Source article.

A New York surgeon is using video games to help develop and train a new generation of surgeons. The surgeon — co-author of a recent study that concluded that surgeons who played video games for at least three hours a week were 27 percent faster and made 37 percent fewer mistakes than surgeons who did not play video games — believes that video games could serve as low-cost surgical simulators and has persuaded Hollywood visual effects experts to help apply state-of-the-art motion-capture technologies — used in creating lifelike virtual characters in movies and video games — to produce new types of surgical training techniques and devices.

A Sony Pictures expert working with the surgeon told the New York Times: “We could capture all motion of expert doctors, create some software, and tell students what he is doing wrong when he is doing the work. . . . We have developed a lot of software that involved a lot of research in anatomy, in how muscles work, how the face works . . . . We have tremendously high budgets to do this kind of stuff for movies. I have always been thinking that if we take this research a little further we could make a difference in medicine and other fields.”

Personalized Medicine

Source article.

“A very different sort of consumer-driven movement is quietly promising to revolutionize the delivery of care,” writes Michael Millenson in H&HN Online. He is talking about personalized medicine through advances in pharmacogenomics, proteomics, and evidence-based medicine. “Infomedicine,” as he summarizes the technologies, “is not a futurist fantasy; it is on providers’ doorsteps today. Pharmaceutical and device companies are already pouring millions of dollars into the development of personalized therapies; hospitals and physicians must be prepared with the knowledge necessary to scrutinize those therapies, discuss them with patients and advocate for reimbursement as appropriate. Medical IT systems will be required to process more than the traditional clinical variables, such as lab values; they’ll also be asked to include information ranging from drug reactivity data based on genomic analysis to individualized patient treatment preferences based on in-depth standardized questionnaires.

The traditional cottage industry structure of health care cannot hope to cope with the complex and intense financial, clinical and ethical challenges that personalized medicine will pose. Changing the way providers process information is no longer optional, it’s urgent.”

We agree.

Virtual Patients

www.wired.com/news/medtech/0,1286,66711,00.html

A Stanford surgeon and collaborators are not waiting on the Physiome Project (sse article in the Diagnostics section.) Running algorithms against MRI and CT data they are able to predict blood flow and the flexibility of veins and arteries, among other parameters, in individual patients. The goal is to enable surgeons to practice each individual operation in virtual reality before the reality itself. Its developers think the software will be ready for release in about two years.

Younger Doctors Better

www.washingtonpost.com/wp-dyn/articles/A100%85-2005Feb21.html

Harvard Medical School researchers who analyzed 62 studies conducted over the past four decades have concluded that the quality of care provided to patients is inversely related to a doctor’s experience and age. “Nearly three-quarters of the studies,” writes Sandra Boodman, “found that older doctors were less likely to adhere to guidelines for cancer screening, to use proper medications to treat heart attacks or to adopt other evidence-based treatments.” One 2000 study of 4,546 internists, cardiologists, and family physicians found that patient mortality increased by 0.5 percent for every year after a doctor graduated from medical school.

The study’s lead author cautioned against attributing the statistic to the individual – against equating all older doctors with inferior care.

A key reason for the performance gap may be the explosion in medical knowledge and the inadequacy of continuing medical education (CME) to help doctors keep pace. One proposed solution, which has had “some success” in Australia, is “academic detailing,” in which educators visit doctors in their offices to teach them about recent advances.

In any event, an editorial in the Annals of Internal Medicine said the findings underscore the need for “continuous professional development,” an approach that would require “an attitudinal shift, in which we accept that professional maturity not only may produce experience and wisdom” but could also hinder physicians from staying abreast of new clinical developments. The president of the American Academy of Family Physicians adds that “the medical profession needs to find better ways to help [physicians] stay current”

Home-use Genetic Tests Begin

www.detnews.com/2005/health/0503/07/A02-109401.htm

DNA Direct has begun direct-to-consumer marketing of two popular breast cancer tests that screen for a few mutations on key genes and cost about US$300 each. They involve just a cotton swab inside the cheek — and the results are made accessible online, eliminating the visit to the doctor’s office. A flood of similar ventures, offering more and more tests for other conditions, could ensue.

Buy Health at Sam’s Club

www.startribune.com/stories/535/5279060.html

US retail/wholesale giant Sam’s Club (46 million members) is offering UnitedHealth Group insurance at discounts of up to 50 percent for hearing aids, eyeglasses, dental care, laser eye surgery, chiropractic care, acupuncture, weight loss, fitness club membership and other health services not traditionally covered by insurance.