Research Roundup: Heart Health, Vaccination Rates, Pregnancy Risks And More

JAMA Cardiology: Cardiovascular Health Trajectories From Childhood Through Middle Age And Their Association With Subclinical Atherosclerosis
In this cohort study of 9388 individuals, a significant number of children were classified as having an intermediate cardiovascular health score by 8 years of age. Many of these children experienced more rapid declines in cardiovascular health, had greater carotid intima-media thickness, and were more likely to have high carotid intima-media thickness by middle age. (Allen et al, 3/11)

CIDRAP: Study: White, Urban Texans' Reluctance To Vaccinate Raises Outbreak Risk
A new study shows that white, college-educated, high-income Texans who live in cities or suburbs are less likely than others to vaccinate their children, putting students at 5% of public, 28% of private, and 22% of charter K-8 schools in the state's metro areas at high risk for vaccine-preventable diseases such as measles. In the study, published yesterday in PLOS Medicine, researchers at the University of Texas at Austin mined public records to evaluate conscientious vaccination exemptions (CVEs) for 318 private, 818 public, and 60 charter schools in Texas from the 2012-13 through 2017-18 school years.Using regression analysis, the investigators related the exemptions to percentages at the school and county to 115 socioeconomic and demographic factors through the US Census Bureau and the Texas Education Agency. (3/11)

The New York Times: Eating Fish During Pregnancy May Have Metabolic Benefits For Children
Eating fish when pregnant — but not too much — is linked to better metabolic health in children, researchers report. For a study in JAMA Network Open, scientists recorded fish consumption and blood mercury levels in 805 women with singleton pregnancies and then followed their children’s metabolic health for an average of eight years. (Bakalar, 3/18)

Health Affairs: Competitive Physician Prices In Fee-For-Service Medicare
The prices of physicians’ services for 38 million beneficiaries in the traditional Medicare program are set by the federal government. The process begins with a set of relative value units (RVUs) determined by a Resource Utilization Committee (RUC) composed of physicians representing different specialties whose job is to report the amount of time or work units required to perform a wide variety of patient care tasks. Those work units, combined with practice cost and liability insurance, constitute RVUs. The RVUs are converted to dollars using a multiplier set each year by the Centers for Medicare and Medicaid Services (CMS). This price-setting process is important because private Medicare Advantage (MA) plans and commercial insurers often build their pricing systems, although not necessarily their multipliers, on traditional Medicare’s RVU system. We refer to this system as “administrative pricing.” (Dowd, Feldman and Coulam, 3/18)

Commonwealth Fund: What Do Likely Voters Think About Their Health Care?
Nearly one-quarter of likely voters said they are very or moderately worried about their ability to afford their health care in the next 12 months. Those most worried were Democrats, voters leaning Democratic, Hispanics, and people earning less than $50,000 a year. But nearly one of five Republicans also said they’re very or moderately worried about paying for their care. (2/27)

Reuters: Even With Atrial Fibrillation, Exercise Linked To Longer Life
People with a common heart rhythm problem who are physically active may live longer than more sedentary counterparts, a recent study suggests. Among 1,100 adults with atrial fibrillation, or AFib, those who got regular exercise were about 45 percent less likely to die of any cause, or of cardiovascular causes specifically, over a seven- to nine-year study period compared to those who got little physical activity. These results suggest that moderate exercise like brisk walking for 30 minutes most days of the week could help people with AFib live longer, Duke University cardiologist Christopher Granger said. (3/10)

CIDRAP: Epidemiology Study Notes Diversity Of CRE In US Hospitals
A study examining the clinical and molecular epidemiology of carbapenem-resistant Enterobacterales (CRE) in US hospital patients indicates there is greater diversity in CRE than previously thought, a finding that could have implications for how hospitals treat and control the pathogens. The study, published late last week in The Lancet Infectious Diseases, looked at clinical and whole-genome sequencing data on a cohort of patients at 49 US hospitals in 15 states who were colonized or infected with CRE according to Center for Disease Control and Prevention (CDC) 2015 CRE guidelines. (Dall, 3/9)

CIDRAP: Study: Flu Case Definitions Often Invalid In Seniors
Flu surveillance case definitions miss many hospitalized patients 65 years and older who have laboratory-confirmed infection—especially those who are frail, according to a prospective cohort study in today's Infection Control & Hospital Epidemiology. Researchers from the Canadian Immunization Research Network and Serious Outcomes Surveillance (SOS) Network determined that standard influenza-like illness (ILI) and severe acute respiratory illness (SARI) case definitions are biased toward detecting infection in people younger than 65 and thus do not characterize the true burden of the flu. (3/9)