Healthcare Unfiltered

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Episode 28: Near Equivalence and Designing Cost-Effective Cancer Therapies Apr 27, 2021

Show notes

Chadi hosts three medical oncologists to break down “near equivalence” for alternative standard-of-care cancer therapies – a new paradigm published in detail in the Journal of Clinical Oncology. Ian Tannock, MD, PhD, Princess Margaret Cancer Center (Canada); Mark Ratain, MD, University of Chicago; and Daniel Goldstein, MD, Rabin Medical Center (Israel), describe what is meant by “near equivalence” and the practice of generating evidence to support global alternative cost-effective treatments. How do you design and implement studies that show lower drug doses are as effective as the labeled doses and treatment schedules? Does listing drugs at a lower price than comparable drugs impede innovation in a capitalistic society? How do poor control arms make it through regulatory and IRB approvals? How can the oncology world come to terms with “imperfect data” for supporting alternative standard-of-care treatments? These questions and more are answered in this meeting of the minds.View the publication in the Journal of Clinical Oncology https://ascopubs.org/doi/full/10.1200/JCO.20.02768

Episode 27: Lung Cancer Screening: Myths and Controversies Apr 20, 2021

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Chadi hosts two thoracic oncologists to dish and debate on the nuances of lung cancer screening: Charu Agarwal, MD, MPH, University of Pennsylvania, and Lecia Sequist, MD, MPH, Massachusetts General Hospital and Harvard Medical School. The trio start by making the case for screening the healthy, low-risk population as well as people with a smoking history, and then jump into a round-up of clinical trials that have shown a positive impact from screening. The highly-questioned JAMA publication on the USPSTF recommendations for lung cancer screening is brought to the table, including the risks and scalability across larger and smaller hospital systems. No stone is left unturned in this riveting dialogue.View the JAMA publication on screening for lung cancer https://jamanetwork.com/journals/jama/fullarticle/2777244

Episode 26: COVID-19 and Mental Health: No Easy Answers Apr 13, 2021

Show notes

George Dawson (@dawso007), MD, addiction and neuropsychiatrist in Minnesota, joins Chadi to discuss mental illness and COVID – of having the virus itself, as well as the result of isolation and lack of social interaction. Dr. Dawson shares how individuals with drug or alcohol addictions have struggled to stay sober while being stuck at home without in-person meetings and human interaction, whether there is reason to believe the COVID lockdowns and social restrictions have worse health ramifications than the disease itself (eg, suicide rates), burnout and other negative effects pervading the health care provider workforce, and how fluctuating school schedules may be negatively impacting the mental health of children.

Episode 25: History of Medicine: Bone Marrow Transplantation and Cellular Therapy Apr 06, 2021

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Krishna Komanduri (@drkomanduri), MD, chief of the division of transplantation and cellular therapy, University of Miami Sylvester Comprehensive Cancer Center, joins the show to provide a fascinating account of the history of allogeneic and autologous transplantation, the discovery of the difference between B cells and T cell, and up through modern cellular therapy with a forecast for the future decades. This is a crash course in cellular and CAR-T therapy that you won’t want to miss.

Episode 24: Mental Illness and Firearm Law with Amy Barnhorst and Rocco Pallin Mar 30, 2021

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Chadi invites Amy Barhorst (@amybarnhorst), MD, and Rocco Pallin, colleagues at UC Davis Health, to tackle the stigma and underdiagnosing of mental health in America and how mental illness intersects with gun violence in this country. The experts delve into whether community and person-to-person violence should be largely attributed to mental illness as well as why policy changes are the clearest way to eliminate mass shootings. Then, the conversation pivots to a true story of how their Review article on ways HCPs can help prevent injury and suicide from firearms was rejected and then plagiarized by the journal editor, all of which was all covered in a viral Twitter thread.View Dr. Barnhorst's interview with CNN on whether shootings are a mental health issue https://www.cnn.com/videos/tv/2018/11/27/exp-gps-1125-gupta-barnhorst-mental-health-guns.cnnRead Dr. Barnhorst's op-ed in the New York Times on why the mental health system cannot stop mass shooters https://www.nytimes.com/2018/02/20/opinion/mental-health-stopping-mass-shooters.html

Episode 23: Artificial Intelligence with Amazon Practice Manager Aziz Nazha Mar 23, 2021

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Aziz Nazha (@AzizNazhaMD), MD, former hem/onc at Cleveland Clinic, self-taught computer science expert, and now practice manager in the Data and Machine Learning Team at Amazon Web Services, joins the show to discuss artificial intelligence (AI) and machine learning from an entirely unique perspective. He details the pitfalls of unstructured healthcare data, privacy and ownership issues related to healthcare data and whether hospitals should be allowed to sell their patient data, why AI lagged in the healthcare industry compared to other industries, whether AI will ultimately replace physicians, and many other topics.

Episode 22: Simplifying the COVID-19 Vaccines With Priya Sampathkumar Mar 16, 2021

Show notes

Chadi is joined by Priya Sampathkumar (@PSampathkumarMD), MD, infectious disease specialist and hospital epidemiologist, Mayo Clinic, to detail the COVID vaccine effort over the past 12 months and how the currently approved ones came to be safe and effective in such a short period of time. She then compares each vaccine in relation to their clinical trials and study populations, side effects (including some rare ones), and efficacy. Chadi and Dr. Sampathkumar converse on what it will take for herd immunity to be reached in the US, how worried we should be about the virus variants, proper precautions to be taken after vaccination, and so much more.

Episode 21: Cardiology and Boxing Promotion: A Sit-Down With Andrew Foy Mar 09, 2021

Show notes

Andrew Foy (@AndrewFoy82), MD, cardiologist at Penn State University, joins the show to discuss publishing bias for medical research along with the psychological dilemma as a result of the pandemic of sacrificing personal liberties for the safety of others. The conversation pivots to Dr. Foy’s experience with boxing at a young age and how he eventually channeled that love into promoting the sport. How can promoting a boxing match be similar to planning a wedding? How can a full-time cardiologist balance his time while also promoting boxing matches? Dr. Foy provides a peek into the boxing world and the way COVID has impacted the sport in this riveting interview.

Episode 20: ASCO-GU Virtual Meeting Round-Up With Toni Choueiri Mar 02, 2021

Show notes

Toni Choueiri (@DrChoueiri), MD, Dana-Farber Cancer Institute, joins the show to guest host a discussion with Rana McKay (@DrRanaMcKay), MD, UC San Diego, and Alicia Morgans (@CaPsurvivorship), MD, MPH, Northwestern University, on the practice-changing abstracts presented at the 2020 ASCO-GU virtual meeting. The trio weigh the importance and real-world implications of the ACIS study for mCRPC, EV-301 for advanced or metastatic urothelial carcinoma as well as CheckMate 274 for muscle-invasive disease, CLEAR for first-line treatment of advanced RCC, and so much more.

Episode 19: Beyond ADAURA: What's Right and What's Wrong With FDA Regulations? Feb 23, 2021

Show notes

Chadi welcomes back Jack West (@JackWestMD), MD, associate clinical professor and medical oncologist, City of Hope Comprehensive Cancer Center, and Nathan Pennell (@n8pennell), MD, PhD, thoracic medical oncologist, director of the thoracic oncology program and director of clinical research, Cleveland Clinic, to the show. The task was to break down the ADAURA trial again, but to go beyond ADUARA and explore the use of various endpoints in lung cancer and how trials should be optimally designed to assure that patients garner the benefits that they deserve. The trio uses this discussion to contextualize a debate on the FDA lowering vs raising regulation on adjuvant therapies and whether the FDA should simply make drugs available and encourage physicians to use their best clinical judgment when prescribing them. ADAURA is only one study, but there are so many lessons that can be learned from the trial that can benefit current and future trial design.View Dr. West’s JAMA viewpoint on the ADAURA trial https://jamanetwork.com/journals/jamaoncology/article-abstract/2775933View Dr. Pennell’s opposing JAMA viewpointhttps://jamanetwork.com/journals/jamaoncology/fullarticle/2775934

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