Here are just 10 of the year’s many significant findings from Group Health Research Institute (GHRI):
Compared to usual care, mindfulness-based stress reduction (a form of meditation training) and cognitive behavioral therapy lessened chronic low back pain and improved functioning in Group Health patients. The JAMA study led by Dan Cherkin, PhD, now a GHRI senior investigator emeritus, showed these effects persisted at one year. More than 100 news outlets covered the results, including the New York Times, NPR, Reuters, Seattle magazine, and Washington Post. It was even parodied in The Onion. Read our news release and Dr. Cherkin’s blog post and watch JAMA’s video. To come: a cost analysis.
Bariatric surgery kept weight off for a decade in a large multisite study of Veterans Affairs patients around the country. Results were best for those who had Roux-en-Y gastric bypass surgery. Senior Investigator David Arterburn, MD, MPH, coauthored the study, which JAMA Surgery published. Read NPR's story and Dr. Arterburn’s blog post.
In a large national data set, use of deep sedation during colonoscopy is rising—and is linked to a 13 percent higher risk of any complication within 30 days, according to Associate Investigator Karen Wernli, PhD, in Gastroenterology. These complications include higher risk of perforation, bleeding, abdominal pain, complications due to anesthesia, and stroke. Unlike many settings, Group Health’s Group Practice does not routinely use deep sedation with propofol during colonoscopy, instead using moderate sedation. Read Dr. Wernli’s blog post and watch her in a video.
GHRI Executive Director Eric B. Larson, MD, MPH, coauthored a JAMA Internal Medicine study showing good news about dementia: The rates of new dementia cases in older American retirees continue to decrease. That’s likely related to better socioeconomic status and control of risk factors. The number of cases is still rising, because of aging of the population. The large national study received wide media coverage. Read our news release and blog post.
Collaborative care for adolescent depression had already proven effective in a randomized clinical trial at nine Group Health primary care clinics. Now its cost-effectiveness has been proven in a JAMA Pediatrics study by Senior Research Associate Evette Ludman, PhD, and colleagues including Affiliate Investigator Laura Richardson, MD, MPH. Read Dr. Ludman’s blog post.
After Group Health launched a systemwide effort to improve preventive care for members at risk of cardiovascular disease, greater statin use was linked to reductions in strokes and heart attacks and lower likelihood of death for cardiovascular reasons. Although increased statin use raised drug costs, the total cost of care didn’t change, probably because the increase in medication costs was offset by fewer treatments for cardiovascular events. The research team included Senior Investigator James D. Ralston, MD, MPH, and Affiliate Investigator David Grembowski, PhD, in the Journal of Managed Care & Specialty Pharmacy. Read Dr. Ralston’s blog post.
Bupropion (Wellbutrin) was the only antidepressant that tended to be linked to weight loss over two years in Group Health patients. This antidepressant should be the first choice for overweight and obese patients with depression, according to Dr. Arterburn and Senior Investigator Greg Simon, MD, MPH, in the Journal of Clinical Medicine. Media coverage included NIH Research Matters. Read our news release.
When people have a history of a traumatic brain injury (TBI) with loss of consciousness, they are more likely to develop Parkinson’s disease, parkinsonian features, microscopic strokes (microinfarcts), and Lewy bodies (which play a role in Parkinson's disease and Lewy body dementia). Dr. Larson and Affiliate Investigator Paul Crane, MD, MPH, published in JAMA Neurology. Media coverage was widespread given rising concerns over head trauma in football players. Read Dr. Larson’s blog post.
GHRI participates in the Evidence‑based Practice Center called Kaiser Permanente Research Affiliates, whose evidence reviews inform recommendations by the U.S. Preventive Services Task Force. As part of this work, Associate Investigator Jessica Chubak, PhD, was the first author of an Annals of Internal Medicine evidence review showing that low-dose aspirin can help lower the risk for colon cancer—not only heart attacks and stroke—in middle-aged people at cardiovascular risk.
Other widely reported evidence reviews with first authors from GHRI included findings that don’t support recommending skin cancer screening for all adults (by Dr. Wernli)—or lipid screening for all children and teens to find familial hypercholesterolemia or multifactorial dyslipidemia (by Senior Investigator Paula Lozano, MD, MPH). The reviews were published in JAMA.
And now? Onward and upward through 2017.
by Rebecca Hughes