Research Spotlight

Ochoa, C., J. Baron-Lee, C. Popescu and K. M. Busl (2020). “Electronic patient portal utilization by neurology patients and association with outcomes.” Health Informatics J Jul 17;1460458220938533. [Epub ahead of print.].

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Existing literature on electronic patient portals demonstrates mixed findings for portal user demographic patterns and relationships between portal usage and clinical outcomes. This study sought to determine characteristics of portal users specific to a neurology patient population and examine whether usage predicted decreased clinic visits and risk of hospitalization. A cross-sectional analysis on 13,483 patients seen at a tertiary neurology outpatient clinic over a 1-year period found significant associations between demographics, and interactions between age, sex, and race. Black and Hispanic patients were less likely to be portal users. While females had higher odds of portal usage overall, their probability decreased with increasing age. Portal users had higher rates of clinic utilization but no difference in hospitalization risk. These results highlight demographics that may need strategic targeting to increase portal uptake and the need for other interventions for populations more likely to experience health events resulting in hospitalization.

Moore, A. Y., M. Nguyen and S. Moore (2020). “Cyclical Calcipotriene 0.005% Foam and 1% 5-Fluorouracil Cream After Cryotherapy in Treatment of Hyperkeratotic Actinic Keratosis: A Retrospective Study.” J Am Acad Dermatol Jul 8;S0190-9622(20)32174-5. [Epub ahead of print.].

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Matsuyama, T., R. Kandimalla, T. Ishikawa, N. Takahashi, Y. Yamada, M. Yasuno, Y. Kinugasa, T. F. Hansen, M. Fakih, H. Uetake, B. Győrffy and A. Goel (2020). “A novel mesenchymal-associated transcriptomic signature for risk-stratification and therapeutic response prediction in colorectal cancer.” Int J Cancer Jul 13. [Epub ahead of print.].

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Risk stratification in Stage II and III colorectal cancer (CRC) patients is critical, as it allows patient selection for adjuvant chemotherapy. In view of the inadequacy of current clinicopathological features for risk-stratification, we undertook a systematic and comprehensive biomarker discovery effort to develop a risk-assessment signature in CRC patients. The biomarker discovery phase examined 853 CRC patients, and identified a gene signature for predicting recurrence-free survival (RFS). This signature was validated in a meta-analysis of 1212 patients from nine independent datasets, and its performance was compared against established prognostic signatures and consensus molecular subtypes (CMS). In addition, a risk-prediction model was trained (n = 142), and subsequently validated in an independent clinical cohort (n = 286). As a result, this mesenchymal-associated transcriptomic signature (MATS) identified high-risk CRC patients with poor RFS in the discovery (hazard ratio [HR]: 1.79), and nine validation cohorts (HR: 1.86). In multivariate analysis, MATS was the most significant predictor of RFS compared to established prognostic signatures and CMS subtypes. Intriguingly, MATS robustly identified CMS4-subtype in multiple CRC cohorts (AUC = 0.92-0.99). In the two clinical cohorts, MATS stratified low and high-risk groups with a 5-year RFS in the training (HR: 4.11) and validation cohorts (HR: 2.55), as well as predicted response to adjuvant therapy in Stage II and III CRC patients. We report a novel prognostic and predictive biomarker signature in CRC, which is superior to currently used approaches and have the potential for clinical translation in near future.

Mathai, S. K., J. Cardwell, F. Metzger, J. Powers, A. D. Walts, J. A. Kropski, O. Eickelberg, S. M. Hauck, I. V. Yang and D. A. Schwartz (2020). “Preclinical Pulmonary Fibrosis (PrePF) Circulating Protein Biomarkers.” Am J Respir Crit Care Med Aug 5. [Epub ahead of print.].

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Idiopathic pulmonary fibrosis (IPF) is characterized by progressive, irreversible scarring of the lung parenchyma that can require invasive diagnostic testing. Interstitial lung abnormalities (ILA) have been described in the general population. Among asymptomatic first-degree relatives of Familial Interstitial Pneumonia (FIP) patients, 14% have radiologic ILA and 35% have interstitial abnormalities on biopsy. In the Framingham population, fibrotic ILA were present in 1.8% of subjects ≥50 years of age and associated with increased risk of death (5, 6), suggesting ILA may be a harbinger of IPF. [No abstract; excerpt from article].

Mack, M. J. and P. Lancellotti (2020). “Early Surgery in Infective Endocarditis: Can it Be Too Early?” J Am Coll Cardiol 76(1): 41-42.

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Approximately 50% of patients with infective endocarditis (IE) will require early surgery (i.e., during the initial hospitalization before the completion of a full therapeutic course of antibiotics). With early surgery, there are concerns that performing the procedure during an active infection, before the valve is completely sterilized, may lead to an increase in post-operative complications. How-ever, recently it has been suggested that early surgical intervention with<7 days of pre-operative antibiotic therapy is associated with a lower risk of mortality in comparison with surgery performed be-tween 8 and 20 days after the initiation of antibiotics. Indeed, in general, clinical practice has moved more aggressively toward earlier surgical intervention. [No abstract; excerpt from Editorial].