2022 Resident Research Day

Obstetrics and gynecology residents and fellows participate in scholarly activity as part of their training at Dartmouth Health, and in May 2022, five learners presented their research and findings at Resident Research Day.

At the event, Kimberly D. Gregory, MD, MPH, gave her keynote address on “Research—From idea to implementation: Case study of the development and implementation of the Childbirth Experience Survey (CBEX).” Gregory is the vice chair of Women’s Healthcare Quality and Performance Improvement and the Helping Hand Chair in Maternal-Fetal Medicine at Cedars Sinai Medical Center. She is also on the faculty at the David Geffen School of Medicine at University of California, Los Angeles and the UCLA Fielding School of Public Health.

Alena Tofte MPH’15,

PGY-4

Tofte reviewed nearly 100,000 obstetrics transfers and found that patients who had federally subsidized insurance or no insurance were more likely to be transferred than patients with private insurance.

Kimberly D. Gregory, MD, MPH

“Kimberly Gregory is an influential and accomplished figure in our field, so it was a privilege and an honor to have her speak at Resident Research Day,” says Amy Paris, MD, MS, the director of Family Planning. “The residents and faculty were inspired by her talk on patientcentered outcomes in obstetrics. This helps our residents understand where they could go professionally with their research if they choose to. It was an energizing experience for them.” dartmouth-hitchcock.org/obgyn

Among the projects, the residents and one fellow investigated the correlation between patients’ medical insurance and their access to care and health outcomes, predictors of vulvar cancer, whether testosterone therapy in transgender patients increases the risk of endometrial cancer prior to gender-affirming surgery, disparities in access to telehealth, and variation of treatment of vaginal prolapse across the country. Lindsay Drew PGY-4 won this year’s award for best research project.

“While this relationship doesn’t prove causality because there are other variables, Alena looked at these transfers through an equity lens to find the predictors of who is at high risk of bad outcomes during childbirth,” Paris says.

Jill Roberts PGY-4

Roberts discovered a novel association between the GATA binding protein 3 (GATA3) and the progression to vulvar cancer or recurrent differentiated vulvar intraepithelial neoplasia (dVIN).

“Jill found that GATA3 staining may be useful in diagnosing dVIN, and this could help determine whether patients are at lower or higher risk for cancer and how aggressively a doctor decides to treat them,” Paris says.

Maris Toland PGY-4

Uterine and Ovarian Histopathological Findings Following Administration of Exogenous Testosterone for Gender Affirmation: A Systematic Review

Toland conducted a literature review to discover whether patients receiving testosterone for gender-affirmation therapy had a low incidence of endometrial cancer.

“Maris adds to the body of knowledge that patients seeking a hysterectomy after receiving testosterone don’t need a biopsy without having clinical symptoms of cancer. This can help prevent a potentially traumatic office visit,” Paris says.

Drew looked at the sociodemographics of patients seen via telehealth during the pandemic and found certain factors, such as age and insurance status, were associated with whether patients completed telehealth visits.

“Telehealth is a new modality for us, so it’s important for us to figure out the disparities and how we can make healthcare more equitable for all our patients,” Paris says.

Gerjevic investigated the variation of care in different hospital referral regions across the U.S. regarding the treatment of vaginal prolapse. She found significant geographic disparities among female Medicare beneficiaries.

“It raises the issue of potential inequities in how we offer care to patients,” says Kris Strohbehn, MD, FACOG, FACS, Gerjevic’s fellowship director. “This research will open more studies to determine why there’s variation in care.”