Dr. Edward Shortliffe, on the History and Future of Biomedical Informatics

The goal of biomedical informatics isn’t for computers to replace humans, he said, but for doctors to learn how to use it – as a tool – so that we (human doctors) can practice better medicine.

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What Does it Mean if Primary Care Doctors Get the Answers Wrong About Screening Stats?

The new findings have no bearing on whether or not cancer screening is cost-effective or life-saving. What the study does suggest is that med school math requirements should be upped and rigorous, counter to the trend

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Confusing Reports On Coffee and Cancer, and What To Do About Breakfast

When I was a medical resident in the late 1980s, we treated some patients with pancreatic cancer on a regimen nick-named the coffee protocol because it included infusions of intravenous caffeine. How absurd, we thought back then, because years earlier caffeine had been linked to pancreatic cancer as a possible cause. Now, two new studies […]

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Internet-Based Medical Information May Prove More Trustworthy Than Printed Texts

Today Ed Silverman of Pharmalot considers the case of a ghost-written medical text’s mysterious disappearance. The 1999 book, “Recognition and Treatment of Psychiatric Disorders: A Psychopharmacology Handbook for Primary Care,” (reviewed in a psychiatry journal here) came under scrutiny last fall when it became evident that the physician “authors” didn’t just receive money from a […]

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Considering the Coverage of the Earthquake, Tsunami and Nuclear Reactor Breakdowns

Listening to and watching the news, last night and this morning, I’ve heard all kinds of stuff – mainly from reporters who don’t seem to know very much about physics or radiation. (Personal kudos to Anderson Cooper, who seems to have a broader command of the terms and handle on the situation than some of […]

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A Glimpse into the Cochrane Library

I’m taking notes on the Cochrane Library. The site – a collection of databases and reviews – drew my attention yesterday when an embargo was breached for an article to be published there having to do with zinc’s putative power to squelch the common cold. From the website, published John Wiley & Sons, Ltd.: the […]

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Internet Surpasses TV as Prime News Source for Young Adults

I must have been reading a magazine when Mashable reported on new findings about the news from the Pew Research Center. A December 2010 survey confirmed that Americans are turning away from newspapers and logging onto the Web. Among young people, the Internet exceeds TV as a news source: In 2010, for the first time, […]

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Word of the Week: floccinaucinihilipilificationism

ML learned a new word upon reading the newspaper: floccinaucinihilipilificationism. According to the New York Times now, Moynihan prided himself on coining the 32-letter mouthful, by which he meant “the futility of making estimates on the accuracy of public data.”

She’s not exactly sure how the term, said to be the longest non-technical word in the English language, might be used in medical communication, but it seems that it might be relevant to estimating health care costs, and – possibly by extrapolation – to understanding the hidden ambiguousness of inferences drawn from vast amounts of seemingly hard data.

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On Patient Empowerment and Autonomy

…I think the answer is inherent in the goal of being engaged, and that has to do with the concept of patient autonomy – what’s essentially the capacity of a person to live and make decisions according to one’s own set of knowledge, goals and values.

Autonomy in medicine, which borders on the empowerment idea, can be an aim in itself, and therefore valuable regardless of any measured outcome.

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Uncertainty Rules (on Eyjafjallajokull, volatility and a patient’s prognosis)

As pretty much anyone traveling in Europe this week can tell you, it’s sometimes hard to know what will happen next. Volcanologists – the people most expert in this sort of matter – simply can’t predict what the spitfire at Eyjafjallajokull will do next.

It comes down to this: the volcano’s eruption could get better or it could get worse…

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When ‘No’ Turns Positive in Medical Care and Education

The medical word of the month is a most definite “no.”

The word is featured, explicitly and/or conceptually, in recent opinions published in two of the world’s most established media platforms – the New York Times and the New England Journal of Medicine. Their combined message relates to a point I’ve made here and elsewhere, that if doctors would or could take the time to provide full and unbiased information to their patients, people might choose less care of their own good sense and free will.

Let’s start with David Leonhardt’s April 7 column, “In Medicine, The Power of No.” In this excellent essay…

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Ten Ways to Better Our Health

(in the Style of a Magazine Cover)

If patients knew more:

1. they’d understand more of what doctors say;

2. they’d ask better questions;

3. they’d be more autonomous;

4. they’d make better decisions (ones they’re comfortable with, long-term);

5. they’d spend less money on care they don’t want or need.

If doctors knew more…

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Peter Sings Colonoscopy

Am I pro- or con- colonoscopy for routine screening, you might wonder. Well, that depends.

Am I pro- or con- famous singers and other celebrities extolling the benefits of particular medical interventions? Well, that depends, too.

But I’m sure I prefer “Puff the Magic Dragon.” Also “Leaving on a Jet Plane” fills me with imperfect memories of 6th grade.

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A Small Study Offers Insight On Breast Cancer Patients’ Capacity and Eagerness to Participate in Medical Decisions

Last week the journal Cancer published a small but noteworthy report on women’s experiences with a relatively new breast cancer decision tool called Oncotype DX. This lab-based technology, which has not received FDA approval, takes a piece of a woman’s tumor and, by measuring expression of 21 genes within, estimates the likelihood, or risk, that her tumor will recur.

As things stand, women who receive a breast cancer diagnosis face difficult decisions…

Posted in Breast Cancer, cancer survival, Communication, Diagnosis, Empowered Patient, Informed Consent, Oncology (cancer), Pathology, Patient Autonomy, Patient-Doctor Relationship, Statistics, Under the RadarTagged , , , , , , , , , , 5 Comments on A Small Study Offers Insight On Breast Cancer Patients’ Capacity and Eagerness to Participate in Medical Decisions

MedlinePlus, A Public Resource

MedlinePlus, a virtual superstore of medical information, is one of the most frequented health-related websites worldwide. The site, co-sponsored by the National Library of Medicine and the National Institutes of Health, is comprehensive and, with some exceptions (see below) relatively free of commercial bias. I find it a useful starting point for almost any health-related search…

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Are Doctors Necessary?

Ten years ago, my colleagues and I squirmed in our swivel chairs when a few tech-savvy patients filed in bearing reams of articles they’d discovered, downloaded and printed for our perusal.

Some of us accepted these informational “gifts” warily, half-curious about what was out there and half-loathing the prospect of more reading. Quite a few complained about the changing informational dynamic between patients and their physicians, threatened by a perceived and perhaps real loss of control.

How a decade can make a difference. In 2008 over 140 million Americans…

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Moms Tweet About Blood and Cancer

This afternoon I found a Tweet from a colleague, a journalist who happens to be a mom in my community:

Tweet from SuSaw:
“RT @JenSinger: Hey, baby. What’s your blood type? Nothing against the Big Pink Machine… http://ow.ly/URkg

As a trained hematologist (blood doc), oncologist and breast cancer survivor, I couldn’t resist checking this out. Here’s what I discovered…

Posted in Communication, Future of Medicine, Health IT, Hematology (blood), Social Media, Women's HealthTagged , , , , , , , , , , 1 Comment on Moms Tweet About Blood and Cancer

Information Overload

Last week I received an email from a former patient. He has hemochromatosis, an inherited disposition to iron overload. His body is programmed to take in excessive amounts of iron, which then might deposit in the liver, glands, heart and skin. He mentioned “some amazing videos on hematology and hemochromatosis and genetics” he’d discovered on YouTube.

This is the future of medicine, I realized. … Whether physicians want their patients to search the Internet for medical advice is beside the point. We’re there already, whether or not it’s good for us and whether what we find there is true.

Posted in Communication, Empowered Patient, Future of Medicine, Health IT, Hematology (blood), Social MediaTagged , , , , , , , , , , , Leave a Comment on Information Overload
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