To gain new insight into how highly specialized workers learn skills or react to stressful situations, researchers are leveraging advanced scanning technologies to look at what's happening inside the brain.
In the latest findings, a team of researchers studied surgeons as they performed surgical simulations and found they could identify novice from experienced surgeons by analyzing brain scans taken as the physicians worked.
The researchers, who described their findings Wednesday in the journal Science Advances, said that the part of the brain involved in planning complex behaviors was more active in the novices. Skilled surgeons had more activity in the motor cortex, which is important for movement. The researchers, who developed a machine-learning system to analyze the scans, also showed that training resulted in a shift toward higher activity in the motor cortex.
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https://www.wsj.com/articles/brain-scans-can-detect-who-has-better-skills-1538589600
Friday, October 5, 2018
Doctors are surprisingly bad at reading lab results. It’s putting us all at risk. - The Washington Post
The man was 66 when he came to the hospital with a serious skin infection. He had a fever and low blood pressure, as well as a headache. His doctors gave him a brain scan just to be safe. They found a very small bulge in one of his cranial arteries, which probably had nothing to do with his headache or the infection. Nevertheless, doctors ordered an angiogram to get images of brain blood vessels. This test, in which doctors insert a plastic tube into a patient's arteries and inject dye, found no evidence of any blood vessel problems. But the dye injection caused multiple strokes, leading to permanent issues with the man's speech and memory.
That case, recounted in JAMA Internal Medicine three years ago, is no surprise. As a doctor in a large urban hospital, I know how much modern medicine has come to rely on tests and scans. I review about 10 cases per day and order and interpret more than 150 tests for patients. Every year, doctors in this country order more than 4 billion tests in total. They've gotten more sophisticated and easier to execute as technology has advanced, and they're essential to helping doctors understand what might be wrong with their patients.
But my research has found that many physicians misunderstand test results or think tests are more accurate than they are. Doctors especially fail to grasp how false positives work, which means they make crucial medical decisions — sometimes life-or-death calls — based on incorrect assumptions that patients have ailments that they probably don't. When we do this without understanding the science of risk and probability, we unacceptably increase the chances of making the wrong choice. In the worst cases, as with the man whose angiogram caused otherwise avoidable strokes, we increase the odds of unnecessarily putting patients in danger.
More ...
https://www.washingtonpost.com/news/posteverything/wp/2018/10/05/feature/doctors-are-surprisingly-bad-at-reading-lab-results-its-putting-us-all-at-risk/?
That case, recounted in JAMA Internal Medicine three years ago, is no surprise. As a doctor in a large urban hospital, I know how much modern medicine has come to rely on tests and scans. I review about 10 cases per day and order and interpret more than 150 tests for patients. Every year, doctors in this country order more than 4 billion tests in total. They've gotten more sophisticated and easier to execute as technology has advanced, and they're essential to helping doctors understand what might be wrong with their patients.
But my research has found that many physicians misunderstand test results or think tests are more accurate than they are. Doctors especially fail to grasp how false positives work, which means they make crucial medical decisions — sometimes life-or-death calls — based on incorrect assumptions that patients have ailments that they probably don't. When we do this without understanding the science of risk and probability, we unacceptably increase the chances of making the wrong choice. In the worst cases, as with the man whose angiogram caused otherwise avoidable strokes, we increase the odds of unnecessarily putting patients in danger.
More ...
https://www.washingtonpost.com/news/posteverything/wp/2018/10/05/feature/doctors-are-surprisingly-bad-at-reading-lab-results-its-putting-us-all-at-risk/?
Thursday, October 4, 2018
The Risk of Alternative Cancer Treatments - The New York Times
A diagnosis of cancer, even an early-stage, highly curable cancer, can prompt some people to feel as if they've suddenly lost control of their future and that they must do whatever they can to regain it.
They may seek guidance from the internet, friends and acquaintances, some of whom may be quick to relate tales of miraculous cures from alternative remedies that claim to spare patients the challenges of established cancer treatments like surgery, radiation and chemotherapy.
One web-based group, Integrative Cancer Answers, states that as many as 83 percent of cancer patients choose to use one or more forms of alternative medicine, ranging from acupuncture and herbs to vitamins and yoga, most often in conjunction with therapies clinically proven to be effective.
However, a small but significant number of cancer patients reject the treatments offered by mainstream oncologists and seek instead alternative remedies that may sound wonderful to a layperson but lack the support of scientifically valid research. Their reasons range from wanting to feel empowered by making their own treatment decisions to avoiding toxic side effects by selecting remedies they consider harmless.
More ...
https://www.nytimes.com/2018/10/01/well/live/the-risk-of-alternative-cancer-treatments.html
They may seek guidance from the internet, friends and acquaintances, some of whom may be quick to relate tales of miraculous cures from alternative remedies that claim to spare patients the challenges of established cancer treatments like surgery, radiation and chemotherapy.
One web-based group, Integrative Cancer Answers, states that as many as 83 percent of cancer patients choose to use one or more forms of alternative medicine, ranging from acupuncture and herbs to vitamins and yoga, most often in conjunction with therapies clinically proven to be effective.
However, a small but significant number of cancer patients reject the treatments offered by mainstream oncologists and seek instead alternative remedies that may sound wonderful to a layperson but lack the support of scientifically valid research. Their reasons range from wanting to feel empowered by making their own treatment decisions to avoiding toxic side effects by selecting remedies they consider harmless.
More ...
https://www.nytimes.com/2018/10/01/well/live/the-risk-of-alternative-cancer-treatments.html
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