Medical

I had been laid off a few months when my ulcerative colitis kicked in, and my doctor and I struggled to get it under control.  After trying a variety of medicines, my health continued to deteriorate and I agreed to take Remicade. Remicade is a potent drug, administered through an IV infusion at the oncology center that comes with a whole host of potential side effects.  The dosage requires an initial cycle of 4 infusions spaced several weeks apart, then a maintenance dosage every 8 weeks thereafter.  The decision was not taken lightly. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.

Last month, a group of 150 Bay Area high-school students visited Stanford to attend a series of hands-on, interactive sessions and lectures on a diverse range of subjects including biodesign, virtual anatomy, neuroscience and cancer. Their visit was part of our annual Med School 101 event, a day-long medical education program designed to expose teens to ongoing research at the School of Medicine and get them excited about potential careers in medicine and science. This gallery illustrates some of the students’ exciting experiences, from performing procedures on simulated patients to examining animal brain tissue samples. To see more images from the day, visit our full photo set on Flickr. Previously: Bay Area students get a front-row seat to practicing medicine, scientific research, Image of the Week: Studying brains at Stanford’s Med School 101, Live tweeting sessions at Stanford’s Med School 101, Med school: Up close and personal, A quick primer on getting into medical school, Teens interested in medicine encouraged to “think beyond the obvious” and High-school students get a taste of med school

A short survey that asks patients to assess their walking ability could be helpful in predicting a person’s risk of cardiovascular disease, as well as mortality risks from any cause. That’s according to a Stanford study recently published online in the journal Circulation. The Walking Impairment Questionnaire, also known as the WIQ, is currently used to predict risks of peripheral artery disease, a narrowing of the arteries that causes limited circulation to the limbs. The authors of this new study wanted to see if the WIQ, which can be filled out by patients while waiting for their doctor appointments, might be helpful in predicting other health risks. “A 70-year-old patient’s ability to walk six minutes is a great predictor of cardiovascular risks,” said Kevin Nead, a Stanford medical student and the first author of the study. “But most people are seen in 15-minute doctor visits. They’re not going to be doing a walking test.” Perhaps, he reasoned, a subjective test like this 17-question survey could be used instead. Nead and his colleagues, who examined questionnaire results from more than 1,700 patients, found that the use of the WIQ alone successfully predicted cardiovascular outcomes. In addition, when the survey was used in conjunction with other common clinical tests such as blood pressure measurements and blood tests, it significantly improved the ability to predict mortality not just from cardiovascular disease but from any cause. “In an era of increasing expense for medical costs, this work suggests that the WIQ, an extremely simple and economical tool, may significantly improve our ability to prognosticate risk,” Nead told me. Photo by timparkinson

PubPeer (highlighted previously on Labrigger) caught some shenanigans that apparently the reviewers and editors at Cell did not. Here’s the comment from PubPeer, and here’s the paper. Figure 2F (top image) and the left side of Figure 6D (second image) are the same set of cells, but are presented as different in the paper. Here’s a second example of image/data reuse from the same paper. Figure S6 reused the same exact data for two panels. The two panels even appear right next to each other in the figure. And here’s a third example. The right half of Figure 6D and the leftmost image in Figure S5 are the same image, but presented as different in the paper. Follow the reactions on Twitter.

Everybody hates curbside consults – the informal, “Hey, Joe, how would you treat asymptomatic pyuria in my 80-year-old nursing home patient?”-type questions that dominate those Doctor’s Lounge conversations that aren’t about sports, Wall Street, or ObamaCare. Consultants hate being asked clinical questions out of context; they know that they may give incorrect advice if the underlying facts and assumptions aren’t right (the old garbage in, garbage out phenomenon). They also don’t enjoy giving away their time and intellectual capital for free. Risk managers hate curbside consults because they sometimes figure into the pathogenesis of a lawsuit, such as when a hospitalist or ER doctor acts after receiving (non-documented) curbside guidance and things go sideways. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.

This afternoon, leading figures from academia, industry, government and philanthropic foundations will gather at the Big Data in Biomedicine conference at Stanford to explore the vast opportunities for mining the growing volume of public health data and develop new ways to prevent, diagnose and treat disease. The event runs today through Friday and features 32 speakers representing large information-technology corporations, startups, venture-capital firms and the research community. As a reminder, those unable to attend in person can tune in to the live webcast and submit questions for panelists by visiting the conference website. Additionally, we’ll be live tweeting the conference keynote speeches by Anne Wojcicki, CEO and co-founder of personal-genetics company 23andMe (which starts around 1 PM Pacific time today) and David Ewing Duncan, author of Experimental Man, as well as other proceedings from the conference. You can follow the tweets on the @SUMedicine feed or by using the hashtag #bigdatamed. Previously: Big Data in Biomedicine conference opens this week, Stanford computer scientist shows stem cell researchers the power of big data, Atul Butte discusses why big data is a big deal in biomedicine and Stanford and Oxford team up for conference on “big data’s” role in biomedicine

Science Insider took another look yesterday at the effects of the budget sequestration on research. After describing the potential harms of the NIH’s recently announced 5 percent budget cut - “part of a larger pattern of declining funding over the past decade” – reporter Jocelyn Kaiser points out another troubling aspect of sequestration: NIH leaders say that the sequester’s most severe effect is the chilling message it sends to young scientists. In testimony last week, [NIH Director Francis Collins, MD, PhD,] quoted a former student who is finishing a Ph.D. at the Massachusetts Institute of Technology. She’s seen her role models struggle with funding. “I can’t erase the fear that this is my future,” Collins quoted her writing. “We’re putting an entire generation of U.S. scientists at risk,” Collins warned. “If they go away, they won’t come back.” Previously: Sequestration hits the NIH – fewer new grants, smaller budgets, NIH director polls Twitter for real-world responses to budget cutbacks and As budget sequester nears, a call for Congress to protect funding for scientific and medical research

This past November, the New England Journal of Medicine published results from the “Advancing Quality” program in the United Kingdom: hospitals in the northwest of England were paid up to 4% more based on quality scores for treating several common medical conditions.  Patient outcomes were compared to other National Health Service hospitals not eligible for the bonuses, and several other conditions that were not explicitly measured in the same hospitals. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.

Each year the National Science Foundation runs a video contest for young IGERT-funded scientists to communicate to the public about their research, and viewers are encouraged to vote for their favorite videos by liking them on Facebook. One of the entries in this year’s contest comes from a group of Stanford graduate students who show how the brain plans movement and discuss their work on neural prostheses - biomedical devices for restoring movement to individuals with paralysis or lost limbs. The students, who are all part of the Stanford Center for Mind, Brain and Computation, conduct their work in the labs of electrical engineer Krishna Shenoy, PhD, whose research we’ve written about in the past, and Surya Ganguli, PhD, an assistant professor of applied physics. The take-away message of the video, student Sergey Stavisky told me yesterday, is that “neural prosthetics are an exciting class of medical technology with the potential to improve the lives of individuals with paralysis,” but that to develop better ones, “we still need to learn a lot about the basic science of how the brain controls movement.” The video, called “Neural Prosthetics: Understanding Reach Planning,” is worth checking out, as are many of the other entries, whose topics range from “virtual blood vessels” to the use of stem cells to revitalize skeletal muscle. Voting is open until 7 PM Pacific time today. Previously: Researchers find neurons fire rhythmically to create movement and Stanford researchers uncover the neural process behind reaction time Via Erica Seigneur from NeuroTalk Video still courtesy of Sergey Stavisky

Like it or not, measuring physician performance is now a key part of the conventional wisdom on improving our health care system. Borrowing from management guru Peter Drucker’s mantra “You can’t manage what you can’t measure” health care policy makers have embraced performance measurement as being central to managing our heretofore unmanageable health care system.  But there is a small but seemingly growing group of Don Quixote-like dissenters who are tilting at the performance measurement windmill, arguing that these measures will not achieve the ends of improving quality and saving money and may instead do considerable harm. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.