Join me at the 2012 Diagnostic Error in Medicine: 5th International Conference

I hope to see you at the 5th international conference on Diagnostic Error in Medicine (DEM) – 2012.

The conference is brought to you by the Society to Improve Diagnosis in Medicine and Johns Hopkins University School of Medicine.

This year, I'll be speaking on a panel where we will be discussing the role of social media in reducing diagnostic errors in medicine. It should be a very interesting conversation given what is happening these days in the rapidly evolving world of social media. Patients and health care professionals are having conversations on social media. How can these digital tools enable the health care team to reach the correct diagnosis? How does social media contribute to diagnostic errors?

The conference will be in Baltimore on November 12 - 14, 2012. For more information, visit the conference page here.

The Society to Improve Diagnosis in Medicine (SIDM) was founded with the goals of making diagnosis timely, accurate, cost-conscious, reliable and safe. The Diagnostic Error in Medicine meetings make up the primary forum for advancing this agenda by promoting discussion, highlighting research advances, and bringing together all of the stakeholders interested in this issue. The theme of this year’s meeting “What Can I Do?” emphasizes the diversity of this stakeholder group. By bringing together all of these interests, we hope to spark new interests, new collaborations, and new projects that will lead to safer and more cost effective diagnosis.

Johns Hopkins Center for Population Health IT

It's exciting to see what Johns Hopkins is doing in the area of public health informatics. The following press release outlines a New Information Technology Center Established to Benefit Population Health:

Johns Hopkins University is establishing a new center aimed at improving and expanding the use of electronic health record systems, e-health and information technology. The Johns Hopkins Center for Population Health IT— known as CPHIT (or "see-fit")—will draw on faculty skilled in public health, medicine, informatics, computer science, business and systems engineering and will focus on helping public health agencies and private health care organizations utilize e-health tools to increase the efficiency and equity of health care delivery.

Johns Hopkins announces the Armstrong Institute for Patient Safety and Quality

Recognizing the urgent need to advance the science of reducing preventable harm and improve health care quality, Johns Hopkins Medicine is announcing the establishment of the Armstrong Institute for Patient Safety and Quality, an organization whose work will benefit not only Johns Hopkins patients but those around the world.

FDA Clears a Test for Ovarian Cancer

Sometimes, I like to republish press releases. Here's a recent one from the FDA regarding a test called OVA1 for ovarian cancer. The key statement in this press release is this: "OVA1 should be used by primary care physicians or gynecologists as an adjunctive test to complement, not replace, other diagnostic and clinical procedures."

FDA Clears a Test for Ovarian Cancer
Test can help identify potential malignancies, guide surgical decisions

The U.S. Food and Drug Administration today cleared a test that can help detect ovarian cancer in a pelvic mass that is already known to require surgery. The test, called OVA1, helps patients and health care professionals decide what type of surgery should be done and by whom.

OVA1 identifies some women who will benefit from referral to a gynecological oncologist for their surgery, despite negative results from other clinical and radiographic tests for ovarian cancer. If other test results suggest cancer, referral to an oncologist is appropriate even with a negative OVA1 result.

OVA1 should be used by primary care physicians or gynecologists as an adjunctive test to complement, not replace, other diagnostic and clinical procedures.

OVA1 uses a blood sample to test for levels of five proteins that change due to ovarian cancer. The test combines the five separate results into a single numerical score between 0 and 10 to indicate the likelihood that the pelvic mass is benign or malignant.

OVA1 is intended only for women, 18 years and older, who are already selected for surgery because of their pelvic mass. It is not intended for ovarian cancer screening or for a definitive diagnosis of ovarian cancer. Interpreting the test result requires knowledge of whether the woman is pre- or post-menopausal.

The American College of Obstetricians and Gynecologists and the Society of Gynecologic Oncologists published recommendations in 2002 for the role of generalist obstetrician-gynecologists in the early detection of ovarian cancer, which included a recommendation of patient referral to a gynecological oncologist when specific indicators of malignancy are present.

These recommendations and later reports indicate that patients with ovarian cancer have improved survival when the surgery is performed by gynecologic oncologists as opposed to general gynecologists or surgeons.

“Tests such as OVA1 personalize and improve public health by providing patients and health care providers with more information to support medical decisions that impact survival rates and reduce surgical complications,” said Jeffrey Shuren, M.D., J.D., acting director of the FDA’s Center for Devices and Radiological Health.

The FDA reviewed a study of 516 patients, including 269 evaluated by non-gynecological oncologists, which compared OVA1 results with biopsy results. When combined with pre-surgical information, such as radiography and other laboratory tests, results from the OVA1 tests identified additional patients who might benefit from oncology referral who were not identified using pre-surgical information alone.

OVA1 is developed by Vermillion Inc., headquartered in Fremont, Calif., in conjunction with researchers at The Johns Hopkins University in Baltimore.

FDA NEWS RELEASE
For Immediate Release: Sept. 11, 2009
Media Inquiries: Peper Long, 301-796-4671, mary.long@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA

Click here to read this on the FDA page.

Former residents suing hospitals

There are two recent stories that may be interesting to you if you're going through residency, or if you're recently survived the toils of residency: (these are snippets from the actual stories)

1. Dr. Claudine Nigro is suing Dr. Francis X. Dennehy of Front Royal for breach of contract, defamation and emotional distress, according to papers filed Aug. 3 in U.S. District Court in Harrisonburg. The Appalachian Osteopathic Postgraduate Training Institute, Warren Memorial Hospital, Valley Health System and Virginia Commonwealth University Medical College of Virginia also are named as defendants in the suit. The suit claims that all defendants unlawfully refused to allow Nigro to progress to the residency program's second year. Read about this case here.
   
2. A former surgical resident (Dr. Oscar K. Serrano) is suing the Johns Hopkins Hospital for $24 million, alleging he was unlawfully fired and then defamed after he accused officials of trying to cover up problems with the residency program. Serrano is also suing Dr. Pamela A. Lipsett, director of the general surgery residency program, and Dr. Julie Ann Freischlag, chief of surgery, among other individuals. Serrano’s superiors told their colleagues and other hospitals Serrano was let go because of mental health problems, a charge denied in Serrano’s lawsuit and by his lawyer. Serrano, 30, was in the third year of his eight-year joint general surgery residency and Ph.D. program at Hopkins when he was fired. Read about this case here.
   

I don't know any of the people involved in these cases, but I think it's very unfortunate to see these types of things happening in the medical field. I'll be curious to see how things turn out for all the parties. Perhaps they will end up pursuing non-clinical physician careers. I could probably help them with that.

Health IT Policy Committee Appoints 3

The United States Department of Health and Human Services (HHS) has appointed three people to the Health Information Technology Policy Committee:

1. David Blumenthal, MD, MPP; head of the Office of the National Coordinator for Health Information Technology
   
2. Michael J. Klag, MD, dean of Johns Hopkins Bloomberg School of Public Health
   
3. Deven McGraw, director of the Health Privacy Project at the Center for Democracy and Technology

Exciting news! Let's see what this committee comes up with over the next few months.