying attention to other healthcare issues, including wellness, or health preservation and promotion activities, remain important, and many of them create and improve resilience for Sars-CoV2 and Covid-19 kind of infections and syndromes.  :30

Nelson especially encourages those with a family history or other risk for cancer to resume routine screening activities. At Johns Hopkins, I’m Elizabeth Tracey.

Both cancer screening and diagnosis are down quite a bit from prepandemic levels, a study of Veterans Administration hospitals shows. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, reviews the data.

Nelson: There was a significant distraction in the normal utilization of healthcare resources. A lot of that included cancer screening and some of the surgeries. This takes stock of what the impact has been. Colonoscopies down 45%, prostate biopsies looking for prostate cancer down 29 to 30%, screening CT scans for lung cancer among heavy smokers down 10%. New cancer diagnoses were down 13 to 23%. Could that be good? Well if there was less cancer it could be good. If it’s just we’re detecting it less that’s obviously not going to be good.  :33

Nelson acknowledges safety concerns but notes that routine health maintenance activities are important to continue, especially cancer screenings. At Johns Hopkins, I’m Elizabeth Tracey.

Many women with ovarian cancer are initially treated with surgery and a type of chemotherapy containing platinum. Now a new study shows that if the cancer returns, some women will benefit from another surgery as well as chemotherapy. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, explains.

Nelson: Sometimes the cancer recurs, and if it recurs six months or more later, the thought is that there may still be some mileage that can garnered out of this platinum kind of chemotherapy regimen. What this did was ask the question whether you were going to get that kind of chemotherapy anyway, they randomized to go in and remove as much of the cancer as they could see and find. What they found was there was an advantage to going in and surgically removing the cancer particularly if they could completely remove all the cancer they could see. The advantage was people lived longer.  :31

Nelson notes that many additional agents are being developed for ovarian cancer that are likely to improve survival still further. At Johns Hopkins, I’m Elizabeth Tracey.

Do you ever feel confused about cholesterol and triglyceride levels? LDL, HDL, VLDL- it’s a bit challenging to figure them out and what they might mean for heart disease risk. Now a recent study suggests that another blood marker, known as apolipoprotein B, could be one size fits all. Seth Martin, a cardiologist at Johns Hopkins, explains.

Martin: Apo B is a very strong lipid marker. It’s something that has been used in many studies and is strongly associated with risk for coronary heart disease and for cardiovascular disease more broadly. It basically represents the concentration of bad lipid particles because there’s one apolipoprotein B  per bad particle. In most people 90% plus of those bad particles are LDL particles. In most people they give the same answer.  :32

Martin says right now apo B is a little more difficult for clinical laboratories to measure, so stay tuned. At Johns Hopkins, I’m Elizabeth Tracey.

A blood pressure monitor, a smart watch, and a smartphone app called Corrie have helped many people avoid another hospitalization after a heart attack, a study by Seth Martin, a cardiologist at Johns Hopkins, and colleagues has shown. Martin says he hopes use of Corrie will continue to grow.

Martin: We can’t force people to use it, ultimately it’s up to the patient but our hope is to inspire as many people as possible to use it. To see the benefits that they could get from engaging with their care with a digital health platform being a medium that really helps organize that and make it a good, positive experience. And so that’s where we’re headed, to really make this part of routine care. And we want to reach everybody, we don’t want this to be for just certain segments of the population that happen to have certain technologies or more comfort for technologies.  :32

Martin predicts that apps like Corrie will soon help people manage much of their health. At Johns Hopkins, I’m Elizabeth Tracey.

Using a smartphone app called Corrie with an Apple watch and a blood pressure monitor helps people being discharged from the hospital feel they are more capable of participating in their own care. That’s according to Seth Martin, a cardiologist at Johns Hopkins and one of Corrie’s developers.

Martin: As patients transitioned home from the hospital they really left more confident about what they needed to do and they would keep interacting with the app, after they left, continuing to learn, continuing to track their medications, tracking blood pressure, and step counts and heart rate. Getting reminders about the follow up appointments that they had, and so forth. And so the emphasis was really on using this for thirty days but our patients did have the option to continue to use it after that study period if desired.  :32

The study demonstrated that people who used Corrie were fifty percent less likely to be readmitted to the hospital within thirty days after their discharge. At Johns Hopkins, I’m Elizabeth Tracey.

Technologies are becoming ever more embedded in healthcare, now enabling people to participate as part of their own healthcare team following a heart attack, with deployment of a smartphone app called Corrie and additional devices. Seth Martin, a cardiologist at Johns Hopkins and one member of the Corrie development team, describes what was needed.

Martin: Provided them with an iPhone if they didn’t have one, we provided an Apple watch, which had the Corrie app on the watch as well so patients could track their physical activity, receive their reminders and so forth on the watch. There was also a companion blood pressure monitor that was part of the intervention. So patients would start using that in the hospital. Patients would then watch educational videos on their phone or stream it to an Apple TV in their hospital room.  :28

Martin predicts that use of an integrated range of devices will become standard of care for people who’ve had a first heart attack, as use of Corrie has been shown to reduce someone’s risk of rehospitalization by fifty percent. At Johns Hopkins, I’m Elizabeth Tracey.

Corrie can help you avoid rehospitalization after you’ve had a heart attack, a study led by Seth Martin, a cardiologist at Johns Hopkins, and colleagues has shown. Corrie is the name of a smartphone app that integrates all aspects of a person’s care as well as providing educational tools so people can become informed participants in their own care.

Martin: The Corrie patients had a fifty percent lower risk of 30 day all cause readmissions compared to patients who were in the historical group that did not use Corrie. We really spanned large academic hospitals as well as more community based hospitals. We also published a cost-effectiveness analysis that really shows the associated of these outcomes with much lower costs of medical care, in fact can result in savings.  :31

Martin says additional studies on various aspects of Corrie’s impact are planned. At Johns Hopkins, I’m Elizabeth Tracey.

Having to come back to the hospital shortly after you’ve been discharged is called rehospitalization, and for people who’ve had a heart attack that’s not an outcome anyone wants. Now an app developed by Seth Martin, a cardiologist at Johns Hopkins, and colleagues, has been shown to help inform and educate people so they can help manage their own care. 

Martin: It’s also about lifestyles, diet and exercise and knowing who to follow up with, knowing about the importance of enrolling in a cardiac rehab program. So as we brought all this together for patients and as they used the app and interacted with Corrie on a smart watch as well as using a connected blood pressure monitor, these high levels of patient activation were associated with improved outcomes, reduced 30 day all cause readmissions. Patients in the Corrie group were less likely to come back to the hospitals.  :31

Martin says using the app, called Corrie, in several types of hospitals has shown its practicality. At Johns Hopkins, I’m Elizabeth Tracey.