Breaking the barriers between cancer research and Black patients, one walk at a time

(CARLOS BERNATE FOR STAT)

Robert Winn (above), director of the Virginia Commonwealth University Massey Cancer Center, calls them district walks. He gets out to the low-income, rural, or ethnic minority neighborhoods his hospital serves at least a couple times a year, employing a “high tech, high touch” strategy to remove barriers to cancer research. “If you’re a minority in this country, it would be abnormal for you not to be suspicious of the health system,” he told STAT’s Angus Chen. “If we have the ability to be mindful of the nature of what that is and how to overcome that, we’re going to see a lot more positive results and — yeah — a lot more people on clinical trials.”

In this special report, the second in a series on health equity and diversity in clinical trials and cancer research, Winn and others explain how it’s not just historical traumas like the Tuskegee study holding people back — the roots of medical mistrust run deeper and wider. Angus has more from Richmond, Va.

Medicare reverses course on plan to hide hospital safety data next year

Here’s an about-face: Last month STAT’s Tara Bannow told us about federal plans to trim Care Compare, a government website that compiles hospital quality data in a user-friendly format, assigning hospitals ratings based on a diverse set of metrics. Now Tara writes that Medicare will continue to report hospital safety data as usual next year, apparently swayed by backlash from patient safety advocates. The change of heart appeared in the agency’s final hospital payment rule for 2023, released Monday.

The data that would have been suppressed next year is a composite score of 10 metrics of patient safety and catastrophic events including pressure ulcers, hip fractures, and sepsis after surgery. Hospitals aren’t happy: The American Hospital Association warned in a statement that the decision could mislead the public and fail to advance patient safety. Read more.

A doctor's view of the Paxlovid rebound mystery

Joan Bregstein, an emergency medicine physician in New York City, often fields calls about medical issues from family members, friends, and even friends of friends. You can imagine how two pandemic years have amplified the volume of those requests for advice. Writing in at STAT First Opinion, she notes the latest slew has concerned confusion about Paxlovid rebound. And she counts herself, her physician colleagues, and at least one Nobel laureate among the perplexed.

Her friends, including Joachim Frank, who shared the Nobel Prize in Chemistry in 2017, wonder if they should have followed their doctors’ recommendation to take the antiviral. “For me, rebound begs the question: Is Paxlovid worth it?” she writes, acknowledging the CDC's advisory endorsing the drug despite the rebound risk. “There are no clear and easy answers to these questions, just as there is no solid explanation.” Read more, on one theory and the nature of medicine.

Closer look: How much are patients actually using mental health apps? Good question

(MIKE REDDY FOR STAT)

The numbers, when they exist, are all over the place. A new paper in Frontiers in Psychiatry looking at four FDA-cleared mental health apps found little data to say how much people are actually using digital therapeutics. The researchers studied four treatments marketed by Akili Interactive and Pear Therapeutics: Akili’s video game-based treatment for childhood ADHD and Pear’s apps for substance use disorder, opioid use disorder, and insomnia.

Some of the apps may be of only fleeting interest to patients outside the research setting, the researchers conclude. But calculating patient engagement in this nascent field can be tricky. “It is becoming increasingly clear that there isn’t an exact bar set for the specific types and quality of clinical evidence that qualifies a DTx evidence package as ‘sufficient,’” Megan Coder of the Digital Therapeutics Alliance told STAT’s Mario Aguilar. Read more.

Study refutes notion behind restricting gender-affirming medical care for adolescents

One of the arguments being used to limit medical treatment for young transgender people cites “social contagion,” the idea that a growing proportion of young people are identifying as transgender. Sometimes called “rapid onset gender dysphoria,” it was advanced in a later-corrected study based on a survey of parents whose children were seen in pediatric gender clinics. That study also said more children assigned female than male at birth were later transitioning.

A study published today in Pediatrics rejects that finding and other assumptions, based on around 100,000 high schoolers’ responses to national surveys in 2017 and 2019. The researchers report the percentage of teens openly identifying as transgender or gender diverse did not increase between 2017 (2.4%) and 2019 (1.6%). "The notion of [rapid onset gender dysphoria] should not be used to restrict the provision of gender-affirming medical care for [transgender or gender diverse] adolescents," the authors write.

A new way to think about low back pain

Chronic back pain can seem insurmountable when traditional treatments including pain relievers, spinal manipulation, injections, and surgery don’t help. A new JAMA study tested a different approach: retraining how the back and the brain communicate through a technique called sensorimotor training, which builds on the idea that pain makes people move differently, reducing fitness and sharpening that pain.

The researchers split 276 people with low back pain into two groups. Half learned how to move without fearing further pain and then helped to do so; half received a sham laser, shortwave diathermy, and noninvasive brain stimulation. After 18 weeks, the sensorimotor training group reported a modest but significant improvement on a 0-10 scale of pain compared to the sham group. “The improvements in pain intensity were small, and further research is needed to understand the generalizability of the findings,” the study authors write.

What to read around the web today

They lost Medicaid when paperwork was sent to a pasture, signaling the mess to come, Kaiser Health News
West Virginia reaches $400 million opioid deal with distributors, Wall Street Journal
Alexis Borisy, biotech’s ‘man of many hats,’ dons another, STAT
Amazon’s foray into primary care won’t be easy, Harvard Business Review
U.S. appeals court panel decides AbbVie's 'patent thickets' for Humira don't thwart competition, STAT