Special report: A clinical trial to close breast cancer disparities struggled to enroll Black women

UCSF surgeon Laura Esserman believes breast screening shouldn’t be one-size-fits-all. The trick is figuring out how much each woman ought to be screened, based on age, genetics, family history, and breast density. To prove her hypothesis, she planned a large study with broad representation from people of color — a contrast from the makeup of most breast cancer trials. But in the first three years, just 1.7% of participants were Black. Esserman needed help. “I thought all that was needed was just making sure you got the word out,” she told STAT’s Angus Chen. “But that’s not it. You have to work on it.”

It’s a problem Consuelo Wilkins of the Vanderbilt Recruitment Innovation Center sees all the time. “We’re getting called to rescue the study,” she said. “It’s much harder to do this work ... later than if you did it in the beginning.” Read more about the next steps.

It's health insurers' and employers' turn to be transparent

You may know hospitals have to post their prices. Starting tomorrow, health insurers and employers that pay directly for their workers’ medical care have to post data on what they pay hospitals, doctors, and other providers. The federal rule follows a similar requirement for hospitals to publish the prices they negotiate with insurers, but in the 18 months since that went into force, compliance has been dismal at best, STAT’s Bob Herman reports. Insurers and employers may do better, given the substantial fines they face for noncompliance.

All that data may not mean much to the average person shopping around for care. It will be more relevant for researchers and corporate benefits directors wanting to see which companies are getting hosed on health care prices. “It's kind of like Christmas Day for us,” Marcus Dorstel of Turquoise Health told Bob. Read more.

Gut instinct: How lattes led to an experimental method to relieve inflammation in mice

When James Byrne heard the whipping siphons foaming milk at Starbucks, he thought beyond lattes. The machines inspired him and other scientists to create their own device to seal carbon monoxide inside little bubbles in a gas-entrapping material. Carbon monoxide is fatal when inhaled at high concentrations, but delivered inside the body at low doses, it can ease inflammation, the researchers report in a Science Translational Medicine study. In mice, the method reduced tissue injury and inflammation in models of chemically induced colitis, radiation-induced proctitis, and liver injury due to acetaminophen overdose.

The team also tested a gel to trap carbon monoxide — essentially a gummy-bear-type system. And after watching a YouTube video to see how Pop Rocks were made, they applied the same strategy to allow controlled carbon monoxide release in the gut. STAT’s Akila Muthukumar has more.

Closer look: In Indiana, an unlikely champion of lower hospital prices succeeds

(Lee Klafczynski for STAT)

When Al Hubbard (above) saw a headline about hospital prices in Indiana outpacing its neighbors, he didn’t sit by quietly. His advocacy played a part in Indiana banning surprise medical billing, forcing hospitals to disclose their prices, and taking steps to make medical insurance claims data more public. But Hubbard isn’t the typical crusader for lowering health care costs. The former chair of Indiana’s Republican Party is a prolific political donor, generous with the millions he made in specialty chemicals, gluten-free baked goods, and camper van rentals.

“One hospital CEO actually said, ‘Who gives you standing to take this on?’” Hubbard told STAT’s Rachel Cohrs. “Nobody gives me standing. I’m a citizen. We’re in America. And it’s important that someone challenge hospitals on their high prices because it’s hurting the standard of living of every single person who lives in Indiana.” Read more of Rachel's report from Indianapolis.

Where searches for abortion medication spiked

Before the U.S. Supreme Court overturned Roe v. Wade last week and set off seismic changes in health care, the leaked draft of the majority opinion on May 2 had already spurred a response. A new analysis in JAMA Internal Medicine correlates the news with about 350,000 Google searches for abortion medication during the first week of May, 165% higher than in the previous week. The searches also tracked with states’ restrictions on reproductive rights, the researchers say, while adding that the searches can't confirm any abortion attempts or online users' demographics.

“Elevated interest in abortion medications should alert physicians that many of their patients may pursue this option with or without them,” the authors say. “Continued surveillance is needed to monitor how changes in federal and state abortion laws affect demand for information about abortion medications and other medical interventions.”

Transplant group eliminates race-based calculations for kidney patients

In the latest move to remove race from the equation when assessing kidney function, the board of the Organ Procurement and Transplantation Network voted this week to require transplant hospitals to eliminate race-based calculations when listing candidates for transplant. Previously, measures such as eGFR (estimation of glomerular filtration rate) have included a modifier for Black patients based on incorrect and outdated assumptions about race and biology.

As STAT’s Usha Lee McFarling explained when the National Kidney Foundation and the American Society of Nephrology recommended a similar move, the practice underestimates the severity of kidney disease in Black patients, meaning they are added to transplant wait lists later. The new policy will correct the waiting time for affected patients, OPTN said. Black Americans are four times more likely than white Americans to have kidney failure and, despite having higher rates of end-stage kidney disease, are less likely to receive kidney transplants.

What to read around the web today

The pandemic is waning. Anthony Fauci has a few lessons to share, Washington Post
First reported case of a person getting Covid from a cat, Nature
Opinion: FDA: Don’t rush a move to change the Covid-19 vaccine composition, STAT
WHO chief: U.S. abortion ruling 'a setback,' will cost lives, Associated Press
ARCH Venture Partners raises $3 billion fund to invest in biotech startups despite brutal stock downturn, STAT