This page features journal articles being discussed by SCS fellows and faculty during journal club.
Theme: Biomarkers in epidemiologic research
Discussant: Karen Costenbader, M.D., M.P.H.
The first article discussed during this journal club meeting studied opioid prescription patterns in emergency physicians along with the risk of long term opioid use. Physician prescribing may partly be driving the growing overuse of opioids in the United States. However, it is unknown how much individual physicians vary in their opioid prescriptions and the implications of that variation for long-term opioid use.
The authors performed a retrospective analysis among Medicare beneficiaries who visited an emergency department but had not received prescriptions for opioids within 6 months before that visit. Emergency physicians were categorized as high-intensity or low-intensity opioid prescribers according to relative quartiles of prescribing rates within the same hospital. Within individual hospitals, rates of opioid prescribing varied widely between low-intensity and high-intensity prescribers. Long-term opioid use was significantly higher among patients treated by high-intensity prescribers than among patients treated by low-intensity prescribers. Rates of long-term opioid use were increased among patients who had not previously received opioids and received treatment from high-intensity opioid prescribers.
The second article presented illustrated how allopurinol may reduce the risk of myocardial infarction in the elderly. Previous observational studies that have examined the association of allopurinol with myocardial infarction (MI) have provided contradictory results. The authors’ objective was to assess whether allopurinol use is associated with a reduction in the risk of MI in the elderly. They used a random sample of Medicare beneficiaries to study the association of allopurinol initiation and the risk of incident MI. Allopurinol use was associated with reduced risk of MI, compared to no allopurinol use. Longer durations of allopurinol use were associated with a lower hazard ratio of MI.
Find the full article here.