Simar Bajaj

All Publications

• Trends and Disparities in Clinician Diagnosis of Overweight and Obesity. Journal of general internal medicine Bajaj, S. S., Zhong, A., Khunte, M., Stanford, F. C. 2026; 41 (6): 1565-1572

  Abstract

  While obesity is a highly visible condition, adiposity often goes undetected by individuals and community members, especially as larger body sizes become more common and recalibrate expectations. However, there are no contemporary data about such underdiagnosis.To examine trends in clinician diagnoses of overweight or obesity by race, ethnicity, and socioeconomic disadvantage.Repeated cross-sectional study.Noninstitutionalized adults age 20 or older who responded to the 2011-2018 National Health and Nutrition Examination Survey (NHANES).Clinician diagnosis of overweight or obesity was defined as affirming the question, "Has a doctor or health professional ever told you that you were overweight?" Weight-related perception and desire to lose weight were also assessed.We included 8311 adults with obesity (weighted, 356,426,842). From 2011 to 2018, the proportion of participants receiving a clinician diagnosis of overweight or obesity increased from 67.5 to 73.0% (p = 0.019). In multivariable logistic regression, Black people with obesity were less likely to receive a diagnosis (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.48-0.75, p < 0.001) than non-Hispanic White people, while citizens (OR, 1.73; 95% CI, 1.22-2.45; p < 0.001) and college graduates (OR, 2.17; 95% CI, 1.55-3.05; p < 0.001) were more likely to be diagnosed than non-citizens and non-high school graduates. Hypertension (OR, 1.40; 95% CI, 1.12-1.75) and diabetes (OR, 2.52; 95% CI, 1.86-3.49) were also associated with a greater likelihood of a diagnosis. People with a diagnosis were more likely to perceive themselves as overweight (94.6% vs. 75.2%, p < 0.001) and preferred to weigh less rather than stay at the same weight (96.4% vs. 83.7%, p < 0.001).While rates of overweight and obesity diagnoses improved over time, almost a third of people with obesity remain undiagnosed, with higher rates among Black Americans, non-citizens, non-high school graduates, sicker patients, and other marginalized groups.

  View details for DOI 10.1007/s11606-025-09633-0

  View details for PubMedID 40471490

  View details for PubMedCentralID PMC13125537

• Racial and Ethnic Differences Between Waist Circumference and BMI in Identifying Obesity. Diabetes care Bajaj, S. S., Lin, J. C., Tandar, C. E., Stanford, F. C. 2026

  View details for DOI 10.2337/dc25-2214

  View details for PubMedID 41854433

• Diagnostic Performance of BMI and Waist Circumference in Detecting Excess Adiposity. Obesity (Silver Spring, Md.) Lin, J. C., Tandar, C. E., Bajaj, S. S., Stanford, F. C. 2026

  Abstract

  This study compared the diagnostic performance of BMI, waist circumference (WC), and Lancet Commission (LC) criteria for assessing excess adiposity measured by dual-energy X-ray absorptiometry (DEXA) in US adults.Using 2011-2018 NHANES data, we included 10,747 adults aged 20-59 years with relevant data. We evaluated the diagnostic performance (sensitivity, specificity, positive and negative predictive values [PPV, NPV], area under the curve [AUC]) of BMI thresholds, waist-based measures, and LC criteria for excess adiposity, as defined by DEXA.The weighted prevalence of DEXA-defined excess adiposity was 36.4%. CDC BMI thresholds demonstrated 74.6% sensitivity and 82.2% specificity (PPV, 67.0%; NPV, 87.0%). Waist-based measures showed higher sensitivity and lower specificity than BMI; NHLBI WC thresholds produced 88.5% sensitivity and 66.7% specificity. LC criteria performed variably: BMI plus ≥ 1 waist measure had 74.6% sensitivity and 82.2% specificity, whereas ≥ 2 waist measures had 88.5% sensitivity and 66.8% specificity. The AUC values were 0.876 for BMI, 0.882 for WC, 0.887 for waist to height ratio, and 0.715 for waist to hip ratio.Waist-based definitions were more sensitive than BMI, whereas BMI provided greater specificity. LC criteria performed comparably to existing definitions. Incorporating WC into screening may improve the detection of excess adiposity.

  View details for DOI 10.1002/oby.70150

  View details for PubMedID 41724736

• Shortage of Obesity Medicine Specialists in the United States. Mayo Clinic proceedings Bajaj, S. S., Teegala, S., Stanford, F. C. 2026; 101 (2): 348-350

  View details for DOI 10.1016/j.mayocp.2025.10.015

  View details for PubMedID 41493442

  View details for PubMedCentralID PMC13380303

• The Fallacy of Community-Based Research. Journal of general internal medicine Bajaj, S. S., Kim, J., Stanford, F. C. 2026; 41 (2): 539-541

  Abstract

  Community-based research offers the promise of equitable partnerships between researchers and historically marginalized communities, but its potential is often undercut by superficial engagement, rigid institutional structures, and systemic inequities in funding and representation. This essay explores the ethical, procedural, and structural shortcomings of current community-based research practices, highlighting the disconnect between stated goals and actual implementation. It calls for reforms to institutional review boards and funding processes, emphasizing the need for sustained community engagement, power-sharing, and accountability. By reimagining research as a collaborative, long-term partnership, the scientific community can move toward more just and effective public health outcomes.

  View details for DOI 10.1007/s11606-025-09661-w

  View details for PubMedID 40627096

  View details for PubMedCentralID PMC12894545

• Development, optimization, and preliminary evaluation of a novel artificial intelligence tool to promote patient health literacy in radiology reports: The Rads-Lit tool. PloS one Doshi, R. H., Amin, K., Chan, S. M., Kaur, M., Bajaj, S. S., Khosla, P., Kothari, V. T., Mozayan, A., Tocino, I., Chheang, S. 2025; 20 (9): e0331368

  Abstract

  Radiology reports are an integral part of patient medical records; however, these reports often contain complex medical terminology that are difficult for patients to comprehend, potentially leading to anxiety, misunderstanding, and misinterpretation. The development of user-friendly instruments to improve understanding is thus critically important to enhance health literacy and empower patients. In this study, we introduce a novel artificial intelligence (AI) interface, the Rads-Lit Tool, which can simplify radiology reports for patients using natural language processing (NLP) techniques. This manuscript presents the development process, methodology, and results of the Rads-Lit Tool, demonstrating its potential to simplify radiology reports across various examination types and complexity levels. Our findings highlight that patient-facing AI-driven tools can enhance patient health literacy and foster improved patient-provider communication in radiology.

  View details for DOI 10.1371/journal.pone.0331368

  View details for PubMedID 40901830

  View details for PubMedCentralID PMC12407389

• Association of Overweight and Obesity With Financial Burden. Annals of internal medicine Bajaj, S. S., Jain, B., Sabet, C. J., Zhong, A., Amen, T. B., Dee, E. C., Stanford, F. C. 2025

  View details for DOI 10.7326/ANNALS-24-03161

  View details for PubMedID 40550135

• Methamphetamine and Cocaine Overdose Deaths in the United States, 1999-2023. Substance use & misuse Zhu, D. T., Bajaj, S. S., Sen, A. 2025: 1-4

  Abstract

  The ongoing "fourth wave" of the U.S. overdose epidemic has been marked by rising deaths co-involving fentanyl with stimulants such as methamphetamine and cocaine.Using data obtained from the CDC WONDER Multiple Cause of Death database, this serial cross-sectional study analyzed stimulant overdose mortality trends between 1999 and 2023. We stratified crude mortality rates by sex, race and ethnicity, and opioid co-involvement. We used Joinpoint regression to examine temporal trends and estimate annual percentage changes (APC) within time segments.From 1999 to 2023, methamphetamine-involved overdose deaths increased from 547 to 34,855, with mortality rates rising from 0.20 (95% CI, 0.18-0.21) to 10.41 (95% CI, 10.30-10.52) per 100,000 (AAPC: 18.49% [95% CI, 17.67-20.17]; p < 0.001). Cocaine-involved overdose deaths increased from 3,822 to 29,449, with mortality rates rising from 1.37 (95% CI, 1.33-1.41) to 8.79 (95% CI, 8.69-8.89) per 100,000 (AAPC: 8.80% [95% CI, 8.18-9.95]; p < 0.001). Stimulants were involved in 7.95% and 10.28% of fentanyl overdoses in 1999 and 2011, respectively, but dramatically rose to 56.67% by 2023. Methamphetamine-involved overdose deaths were highest among American Indian/Alaska Native individuals, accounting for 44.50% of overdose deaths, while cocaine-involved overdose deaths were highest among Black individuals, comprising 48.47% of overdose deaths.Rising stimulant mortality, particularly in racial and ethnic minoritized populations, underscores the need for expanding access to harm reduction resources, greater funding for stimulant use disorder research, and targeted public health interventions.

  View details for DOI 10.1080/10826084.2025.2516735

  View details for PubMedID 40509756

• Trump blew up the global fight against AIDS. Can it recover? NATURE Bajaj, S. S. 2025; 641 (8061): 22-25

  View details for DOI 10.1038/d41586-025-01294-7

  View details for Web of Science ID 001479753100002

  View details for PubMedID 40307524

• Private Equity Ownership of US Opioid Treatment Programs. JAMA psychiatry Zhu, D. T., Song, Z., Kannan, S., Cai, C. L., Bajaj, S. S., Gondi, S. 2025; 82 (2): 204-206

  View details for DOI 10.1001/jamapsychiatry.2024.4011

  View details for PubMedID 39661342

  View details for PubMedCentralID PMC11800012

• International Medical Graduates in Academic Cardiothoracic Surgery. Annals of surgery Bajaj, S. S., Wang, H., Williams, K. M., Boyd, J. H. 2025

  Abstract

  To assess the research productivity, career advancement, grant funding, and scholarly impact of international medical graduates (IMGs) in academic cardiothoracic surgery.Physician shortages undermine patient care and risk exacerbating inequities, especially in cardiothoracic surgery, which may lose a quarter of its workforce by 2050-the most substantial reduction in surgery. IMGs could help alleviate these shortages, but there is limited data about their academic experiences.All cardiothoracic surgeons (n=1065) at accredited United States cardiothoracic surgery training centers in 2020 were included. IMGs were defined as surgeons who completed medical school outside the US and Canada, per the Association of American Medical Colleges. Educational and professional backgrounds were recorded from publicly available sources.24.0% of academic cardiothoracic surgeons were IMGs. These surgeons started as attendings in later years (2012 vs. 2005, P<0.001) than non-IMGs. In unadjusted analyses, IMGs had lower publication counts and H-index, as well as reduced likelihood of R01 funding and full professor attainment. To match for attending start year, propensity score analysis created two groups of 254 surgeons: both IMGs and non-IMGs had similar publication counts (45.0 vs. 45.0, P=0.98), H-index (10.5 vs. 11.0, P=0.61), R01 funding rates (4.3% vs. 5.1%, P=0.83), and full professor attainment (24.8% vs. 20.5%, P=0.45).IMGs represent a more junior cohort of surgeons but contribute significantly to the cardiothoracic surgery workforce, with comparable academic success. Policy efforts to streamline IMGs' path toward US practice could help alleviate surgical shortages, while enhancing diversity and strengthening academia.

  View details for DOI 10.1097/SLA.0000000000006646

  View details for PubMedID 39886768

• Ending vaccine hegemony: Rethinking foreign aid in global health responses. PLOS global public health Teegala, S., Bajaj, S. S., Tomori, O. 2025; 5 (1): e0004177

  View details for DOI 10.1371/journal.pgph.0004177

  View details for PubMedID 39821155

  View details for PubMedCentralID PMC11737687

• No person left behind: Understanding vaccine hesitancy in low- and middle-income countries. Vaccine Tyagi, A., Bajaj, S. S., Nayeu, E. N., Stanford, F. C. 2025; 44: 126446

  View details for DOI 10.1016/j.vaccine.2024.126446

  View details for PubMedID 39419730

  View details for PubMedCentralID PMC11655246

• CAN STUDENTS AND GRANDPARENTS SOLVE THE GLOBAL CRISIS IN MENTAL HEALTH? NATURE Bajaj, S. 2024; 635 (8039): 540-542

  View details for DOI 10.1038/d41586-024-03757-9

  View details for Web of Science ID 001361300200031

  View details for PubMedID 39567778

• Supervised safe consumption sites - lessons and opportunities for North America LANCET REGIONAL HEALTH-AMERICAS Zhu, D. T., Bajaj, S. S., Kerr, T. 2024; 39: 100889

  View details for DOI 10.1016/j.lana.2024.100889

  View details for Web of Science ID 001314892400001

  View details for PubMedID 39309537

  View details for PubMedCentralID PMC11415865

• Medicine's DEI backlash offers an opportunity to refocus on evidence-based approaches NATURE MEDICINE Bajaj, S. S., Ahmed, A. M., Stone, V. E. 2024; 30 (11): 3040-3041

  View details for DOI 10.1038/s41591-024-03236-8

  View details for Web of Science ID 001307632300004

  View details for PubMedID 39237626

  View details for PubMedCentralID 4710482

• Bridging healthcare access: strategies beyond the COVID-19 public health emergency. Discover health systems Razmi, A. N., Bajaj, S. S., Stanford, F. C. 2024; 3 (1): 66

  Abstract

  Issued in January 2020, the federal Public Health Emergency (PHE)'s termination was ultimately inevitable and has prompted reflection over how the pandemic elicited relatively progressive reforms to healthcare. Although we are concerned that the PHE's termination poses a significant threat to public health and equity, we believe that physicians, along with systemic changes, can provide critical support for patients as they navigate a shifting health policy landscape. In response to this evolving landscape, the article emphasizes the pivotal role of physicians and healthcare institutions in safeguarding patient access to care. It proposes strategies such as community-based workshops, patient navigators, and streamlined technology-driven redetermination processes to support vulnerable populations during this transition. Physicians are encouraged to engage in advocacy efforts, from voicing concerns at health meetings to collaborating with non-profit organizations and the media, to influence data-driven policy changes that prioritize patient safety and equitable access. Marginalized patients should not be slipping through the cracks.

  View details for DOI 10.1007/s44250-024-00100-x

  View details for PubMedID 39176184

  View details for PubMedCentralID PMC11335969

• Body Mass Index Thresholds for Asians: A Race Correction in Need of Correction? Annals of internal medicine Bajaj, S. S., Zhong, A., Zhang, A. L., Stanford, F. C. 2024; 177 (8): 1127-1129

  View details for DOI 10.7326/M24-0161

  View details for PubMedID 39038288

  View details for PubMedCentralID PMC11707652

• Impact of American Heart Association Awards on the Academic Careers of Cardiac Surgeons. Journal of the American Heart Association Bajaj, S. S., Wang, H., Kumar, S. S., Williams, K. M., Boyd, J. H. 2024: e034541

  View details for DOI 10.1161/JAHA.124.034541

  View details for PubMedID 39041656

• Contemporary Patterns of Financial Toxicity Among Patients With Rheumatologic Disease in the United States. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases Amen, T. B., Dee, E. C., Jain, B., Batter, S., Jain, U., Bajaj, S. S., Varady, N. H., Amen, L. J., Goodman, S. M. 2024

  Abstract

  Rheumatologic diseases encompass a group of disabling conditions that often require expensive clinical treatments and limit an individual's ability to work and maintain a steady income. The purpose of this study was to evaluate contemporary patterns of financial toxicity among patients with rheumatologic disease and assess for any associated demographic factors.The cross-sectional National Health Interview Survey was queried from 2013 to 2018 for patients with rheumatologic disease. Patient demographics and self-reported financial metrics were collected or calculated including financial hardship from medical bills, financial distress, food insecurity, and cost-related medication (CRM) nonadherence. Multivariable logistic regressions were used to assess for factors associated with increased financial hardship.During the study period, 20.2% of 41,502 patients with rheumatologic disease faced some degree of financial hardship due to medical bills, 55.0% of whom could not pay those bills. Rheumatologic disease was associated with higher odds of financial hardship from medical bills (adjusted odds ratio, 1.29; 95% confidence interval, 1.22-1.36; p < 0.001) with similar trends for patients suffering from financial distress, food insecurity, and CRM nonadherence (p < 0.001 for all). Financial hardship among patients with rheumatologic disease was associated with being younger, male, Black, and uninsured (p < 0.001 for all).In this nationally representative study, we found that a substantial proportion of adults with rheumatologic disease in the United States struggled with paying their medical bills and suffered from food insecurity and CRM nonadherence. National health care efforts and guided public policy should be pursued to help ease the burden of financial hardship for these patients.

  View details for DOI 10.1097/RHU.0000000000002110

  View details for PubMedID 38976618

• Increasing Voter Participation Through Health Care-Based Voter Registration. JAMA health forum McCabe, K., Zhu, Y., Bajaj, S. S., Martin, A. F. 2024; 5 (6): e241563

  Abstract

  Young people and historically marginalized racial and ethnic groups are poorly represented in the democratic process. Addressing voting inequities can make policy more responsive to the needs of these communities.To assess whether leveraging health care settings as venues for voter registration and mobilization is useful, particularly for historically underrepresented populations in elections.In 2020, nonpartisan nonprofit Vot-ER partnered with health care professionals and institutions to register people to vote. This cross-sectional study analyzed the demographics and voting behavior of people mobilized to register to vote in health care settings, including hospitals, community health centers, and medical schools across the US. The age and racial and ethnic identity data of individuals engaged through Vot-ER were compared to 2 national surveys of US adults, including the 2020 Cooperative Election Study (CES) and the 2020 American National Election Study (ANES).Health care-based voter registration.The main outcomes were age composition, racial and ethnic composition, and voting history.Of the 12 441 voters contacted in health care settings, 41.9% were aged 18 to 29 years, 15.9% were identified as African American, 9.6% as Asian, 12.7% as Hispanic, and 60.4% as White. This distribution was significantly more diverse than the racial and ethnic distribution of the ANES (N = 5447) and CES (N = 39 014) samples, of which 72.5% and 71.19% self-identified as White, respectively. Voter turnout among health care-based contacts increased from 61.0% in 2016 to 79.8% in 2020, a turnout gain (18.8-percentage point gain) that was 7.7 percentage points higher than that of the ANES sample (11.1-percentage point gain). Demographically, the age distribution of voters contacted in health care settings was significantly different from the ANES and CES samples, with approximately double the proportion of young voters aged 18 to 29 years.This cross-sectional study suggests that health care-based voter mobilization reaches a distinctly younger and more racially and ethnically diverse population relative to those who reported contact from political campaigns. This analysis of the largest health care-based voter mobilization effort points to the unique impact that medical professionals may have on voter registration and turnout in the 2024 US elections. In the long term, health equity initiatives should prioritize expanding voting access to address the upstream determinants of health in historically marginalized communities.

  View details for DOI 10.1001/jamahealthforum.2024.1563

  View details for PubMedID 38904953

  View details for PubMedCentralID PMC11193121

• Social Media and Artificial Intelligence-Understanding Medical Misinformation Through Snapchat's New Artificial Intelligence Chatbot. Mayo Clinic proceedings. Digital health Tandar, C. E., Bajaj, S. S., Stanford, F. C. 2024; 2 (2): 252-254

  View details for DOI 10.1016/j.mcpdig.2024.04.004

  View details for PubMedID 38962215

  View details for PubMedCentralID PMC11221787

• Community Review Boards offer a path to research equity. Proceedings of the National Academy of Sciences of the United States of America Sabet, C. J., Bajaj, S. S., Stanford, F. C. 2024; 121 (19): e2320334121

  View details for DOI 10.1073/pnas.2320334121

  View details for PubMedID 38691586

  View details for PubMedCentralID PMC11087801

• Digital roots: harnessing digital platforms in advancing traditional and complementary medicine for cancer care in Sub-Saharan Africa. Ecancermedicalscience Nguyen, D., Jain, N., Gupta, A., Sabet, C., Bajaj, S. S., Patel, S., Rutledge-Jukes, H., Diaz, M. J., Le, B. D., Hamati, O. A., Mustafa, M., Krstovski, S., Ngoma, T., Ngwa, W. 2024; 18: ed132

  Abstract

  The rise in cancer rates in Sub-Saharan Africa (SSA), combined with limited access to Western pharmaceuticals, has sparked growing adoption of traditional and complementary medicine (T&CM) for cancer treatment in the region. However, many challenges exist, including the lack of reliable evidence-based research on these products, scarcity of standardized documentation as part of cancer registries, limited physician expertise, and negative effects on mortality. Nonetheless, herbal medicines also present opportunities for further research, development, and stakeholder education, potentially benefiting the regional healthcare systems in SSA countries and global health as whole. Recent trends highlight the willingness of patients to use mobile-based applications that provide accurate information on herbal therapeutics, reflecting the increasing adoption of internet and smart/mobile phone services in SSA. To maximize the potential benefits of traditional and complementary medicine, it is necessary to bridge the trust gap between the public, local practitioners, and Western healthcare providers. Sustained funding and policy support are needed to complement these initiatives. Our preliminary survey hopes to inspire the community and policymakers to embrace innovative solutions, fostering a forward-looking approach to cancer care in SSA.

  View details for DOI 10.3332/ecancer.2024.ed132

  View details for PubMedID 38566766

  View details for PubMedCentralID PMC10984834

• Pharmacotherapy causing weight gain and metabolic alteration in those with obesity and obesity-related conditions: A review. Annals of the New York Academy of Sciences Anekwe, C. V., Ahn, Y. J., Bajaj, S. S., Stanford, F. C. 2024; 1533 (1): 145-155

  Abstract

  This review aims to summarize pharmacological interventions that may affect adiposity and metabolic equilibrium in individuals with obesity. Pharmacological therapy is frequently used to treat medical conditions that are both directly related to obesity (such as hypertension and type 2 diabetes) and indirectly related to obesity (such as asthma, insomnia, and type 1 diabetes). This pharmacological therapy may result in weight gain and alterations in the metabolic profile. Many medication classes are implicated in the pharmacologic causes of weight gain, including antipsychotics, glucocorticoids, beta-adrenergic blockers, tricyclic antidepressants, antihistamines, insulin, neuropathic agents, sleep agents, and steroids. This article describes the mechanisms of action and pathways of pharmacological interventions causing obesity.

  View details for DOI 10.1111/nyas.15112

  View details for PubMedID 38385953

  View details for PubMedCentralID PMC11057385

• Quantitative Evaluation of Large Language Models to Streamline Radiology Report Impressions: A Multimodal Retrospective Analysis RADIOLOGY Doshi, R., Amin, K. S., Khosla, P., Bajaj, S. S., Chheang, S., Forman, H. P. 2024; 310 (3): e231593

  Abstract

  Background The complex medical terminology of radiology reports may cause confusion or anxiety for patients, especially given increased access to electronic health records. Large language models (LLMs) can potentially simplify radiology report readability. Purpose To compare the performance of four publicly available LLMs (ChatGPT-3.5 and ChatGPT-4, Bard [now known as Gemini], and Bing) in producing simplified radiology report impressions. Materials and Methods In this retrospective comparative analysis of the four LLMs (accessed July 23 to July 26, 2023), the Medical Information Mart for Intensive Care (MIMIC)-IV database was used to gather 750 anonymized radiology report impressions covering a range of imaging modalities (MRI, CT, US, radiography, mammography) and anatomic regions. Three distinct prompts were employed to assess the LLMs' ability to simplify report impressions. The first prompt (prompt 1) was "Simplify this radiology report." The second prompt (prompt 2) was "I am a patient. Simplify this radiology report." The last prompt (prompt 3) was "Simplify this radiology report at the 7th grade level." Each prompt was followed by the radiology report impression and was queried once. The primary outcome was simplification as assessed by readability score. Readability was assessed using the average of four established readability indexes. The nonparametric Wilcoxon signed-rank test was applied to compare reading grade levels across LLM output. Results All four LLMs simplified radiology report impressions across all prompts tested (P < .001). Within prompts, differences were found between LLMs. Providing the context of being a patient or requesting simplification at the seventh-grade level reduced the reading grade level of output for all models and prompts (except prompt 1 to prompt 2 for ChatGPT-4) (P < .001). Conclusion Although the success of each LLM varied depending on the specific prompt wording, all four models simplified radiology report impressions across all modalities and prompts tested. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Rahsepar in this issue.

  View details for DOI 10.1148/radiol.231593

  View details for Web of Science ID 001208969200011

  View details for PubMedID 38530171

• Recruitment to retention - Addressing the needs and driving improvement within the rural physician pipeline. The American journal of the medical sciences Tandar, C. E., Bajaj, S. S., Stanford, F. C. 2024; 367 (1): 75-76

  View details for DOI 10.1016/j.amjms.2023.09.025

  View details for PubMedID 37778721

  View details for PubMedCentralID PMC13019735

• Minimally Invasive Mitral Valve Repair with Artificial Chordae: Insights from a 6-Year Single-Center Study JOURNAL OF CARDIAC SURGERY Bui, V., Nguyen, D., Pizano, A., Rutledge-Jukes, H., Iheagwaram, C. S., Bajaj, S. S., Van, D., Nguyen, N., Theologou, T., Akbar, A. F., Vervoort, D., Harky, A., Nguyen, D. 2023; 2023

  View details for DOI 10.1155/2023/5510950

  View details for Web of Science ID 001129182200001

• Equity in Scientific Publishing: Can Artificial Intelligence Transform the Peer Review Process? Mayo Clinic proceedings. Digital health Sabet, C. J., Bajaj, S. S., Stanford, F. C., Celi, L. A. 2023; 1 (4): 596-600

  View details for DOI 10.1016/j.mcpdig.2023.10.002

  View details for PubMedID 40206303

  View details for PubMedCentralID PMC11975676

• Trends and Determinants of Location of Death Due to Colorectal Cancer in the United States : A Nationwide Study. Annals of surgical oncology Sonal, S., Jain, B., Bajaj, S. S., Dee, E. C., Boudreau, C., Cusack, J. C., Kunitake, H., Goldstone, R., Bordeianou, L. G., Cauley Md, C. E., Francone, T. D., Ricciardi, R., Qadan, M., Berger, D. L. 2023

  Abstract

  Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States (US); however, there are limited data on location of death in patients who die from CRC. We examined the trends in location of death and determinants in patients dying from CRC in the US.We utilized the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database to extract nationwide data on underlying cause of death as CRC. A multinomial logistic regression was performed to assess associations between clinico-sociodemographic characteristics and location of death.There were 850,750 deaths due to CRC from 2003 to 2019. There was a gradual decrease in deaths in hospital, nursing home, or outpatient facility/emergency department over time and an increase in deaths at home and in hospice. Relative to White decedents, Black, Asian, and American Indian/Alaska Native decedents were less likely to die at home and in hospice compared with hospitals. Individuals with lower educational status also had a lower risk of dying at home or in hospice compared with in hospitals.The gradual shift in location of death of patients who die of CRC from institutionalized settings to home and hospice is a promising trend and reflects the prioritization of patient goals for end-of-life care by healthcare providers. However, there are existing sociodemographic disparities in access to deaths at home and in hospice, which emphasizes the need for policy interventions to reduce health inequity in end-of-life care for CRC.

  View details for DOI 10.1245/s10434-023-14337-y

  View details for PubMedID 37907701

  View details for PubMedCentralID 4192888

• ASO Author Reflections: Colon Cancer Disparities in Stage at Presentation and Time to Surgery for Asian Americans, Native Hawaiians, and Pacific Islanders. Annals of surgical oncology Jain, B., Bajaj, S. S., Patel, T. A., Vapiwala, N., Lam, M. B., Mahal, B. A., Muralidhar, V., Amen, T. B., Nguyen, P. L., Sanford, N. N., Dee, E. C. 2023; 30 (9): 5506-5508

  View details for DOI 10.1245/s10434-023-13560-x

  View details for PubMedID 37120487

  View details for PubMedCentralID 9069392

• Colon Cancer Disparities in Stage at Presentation and Time to Surgery for Asian Americans, Native Hawaiians, and Pacific Islanders: A Study with Disaggregated Ethnic Groups. Annals of surgical oncology Jain, B., Bajaj, S. S., Patel, T. A., Vapiwala, N., Lam, M. B., Mahal, B. A., Muralidhar, V., Amen, T. B., Nguyen, P. L., Sanford, N. N., Dee, E. C. 2023; 30 (9): 5495-5505

  Abstract

  Vast differences in barriers to care exist among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) groups and may manifest as disparities in stage at presentation and access to treatment. Thus, we characterized AANHPI patients with stage 0-IV colon cancer and examined differences in (1) stage at presentation and (2) time to surgery relative to white patients.We assessed all patients in the National Cancer Database (NCDB) with stage 0-IV colon cancer from 2004 to 2016 who identified as white, Chinese, Japanese, Filipino, Native Hawaiian, Korean, Vietnamese, Laotian, Hmong, Kampuchean, Thai, Asian Indian or Pakistani, and Pacific Islander. Multivariable ordinal logistic regression defined adjusted odds ratios (AORs), with 95% confidence intervals (CI), of (1) patients presenting with advanced stage colon cancer and (2) patients with stage 0-III colon cancer receiving surgery at ≥ 60 days versus 30-59 days versus < 30 days postdiagnosis, adjusting for sociodemographic/clinical factors.Among 694,876 patients, Japanese [AOR 1.08 (95% CI 1.01-1.15), p < 0.05], Filipino [AOR 1.17 (95% CI 1.09-1.25), p < 0.001], Korean [AOR 1.09 (95% CI 1.01-1.18), p < 0.05], Laotian [AOR 1.51 (95% CI 1.17-1.95), p < 0.01], Kampuchean [AOR 1.33 (95% CI 1.04-1.70), p < 0.01], Thai [AOR 1.60 (95% CI 1.22-2.10), p = 0.001], and Pacific Islander [AOR 1.41 (95% CI 1.20-1.67), p < 0.001] patients were more likely to present with more advanced colon cancer compared with white patients. Chinese [AOR 1.27 (95% CI 1.17-1.38), p < 0.001], Japanese [AOR 1.23 (95% CI 1.10-1.37], p < 0.001], Filipino [AOR 1.36 (95% CI 1.22-1.52), p < 0.001], Korean [AOR 1.16 (95% CI 1.02-1.32), p < 0.05], and Vietnamese [AOR 1.55 (95% CI 1.36-1.77), p < 0.001] patients were more likely to experience greater time to surgery than white patients. Disparities persisted when comparing among AANHPI subgroups.Our findings reveal key disparities in stage at presentation and time to surgery by race/ethnicity among AANHPI subgroups. Heterogeneity upon disaggregation underscores the importance of examining and addressing access barriers and clinical disparities.

  View details for DOI 10.1245/s10434-023-13339-0

  View details for PubMedID 37017832

  View details for PubMedCentralID PMC10075171

• Deaths Due to COVID-19 in Patients With Cancer During Different Waves of the Pandemic in the US. JAMA oncology Potter, A. L., Vaddaraju, V., Venkateswaran, S., Mansur, A., Bajaj, S. S., Kiang, M. V., Jena, A. B., Yang, C. J. 2023

  Abstract

  With the ongoing relaxation of guidelines to prevent COVID-19 transmission, particularly in hospital settings, medically vulnerable groups, such as patients with cancer, may experience a disparate burden of COVID-19 mortality compared with the general population.To evaluate COVID-19 mortality among US patients with cancer compared with the general US population during different waves of the pandemic.This cross-sectional study used data from the Center for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database to examine COVID-19 mortality among US patients with cancer and the general population from March 1, 2020, to May 31, 2022. The number of deaths due to COVID-19 during the 2021 to 2022 winter Omicron surge was compared with deaths during the preceding year's COVID-19 winter surge (when the wild-type SARS-CoV-2 variant was predominant) using mortality ratios. Data were analyzed from July 21 through August 31, 2022.Pandemic wave during which the wild-type variant (December 2020 to February 2021), Delta variant (July 2021 to November 2021), or Omicron variant (December 2021 to February 2022) was predominant.Number of COVID-19 deaths per month.The sample included 34 350 patients with cancer (14 498 females [42.2%] and 19 852 males [57.8%]) and 628 156 members of the general public (276 878 females [44.1%] and 351 278 males [55.9%]) who died from COVID-19 when the wild-type (December 2020-February 2021), Delta (July 2021-November 2021), and winter Omicron (December 2021-February 2022) variants were predominant. Among patients with cancer, the greatest number of COVID-19 deaths per month occurred during the winter Omicron period (n = 5958): at the peak of the winter Omicron period, there were 18% more deaths compared with the peak of the wild-type period. In contrast, among the general public, the greatest number of COVID-19 deaths per month occurred during the wild-type period (n = 105 327), and at the peak of the winter Omicron period, there were 21% fewer COVID-19 deaths compared with the peak of the wild-type period. In subgroup analyses by cancer site, COVID-19 mortality increased the most, by 38%, among patients with lymphoma during the winter Omicron period vs the wild-type period.Findings of this cross-sectional study suggest that patients with cancer had a disparate burden of COVID-19 mortality during the winter Omicron wave compared with the general US population. With the emergence of new, immune-evasive SARS-CoV-2 variants, many of which are anticipated to be resistant to monoclonal antibody treatments, strategies to prevent COVID-19 transmission should remain a high priority.

  View details for DOI 10.1001/jamaoncol.2023.3066

  View details for PubMedID 37651113

• Academic hierarchies are an uphill struggle for black women. BMJ (Clinical research ed.) Sabet, C. J., Bajaj, S. S., Stanford, F. C. 2023; 382: 1784

  View details for DOI 10.1136/bmj.p1784

  View details for PubMedID 37532278

• Results following implementation of a cardiac surgery ERAS protocol PLoS One Obafemi, T., Mullis, D. M., Bajaj, S., Krishna, P., Boyd, J. 2023: e0277868

  Abstract

  Adequate peri-operative care is essential to ensuring a satisfactory outcome in cardiac surgery. In this study, we look at the impact of evidence-based protocols implemented at Stanford Hospital.This study is a single-center, retrospective analysis. Enhanced recovery after surgery (ERAS) protocols were implemented for CABG/Valve and open Aortic operations on 11/1/2017 and 6/1/2018, respectively. Propensity-score matched analysis was used to compare 30-day mortality and morbidity of patients from the pre- and post-implementation cohorts. Secondary endpoints included the following: total hospital length of stay (LOS), ICU LOS, time until extubation, and time until urinary catheter removal.After the implementation of the ERAS protocols for CABG/Valve operations, the median post-op LOS decreased from 7.0 days to 6.1 days (p<0.001), and median ICU LOS decreased from 69.9 hours to 54.0 (p = 0.098). There was no significant decrease in 30-day mortality (4% to 3.3%, p = 0.47). However, the incidence of post-op ventilator associated pneumonia (VAP) decreased from 5.0% to 2.1% (p = 0.003) and post-op urinary tract infections (UTIs) from 8.3% to 3.6% (p<0.001). Patients who underwent open aortic procedures experienced an improvement in 30-day mortality (7% to 3.5%, p = 0.012), decrease in median ICU LOS (91.7 hours to 69.6 hours, p<0.001), and a decrease in duration of mechanical ventilation (79.3 hours to 46.3 hours, p = 0.003). There was a decrease in post-op LOS, post-op VAP, and post-op UTI, although statistical significance was not attained.At Stanford Hospital, ERAS pathways have led to decreased morbidity and LOS while simultaneously improving mortality amongst our critically ill patient population.

  View details for DOI 10.1371/journal.pone.0277868

  View details for PubMedCentralID PMC10348550

• Results following implementation of a cardiac surgery ERAS protocol. PloS one Obafemi, T., Mullis, D., Bajaj, S., Krishna, P., Boyd, J. 2023; 18 (7): e0277868

  Abstract

  Adequate peri-operative care is essential to ensuring a satisfactory outcome in cardiac surgery. In this study, we look at the impact of evidence-based protocols implemented at Stanford Hospital.This study is a single-center, retrospective analysis. Enhanced recovery after surgery (ERAS) protocols were implemented for CABG/Valve and open Aortic operations on 11/1/2017 and 6/1/2018, respectively. Propensity-score matched analysis was used to compare 30-day mortality and morbidity of patients from the pre- and post-implementation cohorts. Secondary endpoints included the following: total hospital length of stay (LOS), ICU LOS, time until extubation, and time until urinary catheter removal.After the implementation of the ERAS protocols for CABG/Valve operations, the median post-op LOS decreased from 7.0 days to 6.1 days (p<0.001), and median ICU LOS decreased from 69.9 hours to 54.0 (p = 0.098). There was no significant decrease in 30-day mortality (4% to 3.3%, p = 0.47). However, the incidence of post-op ventilator associated pneumonia (VAP) decreased from 5.0% to 2.1% (p = 0.003) and post-op urinary tract infections (UTIs) from 8.3% to 3.6% (p<0.001). Patients who underwent open aortic procedures experienced an improvement in 30-day mortality (7% to 3.5%, p = 0.012), decrease in median ICU LOS (91.7 hours to 69.6 hours, p<0.001), and a decrease in duration of mechanical ventilation (79.3 hours to 46.3 hours, p = 0.003). There was a decrease in post-op LOS, post-op VAP, and post-op UTI, although statistical significance was not attained.At Stanford Hospital, ERAS pathways have led to decreased morbidity and LOS while simultaneously improving mortality amongst our critically ill patient population.

  View details for DOI 10.1371/journal.pone.0277868

  View details for PubMedID 37450443

  View details for PubMedCentralID PMC10348550

• Trends in location of death for individuals with metastatic lung cancer in the United States. American journal of surgery Jain, U., Jain, B., Dee, E. C., Bajaj, S. S., Paguio, J. A., Yao, J. S., Gomez, D. R., Celi, L. A., Drilon, A. 2023; 226 (1): 135-137

  View details for DOI 10.1016/j.amjsurg.2023.02.017

  View details for PubMedID 36907745

• Supreme Court cases on affirmative action threaten diversity in medicine. Proceedings of the National Academy of Sciences of the United States of America Aaron, D. G., Bajaj, S. S., Stanford, F. C. 2023; 120 (17): e2220919120

  View details for DOI 10.1073/pnas.2220919120

  View details for PubMedID 37075073

  View details for PubMedCentralID PMC10151613

• COVID-19 pandemic relief funding-a lifeline for equity. American journal of infection control Kim, J., Kim, J., Bajaj, S. S., Stanford, F. C. 2023; 51 (3): 354-355

  View details for DOI 10.1016/j.ajic.2022.10.002

  View details for PubMedID 36244571

  View details for PubMedCentralID PMC9558694

• ChatGPT: Temptations of Progress AMERICAN JOURNAL OF BIOETHICS Doshi, R. H., Bajaj, S. S., Krumholz, H. M. 2023; 23 (4): 6-8

  View details for DOI 10.1080/15265161.2023.2180110

  View details for Web of Science ID 000941719300001

  View details for PubMedID 36853242

• Recruitmentology and the politics of consent in clinical research. Lancet (London, England) Sabet, C., Bajaj, S. S., Stanford, F. C. 2023; 401 (10373): 262-263

  View details for DOI 10.1016/S0140-6736(23)00122-8

  View details for PubMedID 36995309

  View details for PubMedCentralID PMC13032760

• Bridging the gap: promoting equity and diversity in global oncology research within Sub-Saharan Africa BMJ ONCOLOGY Nguyen, D., Patel, S., Jain, N., Bajaj, S. S., Ngoma, T., Ngwa, W. 2023; 2 (1): e000013

  View details for DOI 10.1136/bmjonc-2022-000013

  View details for Web of Science ID 001734282400001

  View details for PubMedID 39886496

  View details for PubMedCentralID PMC11203078

• Racial and ethnic disparities in end-of-life care for patients with oesophageal cancer: Death trends over time LANCET REGIONAL HEALTH-AMERICAS Bajaj, S. S., Jain, B., Potter, A. L., Dee, E., Yang, C. 2023; 17: 100401

  Abstract

  Given significant morbidity and mortality associated with oesophageal cancer, supportive, high-quality end-of-life care is critical. Most patients with advanced cancer prefer to die at home, but incongruence between preferred and actual place of death is common. Here, we examined trends and disparities in location of death among patients with oesophageal cancer.Using the Centers for Disease Control and Prevention Wide-Range Online Data for Epidemiologic Research database, we utilized multinomial logistic regression to assess associations between sociodemographic characteristics and location of death for patients with oesophageal cancer (n = 237,063). Additionally, we utilized linear regression models to evaluate the significance of changes in location of death trends over time and disparities in the relative change in location of death trends across sociodemographic groups.From 2003 to 2019, there was a decrease of deaths in hospitals, nursing homes, and outpatient medical facilities/emergency departments and an increase of deaths at home and in hospice. Relative to White decedents, Black and Asian decedents were less likely to die at home (relative risk ratio (RRR): 0.58 [95% confidence interval (CI): 0.56-0.60], RRR: 0.57 [95% CI: 0.53-0.61]) and in hospice (RRR: 0.67 [95% CI: 0.64-0.71], RRR: 0.49 [95% CI: 0.43-0.55]) when compared to the hospital. Similar disparities were noted for American Indian and Alaska Native (AIAN) decedents. These disparities persisted even upon stratifying by the number of listed causes of death, a proxy for severity of illness. Time trend analysis indicated that increases in deaths in hospice over time occurred at a slower rate for AIAN and Asian decedents relative to White decedents.2 in 5 patients with oesophageal cancer die at home, with an increasing proportion dying at home and in hospice-in line with general patient preferences. However, location of death disparities have largely persisted over time among racial and ethnic minority groups. Our findings suggest the importance of improving access to advance care planning and delivering tailored, person-centred interventions.None.

  View details for DOI 10.1016/j.lana.2022.100401

  View details for Web of Science ID 000928219800005

  View details for PubMedID 36776566

  View details for PubMedCentralID PMC9904053

• Out of the Frying Pan Into the Fire: COVID-19 as a Road Map for Integrated Chronic Disease Prevention. Journal of public health management and practice : JPHMP Zhong, A., Bajaj, S. S., Stanford, F. C. 2022; 29 (2): 117-119

  View details for DOI 10.1097/PHH.0000000000001694

  View details for PubMedID 36715590

  View details for PubMedCentralID PMC9897113

• Cigarette package labels to promote lung cancer screening. Nature medicine Bajaj, S. S., Pan, M., Potter, A. L., Yang, C. J. 2022; 28 (12): 2460-2461

  View details for DOI 10.1038/s41591-022-02042-4

  View details for PubMedID 36229665

• Trends in Metabolic and Bariatric Surgery Reimbursement in the USA. Obesity surgery Zhong, A., Bajaj, S. S., Khunte, M., Dang, N., Stanford, F. C. 2022; 32 (12): 4110-4112

  View details for DOI 10.1007/s11695-022-06329-w

  View details for PubMedID 36260220

  View details for PubMedCentralID PMC9911199

• Protecting marginalized women's mental health in the post-Dobbs era. Proceedings of the National Academy of Sciences of the United States of America Nguyen, D., Bajaj, S. S., Ahmed, D., Stanford, F. C. 2022; 119 (40): e2212012119

  View details for DOI 10.1073/pnas.2212012119

  View details for PubMedID 36149969

  View details for PubMedCentralID PMC9546526

• Obesity and Eligibility for Obesity Treatments Among Adults With Disabilities in the U.S. American journal of preventive medicine Townsend, M. J., Claridy, M. D., Bajaj, S. S., Tu, L., Stanford, F. C. 2022; 63 (4): 513-520

  Abstract

  Obesity has been associated with disability; yet, the proportion who meet clinical criteria for obesity treatment among adults with disabilities remains poorly defined. Characterization of obesity and treatment eligibility by disability type may prioritize high-need groups. This study assessed the prevalence of obesity and eligibility for antiobesity pharmacotherapy and/or bariatric surgery in adults with disability.This cross-sectional weighted analysis of the 2019 National Health Interview Survey, including self-reported health and sociodemographic information, was conducted in 2021. Burden of obesity defined by BMI and odds of meeting consensus criteria for antiobesity pharmacotherapy and/or surgery were calculated by functional disability type: vision, hearing, cognition, communication, mobility, and self-care.From 29,170 community-dwelling adult respondents (59.1% response), the overall prevalence of disability was 10%. The prevalence of obesity among adults with a disability was 40.1% vs 30.5% for U.S. adults overall (p<0.0001). An estimated 17.1% with disability met the criteria for both bariatric surgery and antiobesity pharmacotherapy; another 39.8% were eligible for pharmacotherapy alone (vs 7.9% and 33.2%, respectively, for adults overall; p<0.0001). In fully adjusted models, disability was associated with greater ORs for mild obesity (OR=1.2; 95% CI=1.1, 1.4), moderate‒severe obesity (OR=2.1; 95% CI=1.8, 2.3), and criteria for bariatric surgery (OR=2.4; 95% CI=2.1, 2.7) and pharmacotherapy (OR=1.3; 95% CI=1.2, 1.4). Mobility, self-care, and cognition disabilities were associated with eligibility for bariatric surgery and antiobesity pharmacotherapy.Individuals with disabilities have higher odds of obesity and eligibility for antiobesity treatments. Comorbidities should be considered, accommodations should be provided, and insurance coverage should be expanded to ensure access to antiobesity treatments for adults with disabilities.

  View details for DOI 10.1016/j.amepre.2022.04.003

  View details for PubMedID 35613976

  View details for PubMedCentralID PMC9940942

• Reforming global health governance in the face of pandemics and war BMJ-BRITISH MEDICAL JOURNAL Jiang, Y., Zhong, A., Bajaj, S. S., Guyatt, G. 2022; 378: o2216

  View details for DOI 10.1136/bmj.o2216

  View details for Web of Science ID 000860470700008

  View details for PubMedID 36100274

• The hidden surgical humanitarian response in Ukraine - Correspondence. International journal of surgery (London, England) Bajaj, S. S., Mandell, S., Epstein, A., Lim, R. 2022; 105: 106865

  View details for DOI 10.1016/j.ijsu.2022.106865

  View details for PubMedID 36038054

• International lack of equity in modern obesity therapy: the critical need for change in health policy. International journal of obesity (2005) Roser, P., Bajaj, S. S., Stanford, F. C. 2022; 46 (9): 1571-1572

  View details for DOI 10.1038/s41366-022-01176-2

  View details for PubMedID 35778480

  View details for PubMedCentralID PMC9395261

• Virtual Surgical Skills Training in a High School Summer Program. The Annals of thoracic surgery Bajaj, S. S., Patel, H. H., Fann, J. I., Ma, M., Lui, N. S. 2022

  Abstract

  BACKGROUND: The COVID-19 pandemic has disrupted components of traditional education with shifts toward virtual platforms. Here, we describe the virtual approach to basic surgical skills training during our high school program in the summers of 2020 and 2021.METHODS: Two 2-week sessions were held via Zoom with 99 students in 2020 and 198 students in 2021. Each student was sent surgical supplies and instruments. Interactive lectures were held each morning and basic surgical skills instruction each afternoon. After the session, survey links were distributed to students to complete an anonymous 37-item questionnaire regarding surgical skills confidence, simulation kit satisfaction, and technical difficulties.RESULTS: Of the 297 students, 270 (90.9%) completed the questionnaire, including 91 (91.9%) in 2020 and 179 (90.4%) in 2021. On a scale of 1 (fair) to 5 (excellent), students in 2020 and 2021 reported similar confidence in instrument handling (4-5: 90.0% vs 86.3%, p=0.38), suturing skin (4-5: 88.9% vs 82.8%, p=0.19), and thoracic aorta suturing (4-5: 73.3% vs 73.6%, p=0.97). Students reported greater confidence in 2020 on knot-tying (4-5: 98.9% vs 87.9%, p=0.002), coronary vessel suturing (4-5: 82.2% vs 65.5%, p<0.001), and valve model suturing (4-5: 68.5% vs 50.3%, p=0.005) than students in 2021. Students had similar satisfaction rates with the program (extremely or somewhat satisfied: 92.3% vs 86.0%, p=0.51) between 2020 and 2021.CONCLUSIONS: Virtual education carries the potential for basic surgical skills training for a more widespread audience with less access to direct surgical education. Further research is needed to optimize teaching finer surgical skills.

  View details for DOI 10.1016/j.athoracsur.2022.07.034

  View details for PubMedID 35934065

• Early vs Delayed Surgery for Esophageal Cancer During the COVID-19 Pandemic. Journal of the American College of Surgeons Bajaj, S. S., Shah, K. M., Potter, A. L., Mayne, N. R., Sachdeva, U. M., Lin, M. W., Yang, C. J. 2022; 235 (2): 174-184

  Abstract

  During the coronavirus disease 2019 pandemic, national guidelines recommended that elective surgery for esophageal cancer be deferred by 3 months when hospital resources are limited. The impact of this delay on patient outcomes is unknown. We sought to evaluate the survival of patients with stage I and II/III esophageal cancer who undergo early vs delayed treatment.Using the National Cancer Database from 2010 to 2017, multivariable Cox proportional hazards modeling and propensity score-matched analysis were employed to compare survival of patients with stage I esophageal cancer who received early (0 to 4 weeks after diagnosis) vs delayed esophagectomy (12 to 16 weeks) and of patients with stage II/III esophageal cancer who-after receiving timely chemoradiation (0 to 4 weeks after diagnosis)-underwent early (9 to 17 weeks) vs delayed esophagectomy (21 to 29 weeks).For stage I esophageal cancer, 226 (41.7%) patients underwent early esophagectomy, and 316 (58.3%) patients underwent delayed esophagectomy. Propensity score matching created 2 groups of 134 patients with early or delayed esophagectomy, whose 5-year survival was comparable (hazard ratio [HR] 65.0% [95% confidence interval (CI) 55.2% to 73.2%] vs HR 65.1% [95% CI 55.6% to 73.1%], p = 0.50). For stage II/III esophageal cancer, 1,236 (86.1%) patients underwent early esophagectomy, and 200 (13.9%) underwent delayed esophagectomy. Propensity score matching created 2 groups of 130 patients; the early esophagectomy group had improved 5-year survival compared with the delayed esophagectomy group (HR 41.6% [95% CI 32.1% to 50.8%] vs HR 22.9% [95% CI 14.9% to 31.8%], p = 0.006).Early esophagectomy was associated with similar survival compared with delayed esophagectomy for patients with stage I esophageal cancer. For patients with stage II/III esophageal cancer, early esophagectomy was associated with improved survival relative to delayed esophagectomy.

  View details for DOI 10.1097/XCS.0000000000000248

  View details for PubMedID 35839391

• Impact of PhD Degree Versus Non-PhD Research Fellowship on Future Research Productivity Among Academic Cardiothoracic Surgeons. World journal of surgery Bajaj, S. S., Wang, H., Williams, K. M., Heiler, J. C., Pickering, J. M., Manjunatha, K., O'Donnell, C. T., Sanchez, M., Boyd, J. H. 2022

  Abstract

  BACKGROUND: A PhD degree can offer significant research experience, but previous studies yielded conflicting conclusions on the relationship between a PhD degree and future research output. We compared the impact of a PhD degree versus research fellowship(RF) training on research productivity in cardiothoracic surgeons, hypothesizing that training pathways may influence potential associations.METHODS: CT surgeons practicing at all accredited United States CT surgery training programs in 2018 who pursued dedicated time for research (n=597), including earning a PhD degree (n=92) or completing a non-PhD RF (n=505), were included. To control for training pathways, we performed subanalyses of U.S. medical school graduates (n=466) and international medical school graduates (IMGs) (n=131). Surgeon-specific data were obtained from publicly available sources (e.g., institutional webpages, Scopus).RESULTS: PhD surgeons published greater total papers (68.5 vs. 52.0, p=0.0179) and total papers per year as an attending (4.6 vs. 3.0, p=0.0150). For U.S. medical school graduates, there were 40 PhD surgeons and 426 non-PhD RF surgeons; both groups published a similar number of total papers (64.5 vs. 54.0, p=0.3738) and total papers per year (3.2 vs. 3.0, p=0.7909). For IMGs, there were 52 PhD surgeons and 79 non-PhD RF surgeons; the PhD surgeons published greater total papers (80.5 vs. 45.0, p=0.0101) and total papers per year (5.7 vs. 2.7, p=0.0037).CONCLUSION: CT surgeons with dedicated research training are highly academically productive. Although a PhD degree may be associated with enhanced career-long research productivity for IMGs, this association was not observed for U.S. medical school graduates.

  View details for DOI 10.1007/s00268-022-06661-3

  View details for PubMedID 35871657

• Diminishing Basic Science Research Experience Among United States Cardiothoracic Surgery Trainees. The Journal of surgical research Wang, H., Bajaj, S. S., Manjunatha, K., Yu, M. M., Obafemi, O. O., Williams, K. M., Boyd, J. H. 2022; 279: 312-322

  Abstract

  INTRODUCTION: There is growing concern regarding the attrition of surgeon-scientists. To understand the decline of basic science research (BSR), it is essential to examine trends in research conducted by trainees. We hypothesized that, over recent decades, cardiothoracic (CT) surgery trainees have published fewer BSR articles.MATERIALS AND METHODS: CT surgeons at United States training institutions in 2020 who completed training in the past threedecades, excluding international trainees, were analyzed (1991-2000: n=148; 2001-2010: n=228; 2011-2020: n=247). Publication records were obtained from Scopus. Articles with medical subject heading terms involving molecular/cellular or animal research were classified as BSR using the National Institutes of Health iCite Translation module. Data were analyzed using Fisher's exact test or the Wilcoxon rank-sum test.RESULTS: While the proportion of surgeons who published a first-author paper during training remained stable over the past twodecades (178/228 [78.1%] versus 189/247 [76.5%], P=0.7427), the proportion who published a first-author BSR paper decreased significantly (135/228 [59.2%] versus 96/247 [38.9%], P<0.0001). Among surgeons who published a first-author paper in training, the total papers published by each trainee did not change over the past twodecades (3.5 versus 3.3 first-author papers per 10y of training, P=0.8819). However, the number of BSR papers published during training decreased significantly (1.7 versus 0.8 first-author papers per 10y of training, P<0.0001).CONCLUSIONS: CT surgery trainees are publishing fewer BSR papers. Additional efforts are needed to increase exposure of trainees to BSR and reaffirm that BSR is a valuable and worthwhile pursuit for academic surgeons.

  View details for DOI 10.1016/j.jss.2022.06.020

  View details for PubMedID 35809356

• Paradox of telemedicine: building or neglecting trust and equity. The Lancet. Digital health Yee, V., Bajaj, S. S., Stanford, F. C. 2022; 4 (7): e480-e481

  View details for DOI 10.1016/S2589-7500(22)00100-5

  View details for PubMedID 35750399

  View details for PubMedCentralID PMC9214484

• An automated line-clearing chest tube system after cardiac surgery. JTCVS open Obafemi, O. O., Wang, H., Bajaj, S. S., O'Donnell, C. T., Elde, S., Boyd, J. H. 2022; 10: 246-253

  Abstract

  To complete the first in-human study of the automated line clearance Thoraguard chest tube system. The study focuses on the viability and efficacy of the device in comparison with conventional models as well as secondary matters such as patient experience and ease of use.This was a single-center, prospective, open-label study involving adult patients (n = 27) who underwent nonemergent, first-time, cardiac surgery. Patients received automated clearance chest tubes for surgical drainage in both the mediastinal and pleural spaces. The control group was retrospective (n = 80); individuals received conventional chest tubes placed and secured in locations determined at the surgeon's discretion.The automated-clearance tubes exhibited a similar drainage profile at 1, 3, 6, 12, and 24 hours compared with the conventional chest tubes. The final output at the time of tube removal was also similar (1150 [750-1590] vs 1289 [766.3-1890] mL, respectively, P = .76). The number of patients readmitted for drainage of an effusion was similar in both groups (1/27 [3.7%] vs 3/80 [3.75%], P > .99).This study has shown that the Centese Thoraguard chest tube system is a viable option for surgical chest drainage and effective when used in routine cardiac surgery operations.

  View details for DOI 10.1016/j.xjon.2022.02.020

  View details for PubMedID 36004272

  View details for PubMedCentralID PMC9390781

• Career Progression and Research Productivity of Women in Academic Cardiothoracic Surgery. The Annals of thoracic surgery Williams, K. M., Wang, H., Bajaj, S. S., Hironaka, C. E., Kasinpila, P., O'Donnell, C. T., Sanchez, M., Watkins, A. C., Lui, N. S., Backhus, L. M., Boyd, J. 2022

  Abstract

  The objective of this work was to delineate career progression and research productivity of women practicing cardiothoracic surgery in the academic setting.Cardiothoracic surgeons at the 79 accredited U.S. cardiothoracic surgery training programs in 2020 were included in this cross-sectional analysis. Data regarding sub-specialization, training, practice history, and publications were gathered from public sources including department websites, CTSNet, and Scopus.A total of 1065 surgeons (51.3% cardiac, 32.1% thoracic, 16.6% congenital) were identified. Women accounted for 10.6% (113) of the population (7.9% of cardiac, 15.5% of thoracic, 9.6% of congenital surgeons). The median number of cardiothoracic surgeons per institution was 12 [IQR 10-17], with a median of one woman [IQR 0-2]. Fifteen of 79 (19%) programs had zero women. Among women faculty, 5.3% were clinical instructors, 51.3% were assistant professors, 23.0% were associate professors, 16.8% were full professors, and 3.5% had unspecified titles (vs. 2.0%, 32.9%, 23.0%, 37.5%, and 4.6% among men, respectively, p<0.001). Women and men authored a comparable number of first-author (0.4 [0.0-1.3] vs. 0.5 [0.0-1.1], p=0.56) publications per year, but fewer last-author (0.1 [0.0-0.7] vs. 0.4 [0.0-1.3], p<0.0001) and total publications per year (2.7 [1.0-6.2] vs. 3.7 [1.3-7.8], p=0.05) than men. H-index was lower for women than for men overall (8.0 [3.0-15.0] vs. 15.0 [7.0-28.0], p<0.001), but was similar between men and women who had been practicing for 10-20 years.Gender disparities persist in academic cardiothoracic surgery. Efforts should be made to support women in achieving senior roles and academic productivity.

  View details for DOI 10.1016/j.athoracsur.2022.04.057

  View details for PubMedID 35643331

• Extended Delay to Treatment for Stage III-IV Non-Small-Cell Lung Cancer and Survival: Balancing Risks During the COVID-19 Pandemic. Clinical lung cancer Mayne, N. R., Bajaj, S. S., Powell, J., Elser, H. C., Civiello, B. S., Fintelmann, F. J., Li, X., Yang, C. J. 2022

  Abstract

  BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, patients may encounter lung cancer care delays. Here, we sought to examine the impact of extended treatment delay for stage III-IV non-small-cell lung cancer on patient survival.MATERIALS AND METHODS: Using National Lung Screening Trial (NLST) and National Cancer Data Base (NCDB) data, Cox regression analysis with penalized smoothing splines was performed to examine the association between treatment delay and all-cause mortality for stage III-IV lung adenocarcinoma and squamous cell carcinoma. In the NCDB, propensity score-matched analysis was used to compare cumulative survival in patients who received "early" versus "delayed" treatment (ie, 0-30 vs. 90-120 days following diagnosis).RESULTS: Cox regression analysis of the NLST (n=392) and NCDB (n=275,198) cohorts showed a decrease in hazard ratio the longer treatment was delayed. In propensity score-matched analysis, no significant differences in survival were found between early and delayed treatment for patients with stage IIIA, IIIB (T3-4,N2,M0), IIIC, and IV (M1B-C) adenocarcinoma and patients with IIIA, IIIB, IIIC, and IV squamous cell carcinoma (all log-rank P > .05). For patients with stage IIIB (T1-2,N3,M0) and stage IV (M1A) adenocarcinoma, delayed treatment was associated with improved survival (log-rank P=.03, P=.02). The findings were consistent in sensitivity analysis accounting for wait time bias.CONCLUSION: In this national analysis, for patients with stage III-IV adenocarcinoma and squamous cell carcinoma, an extended treatment delay by 3 to 4 months was not associated with significantly decreased overall survival compared to prompt treatment. These findings can be used to guide decision-making during the ongoing COVID-19 pandemic.

  View details for DOI 10.1016/j.cllc.2022.05.001

  View details for PubMedID 35660355

• ASO Research Letter: Trends in Location of Death for Individuals with Pancreatic Cancer in the United States. Annals of surgical oncology Bajaj, S. S., Jain, B., Dee, E. C., Wo, J. Y., Qadan, M. 2022; 29 (5): 2766-2768

  View details for DOI 10.1245/s10434-021-11058-y

  View details for PubMedID 34748124

  View details for PubMedCentralID 6704737

• Vaccine apartheid: global cooperation and equity. Lancet (London, England) Bajaj, S. S., Maki, L., Stanford, F. C. 2022; 399 (10334): 1452-1453

  View details for DOI 10.1016/S0140-6736(22)00328-2

  View details for PubMedID 35218695

  View details for PubMedCentralID PMC8865875

• Orthogeriatric co-management care models: The need for integrated practice units. The Lancet regional health. Western Pacific Jain, B., Bajaj, S. S., Amen, T. B., Dee, E. C., Palakodeti, S. 2022; 21: 100416

  View details for DOI 10.1016/j.lanwpc.2022.100416

  View details for PubMedID 35310900

  View details for PubMedCentralID PMC8928085

• Building a pandemic supply chain - equity over equality. Nature medicine Yee, V., Bajaj, S. S., Stanford, F. C. 2022; 28 (4): 609-610

  View details for DOI 10.1038/s41591-022-01748-9

  View details for PubMedID 35288699

  View details for PubMedCentralID PMC9907003

• Socioeconomic disparities in healthcare utilization for atherosclerotic cardiovascular disease. American heart journal Jain, B., Bajaj, S. S., Paguio, J. A., Yao, J. S., Casipit, B. A., Dee, E. C., Bhatt, D. L. 2022; 246: 161-165

  Abstract

  The impact of the social determinants of health on healthcare utilization for patients with atherosclerotic cardiovascular disease (ASCVD) remains incompletely characterized.We queried the National Health Interview Survey from 2000-2018 to examine disparities in healthcare utilization metrics by education, income-to-poverty ratio, and health insurance coverage for adults with self-reported ASCVD.We show that, while education and income-to-poverty ratios demonstrated significant disparities for provider visits and preventive screenings, the largest disparities were noted for health insurance coverage.These trends suggest that efforts to expand private or government insurance to improve coverage for patients with ASCVD may address healthcare utilization-based disparities.

  View details for DOI 10.1016/j.ahj.2022.01.011

  View details for PubMedID 35093303

• Weight gain after in vitro fertilization: a potential consequence of controlled ovarian stimulation. Journal of assisted reproduction and genetics Bajaj, S. S., Jain, B., Stanford, F. C. 2022; 39 (4): 973-976

  Abstract

  In the USA, 42% of adult women were estimated to have obesity, and 13% of women of childbearing age similarly have impaired fecundity. Obesity is associated with infertility such that patients with obesity often seek out in vitro fertilization (IVF) services. Here, we report on the case of a woman with childhood-onset class II obesity who had been undergoing treatment with phentermine and topiramate prior to undergoing 3 cycles of IVF. With each cycle, the patient temporarily gained 13-15 lbs. during controlled ovarian stimulation (COS). Weight gain from COS may be clinically relevant and merits further study to optimize weight status across women's reproductive life and to better assist women who gain weight secondary to IVF. Incorporating weight monitoring into IVF protocols may also help better characterize the scope of weight gain from COS.

  View details for DOI 10.1007/s10815-022-02444-w

  View details for PubMedID 35218460

  View details for PubMedCentralID PMC9051006

• Overcoming congressional inertia on obesity requires better literacy in obesity science. Obesity (Silver Spring, Md.) Bajaj, S. S., Jain, B., Kyle, T. K., Gallagher, C., Stanford, F. C., Srivastava, G. 2022; 30 (4): 799-801

  Abstract

  Obesity-focused health policies, including the landmark Treat and Reduce Obesity Act, have stalled at the federal level over the past decade. Congressional inaction on obesity reflects both misconceptions of obesity as a lifestyle choice and limited awareness for the burden obesity imposes on our health care system. Given these challenges, we argue that health professionals must bolster their efforts to partner with public figures with obesity and to directly educate the public. These strategies may help destigmatize obesity and build awareness of obesity as a disease. Furthermore, we suggest that these strategies may empower patients to flex their unrealized political muscle and demand more from their elected leaders. A bold, multilevel approach that elicits a public demand for change can propel obesity policy into the 21st century.

  View details for DOI 10.1002/oby.23405

  View details for PubMedID 35244978

  View details for PubMedCentralID PMC8957554

• Analyzing the Scholarly Impact of Cardiothoracic Surgery Research Using the Relative Citation Ratio. The Journal of surgical research Wang, H., Bajaj, S. S., Williams, K. M., O'Donnell, C. T., Heiler, J. C., Krishnan, A., Pickering, J. M., Sanchez, M., Manjunatha, K., Kumar, S. S., Yu, M. M., Boyd, J. H. 2022; 275: 265-272

  Abstract

  INTRODUCTION: The National Institutes of Health (NIH) recently developed the relative citation ratio (RCR), calculated as article citations benchmarked to NIH-funded publications in the same field. Here, we characterized the scholarly impact of academic cardiothoracic (CT) surgeons and their research using the RCR.MATERIALS AND METHODS: Using a database of 992 CT surgeons, we calculated the RCR for all articles published by each surgeon since 1980 using the NIH iCite database. All data were collected from publicly available online sources. Data are presented as median (interquartile range) or as odds ratios (ORs) for multivariable logistic regression analysis.RESULTS: Where RCR 1.00 indicates equal impact as an NIH-funded publication, the RCR among all 37,402 CT surgery articles was 0.84 (0.33-1.83) and the RCR among NIH-funded CT surgery articles was 1.07 (0.53-2.17). CT surgeons exhibited a career median RCR of 0.82 (0.54-1.13) and maximum RCR of 6.20 (3.04-13.57). Predictors of career median RCR >1.00 included female gender (OR 2.23, P=0.001), thoracic subspecialization (OR 2.50, P<0.001), full professor rank (OR 1.89, P=0.001), and NIH funding (OR 1.75, P=0.001). Predictors of career maximum RCR >50th percentile among CT surgeons included male gender (OR 1.87, P=0.030), thoracic subspecialization (OR 2.05, P<0.001), full professor rank (OR 4.89, P<0.001), NIH funding (OR 3.17, P<0.001), and career duration (OR 1.03, P=0.002).CONCLUSIONS: We present the first assessment of the NIH-validated RCR for academic CT surgery. CT surgery research is highly impactful, although gender disparities persist with respect to the highest-impact research of our specialty.

  View details for DOI 10.1016/j.jss.2022.02.007

  View details for PubMedID 35306262

• The Ukrainian refugee crisis and the pathology of racism BMJ-BRITISH MEDICAL JOURNAL Bajaj, S. S., Stanford, F. 2022; 376: o661

  View details for DOI 10.1136/bmj.o661

  View details for Web of Science ID 000770902800010

  View details for PubMedID 35277386

• Quantitative goals for research output and scholarly impact to enhance basic science R01 grant renewal for cardiothoracic surgeons. JTCVS open Wang, H., Bajaj, S. S., Heiler, J. C., Krishnan, A., Williams, K. M., Woo, Y. J., Boyd, J. H. 2022; 9: 162-175

  Abstract

  Objectives: Cardiothoracic (CT) surgeons with National Institutes of Health (NIH) R01 funding face a highly competitive renewal process. The factors that contribute to successful grant renewal for CT surgeons remain poorly defined. We hypothesized that renewed basic science grants are associated with high research output and scholarly impact during the preceding award cycle.Methods: Using a database of academic CT surgeons (n=992) at accredited training institutions in 2018, we identified basic science R01 grants awarded to CT surgeon principal investigators since 1985. Data for each award were obtained from publicly available online sources. Scholarly impact was evaluated using the NIH-validated relative citation ratio (RCR), defined as an article's citation rate divided by that of R01-funded publications in the same field. Continuous data are presented as medians and analyzed using the Mann-Whitney test.Results: We identified 102 basic science R01 award cycles, including 33 that were renewed (32.4%). Renewed and nonrenewed awards had a similar start year and funding period. Principal investigators of renewed versus nonrenewed awards were similar in surgical subspecialty, research training, attending experience, academic rank, and previous NIH funding. Renewed awards produced more publications per year over the funding cycle (3.4 vs 1.5; P=.0010) and exhibited a greater median RCR during the funding cycle (0.84 vs 0.66; P=.0183).Conclusions: CT surgery basic science R01 grants are associated with high research output and scholarly impact. At the 50th percentile among renewed grants, CT surgeons published 3.4 funded manuscripts per year with a median RCR of 0.84 during the previous award cycle.

  View details for DOI 10.1016/j.xjon.2021.10.063

  View details for PubMedID 36003453

• Randomized clinical trials of weight loss: Pragmatic and digital strategies and innovations. Contemporary clinical trials Jain, B., Bajaj, S. S., Stanford, F. C. 2022; 114: 106687

  Abstract

  During the COVID-19 pandemic, digital strategies and decentralized approaches allowed for the continuation of weight loss clinical trials despite in-person engagement coming to a halt. In particular, trials leveraged remote mediums to measure data in real-time across a broad array of metrics while testing novel strategies to streamline patient care. Such approaches may address longstanding challenges with traditional trials, including attrition and underrepresentation of racial and ethnic minorities. Ultimately, emerging data from trials utilizing both digital and in-person strategies may indicate the promise of a hybrid approach in incorporating a robust virtual component for continuous patient monitoring and an in-person component for patient adherence and data standardization. In this commentary, we provide an overview of the most innovative digital approaches in clinical trials of weight loss during the COVID-19 era, as well as identify opportunities and challenges for these modes of research going forward.

  View details for DOI 10.1016/j.cct.2022.106687

  View details for PubMedID 35085830

  View details for PubMedCentralID PMC8785263

• COVID-19: LMICs need antivirals as well as vaccines NATURE Bajaj, S., Stanford, F. 2022; 602 (7895): 33

  View details for DOI 10.1038/d41586-022-00220-5

  View details for Web of Science ID 000749566700015

  View details for PubMedID 35105995

  View details for PubMedCentralID PMC9924299

• Respectful language and putting the person first with obesity. European heart journal Bajaj, S. S., Tu, L., Stanford, F. C. 2022; 43 (5): 430

  View details for DOI 10.1093/eurheartj/ehab837

  View details for PubMedID 34871386

  View details for PubMedCentralID PMC9097011

• History of Surgery for Mitral Stenosis: John Mayow to Charles Bailey. The Annals of thoracic surgery Bajaj, S. S., Fann, J. I. 2022

  Abstract

  Mitral stenosis was first described in 1674 by Englishman John Mayow, but surgical intervention for mitral stenosis was proposed over two centuries later in 1898. Mitral surgery was undertaken in the 1920s with varying success; after two decades of staggered progress, mitral valvuloplasty and commissurotomy would be rediscovered by Americans Horace Smithy, Charles Bailey, and Dwight Harken. The evolution of open surgery for mitral stenosis suggests the troubled triumph of humanity over disease while also underlining surgeons' inability to successfully disseminate their pioneering ideas to a community critical of innovation.

  View details for DOI 10.1016/j.athoracsur.2021.12.046

  View details for PubMedID 35051396

• All Infrastructure Is Health Infrastructure AMERICAN JOURNAL OF PUBLIC HEALTH Jain, B., Bajaj, S. S., Stanford, F. 2022; 112 (1): 24-26

  View details for DOI 10.2105/AJPH.2021.306595

  View details for Web of Science ID 000819836600016

  View details for PubMedID 34936427

  View details for PubMedCentralID PMC8713619

• Promoting stigma BRITISH DENTAL JOURNAL Tu, L., Singh Bajaj, S., Stanford, F. C. 2021; 231 (11): 663-664

  View details for DOI 10.1038/s41415-021-3735-z

  View details for Web of Science ID 000729094000003

  View details for PubMedID 34893706

  View details for PubMedCentralID PMC9910580

• Locking ourselves into the past: the DentalSlim Diet Control device and an incomplete understanding of obesity. International journal of obesity (2005) Tu, L., Bajaj, S. S., Stanford, F. C. 2021; 45 (12): 2513-2514

  View details for DOI 10.1038/s41366-021-00956-6

  View details for PubMedID 34446845

  View details for PubMedCentralID PMC9908357

• Global health responsibilities in a Taliban-led Afghanistan. Nature medicine Jain, B., Bajaj, S. S., Noorulhuda, M., Crews, R. D. 2021

  View details for DOI 10.1038/s41591-021-01547-8

  View details for PubMedID 34750556

• The impact of the American Association for Thoracic Surgery on National Institutes of Health grant funding for cardiothoracic surgeons. The Journal of thoracic and cardiovascular surgery Mehaffey, J. H., Wang, H., Narahari, A. K., Bajaj, S. S., Chandrabhatla, A. S., Krupnick, A. S., Sellke, F. W., Rosengart, T. K., Woo, Y. J. 2021

  Abstract

  OBJECTIVES: The American Association for Thoracic Surgery, through its annual meeting, pilot grant funding, Scientific Affairs and Government Relations Committee activity, and academic development programs (Grant Writing Workshop, Clinical Trials Course, Innovation Summit), has aimed to develop the research careers of cardiothoracic surgeons. We hypothesized that American Association for Thoracic Surgery activities have helped increase National Institutes of Health grants awarded to cardiothoracic surgeons.METHODS: A database of 1869 academic cardiothoracic surgeons in the United States was created in December 2020. National Institutes of Health grant records from 1985 to 2020 were obtained for each surgeon using National Institutes of Health Research Portfolio Online Reporting Tools Expenditures and Results. Analyses were normalized to the number of active surgeons per year, based on the year of each surgeon's earliest research publication on Scopus.RESULTS: A total of 346 cardiothoracic surgeons have received 696 National Institutes of Health grants totaling more than $1.5 billion in funding, with 48 surgeons actively serving as principal investigator of 66 R01 grants in 2020. The prevalence of research grants (7.4 vs 5.6 grants per 100 active surgeons, P<.0001), percentage of surgeons with a research grant (5.3% vs 4.7%, P=.0342), and number of research grants per funded surgeon (1.4 vs 1.2 grants, P<.0001) were significantly greater during the Scientific Affairs and Government Relations era (2003-2020) than the pre-Scientific Affairs and Government Relations era (1985-2002). The incidence of new research grants after surgeon participation in an American Association for Thoracic Surgery academic development program was significantly greater than that in the absence of participation (3.5 vs 1.1 new grants per 100 surgeons per year, P<.0001).CONCLUSIONS: Through dedicated efforts and programs, the American Association for Thoracic Surgery has provided effective support to help increase National Institutes of Health grant funding awarded to cardiothoracic surgeons.

  View details for DOI 10.1016/j.jtcvs.2021.10.031

  View details for PubMedID 34809972

• The Academic Impact of Advanced Clinical Fellowship Training among General Thoracic Surgeons. Journal of surgical education Patel, D. C., Wang, H., Bajaj, S. S., Williams, K. M., Pickering, J. M., Heiler, J. C., Manjunatha, K., O'Donnell, C. T., Sanchez, M., Boyd, J. H., Backhus, L. M. 2021

  Abstract

  OBJECTIVE: Advanced clinical fellowship training has become a popular option for surgical trainees seeking to bolster their clinical training and expertise. However, the long-term academic impact of this additional training following a traditional thoracic surgery fellowship is unknown. This study aimed to delineate the impact of an advanced clinical fellowship on subsequent research productivity and advancement in academic career among general thoracic surgeons.METHODS: Using an internally constructed database of active, academic general thoracic surgeons who are current faculty at accredited cardiothoracic surgery training programs within the United States, surgeons were dichotomized according to whether an advanced clinical fellowship was completed or not. Academic career metrics measured by research productivity, scholarly impact (H-index), funding by the National Institutes of Health, and academic rank were compared.RESULTS: Among 285 general thoracic surgeons, 89 (31.2%) underwent an advanced fellowship, whereas 196 (68.8%) did not complete an advanced fellowship. The most commonly pursued advanced fellowship was minimally invasive thoracic surgery (32.0%). There were no differences between the two groups in terms of gender, international medical training, or postgraduate education. Those who completed an advanced clinical fellowship were less likely to have completed a dedicated research fellowship compared to those who had not completed any additional clinical training (58.4% vs. 74.0%, p = 0.0124). Surgeons completing an advanced clinical fellowship demonstrated similar cumulative first-author publications (p = 0.4572), last-author publications (p = 0.7855), H-index (p = 0.9651), National Institutes of Health funding (p = 0.7540), and years needed to advance to associate professor (p = 0.3410) or full rank professor (p = 0.1545) compared to surgeons who did not complete an advanced fellowship. These findings persisted in sub-analyses controlling for surgeons completing a dedicated research fellowship.CONCLUSIONS: Academic general thoracic surgeons completing an advanced clinical fellowship demonstrate similar research output and ascend the academic ladder at a similar pace as those not pursuing additional training.

  View details for DOI 10.1016/j.jsurg.2021.09.003

  View details for PubMedID 34674980

• Superhuman, but never enough: Black women in medicine. Lancet (London, England) Bajaj, S. S., Tu, L., Stanford, F. C. 2021; 398 (10309): 1398-1399

  View details for DOI 10.1016/S0140-6736(21)02217-0

  View details for PubMedID 34656218

  View details for PubMedCentralID PMC9908326

• Health-based civic engagement is a professional responsibility. Nature medicine Bajaj, S. S., Martin, A. F., Stanford, F. C. 2021; 27 (10): 1661-1663

  View details for DOI 10.1038/s41591-021-01523-2

  View details for PubMedID 34642491

  View details for PubMedCentralID PMC9911186

• The New CDC Mask Guidance: A Catastrophe for Health Equity. Journal of general internal medicine Bajaj, S. S., Stanford, F. C. 2021; 36 (10): 3217-3218

  View details for DOI 10.1007/s11606-021-07026-7

  View details for PubMedID 34382137

  View details for PubMedCentralID PMC8356890

• What the COVID-19 pandemic can teach us about inclusive blood donation. Blood transfusion = Trasfusione del sangue Tu, L., Bajaj, S. S., Stanford, F. C. 2021; 19 (5): 357-359

  View details for DOI 10.2450/2021.0191-21

  View details for PubMedID 34369868

  View details for PubMedCentralID PMC8486603

• Words matter, humanity matters: alienating non-citizens from the COVID-19 vaccine. Postgraduate medical journal Bajaj, S. S., Tu, L., Stanford, F. C. 2021; 97 (1150): 481-482

  View details for DOI 10.1136/postgradmedj-2021-140212

  View details for PubMedID 34039691

  View details for PubMedCentralID PMC9908355

• Characterization of academic cardiothoracic surgeons who started as attendings in private or community practice. Surgery Bajaj, S. S., Wang, H., Williams, K. M., Krishnan, A., Heiler, J. C., Pickering, J. M., Manjunatha, K., O'Donnell, C. T., Sanchez, M., Boyd, J. H. 2021

  Abstract

  BACKGROUND: Surgeons are traditionally categorized as working either in academic or private/community practice, but some transition between the two environments. Here, we profile current academic cardiothoracic surgeons who began their attending careers in private or community practice. We hypothesized that research activity may distinguish cardiothoracic surgeons who started in non-academic versus academic practice.METHODS: Publicly available data regarding professional history and research productivity were collected for 992 academic cardiothoracic surgeons on faculty at the 77 cardiothoracic surgery training programs in the United States in 2018. Data are presented as medians analyzed with the Mann-Whitney test or proportions analyzed with Fisher exact test or the chi2 test.RESULTS: A total of 80 (8.1%) academic cardiothoracic surgery faculty started their careers in non-academic practice, and 912 (91.9%) started directly in academia. Those who started in non-academic practice spent a median 7.0 y in private/community practice and were more likely to be cardiac surgeons (68.8% vs 51.6%, P= .0132). They were equally likely to pursue a protected research fellowship (56.3% vs 57.0%, P= .9067) and publish research during training (92.5% vs 91.1%, P= .8374), but they published fewer total papers by the end of cardiothoracic surgery fellowship (3.0 vs 7.0, P= .0001) and fewer papers per year as an academic attending (0.8 vs 2.9, P < .0001). Nevertheless, the majority of cardiothoracic surgery faculty who started in non-academic practice are currently active in research (68.8%), and 2 such surgeons received National Institutes of Health R01 funding.CONCLUSION: Transitioning from non-academic to academic practice is an uncommon but feasible pathway for interested cardiothoracic surgeons.

  View details for DOI 10.1016/j.surg.2021.06.012

  View details for PubMedID 34294448

• The 2021 USPSTF lung cancer screening guidelines: a new frontier. The Lancet. Respiratory medicine Potter, A. L., Bajaj, S. S., Yang, C. J. 2021; 9 (7): 689-691

  View details for DOI 10.1016/S2213-2600(21)00210-1

  View details for PubMedID 33965004

• Dignity and Respect: People-First Language with Regard to Obesity. Obesity surgery Bajaj, S. S., Stanford, F. C. 2021; 31 (6): 2791-2792

  View details for DOI 10.1007/s11695-021-05304-1

  View details for PubMedID 33638757

  View details for PubMedCentralID PMC9910582

• Career Research Productivity Correlates With Medical School Ranking Among Cardiothoracic Surgeons. The Journal of surgical research Bajaj, S. S., Wang, H., Williams, K. M., Pickering, J. M., Heiler, J. C., Manjunatha, K., Sanchez, M., O'Donnell, C. T., Boyd, J. H. 2021; 264: 99–106

  Abstract

  BACKGROUND: The foundation for a successful academic surgical career begins in medical school. We examined whether attending a top-ranked medical school is correlated with enhanced research productivity and faster career advancement among academic cardiothoracic (CT) surgeons.MATERIALS AND METHODS: Research profiles and professional histories were obtained from publicly available sources for all CT surgery faculty at accredited US CT surgery teaching hospitals in 2018 (n=992). We focused on surgeons who completed medical school in the United States during or after 1990, the first-year US News & World Report released its annual medical school research rankings (n=451). Subanalyses focused on surgeons who completed a research fellowship (n=299) and those who did not (n=152).RESULTS: A total of 124 surgeons (27.5%) attended a US News & World Report top 10 medical school, whereas 327 (72.5%) did not. Surgeons who studied at a top 10 medical school published more articles per year as an attending surgeon (3.2 versus 1.9; P<0.0001), leading to more total publications (51.5 versus 27.0; P<0.0001) and a higher H-index (16.0 versus 11.0; P<0.0001) over a similar career duration (11.0 versus 10.0y; P=0.1294). These differences in career-long research productivity were statistically significant regardless of whether the surgeons completed a research fellowship or not. The surgeons in both groups, however, required a similar number of years to reach associate professor rank (P=0.6993) and full professor rank (P=0.7811) after starting their first attending job.CONCLUSIONS: Attending a top-ranked medical school is associated with enhanced future research productivity but not with faster career advancement in academic CT surgery.

  View details for DOI 10.1016/j.jss.2021.01.008

  View details for PubMedID 33794390

• Beyond Tuskegee - Vaccine Distrust and Everyday Racism. The New England journal of medicine Bajaj, S. S., Stanford, F. C. 2021; 384 (5): e12

  View details for DOI 10.1056/NEJMpv2035827

  View details for PubMedID 33471971

  View details for PubMedCentralID PMC9908408

• Treatment of Obesity: Pharmacotherapy Trends of Office-Based Visits in the United States From 2011 to 2016. Mayo Clinic proceedings Claridy, M. D., Czepiel, K. S., Bajaj, S. S., Stanford, F. C. 2021

  Abstract

  To examine pharmacotherapy for obesity in the United States from 2011 to 2016 using a large, nationally representative sample.Data were obtained during 6 years, 2011 to 2016, from the National Ambulatory Medical Care Survey. There were 3 types of visits identified: patients with obesity and an antiobesity drug mention; patients with obesity and no antiobesity drug mention; and patients without obesity and with antiobesity drug mention. The χ2 test was used to compare characteristics across each type of visit. To predict the odds of an antiobesity medication mention for patients with obesity, a logistic regression analysis was conducted.Of the overall weighted 196,872,870 office-based physician visits made by patients with obesity from 2011 to 2016, 1% mentioned an antiobesity drug. In addition, there were 760,470 office-based physician visits by patients without obesity but with an antiobesity medication mention. An antiobesity drug mention was more likely for those aged 51 years or older and those residing in the South (adjusted odds ratio, 5.31 95% CI, 1.19 to 23.59).There was a slight increase in antiobesity medication mentions, from 0.26% in 2011 to 0.28% in 2016, but only 1% of office-based visits for patients with obesity received a prescription for an antiobesity medication. Physicians tended to prescribe antiobesity medications to those with obesity aged 51 years or older and residing in the South. Antiobesity medication for treatment of obesity is significantly underused.

  View details for DOI 10.1016/j.mayocp.2021.07.021

  View details for PubMedID 34728060

• Characterization of Cardiothoracic Surgeons Actively Leading Basic Science Research. The Journal of surgical research Wang, H., Bajaj, S. S., Krishnan, A., Heiler, J. C., Williams, K. M., Pickering, J. M., Manjunatha, K., Sanchez, M., O'Donnell, C. T., Boyd, J. H. 2021; 268: 371-380

  Abstract

  There is increasing concern regarding the attrition of surgeon-scientists in cardiothoracic (CT) surgery. However, the characteristics of CT surgeons who are actively leading basic science research (BSR) have not been examined. We hypothesized that early exposure to BSR during training and active grant funding are important factors that facilitate the pursuit of BSR among practicing CT surgeons.We created a database of 992 CT surgeons listed as faculty at accredited United States CT surgery teaching hospitals in 2018. Data regarding each surgeon's training/professional history, publication record, and National Institutes of Health funding were acquired from publicly available online sources. Surgeons who published at least one first- or last-author paper in 2017-2018 were considered to be active, lead researchers.Of the 992 CT surgeons, 73 (7.4%) were actively leading BSR, and 599 (60.4%) were actively leading only non-BSR. Only 2 women were actively leading BSR. Surgeons actively leading BSR were more likely to have earned a PhD degree (20.5% versus 9.7%, P = 0.0049), and more likely to have published a first-author BSR paper during training (76.7% versus 40.9%, P< 0.0001). Surgeons actively leading BSR were also more likely to have an active National Institutes of Health grant (34.2% versus 5.8%, P< 0.0001), especially an R01 grant (21.9% versus 2.5%, P< 0.0001).A small minority of CT surgeons at academic training hospitals are actively leading BSR. In order to facilitate the development of surgeon-scientists, additional support must be given to trainees and junior faculty, especially women, to enable early engagement in BSR.

  View details for DOI 10.1016/j.jss.2021.06.065

  View details for PubMedID 34399359

• National Institutes of Health R01 Grant Funding Is Associated with Enhanced Research Productivity and Career Advancement Among Academic Cardiothoracic Surgeons. Seminars in thoracic and cardiovascular surgery Bajaj, S. S., Wang, H., Williams, K. M., Pickering, J. M., Heiler, J. C., Manjunatha, K., O'Donnell, C. T., Sanchez, M., Boyd, J. H. 2020

  Abstract

  National Institutes of Health (NIH) funding has declined among cardiothoracic surgeons. R01 grants are a well-known mechanism to support high-impact research, and we sought to clarify the association between NIH funding and academic achievement. We hypothesized that cardiothoracic surgeons who acquired R01 funding exhibit greater research output and faster career advancement. All cardiothoracic surgeons (n=992) working at accredited United States cardiothoracic surgery training hospitals in 2018 were included. Institutional webpages, Scopus, and Grantome were utilized to collect publicly-available data regarding each surgeon's training and career history, research publications, and NIH funding. 78 (7.9%) surgeons obtained R01 funding as a principal investigator, while 914 (92.1%) did not. R01-funded surgeons started their attending careers earlier (1998 vs 2005, p<0.0001) and were more likely to have pursued dedicated research training (p<0.0001). R01-funded surgeons authored 5.3 publications/year before their first R01 grant, 9.3 during the grant period, and 8.6 after the grant expired, all of which were greater than the publication rate of non-R01-funded surgeons at comparable career timepoints (2.0-3.0 publications/year, p<0.0001). Among time-matched surgeons who completed medical school in 1998 or earlier (n=73 R01-funded vs n=602 non-funded), R01-funded surgeons have published more total publications (178.0 vs 56.5 papers, p<0.0001) and exhibit a greater H-index (41.0 vs 19.0, p<0.0001). R01-funded surgeons have also advanced to higher academic ranks (p<0.0001) and are more likely to be chiefs of their departments or divisions (42.5% vs 25.7%, p=0.0035). Cardiothoracic surgeons who obtain R01 funding exhibit greater research productivity and faster career advancement.

  View details for DOI 10.1053/j.semtcvs.2020.12.002

  View details for PubMedID 33359763

• Early Engagement in Cardiothoracic Surgery Research Enhances Future Academic Productivity. The Annals of thoracic surgery Wang, H., Bajaj, S. S., Williams, K. M., Heiler, J. C., Pickering, J. M., Manjunatha, K., O'Donnell, C. T., Sanchez, M., Boyd, J. H. 2020

  Abstract

  BACKGROUND: Early engagement in cardiothoracic (CT) surgery research may help attract trainees to academic CT surgery, but whether this early exposure boosts career-long academic achievement remains unknown.METHODS: A database of all CT surgery faculty at accredited, academic CT surgery training programs in the United States during the year 2018 was established. Excluding international medical graduates, surgeons who started general surgery residency in the United States prior to 2004 and who published at least one manuscript prior to traditional CT fellowship training were included (n=472). Each surgeon's educational background, work history, and research publications were recorded from publicly-available online sources.RESULTS: In total, 370 surgeons (78.4%) co-authored a CT surgery manuscript before fellowship training, while 102 (21.6%) published only on subjects unrelated to CT surgery. Regardless of whether surgeons pursued dedicated research training or not, those who co-authored a CT surgery manuscript prior to fellowship training published more papers per year as an attending (p<0.01), resulting in more total publications (p<0.01) and a higher H-index (p<0.01) over comparably long careers. Among CT surgeons who did not publish CT surgery research prior to fellowship training, those who co-authored a CT surgery manuscript during fellowship also exhibited enhanced future academic productivity.CONCLUSIONS: Academic CT surgeons who published CT surgery research prior to fellowship training ultimately exhibit more prolific and impactful research profiles compared to those who published only on subjects unrelated to CT surgery during training. Efforts to increase early engagement in CT surgery research among trainees should be fully endorsed.

  View details for DOI 10.1016/j.athoracsur.2020.10.013

  View details for PubMedID 33159869

• New Attending Surgeons Hired by Their Training Institution Exhibit Greater Research Productivity. The Annals of thoracic surgery Bajaj, S. S., Wang, H., Williams, K. M., Pickering, J. M., Heiler, J. C., Manjunatha, K., O'Donnell, C. T., Sanchez, M., Boyd, J. H. 2020

  Abstract

  BACKGROUND: A first attending job often sets the tone for academic surgeons' future careers, and many graduating trainees are faced with the decision to begin their career at their training institution or another institution. We hypothesized that surgeons hired as first-time faculty at their cardiothoracic surgery fellowship (CSF) institution exhibit greater research productivity and career advancement than those hired as first-time faculty at a different institution.METHODS: Cardiothoracic surgeons who were listed as clinical faculty at all 77 accredited U.S. cardiothoracic surgery training programs and who trained via the general surgery residency and CSF pathway in 2018 were included (n=904). Surgeon-specific data regarding professional history, publications, and grant funding were obtained from publicly available sources.RESULTS: 294/904 (32.5%) surgeons were hired as first-time faculty at their CSF institution while 610/904 (67.5%) surgeons were hired at a different institution (start year 2005 vs 2006, p=0.3424). Both groups exhibited similar research productivity upon starting their first job (total papers: 7.0 vs 7.0, p=0.5913). Following them to the present, surgeons hired at their CSF institution produced more total papers (64.5 vs 39.0, p<0.0001) and exhibited a higher H-index (20.0 vs 14.0, p<0.0001). Surgeons in both groups required a similar amount of time to achieve associate (p=0.2079) and full professor (p=0.5925) ranks.CONCLUSIONS: Surgeons hired as first-time faculty at their CSF institution may experience benefits to research productivity but not career advancement. Trainees may find it advantageous to begin their careers in a familiar environment where they have already formed a robust specialty-specific network.

  View details for DOI 10.1016/j.athoracsur.2020.09.026

  View details for PubMedID 33152331

• Impact of advanced clinical fellowship training on future research productivity and career advancement in adult cardiac surgery. Surgery Wang, H., Bajaj, S. S., Williams, K. M., Pickering, J. M., Heiler, J. C., Manjunatha, K., O'Donnell, C. T., Sanchez, M., Boyd, J. H. 2020

  Abstract

  BACKGROUND: Advanced clinical fellowships are important for training surgeons with a niche expertise. Whether this additional training impacts future academic achievement, however, remains unknown. Here, we investigated the impact of advanced fellowship training on research productivity and career advancement among active, academic cardiac surgeons. We hypothesized that advanced fellowships do not significantly boost future academic achievement.METHODS: Using online sources (eg, department webpages, CTSNet, Scopus, Grantome), we studied adult cardiac surgeons who are current faculty at accredited United States cardiothoracic surgery training programs, and who have practiced only at United States academic centers since 1986 (n= 227). Publicly available data regarding career advancement, research productivity, and grant funding were collected. Data are expressed as counts or medians.RESULTS: In our study, 78 (34.4%) surgeons completed an advanced clinical fellowship, and 149 (65.6%) did not. Surgeons who pursued an advanced fellowship spent more time focused on surgical training (P < .0001), and those who did not were more likely to have completed a dedicated research fellowship (P= .0482). Both groups exhibited similar cumulative total publications (P= .6862), H-index (P= .6232), frequency of National Institutes of Health grant funding (P= .8708), and time to achieve full professor rank (P= .7099). After stratification by current academic rank, or by whether surgeons pursued a dedicated research fellowship, completion of an advanced clinical fellowship was not associated with increased research productivity or accelerated career advancement.CONCLUSION: Academic adult cardiac surgeons who pursue advanced clinical fellowships exhibit similar research productivity and similar career advancement as those who do not pursue additional clinical training.

  View details for DOI 10.1016/j.surg.2020.06.016

  View details for PubMedID 32747139

• Women in Thoracic Surgery Scholarship: Impact on Career Path and Interest in Cardiothoracic Surgery. The Annals of thoracic surgery Williams, K. M., Hironaka, C. E., Wang, H. n., Bajaj, S. S., O'Donnell, C. T., Sanchez, M. n., Boyd, J. n., Kane, L. n., Backhus, L. n. 2020

  Abstract

  Women remain underrepresented in Cardiothoracic Surgery (CTS). In 2005, Women in Thoracic Surgery (WTS) began offering scholarships to promote engagement of women in CTS careers. This study explores the effect of WTS scholarships on CTS career milestones.We assessed career development using the number of awardees matching into CTS residency/fellowship, American Board of Thoracic Surgery (ABTS) certification, and academic CTS appointment. Scholarship awardee data were obtained from our WTS database. Comparison data were gathered from the National Residency Match Program and ABTS. Details of the current roles of ABTS certified women were determined from public resources. Qualitative results were gathered from post-scholarship surveys.106 WTS scholarships have been awarded to 38 medical students (MS, 36%), 41 General Surgery residents (GR, 39%), and 27 CTS residents/fellows (CR, 25%). Among MS, 26% of awardees entered integrated CTS residency (vs. <0.1% for medical students, p<0.0001), while 37% entered general surgery residency (vs. 4.8% for medical students, p<0.0001). Of GR awardees, 59% entered CTS fellowships (vs. 7.7% for general surgery residents, p<0.0001), and of CR awardees, 100% earned ABTS certification (vs. 73% ABTS pass rate, p=.01). Of ABTS certified awardees, 44% are practicing CT surgeons at U.S. academic training institutions (vs. 33% of non-awardee ABTS certified women, p=0.419). All awardees reported that their scholarship was valuable in their development.Receipt of a WTS scholarship is associated with successful pursuit of CTS career milestones at significantly higher rates than contemporaries. These scholarships foster a supportive community for women trainees in CTS.

  View details for DOI 10.1016/j.athoracsur.2020.07.020

  View details for PubMedID 32961134

• Off-Pump Mini Thoracotomy Versus Sternotomy for Left Anterior Descending Myocardial Bridge Unroofing. The Annals of thoracic surgery Wang, H. n., Pargaonkar, V. S., Hironaka, C. E., Bajaj, S. S., Abbot, C. J., O'Donnell, C. T., Miller, S. L., Honda, Y. n., Rogers, I. S., Tremmel, J. A., Fischbein, M. P., Mitchell, R. S., Schnittger, I. n., Boyd, J. H. 2020

  Abstract

  Myocardial bridge (MB) of the left anterior descending (LAD) coronary artery occurs in approximately 25% of the population. For patients with a symptomatic, hemodynamically significant MB who fail medical therapy, MB unroofing represents the optimal surgical management. Here, we evaluated minimally invasive MB unroofing in selected patients compared with sternotomy.MB unroofing was performed in 141 adult patients via sternotomy on-pump (ST-on, n=40), sternotomy off-pump (ST-off, n=62), or mini thoracotomy off-pump (MT, n=39). Angina symptoms were assessed preoperatively and 6-months postoperatively using the Seattle Angina Questionnaire. Matching included all MT patients and 31 ST-off patients with similar MB characteristics, no previous cardiac surgery or coronary interventions, and no concomitant procedures.MT patients tended to have a shorter MB length than ST-on and ST-off patients (2.57 vs 2.93 vs 3.09 cm, p=0.166). ST-on patients had a longer hospital stay than ST-off and MT patients (5.0 vs 4.0 vs 3.0 days, p<0.001), and more blood transfusions (15.2% vs 0.0% vs 2.6%, p=0.002). After matching, MT patients had a shorter hospital stay than ST-off patients (3.0 vs 4.0 days, p=0.005). No deaths or major complications occurred in any group. In all groups, MB unroofing yielded significant symptomatic improvement regarding physical limitation, angina stability, angina frequency, treatment satisfaction, and quality of life.We report the largest experience of off-pump minimally invasive MB unroofing, which may be safely performed in carefully selected patients, yielding dramatic improvements in angina symptomatology at 6 months after surgery.

  View details for DOI 10.1016/j.athoracsur.2020.11.023

  View details for PubMedID 33333083