Theresa Gaffney is the lead Morning Rounds writer and reports on health care, new research, and public policy, with a particular interest in mental health, gender-affirming care, and LGBTQ+ patient communities. You can reach Theresa on Signal at theresagaff.97.

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Good morning. I spent most of last night on an Amtrak train home from New York, reading the latest novel from a wonderful writer that I worked with in my past life as a book publicist: “Moderation” by Elaine Castillo.

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Efforts to improve health care undermined by cuts

A small federal agency that studies how to improve the health care system has been rendered functionally “incapacitated” after much of its staff was laid off or retired, according to three people who spoke with STAT’s Chelsea Cirruzo. In April, about half of the Agency for Healthcare Research and Quality was estimated to have been laid off as the Trump administration began a massive restructuring of HHS. But folks who spoke with Chelsea say closer to 90% of workers are now gone, including people who took early retirement offers.

“None of the other science agencies in HHS — NIH, FDA, nor CDC — focus on actually improving the quality of care that Americans can receive,” Robert Otto Valdez, who directed the agency through January, said in an email. “That has been AHRQ’s scientific focus.” Read more from Chelsea on what the future of the agency’s work looks like.

30%

In a recent study, that’s how much somebody’s odds of recovering from substance use disorder increased if they quit smoking. Researchers followed two cohorts totalling more than 2,600 people with a history of substance use disorder for 4 years each. The association suggests that smoking cessation could be used “as a tool to assist recovery processes,” write the authors of the paper, published yesterday in JAMA Psychiatry.

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Should cell phones be allowed in rehab?

A new First Opinion essay proposes another tool for addiction recovery: the cell phone. The prevailing wisdom in addiction treatment centers is to confiscate a person’s cell phone upon admission. On the one hand, the rationale makes sense, writes Ryan Hampton, who is in long-term recovery himself. The little screen can distract and tempt and trigger a person who is trying to recover from addiction — and even become a new addiction itself. But Hampton also believes that a blanket ban on cell phones in rehab can do more harm than good.

“My hands trembled, not from withdrawal alone, but from the phantom weight of a smartphone I didn’t have,” he writes about an experience in rehab over a decade ago. Read more on where he believes the middle ground might be.

Investors are more wary than ever of mRNA vaccines

Despite an increase in enthusiasm and investment during the pandemic, mRNA vaccines for infectious disease have long been a difficult proposition for investors. It’s simple: the odds of a lucrative return are notoriously hard to predict. But now, the Trump administration’s recent decision to halt nearly $500 million in funding for mRNA vaccine research has only made things worse.

“It’s taken a space we would have struggled with anyway and turned it into a non-starter,” according to Niall O’Donnell at RiverVest Venture Partners. Read more from STAT’s Jonathan Wosen and Allison DeAngelis on what it means for the future of this science.

And if you’re still confused about why the Trump administration canceled those grants, check out the latest video from STAT’s Alex Hogan. In this one, he and our colleague Anil Oza deconstruct the explanation from health secretary Robert F. Kennedy Jr. on the cancellation.

How clinicians write about Black patients in the EHR

Doctors, trainees, and other advanced practitioners are more likely to use language in their notes that undermines a Black patient’s credibility than they are when writing about white patients. That’s according to a study published yesterday in PLOS One, in which researchers analyzed more than 13 million notes about 1.5 million patients, written by about 12,000 doctors in a single, large health system.

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The researchers used an algorithm to identify words such as “poor,” “unreliable,” “challenging,” and “inconsistent” that cast doubt on a patient’s competence and words like “claims” and “insists” that undermine someone’s sincerity. This language wasn’t used often overall — less than 1% of notes used this sort of language at all. But within that group, notes written about Black patients had 29% higher odds of including such language. The disparity “represents the tip of an iceberg in terms of how words are used to undermine patients’ credibility,” the authors write. “Our findings accordingly signal larger underlying disparities in credibility assessments.”

New docs in this century’s biggest research scandal

In the early 2010s, Anil Potti was a rising star in the world of biomedical research. He had developed algorithms to analyze the genetic material inside cancerous tumors and then select the best chemotherapy cocktail to kill them — or so he said. Some of his colleagues believed he might eventually win a Nobel Prize. Some called his algorithms a Holy Grail.

But there was no prize, no Holy Grail. Instead, it was the start of what became one of the worst medical research scandals of this century. Relatives of people who had enrolled in Potti’s clinical trials sued Duke, where he was worked, and the university settled for an undisclosed sum in 2015.

A decade later, the Boston Globe’s Mike Damiano reviewed thousands of pages of court records and investigative documents — most of which were never previously reported — that detail how Duke leaders responded to mounting warnings about Potti’s research and allowed his algorithms to be tested on humans for years before the experiments were shut down. Read the story.

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