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Monday, 5 May, 2008

Medicine 2.0 carnival #23

Welcome to the latest edition of the Medicine 2.0 blog carnival.

For those of you unfamiliar with the newfangled internet jargon, "Medicine 2.0" is typically defined as the application of so-called web 2.0 technologies to the field of medicine. "Web 2.0" technologies are interactive internet tools, like this blog, or like Wikipedia -- websites that allow and encourage participation from their users.

This is Canadian Medicine's first time hosting Medicine 2.0. Enjoy.

Your PubMed rage may not be calmed by watching this video (We wrote about this subject .) into the "semantic search" website , which is still in beta testing. Hakia isn't half bad, he explains, but Google's got it beat. " greatly surpasses Hakia’s effort here by including a greater number of recommended sites and greater value from having more authoritative recommenders than just the MLA." Gunning for a job at Google, Mr Rothman? I hear the perks are to die for.

A partnership between Ozmosis (an online MD-only community) and The Doctor's Channel (med ed videos) has Bertalan Meskó of of collaborative online medical resources.

Scientific American magazine whether the "open access" concept should be applied to raw data -- an aspect of what is being called Science 2.0. In theory, the idea sounds attractive; as in the case of Wikipedia, it sort of makes sense that two minds are better than one, and therefore a whole bunch of minds is even better still. But what about some researchers' very legitimate concerns about getting scooped if they publish preliminary results online, or about having their laboratory's website vandalized if their "open access" is too open? "Acceptance of such measures would require a big change in academic culture," admits the article. "But for Science 2.0 advocates, the real significance is the technologies’ potential to move researchers away from an obsessive focus on priority and publication toward the kind of openness and community that were the supposed hallmarks of science in the first place." I'm not holding my breath for that to happen anytime soon. Publish or perish is in full swing around the world, same as always. Will a few collaborative websites change that? Unlikely. But one note of positivity: when journals embrace collaborative research and ongoing updating of publications, as has happened with the very interesting PLoS One, we may begin to see some change.

Dr Steven Palter of at the National Association of Broadcasters meeting in Las Vegas late last month. Why, you ask? Because he's looking around for the next wave of video technology to be used in endoscopic surgeries. "The progress we make in medical video surgery is a direct trickle down of innovations from the broadcast arena. From the first CCD camera hooked to a laparoscope and suspended from the ceiling via a jerry-rigged boom to the first use of HDTV in the OR - broadcast and TV technology drives innovation in surgical video. I thrive on researching new technology and then extrapolating new solutions to medical problems using these developments. This meeting provides the raw material for my creative process." (Plus, it sounds as though he had an added incentive to go to the meeting: "I was honored to accept invitations from several major broadcast, video, computer, and even surgical companies to attend the meeting, walk the floor with them, brainstorm new ways of helping patients with new devices and predict future needs and uses for technology in medicine." Sounds lucrative!) The coolest stuff he saw: fancy new helicopters and "ultra HD" cameras and displays.

Electronic medical records are the way of the future... right? Well, maybe, but you might want to consider a recent study from Norway before you jump in head-first, Dr Alan Brookstone of "GPs' use of EPRs [electronic patient records] were efficient and comprehensive, but have resulted in transfer of administrative work from secretaries to physicians." Dr Brookstone's post elicited several very thoughtful, thorough replies from doctors who use electronic records and have some complaints.

Second-year University of Alberta med student Daniel Kozan had a great idea that's beginning to really take off: . It's an online collection of multiple-choice medical education quizzes to help students study for their exams, and it's gained a lot of positive feedback so far. "The obvious benefit is that it gives you practice questions that you can use as a measure of your learning. The less obvious thing is that writing a good exam question takes considerable depth of knowledge. It’s actually quite difficult to write a decent exam question, so if students are putting questions together, then that’s real depth learning. It means that they have to know the material pretty well,” Dr David Rayner, the school's associate dean of undergraduate medical education, . “Really, the sky’s the limit in terms of where Daniel wants to take QuizMD... There are a lot of different types of online learning resources that could be incorporated into that. It has a lot of potential to be an amazing learning tool for medical students," said U of Alberta Medical Students' Association president Aaron Knox. Mr Kozan has big dreams: “I would really like to see it become the Wikipedia of practice exam questions, but along with that, I want to make it a legitimate medical resource.”

The med student behind My MD Journey waxes interrogative in . Among other things, he bemoans "the extremely low revenues" to be had from Google Adsense ads and wonders if you're all doing as badly as him. He also asks fellow bloggers whether he should reveal his secret blogging identity: "What should I do? continue blogging anonymously or just go public?"

John Sharp of the blog eHealth recently to Steve Case, whom you may remember from his days as the CEO of American Online. They talked about what features have contributed to Revolution Health's success , as well as a forthcoming initiative called "Mom Advocacy." No details on the project, unfortunately.

"Docs: At some point it will be 'evolve or die.' Phrased in kindler, gentler language, that’s ‘adapt or become obsolete.’" This comes courtesy of Jen McCabe Gorman and her Health Management Rx blog as part of a response to our fellow Canadian Ian Furst's (of ) comments on an earlier about the limitations of EMR. Sceptical as he is about the technology, he insists that it's coming, whether we like it or not. "That point may be 20 years off, it may be 50, or it may be 2, but it is coming. Here’s how I think it’ll progress – you won’t be able to get paid if you haven’t evolved to daily use of an integrated EMR/EHR/PHR system."

West Virginian health lawyer Bob Coffield about the nexus of healthcare and online social media, on his Health Care Law Blog. The report, called "," was written by a health economist from California (PDF). Mr Coffield summarizes: "Online health care is moving from one based on "health information retrieval" to patients and providers generating and sharing content online. This growing online collaboration is leading to unique approaches to care and a larger value proposition of harnessing the collective wisdom for other purposes including -- coordination of care, clinical insight, higher quality, prevention, etc. In the end, this may even lead to more cost efficient care." Also, see if you can decipher the deeper meaning of a link to a one-sentence entry about some sort of Pong and Nintendo Wii analogy... Also, the author of the report blogged about it .

The next edition of Medicine 2.0 will be hosted by on May 18. To read previous editions, check out the carnival's homepage .

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Friday, 2 May, 2008

Public's respect for doctors rises, while trust for journalists plummets

Canadians love their doctors. But journalists? Not so much.

That's according to the results of a , released yesterday.

Since 1994, the public's respect for physicians has grown from 91% to 94%. Over the same period of time, respect for journalists (that's me!) dropped from 73% to a meagre 49%.


I have a theory, though: if the survey had taken into account specialization within those professions, I'm confident that we medical journalists would come out on top compared to other beat reporters. Maybe that's the doctors' respect level just rubbing off on us, but it certainly seems that nowadays, as medical reportage is becoming more and more popular in all media -- TV, print, web and radio -- the public has a near-insatiable demand for health news.

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Yet another Canadian pathology disaster emerges

First it was Toronto. Then St John's, Newfoundland. Next came Miramichi, New Brunswick.

Now, we learn of the fourth incident in a that have recently come to light.

This time, it's in Owen Sound, Ontario, where an internal audit at the Grey Bruce Health Services hospital that pathologist Barry Sawka's error rate over his last 600 cases was 6% -- far more than the average of 1%.

Dr Sawka withdrew from practice voluntarily -- after the hospital requested he do so -- when the internal review was started in February. He has reviewed around 40,000 cases since he began working at Grey Bruce Health Services in 1994, all of which the hospital says could potentially be subject to review.

The hospital that it has already begun contacting patients to be reexamined in light of the revelation, but claims no deaths have been connected to any of Dr Sawka's errors.

has been set up to inform patients about the situation as it develops. According to the Owen Sound Sun Times, lawyers' phones are .

"The shortages and the deficiencies and the gaps in laboratory services are so widespread, I think there's a risk in many locations that problems are going to come to the surface," Royal College of Physicians and Surgeons CEO Dr Andrew Padmos this week.

Canadian Association of Pathologists president Dr Jagdish Butany echoed that same sentiment when he and I spoke last month. "Over the last 20-plus years, we have not paid enough attention to laboratories and pathology and pathologists," he said. "[The healthcare system has] relegated pathologists to the basement and given them that same priority."

For more on the root causes and the implications of the recent problems in pathology, read my article "" in the April issue of the National Review of Medicine.

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Around the web: Grand Rounds and Health Wonk Review

is hosted by . The theme, oddly enough, is professional wrestling. I'm at a loss to explain how that pertains to medicine but the collection of articles is worthwhile reading nevertheless. Our on the CMAJ's spoof article mix-up problem is included.

The is also online, at the . Canadian Medicine's on apology protection legislation proposed in Ontario is mentioned.

Keep your eye out for the next editions, whether you're a reader or a blogger who'd like to submit an article for consideration: here are the schedules for upcoming and anthologies. Another excellent medical blogging collection is the biweekly .

We're hosting the next edition of the Medicine 2.0 blog carnival on May 5. For details, click .

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