August 4th, 2011 by AndrewSchorr in Opinion, Research
Tags: Blood-Thinning, Clinical Trials, Control Group, Coumadin, Deep Vein Thrombosis, Double Blind Study, DVT, Experimental Group, FDA Approval, Hokusai, Leukemia, Pharmaceutical Companies, Quintiles, Warfarin
No Comments »
There are big companies like Quintiles that run clinical trials around the world. There are local clinics that specialize in clinical trials and make a lot of money at it. There are, of course, pharmaceutical companies and device manufacturers who depend upon the results to gain marketing approval for new products. People in all those groups know a lot about trials.
But the perspective that counts is the view from you and me – patients. Most of us do not enroll in clinical trials. We don’t want to get too up close and personal with anything “experimental.” And often our doctors never tell us about available trials anyway since it can be a lot of paperwork for them. Given that most people don’t enroll in trials and new science is delayed because of it and also because most people in trials are not journalists, I thought I’d put hunt and peck to the computer keyboard and speak out about trials. I am especially motivated because I have participated twice. The first one, a leukemia trial in 2000, I believe, saved my life. And I enrolled in a second one, studying a new drug for clots in the legs (deep vein thrombosis or DVT) just a week and a half ago.
I enrolled in the DVT trial because 1) the first one worked for me and 2) I crow all the time about how patients should always consider being in a trial as a treatment option. I had to put up or shut up. So I signed on the dotted line.
This particular trial, Read more »
*This blog post was originally published at Andrew's Blog*
August 4th, 2011 by StevenWilkinsMPH in Opinion, Research
Tags: Doctor-Patient Communication, Electronic Health Record, Group Health Cooperative, Journal of Internal Medicine, Medical Technology, Medicine, Next Big Thing, Patient, Patient Portal, Patient Satisfaction, Patient-centered service, Physician, Primary Care Physician, Provider-Patient Relationship, Seattle, Test Results
1 Comment »
There seems to be an inverse relationship between the amount of spin one hears about “the next big thing”…and reality. First it was EMRs and virtual e-visits, then social media, and now patient portals seem poised to be next big thing. The drumbeat of vendors and pundits is unmistakable….physicians that don’t adapt will be toast. It can all sound pretty convincing until you ask to see the evidence. What do patients think?
Take the physician patient portal. If you read between the lines, patient portals are frequently being positioned as the new “front door” to physician practices. By signing on to a secure website patients will have real time access to the electronic health record and will be able to communicate with their physicians by e-mail. Additional patient features include being able to schedule an appointment with their doctor, reading their test results and refilling prescriptions. But despite these features, according to John Moore at Chilmark Research, “nationwide use of patient portals remains at a paltry 6%.”
Ok… so now we know what vendors and pundits think about patient portals. What about patients – what do they think? Read more »
*This blog post was originally published at Mind The Gap*
August 4th, 2011 by RamonaBatesMD in News, Research
Tags: Biological Molecules, Biosynthetic Soft Tissue Replacement, Composite Material, hyaluronic acid, Jennifer Elisseeff, Johns Hopkins, Jules Stein, Medicine, PEG-HA Composite, poly ethylene glycol, Reconstruction, Science Translational Medicine, Synthetic Molecules, Translational Tissue Engineering
No Comments »
Yesterday, I came across this press release from Johns Hopkins regarding a new composite material which may someday be used to restore damaged soft tissue. (photo credit)
The liquid material is a composite of biological and synthetic molecules which is injected under the skin. Transdermal light is then used to “set” the material into a more solid structure.
The results of the early experiments in rats and humans has been reported in the July 27 issue of Science Translational Medicine (full reference below).
It is hoped that the new liquid material is a biosynthetic soft tissue replacement composed of poly(ethylene glycol) (PEG) and hyaluronic acid (HA).
From the press release Read more »
*This blog post was originally published at Suture for a Living*
August 3rd, 2011 by Michael Kirsch, M.D. in Opinion, Research
Tags: Biopsy, Bowel, Camera, Capsule Endoscopy, Colonoscope, Colonoscopy, Diagnostic Procedure, Gastroenterology, Medical Technology, Miniaturized Camera, Miniaturized Medical Care, Polyp, Therapeutic Task, WCE, Wireless Capsule Endoscopy
2 Comments »
Most of us born several decades ago, recall the futuristic book Fantastic Voyage by Isaac Asimov, where a miniaturized crew traveled through a human body to cure a scientist who has a blot clot lodged in his brain. Ironically, miniaturized medical care is now upon us while books are at risk of becoming obsolete.
I hope that gastroenterologists won’t become obsolete, at least until my last kid graduates from college.
I perform an amazing diagnostic procedure called wireless capsule endoscopy (WCE), when patients swallow a camera. Once swallowed, this miniaturized camera takes its own fantastic voyage through the alimentary canal. The test is used primarily to identify sources of internal bleeding within the 20 feet of small intestine, which are beyond the reach of gastroenterologists’ conventional scopes. I have performed over 200 of these examinations, and I am still awestruck when I watch a ‘movie’ of someone’s guts. While most examinations do not reveal significant findings, I have seen dramatic lesions that were bleeding before my eyes. WCE can crack a cold medical case wide open.
Here’s a typical view of the small bowel as seen by the cruising camera: Read more »
*This blog post was originally published at MD Whistleblower*
August 2nd, 2011 by Steve Novella, M.D. in Opinion, Research
Tags: Anti-Vaccine Movement, Chicken Pox, Evidence Based Medicine, Herpes Zoster, Safety of Vaccinations, Science Based Medicine, Vaccines, Varicella Vaccine, Varicella-related deaths
No Comments »
One of the basic human “needs” is the desire for simplicity. We have limited cognitive resources, and when we feel overwhelmed by complexity one adaptive strategy is to simplify things in our mind. This can be useful as long as we know we are oversimplifying. Problems arise when we mistake our schematic version with reality.
In this same vein we also like our narratives to be morally simple, so there is a tendency to replace the complex shades of gray with black and white. This is perhaps related to cognitive dissonance theory. We have a hard time reconciling how someone can be both good and bad, or how a good person can do bad things. So there is also a tendency to see people as all good or all bad. We can transcend these tendencies with maturity and wisdom, but that takes work.
A good example of the desire for simple moral clarity is the anti-vaccine movement. Their world is comprised of white hats and black hats (guess which one they perceive themselves as wearing), as evidenced by the blog posts and comments over at Age of Autism. There is a certain demand for purity of thought and message that seems to be getting worse over time in a self-reinforcing subculture. Many now see their struggle in apocalyptic terms.
The desire for simplicity even extends to factual claims. Read more »
*This blog post was originally published at Science-Based Medicine*
