Christopher Sam Babu

All Publications

• Patient Experiences With GLP-1 Receptor Agonists. JAMA network open de Vere Hunt, I., Ramirez-Posada, M., Babu, C. S., Brown-Johnson, C., Linos, E., Rodriguez, F. 2026; 9 (6): e2616951

  Abstract

  Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are transformational therapies in the treatment of obesity; yet discontinuation rates are high, and patients experience rapid weight regain after stopping treatment. Few scientific publications have reported patients' experiences of taking GLP-1 RAs in a variety of health contexts outside its use as treatment for type 2 diabetes.To provide insight into the lived experiences of patients taking GLP-1 RAs to inform optimal long-term weight management treatment.This qualitative study used inductive thematic analysis of semistructured video interviews conducted between July 22 and September 10, 2025, with participants from 15 US states. Participants included adults who were taking or had previously taken GLP-1 RAs for any treatment indication, recruited through ResearchMatch and snowball sampling.Themes identified through inductive thematic analysis.Of 30 participants, 10 self-identified as men, 1 as nonbinary, and 19 as women; their mean (SD) age was 54.0 (8.8) years. A total of 23 participants were using a GLP-1 RA at time of interview, and 7 participants had stopped GLP-1 RA use. Eight key themes were extracted and categorized into 2 overarching domains. The first domain was patient-reported benefits and trade-offs. It comprised the following themes: (1) reduction in food noise, psychological hunger, or appetite; (2) GLP-1 RAs are not a standalone weight loss solution; (3) wide spectrum of adverse effects experienced; and (4) patients prepared to withstand substantial adverse effects and logistical challenges to achieve weight loss. The second domain was social, clinical, and structural context. It comprised the following themes: (5) perceived stigma associated with taking GLP-1 RAs, influenced by primary indication for prescription; (6) information provision and clinical support are essential but highly variable; (7) access challenges and cost can be prohibitive; and (8) value of shared experiences.In this qualitative study of patient experiences with GLP-1 receptor agonists, participants described GLP-1 RA therapy functioning as a facilitator rather than a replacement for lifestyle change, emphasizing the need for behavioral interventions alongside pharmacotherapy to sustain treatment benefits. Quality of care was highly variable; thus, standardized guidelines for patient education and clinical support could improve expectation management around likely adverse effects and long-term management.

  View details for DOI 10.1001/jamanetworkopen.2026.16951

  View details for PubMedID 42247231

• Enhancing Resident Education in Internal Medicine and Psychiatry Through an Integrated Behavioral Health Model Ong, S., Babu, C., Mui, D., Gunther, M., Zein, M., Chang, K. ELSEVIER SCIENCE INC. 2025

  View details for DOI 10.1016/j.jaclp.2025.10.140

  View details for Web of Science ID 001633400000009

• Higher Rates of Inadequate Adjuvant Radiation Dose Among Older Adults with Head and Neck Cancer. The Laryngoscope Raab, G., Babu, C., Yu, Y., Givi, B., Wong, R. J., Lee, N. Y., Zakeri, K. 2024; 134 (5): 2206-2211

  Abstract

  To determine the rate of inadequate radiotherapy and identify risk factors associated with inadequate adjuvant radiotherapy for head and neck cancer among older adults.A retrospective review of the National Cancer Database (NCDB) was performed to identify patients diagnosed with squamous cell cancer of the head and neck between 2004 and 2017. Patients with a single malignancy, negative surgical margins, no extranodal extension, and receipt of adjuvant radiation without systemic therapy were included in the study cohort. The main outcome of interest was the adjuvant radiation dose received. Participant data were compared using univariable, multivariable, and correlation analyses to evaluate risk factors for inadequate radiation therapy (RT) dosing.Among 7608 patients, 1010 patients (13.3%) received an inadequate radiation dose and 6598 (86.7%) received an adequate dose. Patients living in a higher income zip-code, younger age, and those who received intensity-modulated RT (IMRT) were more likely to receive an adequate radiation dose (p < 0.05). Patients older than 70 and 80 years old had a greater likelihood of receiving an inadequate radiation dose (≥70 vs. <70: 16.9% vs. 12.5%; p < 0.05 and ≥80 vs. <80: 20.6% vs. 13.0%%; p < 0.05). Similarly, increasing age was negatively correlated with radiation dose (correlation coefficient: -0.05; p < 0.001).A substantial proportion of older patients receiving adjuvant radiation do not complete the full treatment. Older age, year of diagnosis, non-IMRT, and living in a lower-income zip code were associated with early termination of RT. Future studies should examine strategies to improve tolerance of adjuvant RT so that more patients complete the full treatment.3; Cohort Study Laryngoscope, 134:2206-2211, 2024.

  View details for DOI 10.1002/lary.31188

  View details for PubMedID 37983853

• Epistemological Challenges of Artificial Intelligence Clinical Decision Support Tools in Otolaryngology: The Black Box Problem. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery Babu, C. S., Holsinger, F. C., Zuchowski, L., Ratti, E., Rameau, A. 2023

  View details for DOI 10.1002/ohn.410

  View details for PubMedID 37344955

• Additive risk of surgical site infection from more than one risk factor following craniotomy for tumor. Journal of neuro-oncology Maayan, O., Tusa Lavieri, M. E., Babu, C., Chua, J., Christos, P. J., Schwartz, T. H. 2023; 162 (2): 337-342

  Abstract

  This study seeks to expound upon risk factor etiologies for surgical site infection (SSI) and investigate their combinatorial effects on infection rate following craniotomy for neuro-oncologic pathology.Patients who underwent neuro-oncologic craniotomy between 2006 and 2020 were included. Medical records were reviewed to identify the occurrence of wound infection at ≤ 3 months postoperatively. Potential risk factors for infection included tumor pathology, location, anesthesia type, indication, ventricular entry, foreign body, brachytherapy, lumbar drain, prior operation, prior cranial radiation, prior infection, bevacizumab, and medical comorbidities (hypertension, obesity, diabetes, hyperlipidemia, other cancer, cirrhosis). Logistic regression was implemented to determine risk factors for SSI. Chi-square tests were used to assess whether the number of risk factors (e.g., 0, ≥ 1, ≥2, ≥ 3, ≥4) increases the risk of SSI compared to patients with fewer risk factors. The relative increase with each additional risk factor was also evaluated.A total of 1209 patients were included. SSI occurred in 42 patients (3.5%) by 90 days after surgery. Significant risk factors on multivariate logistic regression were bevacizumab (OR 40.84; p < 0.001), cirrhosis (OR 14.20, p = 0.03), foreign body placement (OR 4.06; P < 0.0001), prior radiation (OR 2.20; p = 0.03), and prior operation (OR 1.92; p = 0.04). Infection rates in the combinatorial analysis were as follows: ≥1 risk factor = 5.9% (OR 2.74; p = 0.001), ≥ 2 = 6.7% (OR 2.28; p = 0.01), ≥ 3 = 19.0% (OR 6.5; p < 0.0001), ≥ 4 = 100% (OR 30.2; p < 0.0001).Risk factors in aggregate incrementally increase the risk of postoperative SSI after craniotomy for tumor.

  View details for DOI 10.1007/s11060-023-04294-7

  View details for PubMedID 36988747

  View details for PubMedCentralID PMC10953908

• Health Status, Persistent Symptoms, and Effort Intolerance One Year After Acute COVID-19 Infection. Journal of general internal medicine Kingery, J. R., Safford, M. M., Martin, P., Lau, J. D., Rajan, M., Wehmeyer, G. T., Li, H. A., Alshak, M. N., Jabri, A., Kofman, A., Babu, C. S., Benitez, E. K., Palacardo, F., Das, I. G., Kaylor, K., Woo, K. M., Roberts, N. L., Rahiel, S., Gali, V., Han, L., Lee, J., Roszkowska, N., Kim, Y. E., Bakshi, S., Hogan, C., McNairy, M., Pinheiro, L. C., Goyal, P. 2022; 37 (5): 1218-1225

  Abstract

  The long-term prevalence and risk factors for post-acute COVID-19 sequelae (PASC) are not well described and may have important implications for unvaccinated populations and policy makers.To assess health status, persistent symptoms, and effort tolerance approximately 1 year after COVID-19 infection DESIGN: Retrospective observational cohort study using surveys and clinical data PARTICIPANTS: Survey respondents who were survivors of acute COVID-19 infection requiring Emergency Department presentation or hospitalization between March 3 and May 15, 2020.Self-reported health status, persistent symptoms, and effort tolerance KEY RESULTS: The 530 respondents (median time between hospital presentation and survey 332 days [IQR 325-344]) had mean age 59.2±16.3 years, 44.5% were female and 70.8% were non-White. Of these, 41.5% reported worse health compared to a year prior, 44.2% reported persistent symptoms, 36.2% reported limitations in lifting/carrying groceries, 35.5% reported limitations climbing one flight of stairs, 38.1% reported limitations bending/kneeling/stooping, and 22.1% reported limitations walking one block. Even those without high-risk comorbid conditions and those seen only in the Emergency Department (but not hospitalized) experienced significant deterioration in health, persistent symptoms, and limitations in effort tolerance. Women (adjusted relative risk ratio [aRRR] 1.26, 95% CI 1.01-1.56), those requiring mechanical ventilation (aRRR 1.48, 1.02-2.14), and people with HIV (aRRR 1.75, 1.14-2.69) were significantly more likely to report persistent symptoms. Age and other risk factors for more severe COVID-19 illness were not associated with increased risk of PASC.PASC may be extraordinarily common 1 year after COVID-19, and these symptoms are sufficiently severe to impact the daily exercise tolerance of patients. PASC symptoms are broadly distributed, are not limited to one specific patient group, and appear to be unrelated to age. These data have implications for vaccine hesitant individuals, policy makers, and physicians managing the emerging longer-term yet unknown impact of the COVID-19 pandemic.

  View details for DOI 10.1007/s11606-021-07379-z

  View details for PubMedID 35075531

  View details for PubMedCentralID PMC8786200

• Visual deterioration after endonasal endoscopic skull base surgery: causes, treatments, and outcomes. Journal of neurosurgery Carnevale, J. A., Babu, C. S., Goldberg, J. L., Fong, R., Schwartz, T. H. 2022; 136 (4): 1103-1113

  Abstract

  Visual deterioration after endoscopic endonasal transsphenoidal surgery (EETS) for sellar and parasellar masses is a rare but serious complication caused by either compressive or ischemic mechanisms. Timely diagnosis and intervention may restore vision if instituted appropriately. The associated risk factors and their relation to the success of intervention are not well understood.The authors examined a series of 1200 consecutive EETS cases performed by the senior author at Weill Cornell/NewYork-Presbyterian Hospital from 2010 to 2020. Cases with postoperative visual deterioration were identified. Pre- and postoperative clinical data, mechanism of visual decline, latency to intervention, and long-term visual outcome were retrospectively collected and analyzed with appropriate statistical methods.Twenty-one patients (1.75%) complained of early postoperative visual deterioration. The most common pathology associated with postoperative visual loss was craniopharyngioma (7.69%), followed by meningioma (5.43%) and then pituitary adenoma (1.94%). Timely intervention restored vision in 81% of patients for a 0.33% rate of permanent visual deterioration. Average time to visual deterioration was 28.8 hours, and over 70% of patients experienced vision loss within the first 13 hours. Compressive etiology (n = 11), consisting of either hematoma (n = 8) or graft displacement (n = 3), occurred 7.3 hours and 70.3 hours after surgery, respectively, and was more common in adenomas. Acute postoperative visual deterioration was more common in firm closures (4.78%) compared with soft closures (1.03%; p = 0.0006). Ischemic etiology (n = 10) occurred 10.3 hours after surgery and was more common with craniopharyngiomas and meningiomas (p = 0.08). Sixteen patients (76.2%) underwent early reoperation to explore and decompress the optic apparatus. Vision was restored to baseline after reoperation in all 11 compressive cases, whereas 6/10 ischemic cases improved with supplemental oxygen and hypervolemic hypertensive therapy (p = 0.02). Fluid expansion from 8 to 16 hours (p = 0.034) and systolic blood pressure elevation from 32 to 48 hours (p = 0.05) after surgery were significantly higher in those ischemic patients who recovered some vision compared with those with persistent visual deficits.Visual deterioration after EETS is a rare event but can be effectively treated if acted upon appropriately and in a timely fashion. Compressive etiology is reversible with early reoperation. Ischemic etiology can be successfully treated in roughly half of cases with supplemental oxygen and hypertensive hypervolemic therapy but may result in permanent visual deterioration if not instituted appropriately or if delayed with unnecessary exploratory surgery.

  View details for DOI 10.3171/2021.3.JNS204378

  View details for PubMedID 34598134

• Combined use of vancomycin powder and betadine irrigation lowers the incidence of postcraniotomy wound infection in low-risk cases: a single-center risk-stratified cohort analysis. Acta neurochirurgica Maayan, O., Babu, C., Tusa Lavieri, M. E., Chua, J., Christos, P. J., Schwartz, T. H. 2022; 164 (3): 867-874

  Abstract

  Postoperative surgical site infections (SSIs) constitute a significant source of morbidity for neurosurgical patients. Protocols that minimize postoperative wound infections are integral to improving outcomes and curtailing expenditures. The present study seeks to identify risk factors for infection and assess the efficacy of prophylactic betadine irrigation and vancomycin powder in addition to standard antibiotic irrigation.We reviewed craniotomies performed by THS at Weill Cornell/New York Presbyterian Hospital to treat neuro-oncologic pathology. Patients were divided into three groups: group 1 - antibiotic irrigation, group 2 - antibiotic irrigation and betadine irrigation, group 3 - antibiotic irrigation, betadine irrigation, and vancomycin powder. SSI was confirmed with bacterial culture. Risk factor identification and assessment of treatment paradigms was performed using chi-square tests and univariate logistic regression.Among 1209 total patients, the 30- and 90-day SSI rates were 1.7% and 3.5%, respectively. Significant predictors of SSI included preoperative use of bevacizumab (OR 40.84; p < 0.0001), foreign body (OR 4.06; p < 0.0001), prior radiation (OR 2.20; p = 0.03), and prior operation/biopsy (OR 1.92; p = 0.04). Risk of infection was 2.1% in low-risk cases and 6.9% in high-risk cases. A significant, incremental decrement in SSIs was identified between the prophylaxis groups, although only among low-risk cases: group 1: 4.53%, group 2: 1.39%, group 3: 0.42% (p = 0.02). Neither vancomycin powder nor betadine significantly reduced the risk of SSI in patients with one or more risk factors.Vancomycin powder with betadine irrigation decreased SSI rates following neuro-oncologic cranial procedures in patients at low risk of infection (i.e., no preoperative risk factors).

  View details for DOI 10.1007/s00701-021-05075-9

  View details for PubMedID 35028744

  View details for PubMedCentralID 6563908

• Public access to protocols of contemporary cancer randomized clinical trials. Trials Babu, C., Mell, L., Lee, N., Zakeri, K. 2021; 22 (1): 418

  Abstract

  Access to randomized clinical trial (RCT) protocols is necessary for the interpretation and reproducibility of the study results, but protocol availability has been lacking. We determined the prevalence of protocol availability for all published cancer RCTs in January 2020. We found that only 36.1% (48/133) of RCTs had an accessible protocol and only 11.3% of RCTs (15/133) had a publicly accessible protocol that was not behind a paywall. Only 18.0% (24/133) of RCTs were published in conjunction with the protocol on the journal website. In conclusion, few cancer RCTs have an accessible research protocol. Journals should require publication of RCT protocols along with manuscripts to improve research transparency.

  View details for DOI 10.1186/s13063-021-05382-7

  View details for PubMedID 34176506

  View details for PubMedCentralID PMC8237482

• Endoscopic endonasal approach for craniopharyngiomas. Journal of neurosurgical sciences Fong, R. P., Babu, C. S., Schwartz, T. H. 2021; 65 (2): 133-139

  Abstract

  The operative management of craniopharyngiomas has evolved over the last two decades. Traditional transcranial microsurgical approaches were the only option until the advent of the endoscopic endonasal approach. It has given surgeons the ability to tackle a challenging entity from a new perspective with comparable if not superior results. In this review we outline the advancements in endoscopic endonasal approach for craniopharyngiomas, address controversies and review the current literature.

  View details for DOI 10.23736/S0390-5616.21.05097-9

  View details for PubMedID 33890754