Medical Students Can Learn How to Use Handheld Ultrasound Technology to Improve Their Physical Diagnosis

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Newswise A new study by researchers from Icahn School of Medicine at Mount Sinai found that training medical students to use a handheld ultrasound device can enhance the accuracy of their physical diagnosis. The study was presented November 18 at the American Heart Associations Scientific Sessions 2014.

The study by Icahn School of Medicine at Mount Sinai included a 90-minute, personalized lesson for 64 second-year medical students in how to use handheld echocardiography technology, with a review of a 3D cardiac anatomy model, video images of normal echocardiograms, and the opportunity to test the handheld device on classmates.

The studys goal was to evaluate an entire medical student class and observe if a group of novice medical students given this training could employ the technology successfully to achieve more accurate diagnosis of valvular heart disease than 72 of their classmates who received only traditional instruction in how to review medical histories and analyze heart murmur sounds using a stethoscope.

Valvular heart disease is when one or more of the four valves inside the heart are not functioning properly leading to improper blood flow throughout the heart. The condition can be caused by an infection, heart disease, or a heart attack. Heart valve disease is traditionally first suspected when a doctor hears a heart murmur while listening to a patients heart using a stethoscope. An echocardiogram machine, or a handheld echocardiography device, is a tool which uses sound waves to create images of the heart for doctors to visually identify any irregular heartbeat or valve abnormalities.

After all 136 students in the Cardiac Pathophysiology course took the identical final examination test, results showed that those with the enhanced training in handheld technology were more likely than the students with standard training to correctly diagnose valvular heart disease, 58 percent versus 40 percent, when the students were additionally provided with video of echocardiograms.

As the field of medicine grows more complex, our study findings show that the addition of handheld echocardiography as a component of students diagnostic skill set can substantially enhance the accuracy of physical diagnosis, even when introduced at the earliest stages of the students training, says the studys lead author David Vorchheimer, MD, Associate Professor of Medicine, Cardiology at Icahn School of Medicine at Mount Sinai. We have shown that even a limited 90-minute training session with the small, portable handheld ultrasound device can give medical students and other healthcare professionals in the hospital or the community the ability to more quickly and more accurately diagnose certain heart conditions, added Dr. Vorchheimer, also the new Director of Clinical Cardiology at the Montefiore Einstein Center for Heart and Vascular Care.

The Vscan device used in the study, made by GE Healthcare, is an echocardiography handheld device that permits rapid assessment of cardiac size, structure, function, and hemodynamics or blood flow. The device can fit in the hand of the physician and its screen is the size of a smart phone.

Imaging is going to become an essential component of medical education. Icahn School of Medicine at Mount Sinais education project Seeing is Believing, is currently evaluating the role of this strategy, says the studys principal investigator Jagat Narula, MD, PhD, Professor of Medicine, Philip J. and Harriet L. Goodhart Chair in Cardiology, and the Director of Cardiovascular Imaging Program at Icahn School of Medicine at Mount Sinai. Mount Sinai is at the forefront of equipping future doctors with the most advanced tools possible to help them in their learning today, and with the patient care of tomorrow.

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Medical Students Can Learn How to Use Handheld Ultrasound Technology to Improve Their Physical Diagnosis

Law Professor Discusses Medical Tourism

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When most people hear the word tourism, they immediately think of flocking to the sandy beaches of the Caribbean or exploring museums in a European city. For Harvard Law School graduate I. Glenn Cohen, the word has a different implication: travelling to another country for medical treatment.

The now-Law School professor discussed this phenomenon, called medical tourism, and his new book, Patients with Passports: Medical Tourism, Law, and Ethics, on Wednesday afternoon. Cohen was joined by three other panelistsKennedy School of Government professor Amitabh Chandra, School of Public Health professor Alicia Ely Yamin, and Medical School professor Nir Eyalfor a discussion of medical tourism and its implications.

Cohen started the conversation by defining medical tourism as the process of people travelling from less developed countries to more developed countries like the United States in pursuit of higher-level medical treatment.

According to Cohen, another reason why a patient might travel to a country for medical purposes, besides seeking higher quality care, may deal with issues of legalitya phenomenon sometimes called circumvention tourism. Procedures that are illegal in certain countries include abortion, assisted suicide, reproductive technologies, and stem cell therapies.

According to Chandra, because the majority of patients seeking medical procedures abroad seek the lowest costs possible, medical tourism might force medical institutions and countries to better evaluate their cost structures, which would lead to increased price competition. He mentioned, however, that although medical tourism can be used to measure cost, the travel of patients will not translate into quality of care.

Yamin commented on ethical and legal implications of medical tourism, especially as they relate to the concept of the right to health.

To define [health] as a right implies one, that it is of special moral importance; and two, that it is subject to social influence, said Yamin, quoting from Cohens book.

Eyal noted that costs affiliated with medical tourism may negatively impact destination countries and mentioned that locals would have to compete with tourists for the same services they currently receive.

Cohens book is divided into discussion of legal scenarios and illegal scenarios. It considers client questions of where one would travel, instances of suing for malpractice and other liabilities, how medical tourism would affect the destination countrys healthcare, and policy regulation.

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Law Professor Discusses Medical Tourism

Liberty's Malone on net neutrality

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While the debate rages over net neutrality and how heavily Internet service providers should be regulated, the bottom line is that as Web usage explodes, somebody will have to pay for the capacity it takes for that connectivity, Liberty Media Chairman John Malone told CNBC on Wednesday.

"It's either going to be the people who have a relationship with the consumer indirectly through the transport of the Internet or it's going to be the Internet companies themselves ... charging for volume usage at the consumer end," he said in an interview aired on "Squawk on the Street."

"The economics have to work because this capacity is not cheap."

Last week, President Barack Obama asked the Federal Communications Commission to set strong rules to protect net neutrality, which would keep the Internet open and free.

Read MoreConfused by net neutrality? Read this

Malone said it would be "unfortunate" if the government intervened too heavily.

"Letting this capital marketplace play out will see multiple terrestrial providersat least two, since the telephone industry has pretty much committed to build out and upgrade their network."

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Liberty's Malone on net neutrality

Iain Bankss Culture lives on

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The place we might hope to get to after weve dealt with all our stupidities Iain Banks on the Culture stories. Photograph: Murdo MacLeod for the Guardian

If the death of Iain Banks last summer left a giant, Culture-shaped hole in your life, it is really worth sampling these hugely detailed and lengthy interviews with the late, great man. Conducted by Jude Roberts for her PhD in 2010, the interviews have just been published by the excellent speculative fiction magazine Strange Horizons, as part of a funding drive that has raised more than $15,000 (9,500) to pay for the magazines 15th year of publication.

The full, strident, and often playful answers he gives here are entirely characteristic of his writing and persona more generally, says Roberts; and its true, many of Bankss answers are a joy.

Many critics and reviewers have claimed that the Culture represents the American Libertarian ideal. Given that this is clearly not the case, how do you characterise the politics of the Culture? asks Roberts. Really? I had no idea, replies Banks. Lets be clear: unless I have profoundly misunderstood its position, I pretty much despise American Libertarianism. Have these people seriously looked at the problems of the world and thought, Hmm, what we need here is a bit more selfishness? I beg to differ.

We also learn that Banks started work on a Culture-English dictionary. I was doing it as a laugh, as a sort of tiny hobby, for a brief while. It was quite fun working out how much information you could pack into a nonary grid but it was always going to be too big a job, and it all felt rather arbitrary, just pulling phonemes out of the air and deciding, Right, thats what General Contact Unit is in Marain (something like Wukoorth Sapoot-Jeerd, if memory serves).

And that the Culture stories are me at my most didactic, though its largely hidden under all the funny names, action, and general bluster. The Culture represents the place we might hope to get to after weve dealt with all our stupidities. Maybe. I have said before, and will doubtless say again, that maybe we that is, homo sapiens are just too determinedly stupid and aggressive to have any hope of becoming like the Culture, unless we somehow find and isolate/destroy the genes that code for xenophobia, should they exist.

It emerges that Banks doesnt think much of work by Michel Foucault, Jacques Derrida, or Emanuel Levinas (or any other continental philosophers). The little Ive read I mostly didnt understand, and the little I understood of the little Ive read seemed to consist either of rather banal points made difficult to understand by deliberately opaque and obstructive language (this might have been the translation, though I doubt it), or just plain nonsense. Or it could be Im just not up to the mark intellectually, of course.

Theres more so much more. Its got me itching to crack open my old copy of Consider Phlebas, and start the whole thing all over again. Although, is my favourite Culture novel The Player of Games? Decisions, decisions.

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Iain Bankss Culture lives on

Libertarian may have hurt Rick Scott more than Charlie Crist

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We're overdue posting Alex Patton's look at Libertarian candidate Adrian Wyllie's effect on the governor's race:

...Further study is warranted, but an initial review of the data indicates Wyllie having a far greater negative effect on Rick Scott with almost no effect on Charlie Crist. However, that is not the end of the story.

There appears to be a strong correlation of increased turnout (at least higher than the statewide turnout increase) in the counties that Wyllie performed best in.

Did Wyllie increase turnout? I am not sure yet, becauseit would take more research and analysis to be able to risk declaring causation.

However, from an initial glance ofone afternoons work, there appears a revisedhypothesis forming:

Wyllie may have took votes from Governor Scott, but Wyllie also brought more new voters to the2014 Florida Gubernatorial Campaign(at least in the countiessurrounding the Tampa Bay Area)...

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Libertarian may have hurt Rick Scott more than Charlie Crist