Which one is the best? Which one is the most popular? How do you determine the relative "value" of a medical blog? I do not have the answer but some web sites have attempted to address those questions. The science behind the ranking is still controversial though.
There are 2 algorithms so far:
Medgadget.nl -- which, by the way, is not the same as Medgadget.com... The algorithm consists of 8 parameters: number of published articles, number of comments, Google PageRank, Technorati rank, inblog and inlink numbers, number of Feedburner subscribers and hits on Feedburner.
eDrug Search Top 100. The algorithm consists of Google PageRank, Bloglines Subscribers, Technorati Authority Ranking, eDrugSearch.com points.
CasesBlog is listed on both web sites at number 19 and 54.
"You are vitamin D deficient, very probably, and this is making your muscles ache, slowing you brain, thinning your bones and making you more likely to get cancer and heart disease. The secret of the Mediterranean is not its food but its sunshine. Or both. Go on, take your clothes off, get outside, and eat lots of oily fish, cheese, wild fungi and eggs. Abandon your miserable existence in the dark North and start living before it is too late. Alternatively, get a sunbed and take large daily supplements of vitamin D. It’s the elixir of life, according to this very thorough and plausible review."
Vitamin D is a steroid hormone and a component of a complex endocrine pathway sometimes called 'vitamin D endocrine system' (Medscape, 2012).
"Web Digest is a publication of the Education Resource Center (ERC) at Baylor College of Medicine. Its goal is to distill and condense medical educational technology information by informing you about local ed tech events, reviewing and highlighting web sites you may wish to use to supplement lecture and/or curriculum content and apprising you of current issues, best practices and latest trends in educational technology."
The archive of Web Digest is available but it does not seem to be very up-to-date.
One of the recent issues covers some Web 2.0 topics: wikis, blogs and podcasts. Clinical Cases and Images (ClinicalCases.org) is featured in the blog section of the article Web 2.0: Are you ready for it? ClinicalCases.org does use blog software (Blogger.com from Google) to power the web site although it is not a typical blog -- the entries are not in a reverse chronological order, etc. Clinical Cases and Images - Blog (CasesBlog) is a standard blog which I use to post updates about ClinicalCases.org and to collect interesting links and comments.
It looks like UpToDate is gradually becoming "the universal textbook of medicine." Do you remember the last time you opened Harrison's to consult about a clinical topic? Was that in 1997 or 2001? By the time Harrison's is on the shelf, it is often 5-10 years out of date. And this is where UpToDate steps in -- "up-to-date", what a catchy promising name.
UpToDate is useful and easy to use. We have it installed on every computer at the Cleveland Clinic and residents read it all the time. How many times I have not found the answer to a clinical question in UpToDate? Many. Then I try Pubmed and the plain Google search which both have almost always been helpful.
I don't think anybody should be dependent on a single source. If one cannot practice medicine without UpToDate, may be one should not practice at all.
There is an old proverb: beware the man of a single book (homo unius libri). It describes people with limited knowledge. The current version of the Internet has billions of scientific journal pages and the answer to your questions must be somewhere out there. Do not be the man of one book only.
CME thought police alert! Notes from Dr. RW, 01/2008. Thought Questions Small association between use of UpToDate and reduced patient length of stay, lower mortality (study sponsored by UTD) http://goo.gl/zSG8R 95% of junior doctors consider electronic textbooks the most effective source of knowledge. 70% of junior doctors read the medical literature in response to a specific patient encounter. BMJ, 2011. http://goo.gl/QZyJE Most up-to-date point-of-care medical resource? Sorry, UpToDate, Dynamed is way faster - BMJ http://goo.gl/4GC5l and http://goo.gl/QQcOh How Current Are Leading Evidence-Based Medical Textbooks? An Analytic Survey of 4 Online Textbooks (including UpToDate) http://buff.ly/X2kUKw
A video by the Portuguese Cardiology Foundation graphically conveys the danger of intrabadominal fat for "big belly people."
According to Harvard Medical School, "it’s appropriate to think of fat as an endocrine organ or gland, producing hormones and other substances that can profoundly affect our health. Scientists are also learning that visceral fat pumps out immune system chemicals called cytokines — for example, tumor necrosis factor and interleukin-6 — that can increase the risk of cardiovascular disease."
Calling patients (or anybody) fat or "big belly" is not advisable though. A New Hampshire doctor was recently reprimanded by the state medical board because he “told a fat woman she was obese.” Dr. Bennett says, “I tried to get her attention. I told her, 'You need to get on a program, join a group of like-minded people and peel off the weight that is going to kill you.'"
Oscar is a cat at a nursing home in Providence, Rhode Island. It seems to have the strange ability to predict the imminent death of some of the nursing home residents.
No matter what the latest newspaper headlines say, obesity is not a contagious disease although it does seem to spread across a social network according to this large NEJM study based on the Framingham cohort (free full text).
Authors claim that a person's chances of becoming obese increased by 57% if he or she had a friend who became obese in a given interval. In family networks, if one sibling became obese, the chance that the other would become obese increased by 40% and if one spouse became obese, the likelihood that the other spouse would become obese increased by 37%.
The most striking association was observed among adult males: "Among friends of the same sex, a man had a 100% increase in the chance of becoming obese if his male friend became obese, whereas the female-to-female spread of obesity was not significant (38% increased chance)."
CNN reported that astronauts were allowed to fly drunk on at least two occasions. A special panel studying astronaut health, which found "heavy use of alcohol" before launch that was within the standard 12-hour "bottle-to-throttle" rule.
I never knew that such bottle-to-throttle" rule even existed... According to the the International Herald Tribune, "the level of alcohol in the bloodstream allowed by the Japan Civil Aviation Bureau is zero. In Britain, in contrast, the alcohol limit for pilots and other air crew is set at 20 milligrams per 100 milliliters of blood.
We have a 10-hour bottle-to-throttle rule," said a senior pilot for the Cathay Pacific Airways who did not wish to be identified."
Chocolate Rain has been viewed 2,580,00 times on YouTube as of today. Tay has a new song called Internet Dream that many bloggers may identify themselves with:
"So every day I'm gonna go to bed at like eleven. And all of a sudden its 4AM . . . And I was just watching Youtube and reading Wikipedia for five hours."
IAMSE stands for International Association of Medical Science Educators. The 11th Annual Meeting of IAMSE is hosted by the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University right here at the main campus of the Cleveland Clinic from July 21 to July 24, 2007.
IAMSE published all abstracts on its web site and many of them are focused on using new tools (Internet-based and others) for medical education. There may be some interesting ideas there:
An ER doctor is unhappy about the transfer of care from PCP to ER: "Is is equally possible that your doctor sent you to the ER because it was the easiest way for him to get you off his back and pass the buck to another doctor. It is possible that he simply forgot how to arrange a "direct admission" because "just go to the ER" is a million times more common these days. We will never know because a review of the ER phone log reveals that he did not call with any instructions for the ER doctors regarding the expectations for your ER visit."
This is the opposite view -- an internal medicine doctors is unhappy about the transfer of care from ER to IM: "So it's just as easy for me to make disparaging remarks about the ER's complete lack of motivation to diagnose (DISPO DISPO DISPO... the mantra goes, right?) as it is for these ER heads to lament how lazy primary care docs have become."
This is should be a reference point for any physician planning to start a blog or a regular web site and I am planning to update the disclaimer of the sites I maintain accordingly. Dr. Charles was the first medical blogger to publish a long disclaimer and it looks like Kevin has improved that early version.
Somewhat paradoxically, the journal lists open-access resources on the web but the article itself is close-access: you have to be a subscriber to see the full text.
This is an excerpt:
"For example, the case presentations found at Clinical Cases and Images–Infectious Diseases presented by the Section of Hospital Medicine–Cleveland Clinic (http://clinicalcases.blogspot.com/2005/07/infectious-diseases-cases.html) include links to clinical examination Web sites that are useful to medical students."
Clinical Infectious Diseases is the official journal of the the Infectious Diseases Society of America and we proud to be included in the list of 25 educational web sites.
AllergyNotes links to a case description in the Journal of Investigational Allergology and Clinical Immunology of something never reported before (according to the authors, at least): a sexually transmitted allergic reaction to Brazil nuts.
Allergic reactions due kisses have been reported in the media and medical literature before.
This is a map view of the Cleveland Clinic campus with user-created photos from Panoramio -- a company acquired by Google a few months ago. You have to select the Panoramio layer from the front page of Google Maps in order to see the photos. This is similar to the Wikipedia, National Geographic and other layers which have been available in Google Earth for a while. There is no doubt the photos add significantly more information to the map, it almost feels like being there.
A Panoramio user even uploaded a photo of the Cleveland Clinic "information skyway": a series of 40 large TV screens which show photo exhibits with the goal of educating the thousands of people who walk across the skyway every day.
It has been only 7 months since the beginning of the year but there are already 3 new "diagnoses" published in the professional and mainstream media:
Prostatempathy is the reported tendency for male physicians of a certain age to order prostate-specific antigen (PSA) screening more than what deemed appropriate. The term was first used in a paper published in the Archives of Internal Medicine.
Wiiitis is acute tendonitis due to playing too much with the new Nintendo video game console called Wii.
Blogger in Draft is the test version of the popular blogging platform by Google which I also use to power many of our educational web sites. The Blogger team just introduced 2 new features: Podcasting Enclosures and Polls:
"Starting today, we’re automatically adding enclosure information for Blogger video uploads, so your blog with video has instantly become a video podcast. Your readers can watch your videos on your blog with the Flash player, or they can subscribe to your videos with their favorite podcatcher."
The Blogger team sense of humor is admirable:
"We’re not 100% versed in podcasting ourselves (thoseguysleft), so this is an area where we’re really listening to you for advice."
Those guys are Evan Williams, Biz Stone and Jason Goldman who started the original Blogger and added such great features as audioblogging which we used extensively to discuss EKGs, X-rays and clinical management. Ev and Biz (shorter names are easier to remember) created the podcasting web site Odeo which did not really take off and was sold some time ago. Unfortunately, our audio files have been unavailable for several months although the new Odeo owners are reportedly working to fix the problem. The latest (and wildly popular) project by "those guys" is Twitter which Joshua Schwimmer of Kidney Notes uses for microblogging -- just scroll down his sidebar to see the Twitter widget.
In conclusion, the video upload and podcasting make an already good blogging platform by Google even better. I would recommend it as a starting point to any aspiring blogger/medical educator.
Study volunteers ate a tiny amount of dark chocolate daily for five months - one square from a 16-square German chocolate bar called Ritter Sport (6 grams/30 calories/30 mg of polyphenols). This daily tidbit of dark chocolate lowered the blood pressure without weight gain or increase in cholesterol and blood glucose. The average decrease in blood pressure in the study participants was a 3-point drop in systolic blood pressure and a 2-point drop in diastolic blood pressure.
This is likely the most delicious "pill" (square) these volunteers have ever tasted. Speaking from personal experience, I have to confirm that both Ritter Sport Dark and Ritter Sport Dark with whole hazelnuts taste great.
The best headline award goes to: Dark chocolate helps keep arteries open for business (from a web site in New Zealand).
Chocolate could lower blood pressure but the required dose may be too much - BMJhttp://goo.gl/uoBN
Which one is the best? Which one is the most popular? How do you determine the relative "value" of a medical blog? I do not have the answer but some web sites have attempted to address those questions. The science behind the ranking is still controversial though.
