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Morning Rounds Shraddha Chakradhar

Johnson & Johnson Covid-19 vaccine study paused due to unexplained illness in participant

Johnson & Johnson's Covid-19 vaccine study has been paused due to an unexplained illness in a participant. STAT obtained a document sent to outside researchers that said a "pausing rule" had been met for the 60,000-person trial, that the online system being used to enroll participants has been closed, and that an independent committee overseeing the safety of patients in the trial was being convened. J&J declined to provide further details. The company emphasized that so-called adverse events are an expected part of a clinical trial, and that the study pause is different from a clinical hold, the latter of which is a formal regulatory action that can last longer. And in cases like these, J&J said, “it is not always immediately apparent” whether the adverse event occurred in the treatment or placebo arm. 

Trump prepares to campaign in Iowa, where Covid-19 is 'out of control'

It's been about a week since President Trump was hospitalized with Covid-19, but he is already back on the campaign trail with a week full of in-person rallies and events. On the docket are stops in Pennsylvania and North Carolina, and just last night he held an event in Florida, where few supporters were seen wearing masks. But perhaps his most audacious stop will be the one in Iowa, which the White House's own coronavirus task force has flagged as being in the "red zone" for its high transmission rates and uptick in preventable Covid-19 deaths. The state reported 463 deaths on Monday alone, and the positive case rate has gone up 9.5% in the past two weeks. Attendees at the Iowa aren't being asked to socially distance themselves, but will be asked to sign waivers. “You’re going to get exposures, you’re going to have cases there,” one expert tells STAT. “It’s a question of: Will they be manageable?”

Researcher studying ways to improve rural maternal care wins Heinz Public Policy award 

Katy Kozhimannil, a health policy researcher at the University of Minnesota, has won this year's Heinz Award in Public Policy for her work on rising maternal mortality rates in the rural U.S. and especially among women of color. Her research has found that pregnant women in rural areas are 9% more likely to die from complications than those in more populated areas. And her work on how doulas could reduce maternal complications and racial inequities helped drive policy change in Minnesota: In 2013, the state passed legislation for Medicaid coverage of doula care. Kozhimannil and the other Heinz Award winners — in the categories of arts and humanities; environment; human condition; and technology, the economy, and employment — will get an unrestricted $250,000 prize.

Inside STAT: How software infuses racism into U.S. health care


A railroad crossing in Ahoskie, N.C. (LANDON BOST FOR STAT)

A new STAT investigation lays out how algorithms that sift through patients' data to make determinations about who should get extra care or support for their illnesses are infusing racial bias into the U.S. health system. These algorithms soak up long-standing disparities that affect places all over the U.S, including the 5,000-person town of Ahoskie, N.C. STAT's Casey Ross says that was apparent when he visited the town, where there are still leftovers of Jim Crow-era laws such as how all the health providers are all located in the historically white part of town. "The differences in access are still creating huge disparities for Black people, who are much more likely to die from chronic conditions like diabetes and heart failure," Casey tells me. And even as multiple software products predict the cost of care of nearly 200 million people in the U.S., "patients are not privy to the details on how they are being applied," Casey shares. Read more of Casey's investigation here — and check out the five key takeaways from it here

1 in 8 people who underwent an elective colonscopy may have received a 'surprise' medical bill

Around 1 in 8 people with insurance potentially received surprise out-of-network bills for colonoscopies, new research finds. Scientists looked at data between 2012-2017, and found that around 12% of claims for the more than 1.1 million elective colonoscopies conducted at in-network facilities may have still been out-of-network. The median cost of these bills was $418, and nearly two-thirds of the surprise bills involved out-of-network anesthesiologists (pathologists who were not in-network made up around 40% of cases). The analysis also found that the likelihood of an out-of-network bill increased if doctors had to perform some kind of intervention — such as a biopsy — during the procedure.  

World's largest study evaluating genetics of eating disorders is recruiting volunteers

Researchers at the University of North Carolina are looking for at least 6,000 adult volunteers for what they're saying is the world's largest study of the genetics of eating disorders. The Eating Disorders Genetics Initiative aims to uncover how genes influence the risk of developing anorexia nervosa, bulimia nervosa, or binge-eating disorder. Recent research has suggested that although social and cultural factors play a role, there are also biological underpinnings that may make some people likelier to develop these conditions than others. EDGI also has international sites in the U.K., Australia, New Zealand and Sweden. Interested participants will be asked to take a survey, after which a select group will be invited to send saliva samples for genetic analysis. 

What to read around the web today

  • Covid-19 costs Ohio Valley hospitals billions, putting some rural hospitals at risk of closing. WFPL
  • Two Black university leaders urged their campuses to join a Covid-19 vaccine trial. The backlash was swift. STAT
  • He’d waited decades to argue his innocence. His judge believed in second chances. Nobody knew she had Alzheimer’s. ProPublica
  • Doctors are questioning Trump’s Covid-19 test after his physician said he tested negative. BuzzFeed News
  • When off-label may mean off-target: How would doctors and insurers navigate demand for a new, narrow Alzheimer’s drug? STAT Plus

Thanks for reading! More tomorrow,

Shraddha

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Tuesday, October 13, 2020

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