Ranking Medical Blogs by an Algorithm

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.

Further reading:
List of the best medical blogs. ScienceRoll, 08/2007.
Rating Medical Blogs. DavidRothman.net, 08/2007.
Image source: Wikipedia, public domain.

Updated: 08/07/2007

Vitamin D -- Elixir of Life?

It could be, according the BMJ blog:

"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). 

Relative vitamin D deficiency may also explain why anaphylaxis seems to be more prevalent in the Northern parts of the U.S.

References:
Vitamin D Deficiency. Michael F. Holick, M.D., Ph.D. NEJM, 2007.
Where are EpiPens prescribed the most in the U.S.? Allergy Notes, 2007.
Image source: Wikipedia, public domain.

Baylor's Web Digest Features Clinical Cases and Images

"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.

Kelleys Island and Marblehead Lighthouse in Ohio

Kelleys Island and Marblehead Lighthouse in Ohio. See all the photos from this album.

The location on Google Maps.

Read more about Kelleys Island and Marblehead Lighthouse.

Are You Dependent on UpToDate for Your Clinical Practice?

The text below is a comment on an interesting post by Dr. RW: Are you UpToDate dependent?

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.

References:

Are you UpToDate dependent? Notes from Dr. RW, 07/2007.
Image source: UpToDate.

Related reading:

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

Dangers of Intrabdominal Fat on YouTube

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.'"

References:
Abdominal fat and what to do about it. Harvard Medical School Family Health Guide.
Doctor in trouble for calling patient obese. MSNBC.
Boomeritis, Man Flu & Salad Dodging Down Under. WSJ Health Blog, 01, 2008.
Link via Dr. Wes.
Belly Fat, Also Called Visceral Fat, Boosts Inflammation and Atherosclerosis, Say Scientists Studying Mice. WebMD, 01/2008.

Updated: 01/29/2008

A "cat scan" by Oscar predicts end of life

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.

The whole story was reported in an essay in the NEJM. See the CNN video. Oscar now has a Wikipedia page: Oscar (therapy cat).

Related Video


Do Not Resuscitate (DNR) Sung to Rockstar by Nickelback

References:

A Day in the Life of Oscar the Cat. David M. Dosa, M.D., M.P.H. NEJM, 2007.

Related reading:

Oscar the cat, confirmation bias and NEJM editorial judgement. Retired doc's thoughts, 08/2007.
Seizure Dogs and Death Cats. NeuroLogica Blog, 08/2007.
The Guardian: A sombre series of portraits taken of people before and after they had died is a challenging and poignant study, 03/2008.
Doctor casts new light on Oscar, "the NEJM cat", that has accurately predicted 50 deaths at a nursing home http://goo.gl/Odt7

WJM, Volume 163(3); September 1995. http://www.ncbi.nlm.nih.gov/pmc/issues/124736
A Son's Photo Journal of His Aging Father's Decline - Photo Essays - TIME http://goo.gl/RVCt
The Lancet calls end-of-life care "the neglected core business of medicine" http://goo.gl/VtgeA