News and Highlights
November 2009
Publications
Patients Often Not Informed of Abnormal Test Results
Lawrence P. Casalino, MD, PhD, MPH, Associate Professor and Chief of the Division of Outcomes and Effectiveness Research, was the lead author of an article titled “Frequency of Failure to Inform Patients of Clinically Significant Outpatient Test Results,” published June 22, 2009, in Archives of Internal Medicine. Dr. Casalino and his colleagues found that failures to inform patients of abnormal test results or to document informing them are very common, but the use of simple organizational processes for managing test results reduces failure rates. The article was described in a Weill Cornell Medical College press release as well as a press release from Journal of the American Medical Association (Archives of Internal Medicine of one of the JAMA/Archives journals.) The study was covered extensively by television, radio, print, and online media. Examples include The New York Times, AP, Reuters, Wall Street Journal, Boston Globe, NY Daily News, Newsday, The Los Angeles Times, U.S. News and World Report,Consumer Reports, HealthDay, HealthNewsDigest.com, NPR’s Health Blog, Ama-assn.org, ClinicalAdvisor.com, and numerous affiliates of ABC, CBS, and NBC television and radio.
Public Health Faculty Author Three Studies in July/August issue of Journal of Medical Decision Making
Nathaniel Hupert, MD, MPH, Associate Professor of Public Health in the Division of Outcomes and Effectiveness Research, had two articles that appeared in the July/August issue of the Journal of Medical Decision Making. He was the lead author of “ Predicting hospital surge after a large-scale anthrax attack: A model-based analysis of CDC’s Cities Readiness Initiative prophylaxis recommendations.” Co-authors included Wei Xiong, PhD, Assistant Professor of Public Health, and Eric Hollingsworth and Kristof Neukermans, both formerly Research Data Specialists in the Department of Public Health. The researchers conducted a computer simulation study of a large anthrax attack on a major metropolitan area. They found that quick detection and treatment are essential for an effective response, and any delay beyond a couple of days would overwhelm hospitals with critically ill patients. The paper was described in a Medical College press release; Reports on the findings appeared in MedicalNewsToday.com, United Press International, USA Today, ScienceDaily.com, and AllHeadlineNews.com.
The second study, “Recommendations for Modeling Disaster Responses in Public Health and Medicine: A Position Paper of The Society for Medical Decision Making,” is the first position paper published by the Society. The study’s lead author is Dr. Margaret Brandeau of Stanford University, and, with the exception of Dr. Hupert, the other co-authors are from Stanford University. The authors examined various approaches for modeling disaster response and recommended several best practices.
Andrew Vickers, PhD, Associate Attending Research Methodologist at Memorial Sloan-Kettering Cancer Center (MSKCC) and Associate Professor of Public Health in the Division of Biostatistics and Epidemiology, was the lead author of “Long-term health outcomes of a decision aid: data from a randomized trial of Adjuvant! In women with localized breast cancer.” Co-authors included Elena Elkin, PhD, Assistant Attending Outcomes Research Scientist at MSKCC and Assistant Professor of Public Health in the Division of Health Policy.
Dr. Nathaniel Hupert Co-Authors Articles on H1N1 Flu Transmission and Vaccine Cost-Effectiveness
Dr. Hupert was a co-author of a paper titled “Initial human transmission dynamics of the pandemic (H1N1) 2009 virus in North America,” published in the September 2009 issue of Influenza and Other Respiratory Viruses. The study used advanced network mathematics to determine the reproduction number of the new virus. It represented a major international effort to examine H1N1 transmission and involved collaboration among researchers in Mexico, Canada, the U.S., and England. This project, which received clearance from the U.S. Centers for Disease Control and Prevention (CDC), is Dr. Hupert’s first publication as Director of the CDC’s Preparedness Modeling Unit.
Dr. Hupert was also co-author on “Effectiveness and Cost-Effectiveness of Vaccination Against Pandemic Influenza (H1N1) 2009,” published in Annals of Internal Medicine. This study, headed by researchers from Stanford University led by Dr. Nayer Khazeni, a pumonary and critical care specialist, found that vaccination campaigns beginning in October or November of this year could be cost-effective or cost-saving if over 30% of the U.S. population were inoculated.
Genetic Testing to Guide Chemotherapy Treatment
Heather Taffet Gold, PhD, Assistant Professor of Public Health in the Division of Health Policy, was the lead author of a paper published in the September 1, 2009, issue of Cancer titled ” Cost effectiveness of pharmacogenetic testing for UGT1A1 before irinotecan administration for metastatic colorectal cancer. Bruce R. Schackman, PhD, Chief of the Division of Health Policy, was the senior author; Michael J. Hall, MD, MS, Director of the Gastrointestinal Tumor Risk Assessment Program at Fox Chase Cancer Center, and Victoria S. Blinder, MD, Medical Oncologist at Memorial Sloan-Kettering Cancer Center, were co-authors. The researchers found that testing for a genetic variation that makes some people prone to developing neutropenia with chemotherapy can be cost-effective, but only if reducing the dosage of the chemotherapy drug does not reduce treatment efficacy. The article was covered by a Weill Cornell Medical College press release. Reports of the research appeared in several online news websites, including Sciencedaily.com, Newswise.com, and Eurekalert.org.
Falls Significantly Contribute to Mortality from Severe Traumatic Brain Injury in People Over 65
Linda M. Gerber, PhD, MA, Professor of Public Health in the Division of Biostatistics and Epidemiology and Professor of Epidemiology in Medicine, was the lead author of an article published in the July 30, 2009 issue of the Journal of Trauma Management and Outcomes titled “Impact of Falls on Early Mortality from Severe Traumatic Brain Injury.” The article reflects a multi-center study of the impact of falls on early mortality from severe traumatic brain injury (TBI) among the elderly. The authors found that falls contributed to 61% of all TBI injuries among people age 65 and older and that people falling from a height of less than 3 meters were especially likely to die from their injuries. The article’s co-authors were Quanhong Ni, MS, formerly of Weill Cornell’s Department of Public Health, Roger Hartl, MD, Associate Professor of Neurological Surgery, and Jamshid Ghajar, Clinical Professor of Neurological Surgery and President of the Brain Trauma Foundation.
Teen Attitudes Toward Smoking Linked to Lifetime Substance Use
A study led by Jennifer Epstein, PhD, Assistant Professor of Public Health, examined specific ways parents and peers influence teenagers to smoke, drink, and use marijuana. The authors, who also included Gilbert Botvin, PhD, Professor and Chief of the Division of Prevention and Health Behavior; and Margaret Doyle, formerly of Weill Cornell Medical College, found that attitudes toward smoking influenced teenager’s use of multiple drugs, and that there are some differences between boys and girls in the way social influences affect their behavior. The article, titled “Gender-specific effects of social influences and competence on lifetime poly-drug use among inner-city adolescents,” was published in the July 2009 issue of Journal of Child & Adolescent Substance Abuse. It was reported on by a Medical College press release and was covered by MedicalNewsToday.com, RDMag.com, and other popular and medical websites. The October 9 issue of Cornell Chronicle mentioned it on the first page with a link to ScienceBlog.com.
Dr. Epstein was also the lead author of another recently published article, “ Risk Factors for Suicidality Among a Nationally Representative Sample of High School Students ,” which appeared in the June 2009 issue of Suicide and Life-Threatening Behavior. The co-author was Anthony Spirito, PhD, of the Center for Alcohol & Addiction Studies at Alpert Medical School of Brown University.
Self-Management Skills Protective Against Teen Substance Use
A study led by Kenneth Griffin, PhD, MPH, Professor of Public Health in the Division of Prevention and Health Behavior, examined various cognitive and behavioral self-management skills (e.g., of decision-making, problem solving, self-reinforcement, and self control skills) and their relationship to alcohol, tobacco, and marijuana use in students followed from the 7th through 10th grades. The authors, who also included Lawrence Scheier, PhD, Associate Professor of Psychology in Public Health (Courtesy), and Gilbert Botvin, PhD, Professor and Chief of the Division of Prevention and Health Behavior, used latent growth modeling techniques to find that early self-management skills were protective and slowed growth in substance use. Early levels of substance use, on the other hand, led to a decline in self-management skills over time. Relations between the two slope growth factors indicated that increases in substance use over time were associated with parallel decreases in self-management skills. The article was published in the summer 2009 issue of Health & Addictions. The findings support the utility of prevention programs that emphasize self-management skills training as an effective deterrent to early-stage substance use.
Book Chapter Co-authored by Dr. de Melo-Martín
Inmaculada de Melo-Martín, PhD, MS, Associate Professor of Public Health in the Division of Medical Ethics, contributed a book chapter with co-author M. Gillis, titled “Ethical Issues in Human Stem Cell Research: Embryos and Beyond.” The chapter appears on pages 323 to 334 of Technology and Values: Essential Readings , edited by C. Hanks (Malden, MA: Wiley-Blackwell, 2009).
Authors Comment on Cost-Effectiveness Analysis of Total Knee Arthroplasty
An editorial in the June 22 issue of Archives of Internal Medicine titled “Cost-effectiveness Analysis of an Established, Effective Procedure” comments on a study in the same issue investigating the influences of hospital volume and patient risk on Total Knee Arthroplasty (TKA) cost-effectiveness in the United States. The editorial was written by Stephen Lyman, PhD, Assistant Professor of Public Health and Director of Epidemiology & Biostatistics at the Hospital for Special Surgery (HSS), Robert G. Marx, MD, MSc, Professor of Orthopedic Surgery and Public Health and Director of the HSS Foster Center for Clinical Outcome Research, and Peter B. Bach, MD, MAPP, Assistant Professor of Clinical Public Health and Associate Attending Physician at Memorial Sloan-Kettering Cancer Center. Specifically, the authors discussed challenges of translating findings of cost-effectiveness to clinical practice. Both the article and the editorial were covered by Reuters.
Dr. Stephen Lyman and Co-Authors Study Epidemiology of ACL Reconstruction
Stephen Lyman, PhD, Assistant Professor of Public Health and Director of Epidemiology & Biostatistics at the Hospital for Special Surgery (HSS), was the lead author of an article published in the October 1, 2009, issue of the Journal of Bone and Joint Surgery titled “Epidemiology of Anterior Cruciate Ligament Reconstruction: Trends, Readmissions, and Subsequent Knee Surgery.” Robert G. Marx, MD, MSc, Professor of Orthopedic Surgery and Public Health and Director of the HSS Foster Center for Clinical Outcome Research, was the senior author. Co-authors, all from the HSS Foster Center for Clinical Outcome Research, included Panagiotis Koulouvaris, MD, Seth Sherman, MD, Huong Do, MA, and Lisa A. Mandl, MD, MPH, Assistant Professor of Medicine and Public Health. The authors found that the rate of anterior cruciate ligament reconstruction has increased in frequency in recent years. Also, while anterior cruciate ligament reconstruction appears to be a safe procedure, the risk of a subsequent operation on either knee is increased among younger patients and those treated by a lower-volume surgeon or at a lower-volume hospital.
Modeling the Effects of Tuberculosis Prevention and Treatment Strategies
Laith J. Abu-Raddad, PhD, Assistant Professor of Public Health and Physics/Qatar, was the lead author of an article published in the August 18, 2009, issue of Proceedings of the National Academy of Science titled “Epidemiological benefits of more-effective tuberculosis vaccines, drugs, and diagnostics .” The authors examined the benefits of implementing new TB tools developed with support from the Bill & Melinda Gates Foundation, using a mathematical model applied to the World Health Organization Southeast Asia region.
Study Examines Disparities in Use of High-Volume Providers for Coronary Artery Bypass Graft 
Yuhua Bao, PhD, Assistant Professor of Public Health in the Division of Health Policy, was the lead author of an article published in the July 2009 issue of Medical Care titled “Geographical distribution of surgical capabilities and disparities in the use of high-volume providers: the case of coronary artery bypass graft (CABG).” The co-author was Shital Kamble, PhD, currently a post-doctoral fellow at Duke University. The authors examined the extent to which regional availability of surgical capabilities in Florida explains differences by patient race/ethnicity and insurance in the use of high-volume surgical providers. They found that unequal distribution of CABG capabilities coupled with racial/ethnic concentration in residence across regions in Florida accounted for almost all racial/ethnic differences in using high-volume hospitals. Factors other than availability of surgical resources were responsible for differences between Medicaid/uninsured and privately insured patients.
Regular ECG Tests May Predict Sudden Cardiac Death
Majnu John, PhD, Instructor of Biostatistics in Public Health, was a co-author of an article published online August 17, 2009, in the European Heart Journal titled “QRS duration predicts sudden cardiac death in hypertensive patients undergoing intensive medical therapy: the LIFE study.” The study found that a prolonged QRS duration, a measure of heart function recorded during a routine electrocardiogram, is a significant predictor of sudden cardiac death. The study was covered in a Weill Cornell Medical College press release. The senior author was Dr. Peter Okin, Professor of Medicine at Weill Cornell Medical College and a cardiologist at of the Ronald P. Perelman Heart Institute of NewYork-Presbyterian Hospital/Weill Cornell Medical Center. The lead author was Dr. Daniel P. Morin of the Ochsner Clinic Foundation in New Orleans. Dr. Richard Devereux of the Ronald P. Perelman Heart Institute was also a co-author, as were investigators from hospitals in Finland, Norway, and Sweden.
Dr. Lawrence Scheier’s Book on Drug Use Etiology Is Published 
Handbook of Drug Use Etiology: Theory, Methods, and Empirical Findings, a new book edited by Lawrence M. Scheier, PhD, has been published. Dr. Scheier is president of LARS Research Institute, Inc., and Associate Professor of Psychology in Public Health (Courtesy) in the Division of Prevention and Health Behavior. The book explores the complex interplay of factors that contribute to drug use, its prevention, and its cessation, and describes the history and development of the field of drug use etiology. Division faculty contributed to the book. Dr. Kenneth Griffin contributed a chapter entitled "The epidemiology of substance use among adolescents and young adults: A developmental perspective" and Dr. Gilbert Botvin (with Dr. Griffin) contributed a chapter entitled "Advances in the science and practice of prevention: Targeting individual-level etiologic factors and the challenge of going to scale."
Recent Publications by Dr. Larry Liu
Larry Liu, MD, PhD, Assistant Professor of Public Health (Courtesy) in the Division of Outcomes and Effectiveness Research, was a co-author of several recently published articles:
- Chapman RH, Benner JS, Girase P, Benigno M, Axelsen K, Liu LZ, Nichol MB. Generic and therapeutic statin switches and disruptions in therapy. Current Medical Research & Opinion 2009; 25:1247-60.
- Aronow HD, Hess G, Hill J, Kuznik A, Liu LZ. Switching from atorvastatin to simvastatin in patients at high cardiovascular risk: Effects on low-density lipoprotein cholesterol. Am J Therapeutics 2009; epub.
- Straka RJ, Liu LZ, Girase PS, Delorenzo A, Chapman RH. Incremental cardiovascular costs and resource use associated with diabetes: An assessment of 29,863 patients in the US managed-care setting. Cardiovascular Diabetology 2009; 8:53:1-11.
