Using the physiology of normal aging as a capstone integration exercise in a medical physiology course

As the Baby Boomer generation reaches old age, there has been a significant increase in the number of older adults needing healthcare over the past decade. The physiology of aging is therefore a highly relevant topic for the preclinical medical curriculum. I describe a new capstone unit on the physiology of aging, placed at the end a medical physiology course, to provide a vehicle for integration of prior learning about physiology of each individual body system. Students were provided with online self-study modules as preparation for a mandatory small group case-based learning activity. A detailed case of an elderly female patient being assessed for fall risk was provided. Students were required to document a “Review of Systems” predicting decreased system functions due to senescence and to prepare a group concept map illustrating how physiologic deficits contributed to fall risk in the patient. Students successfully completed the activity and reported generally good satisfaction with the experience. The activity was judged an effective tool for students to consolidate prior learning and to apply physiology to an important medical topic. The lesson also provided several opportunities for curriculum integration with cell biology, biochemistry, anatomy, and clinical skills components.

Innovative application of strategic foresight to oncology research

Purpose This study aims to investigate into the future of cancer and cancer research in preparation for a strategic plan for a cancer research centre. Design/methodology/approach The study used framework foresight, a method for creating scenarios and their implications developed by the MS program in Foresight at the University of Houston. Findings The study identified four scenarios: a continuation scenario in which progress in detecting and treating cancer progressed as it has over the past few decades, a collapse scenario in which attention was diverted from medical research due to a climate crisis, a new equilibrium scenario in which cost became the overriding concern for cancer treatment, and a transformation scenario in which individuals took control of their treatment through Do-It-Yourself remedies. Those scenarios suggested four strategic issues for the planning exercise: the growing volume of genomic and clinical data and the means to learn from it, the increased involvement and influence of patients in diagnosis and treatment, the ability to conduct research in a time of fiscal austerity and declining levels of trust in all professions, including medicine. Research limitations/implications The paper not only provides guidance for cancer centers but also for medical practice in general. Practical implications The client used the scenarios and their implications as part of its considerations in strategic planning. Originality/value This paper represents the first time that Framework Foresight has been applied to a medical topic.

Use of Artificial Intelligence for Medical Literature Search: Randomized Controlled Trial Using the Hackathon Format

Background Mapping out the research landscape around a project is often time consuming and difficult. Objective This study evaluates a commercial artificial intelligence (AI) search engine (IRIS.AI) for its applicability in an automated literature search on a specific medical topic. Methods To evaluate the AI search engine in a standardized manner, the concept of a science hackathon was applied. Three groups of researchers were tasked with performing a literature search on a clearly defined scientific project. All participants had a high level of expertise for this specific field of research. Two groups were given access to the AI search engine IRIS.AI. All groups were given the same amount of time for their search and were instructed to document their results. Search results were summarized and ranked according to a predetermined scoring system. Results The final scoring awarded 49 and 39 points out of 60 to AI groups 1 and 2, respectively, and the control group received 46 points. A total of 20 scientific studies with high relevance were identified, and 5 highly relevant studies (“spot on”) were reported by each group. Conclusions AI technology is a promising approach to facilitate literature searches and the management of medical libraries. In this study, however, the application of AI technology lead to a more focused literature search without a significant improvement in the number of results.

A Study on Ranking Fusion Approaches for the Retrieval of Medical Publications

In this work, we compare and analyze a variety of approaches in the task of medical publication retrieval and, in particular, for the Technology Assisted Review (TAR) task. This problem consists in the process of collecting articles that summarize all evidence that has been published regarding a certain medical topic. This task requires long search sessions by experts in the field of medicine. For this reason, semi-automatic approaches are essential for supporting these types of searches when the amount of data exceeds the limits of users. In this paper, we use state-of-the-art models and weighting schemes with different types of preprocessing as well as query expansion (QE) and relevance feedback (RF) approaches in order to study the best combination for this particular task. We also tested word embeddings representation of documents and queries in addition to three different ranking fusion approaches to see if the merged runs perform better than the single models. In order to make our results reproducible, we have used the collection provided by the Conference and Labs Evaluation Forum (CLEF) eHealth tasks. Query expansion and relevance feedback greatly improve the performance while the fusion of different rankings does not perform well in this task. The statistical analysis showed that, in general, the performance of the system does not depend much on the type of text preprocessing but on which weighting scheme is applied.

Use of Artificial Intelligence for Medical Literature Search: Randomized Controlled Trial Using the Hackathon Format (Preprint)

BACKGROUND Mapping out the research landscape around a project is often time consuming and difficult. OBJECTIVE This study evaluates a commercial artificial intelligence (AI) search engine (IRIS.AI) for its applicability in an automated literature search on a specific medical topic. METHODS To evaluate the AI search engine in a standardized manner, the concept of a science hackathon was applied. Three groups of researchers were tasked with performing a literature search on a clearly defined scientific project. All participants had a high level of expertise for this specific field of research. Two groups were given access to the AI search engine IRIS.AI. All groups were given the same amount of time for their search and were instructed to document their results. Search results were summarized and ranked according to a predetermined scoring system. RESULTS The final scoring awarded 49 and 39 points out of 60 to AI groups 1 and 2, respectively, and the control group received 46 points. A total of 20 scientific studies with high relevance were identified, and 5 highly relevant studies (“spot on”) were reported by each group. CONCLUSIONS AI technology is a promising approach to facilitate literature searches and the management of medical libraries. In this study, however, the application of AI technology lead to a more focused literature search without a significant improvement in the number of results.

Perceived Level of Interest in Health Research from Patients Who Use Social Networking Sites: A Secondary Data Analysis of HINTS Data (Preprint)

BACKGROUND There is a need to address the factors associated with underrepresentation of socioeconomically disadvantaged groups in research participation. The growth of social networking sites over the past decade provides an opportunity to engage and educate patients from underrepresented populations about health information and research. OBJECTIVE To use the National Cancer Institute’s Health Information National Trends Survey (HINTS) to determine if there is an association between social networking site use and interest in patient engagement in research, and to identify sociodemographic disparities between social networking site use and interest in patient engagement in research. METHODS Data from the 2013 administration of HINTS were analyzed. Descriptive statistics were generated for all items, and bivariate analyses were conducted between sociodemographic variables and interest in participating in patient engaged research. Multivariate logistic regression modeling was used to examine the effects of each independent variable on respondent interest in patient-engaged research. RESULTS There was a statistically significant association between social networking site use for reading/sharing a medical topic (P< .001) and being interested in patient engagement in research, after adjusting for relevant covariates (OR=3.17; 95% CI: 2.04, 4.90). Respondents who had some college education (OR=3.13; 95% CI: 1.56, 6.27) or were college graduates (OR=3.98; 95% CI: 2.19, 7.24) had higher odds of interest in patient engagement in research, as compared to respondents with less than a high school education (P=.002). Among respondents who indicated using social networking sites for medical topics, males (P=.006) showed increased interest in patient engagement in research, as compared to females (OR=1.56; 95% CI: 1.13, 2.17). Interest in patient engagement in research did not differ significantly between different races/ethnicities, irrespective of their social networking site use (P<.001). CONCLUSIONS The relationship found between social networking site use and increased interest in patient engagement in research gives researchers an avenue to overcome barriers that have limited participation among different groups. Our study found no significant difference in this association among race/ethnicity, suggesting that social networking could be a tool to address the underrepresentation of certain groups regarding participation in research.

A Novel Meta-Analytic Approach with Applications to Nutrition Research: A Comprehensive Analysis of Sodium Restriction (OR06-05-19)

Objectives Since the application of meta-analysis to biomedical research, the breadth of evidence covered in published meta-analyses has diminished. Despite the imperative of literature reviews to present “state of the art” knowledge, current meta-analyses are confined to pooling only select evidence. Imposing a priori criteria on scientific evidence results in biased and myopic conclusions. These current practices, in addition to the vastness of the literature base, ensure that research evidence remains opaque, and unusable to guide research and clinical practice. For example, whether and how much dietary sodium should be restricted for healthy or at-risk populations remains controversial. New epidemiological data suggest a striking increase in mortality with sodium intake <3 g/day, confounding this discussion. Thus, a system enabling investigators to access, review, and interpret all evidence is needed. Methods MedAware Systems, Inc. is a platform that continuously identifies, extracts and organizes medical research data from multiple repositories. A blinded, cross-validated data extraction process, using artificial intelligence, guides two research scientists to process each study with near 100% accuracy. Intelligent software compares each data field for matches, prompting a senior scientist to review and reconcile any mismatched data fields. Over 200 methodological and clinical parameters are coded and organized, supporting comprehensive meta-analytic reviews of any medical topic. We demonstrate this innovative technology by addressing the effects of dietary sodium intake. We identify and analyze the complete domain of studies pertaining to sodium intake and cardiovascular outcomes. Results To date, 368 studies have been identified. Initial review of patients, interventions, and outcomes data show extreme heterogeneity of this literature domain. This confirms the need for comprehensive evidence review, data extraction, and pooling. Conclusions Sodium intake literature is vast and difficult to interpret. We introduce a comprehensive process to analyze thousands of studies that traditional approaches cannot match. Our database and meta-analytic methodology profile the domain of evidence, summarizing the diversity and efficacy of sodium restriction recommendations. Funding Sources MedAware Systems, Inc.

The state of English-language training of future doctors in medical universities

The article is devoted to the study of the current state of English-language training of future doctors in medical universities. During experimental work, students were questioned, educational programs and curricula of this training were analyzed. The characteristic of educational materials that are used for English-language professional training of students-future doctors is presented. The analysis of the English language training programs of future doctors has shown that the speaking skills that students are expected to develop generally cover the range of speech skills that have been highlighted in the earlier stages of the study. Instead, they are presented according to the traditional classification of speech activities without taking into account the differentiation in production and communication processes. It has been established how the skills offered in these educational programs correlate with the vocational skills we have identified. Thus, the programs envisage the development of speaking skills: to conduct a conversation on the given medical topic; participate in a discussion or conversation; clarify information regarding treatment; be able to discuss the topic being studied; participate in simulation of a professionally oriented situation; to make dialogues and messages based on the subject matter being studied; listen (understanding monologue and dialog speech) and read (working with medical literature). We conclude that the skills are formulated quite broadly, it is not expected to work on the development of specific skills, without which the formation declared in the analyzed programs of general skills is impossible. For example, to plan utterances, differentiate information, analyze, compare, systematize it, transmit brief professional information in writing. Thus, the students can use acquired integrated knowledge of professional English in senior courses while studying other disciplines, where on the basis of the learned models of communicative interaction future doctors will have the ability to perform professionally directed English-speaking interaction and to use professional vocabulary correctly.

YouTube as an Educational Resource in Medical Education: A Scoping Review (Preprint)

BACKGROUND Video has been a powerful teaching and learning tool in medical education, enabling knowledge, skill and attitude formation in a variety of areas and reaching learners with various learning and communication styles. The millennial generation has grown up with video at their fingertips at any time and any place, and social networking sites such as YouTube enable the sharing of video amongst a vast online community. YouTube has emerged as a growing educational resource for both learners and medical educators. However, the usefulness of YouTube in supporting teaching and learning across the continuum of medical education has not been explored in detail. Given the increasing usage of YouTube in medical education, a review of the literature on YouTube and its utilization in medical education could inform more effective adoption and usage by institutions, educators, practitioners and learners. OBJECTIVE To explore the use of YouTube across the medical education continuum. METHODS A scoping review of the literature was performed. PubMed, ERIC and CINAHL were searched for literature on YouTube usage for medical education purposes published between 2005 and 2017 using a combination of search terms. Articles were screened using a defined set of inclusion criteria. Key items of information from each paper were collated using a data extraction tool and common themes from the literature were identified via thematic analysis. RESULTS Of the 113 articles initially identified in the literature search, 31 met inclusion criteria. Results show that a large number of YouTube videos exist across a variety of medical topic areas. However, only a small number of studies have evaluated the effectiveness of YouTube as an educational intervention and these are largely limited to learner satisfaction only. YouTube does offer the opportunity for educators to share videos and for learners to access a wide array of video materials. However, a majority of studies involving the assessment of content quality suggest that YouTube videos may be an inadequate source of information for learning due to the high variability of content. A key limitation in many of these studies was that searches were mainly restricted to publicly available video content. CONCLUSIONS There is a paucity of research and evaluative work surrounding the use of YouTube as an educational resource across the medical education continuum. The quality of the content on YouTube is highly variable due to a lack of peer-review. Further evaluation of the effective integration of YouTube in medical education would inform further understanding and future practice.