Each month on our blog, we feature posts on grounding breaking cancer research news. Our new “Featured Researcher” series will highlight the work and recent research activities of MSK cancer researchers in their own words. This month we feature Dr. Deborah Korenstein, MD, Chief, General Internal Medicine Service.
One area of your research is the health effects of marijuana. Based on your research findings, what have you discovered about this topic that has surprised you the most?
I got involved in this work through my colleague Salomeh Keyhani. In the context of expansion of legalization of marijuana across the country and endorsement of its use in lieu of opioids, it is important to understand its potential toxicities. In one of our first projects we found that media messages regarding health effects of marijuana are overwhelmingly positive, despite little evidence for health benefits. We have also published systematic reviews/metaanalyses looking at the long-term pulmonary and cardiovascular harms, finding that the evidence is insufficient to assess these important toxicities, and we have an ongoing systematic review of the effect of marijuana use on cancer diagnoses. Most surprising (but perhaps not surprising at all) has been the willingness of the public and the medical community to embrace marijuana as a health promoter despite very little evidence. It speaks to the need for the medical community to maintain a healthy skepticism and demand solid evidence before endorsing products or habits.
You also study medication and medical testing overuse. What are your future plans for research on this topic?
I have been involved in research related to overuse of medical tests and treatments for a long time and have been working to reduce unnecessary care. Currently I am working to understand what drives physicians to overuse; we are conducting a multi-site survey study measuring physician attributes and clinical tendencies. Our group here at MSK recently published a framework for understanding harms of overused tests and treatments and the mechanisms through which they occur. Our next step is to work with patients to explore their understanding of these harms, in particular the relative importance of different types of harms.
Could you tell us about your other research plans for 2019 you’re particularly excited about?
I am working on several interesting projects, including a small study of factors associated with the volume of tests ordered by residents, an exploration of executive physicals and their inclusion of recommended and non-recommended services. I am also continuing my work in systematic reviews, including a review of the effects of marijuana in the treatment of cancer-related symptoms and a review of whether for-profit health care entities in the US provide better quality care compared with not-for-profit entities.