Research Roundup: Ovarian Cancer; Opioid Deaths; And Marijuana Use During Pregnancy

JAMA Oncology: Association Of Breast And Ovarian Cancers With Predisposition Genes Identified By Large-Scale Sequencing
In this study assessing whole-exome sequencing results from 11 416 patients with breast cancer, ovarian cancer, or both and 3988 controls, an increased risk of breast cancer was associated with PALB2, ATM, CHEK2, and MSH6 genes, whereas MSH6, RAD51C, TP53, and ATM genes were associated with an increased risk of ovarian cancer. (Lu et al, 8/16)

Commonwealth Fund: States Of Despair: A Closer Look At Rising State Death Rates From Drugs, Alcohol, And Suicide
In late June, the U.S. House of Representatives overwhelmingly approved the most sweeping legislation yet aimed at combating opioid addiction and overdoses. Although the House bill has a ways to go before it becomes law, its passage reflected bipartisan cooperation, likely propelled by the depth of the problem. The opioid crisis has helped fuel a 51 percent increase in the combined death rate from drug overdoses, alcohol abuse, or suicide between 2005 and 2016. (Hayes, Radley and McCarthy, 8/9)

JAMA Internal Medicine: Association Of Nausea And Vomiting In Pregnancy With Prenatal Marijuana Use
Use of marijuana, an antiemetic, is increasing among pregnant women,1,2 and data from 2 small surveys3,4 indicate that women self-report using marijuana to alleviate nausea and vomiting in pregnancy (NVP). To date, only 1 epidemiologic study5 has examined whether women with NVP are at elevated risk of using marijuana. The study of 4735 pregnant women in Hawaii5 from 2009 through 2011 found that self-reported prenatal marijuana use was more prevalent among those with (3.7%) vs without (2.3%) self-reported severe nausea during pregnancy. (Young-Wolff et al, 8/20)

Health Affairs: Medicaid/CHIP Participation Reached 93.7 Percent Among Eligible Children In 2016
Children’s participation in Medicaid and the Children’s Health Insurance Program (CHIP) rose by 5 percentage points between 2013 and 2016. As a result, 1.7 million fewer Medicaid/CHIP-eligible children were uninsured in 2016. Participation was lower among adults than among children, and nearly 6 million Medicaid-eligible adults were uninsured in 2016. (Haley et al, 8/6)

The Henry J. Kaiser Family Foundation: One Year After The Storm: Texas Gulf Coast Residents’ Views And Experiences With Hurricane Harvey Recovery
On August 25, 2017, Hurricane Harvey made landfall as a Category 4 hurricane near Rockport, Texas. Hovering over the region for days, the storm dropped record amounts of rainfall, and flooded over 300,000 structures, 500,000 cars, and caused damage in excess of $125 billion.1 In order to understand the needs and circumstances of vulnerable Texans affected by the hurricane, the Kaiser Family Foundation and the Episcopal Health Foundation partnered to conduct two surveys of adults living in 24 counties along the Texas coast that were particularly hard-hit. (Hamel et al, 8/23)

JAMA Internal Medicine: Evaluating Shared Decision Making For Lung Cancer Screening
In this qualitative content analysis of 14 recorded and transcribed outpatient clinical encounters, the quality of shared decision making about lung cancer screening was poor, as rated by 2 independent observers using a validated shared decision making scale. Potential harms of screening were not adequately explained, and decision aids were not used. (Brenner et al, 8/13)

The Henry J. Kaiser Family Foundation: Analysis: For Patients With Large Employer Coverage, About 1 In 6 Hospital Stays Includes An Out-Of-Network Bill
A new Kaiser Family Foundation analysis of medical bills from large employer plans finds that a significant share of inpatient hospital admissions includes bills from providers not in the health plan’s networks, generally leaving patients subject to higher cost-sharing and potential additional bills from providers. Almost 18 percent of inpatient admissions result in non-network claims for patients with large employer coverage. Even when enrollees choose in-network facilities, 15 percent of admissions include a bill from an out-of-network provider, such as from a surgeon or an anesthesiologist.  These bills potentially expose enrollees to high out-of-pocket costs if these providers charge enrollees more than their plans pay for services.  This is typically referred to as “balance billing,” and can result in a “surprise” medical bill if a patient did not anticipate receiving care from an out-of-network provider. Health insurance plans also typically require higher patient cost-sharing for out-of-network claims. (8/13)