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Have We Killed Clinical Research?

“…I have always depended on the kindness of strangers.”  — Blanche DuBois in Tennessee Williams’ play A Streetcar Named Desire

Years ago when I began my medical training, I recall enrolling patients for clinical research. In cardiology, there were a myriad of questions that needed to be answered, especially in the area of defining which medications were best to limit the damage caused by a heart attack.

Patients routinely participated in large, multi-center prospective randomized trials to answer these questions. It was routine for them not to charged for participating in the trial — the drug(s) and additional testing would be funded by the company whose drug was being studied. Patients enrolled willingly, eager to help advance science and perhaps, in some small way, their fellow man. It never dawned on me in those early days why hospitals and research centers were so eager to promote research. Read more »

*This blog post was originally published at Dr. Wes*

Recent Readings On Social Media In Medicine

Here are a few papers and publications focusing on how social media can be used in medicine, healthcare and science. These represent the evidence-based approach in social media:

Google docs: a better method than a paper clinical schedule. Kippenbrock T, Holloway E, Moore DD. Comput Inform Nurs. 2010 May-Jun;28(3):138-40.

How to get the most from the medical literature: keeping up to date in nephrology. Cullis J, Webster AC. Nephrology (Carlton). 2010 Apr;15(3):269-76.

Twitter: consider the possibilities for continuing nursing education. Billings DM, Kowalski K, Bristol TJ. J Contin Educ Nurs. 2010 May;41(5):199-200.

Literature search on risk factors for sarcoma: PubMed and Google Scholar may be complementary sources. Mastrangelo G, Fadda E, Rossi CR, Zamprogno E, Buja A, Cegolon L. BMC Res Notes. 2010 May 10;3(1):131.

Effect of visual media use on school performance: a prospective study. Sharif I, Wills TA, Sargent JD. J Adolesc Health. 2010 Jan;46(1):52-61.

Patients’ Evaluations of Health Care Providers in the Era of Social Networking: An Analysis of Physician-Rating Websites. Lagu T, Hannon NS, Rothberg MB, Lindenauer PK. J Gen Intern Med. 2010 May 13.

Tweeting science and ethics: social media as a tool for constructive public engagement. Regenberg AC. Am J Bioeth. 2010 May;10(5):30-1.

*This blog post was originally published at ScienceRoll*

Science Media Misinterprets New Acupuncture Studies

Two recent acupuncture studies have received some media attention, both purporting to show positive effects. Both studies are also not clinical efficacy trials, so cannot be used to support any claims for efficacy for acupuncture –- although that is how they are often being presented in the media.

These and other studies show the dire need for more trained science journalists or science blogging –- they only make sense when put into a proper context. No media coverage I read bothered to do this. Read more »

*This blog post was originally published at Science-Based Medicine*

Health And Medicine: Scientific Or Miraculous?

I was recently listening to an audiobook about diet, written and read by a “famous” doctor who gets people healthy through dietary changes.

Since my podcast pushes me a little into the mainstream (more than this blog does), I thought it would be good to hear what the “average” person is reading about health. Plus, I am not exactly the most compliant patient when it comes to diet, so I thought I could possibly get something out of it personally.

I did my best to listen with an open mind, ignoring what I thought were gimmicks and trying to glean the valuable information from what this doctor was saying.

I had to stop, however, before finishing the book. It wasn’t the content so much that gave me cause to feel the desire to smash my iPod, it was the hype. The author was constantly using words like “amazing,” “magical,” and “miraculous.” Read more »

*This blog post was originally published at Musings of a Distractible Mind*

The “File Drawer” Effect: Failure To Publish Negative Studies

A new study published in PLOS Biology looks at the potential magnitude and effect of publication bias in animal trials. Essentially, the authors conclude that there is a significant file drawer effect –- failure to publish negative studies -– with animal studies and this impacts the translation of animal research to human clinical trials.

SBM is greatly concerned with the technology of medical science. On one level, the methods of individual studies need to be closely analyzed for rigor and bias. But we also go to great pains to dispel the myth that individual studies can tell us much about the practice of medicine.

Reliable conclusions come from interpreting the literature as a whole, and not just individual studies. Further, the whole of the literature is greater than the sum of individual studies –- there are patterns and effects in the literature itself that need to be considered.

One big effect is the file drawer effect, or publication bias –- the tendency to publish positive studies more than negative studies. A study showing that a treatment works or has potential is often seen as doing more for the reputation of a journal and the careers of the scientists than negative studies. So studies with no measurable effect tend to languish unpublished. Read more »

*This blog post was originally published at Science-Based Medicine*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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