Welcome to our new biweekly overview of recent studies published by Institute investigators and collaborators.

This Research Recap, topics include: bariatric surgery, skin cancer care, Medicare, nonventilator hospital-acquired pneumonia, genetic screening/Lynch syndrome, masking guidance for health care workers, a possible link between Vitamin D deficiency and the risk of opioid addiction, and SARS-COV-2 transmission in shared hospital rooms.

For all publications, see our Publications page. For up-to-date media coverage and research findings, visit In the Media, and follow us on Twitter. To search for a subject matter expert, visit our Investigator Directory.

The effects of weight loss surgery on acute care utilization

A new study in Annals of Surgery led by former Institute SAS Programmer/Analyst Katherine Callaway compares acute care utilization and costs in patients receiving sleeve (SG) vs bypass (RYGB), which  make up over 90% of bariatric surgeries. Using a national claims database, the team identified adults undergoing SG and RYBG between 2008-16 and examined emergency department visits, hospitalizations, and associated costs in the cohort up to 4 years after surgery. Study results suggest that, though SG carries slightly less risk and cost in the short term, RYBG may have more durable clinical impacts.

Institute Investigator(s): J. Frank Wharam; Fang Zhang; Dennis Ross-Degnan

Eighteen evidence-based recommendations for the treatment of actinic keratosis

A new executive summary that appears in the Journal of the American Academy of Dermatology co-authored by Maryam Asgari provides a synopsis of the 18 evidence-based recommendations for treatment of actinic keratosis (AK), a condition where rough patches on chronically ultraviolet-exposed skin can progress to keratinocyte carcinoma. The workgroup conducted a systematic review to address five clinical questions on management of AK. The top recommendations include using UV protection, topical treatments, and cryosurgery.

Institute Investigator(s): Maryam Asgari

Early initiation of biologics in untreated Juvenile Idiopathic Arthritis

New work by Mei Sing Ong in Arthritis & Rheumatology examined the effects of early introduction of biologic disease-modifying antirheumatic drugs (bDMARDs) on disease course in untreated polyarticular Juvenile Idiopathic Arthritis (pJIA). The team found that starting bDMARDs within 3 months of a baseline assessment is associated with more rapid achievement of inactive disease in subjects with untreated pJIA.

Institute Investigator(s): Mei-Sing Ong

Medicare beneficiaries with disabilities experience difficulty accessing ambulatory care

A study in Health Affairs co-authored by Hefei Wen explores whether Medicare beneficiaries with disabilities experience difficulty accessing primary care and specialist clinicians, versus those without disabilities. Using Medicare Current Beneficiary Survey (MCBS) data from 2015-17 linked to claims and administrative data, the study team found that barriers to accessing ambulatory care may be a key contributor to the reliance of Americans with disabilities on emergency department services rather than routine primary and specialist clinician care.

Institute Investigator(s): Hefei Wen

Establishing research needs to address nonventilator hospital-acquired pneumonia

In 2020, a number of US healthcare leaders formed the National Organization to Prevent Hospital-Acquired Pneumonia (NOHAP) to issue a call to action to address non-ventilator hospital-acquired pneumonia (NHVAP). In a commentary in Infection Control and Epidemiology, senior author Michael Klompas and fellow NOHAP members outline the primary research needs the organization has to support the call to action. These needs include developing better models to estimate the economic cost of NHVAP, making clear its pathophysiology and identifying pathways for prevention, developing surveillance methods, and policy levers to engage hospitals in NHVAP surveillance and prevention.

Institute Investigator(s): Michael Klompas

A qualitative approach to determining primary care provider response to unsolicited Lynch syndrome secondary findings of varying clinical significance

Lynch syndrome is the most common cause of hereditary colorectal cancer*. A study team led by research assistant Lauren Galbraith and senior author Kurt Christensen examined how primary care providers might respond to genomic secondary findings of varying clinical significance: pathogenic, uncertain significance, or benign. The team asked a randomized group of 148 members American Academy of Family Physicians to review three reports with varying significance for Lynch syndrome. Each provided an open-ended response about the follow-up they would address and ranked the secondary findings reports and five other topics in the order they would prioritize responding to each. Findings, published in Genetics in Medicine, show that while PCPs do consider the differences between pathogenic variants and those of uncertain significance when weighing next steps, they would follow both up in similar ways.

Institute Investigator(s): Kurt Christensen

Recognizing the need for nuanced masking guidance for health care workers

Michael Klompas, Chanu Rhee, and Meghan Baker have spent the pandemic both on the front lines and conducting research on the transmission and prevention of COVID-19 in health care settings. In a new commentary in Clinical Infectious Diseases, they suggest that new CDC guidance – that all providers seeing patients with possible or confirmed COVID-19 wear N95 respirators – be adjusted to consider communities where incidence of the disease is elevated. They reason that because SARS-COV-2 is most contagious before the onset of symptoms, universal use of N95s when community incidence rates are high may help decrease nosocomial transmission. Read more in McKnight’s Long-term Care News and CIDRAP.

Institute Investigators: Michael Klompas, Chanu Rhee, Meghan Baker

A potential link between vitamin D deficiency and the risk of opioid addiction

A team of investigators including the Institute’s Maryam Asgari sought to determine whether a relationship may exist between opioid use and serum VitD levels in humans, independently of pain, using data from the National Health and Nutrition Examination Survey. The study, published in Science Advances, draws its hypothesis from prior studies showing that the addiction to UV exposure through tanning is highly suggestive of opioid addiction. Read more in Medscape, The Scientist, and MSN.

Institute Investigator(s): Maryam Asgari

Examining infection control in shared hospital rooms during COVID-19

Michael Klompas, Meghan Baker, Chanu Rhee, and colleagues examined an ongoing vulnerability for in-hospital SARS-CoV2 transmission: shared hospital rooms. The report, published in Clinical Infectious Diseases, assessed transmission rates of patients admitted between September 2020-April 2021. Twenty-five tested positive, exposing 31 roommates, 12 of whom tested positive within 14 days. The paper recommends potential mitigation strategies, and also received much attention on Twitter.

Institute Investigators: Michael Klompas, Meghan Baker, Chanu Rhee

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