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Media, Medical Education, Medicine and Society, Research, Stanford News

Anthropologist discusses Wikipedia’s implications for health information

Anthropologist discusses Wikipedia's implications for health information

pid_24010Many of us turn to Wikipedia for quick answers to medical questions: What’s an amniocentesis, or what’s the difference between autism and Asperger’s?

Stanford University Press recently published Common Knowledge: An Ethnography of Wikipedia by anthropologist Dariusz Jemielniak, PhD, who studies managerial culture and has long been active in the Wikipedia community. As a fellow anthropologist, I was curious about his perspective and I wondered how medical knowledge is different in the age of Wikipedia.

When I interviewed the personable Jemielniak, he offered some insightful answers to my questions:

How empowering is it for people to have knowledge at their fingertips, on the internet? How is this different from finding information in reference books?

The basic difference is that on Wikipedia it’s usually put in lay terms. It’s readable, it’s comprehensible… With information, people have the perception that they know something about their condition. I’m not sure if they’re right – obviously, knowledge is not just one tidbit of information. On Wikipedia you can’t learn the relations between all kinds of knowledge – you need to have a medical degree to really understand that – but patients feel they are operating in a situation of informational deficit… Information on Wikipedia probably makes people have this feeling of empowerment, though I’m not really certain whether in all cases this contributes to their overall health. Sometimes they’ll misunderstand, misconstrue, or misinterpret because they don’t have the systematic knowledge.

In your ethnography, you discuss how the decentralized power in Wikipedia’s management changes the knowledge structure away from institutions and certified expertise. Without an authority structure, how do you determine who’s an expert?

On Wikipedia, the point is you don’t have to know if someone is an expert… Trust is transferred from formal expertise to procedure. If you follow procedure to the letter, by default you’re producing proper knowledge. If you use correct sources, if you cite all the sources that you found, if you’re doing justice to whatever you read, by default on Wikipedia it’s assumed that you’re just as good as an expert.

What about biases? In the book you say biases usually get toned down through copious editing.

I think on Wikipedia there’s a strong scientific bias of a sort. If a community of people are contradicting what is considered to be the scientific knowledge, quite likely those activist groups will be ignored. If there is consensus in the academic world, this is what will prevail in Wikipedia.

You say Wikipedia is never “published” but in an ongoing process of creation. Is this better for updates about new research?

By all means, I think obviously. Thirty seconds after the new pope was elected this new information was on Wikipedia. On Britannica you’d probably have to wait one year. Traditional media takes a year to go through the publishing process. The continuous release mode that Wikipedia operates on allows for instantaneous improvements and corrections, which is wonderful, it’s really great.

The pope is one thing, but research? How often are pages on research updated?

One of the problems is that research on Wikipedia is accurate at time of writing the article, but gets obsolete if people do not update. Articles that are most updated are ones people care most about… The real question is how many people actually read the incorrect information? Chances are, if there’s a big proportion of people who care about a topic… the more likely it is to be updated.

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Addiction, Behavioral Science, Ethics, Events, In the News, Media

At Stanford visit, Glenn Beck addresses compassion, change and humility

At Stanford visit, Glenn Beck addresses compassion, change and humility

glennUntil this week, I wouldn’t have associated radio personality Glenn Beck with compassion. And when Jim Doty, MD, director of Stanford Medicine’s  Center for Compassion and Altruism Research and Education invited Beck to the Stanford campus, he realized the right-of-center author and provocateur might be a tough sell to his audience accustomed to guests such as the Dalai Lama and Sri Sri Ravi Shankar.

“Please trust me,” Doty tweeted last week.

Yet fireworks were absent from the nearly two-hour conversation, which ranged from Beck’s struggle with addiction to his Mormon faith and his passion for radio.

Beck came across as human, a man who had endured struggles, made mistakes and is striving to learn from them. He is a father and husband, who organizes charity efforts and volunteers in his church. He said he’s gone from a person for whom the audience size was just a measure of his success to a man who cares deeply about people and his audience members. He prays for humility and said he is not trying to be divisive.

“I spend a lot of time, at the end of my day, saying, ‘Okay, am I that guy? What could I have done better,'” Beck said. “You self-examine all the time and with that self-examination you grow. It’s good. I know who I am because I’m pushed up against the wall all the time.”

Americans share a certain set of principles in common, Beck said. The rift begins when people replace their principles with specific interests and policies.

“For example, if I said to you, ‘Do we torture?’,” Beck said. Nearly everyone would say no. But once threats from terrorists are introduced, the conversation becomes more divided.

“The left and the right have principles in common. We may disagree on interests, but we have to start anchoring ourselves in the principles.”

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Aging, Chronic Disease, In the News, Media, Neuroscience, Women's Health

Science Friday explores women’s heightened risk for Alzheimer’s

Science Friday explores women's heightened risk for Alzheimer's

More than two-thirds of the Americans living with Alzheimer’s are women — some like the character Alice in the movie “Still Alice,” who suffers from an early onset form of the disease.

Science Friday tackled that topic Friday, with guests Michael Greicius, MD, MPH, associate professor of neurology and director of the Stanford Center for Memory Disorders, and Roberta Diaz Brinton, PhD, professor of pharmacology at the University of Southern California. The two quickly disputed the belief that more women get Alzheimer’s disease because they live longer.

“The way women age puts them at risk,” Brinton said. As they transition through menopause, some women develop cognitive symptoms such as insomnia, depression and short-term memory loss, leaving them at greater risk for Alzheimer’s, she explained.

Women who have a form of a gene called APOE-e4 are particularly at risk, although it doesn’t seem to affect men, Greicius said. The gene interacts with estrogen.

Scientists are continuing to decipher the link between estrogen and Alzheimer’s and the possibility of hormone therapies, as well as the connection — if any — between pregnancy and Alzheimer’s risk, the scientists told listeners.

The 18-minute segment is available here.

Previously: Blocking a receptor on brain’s immune cells counters Alzheimer’s in mice, The state of Alzheimer’s research: A conversation with Stanford neurologist Michael Greicius, Having a copy of ApoE4 gene variant doubles Alzheimer’s risk for women but not for men and The toll of Alzheimer’s on caretakers

Global Health, Media, Patient Care, Pediatrics, Research, Technology, Videos

OPENPediatrics offers opportunity to help physicians, and sick children, worldwide

OPENPediatrics offers opportunity to help physicians, and sick children, worldwide

6948764580_97d353e8d4_zAs chief of critical care at Boston Children’s Hospital, Jeffrey Burns, MD, MPH, was asked to consult on the case of a young girl who fell ill while vacationing with her family in Guatemala. He had treated a similar case in the U.S. before, but he encountered unexpected technological hurdles.

That spurred Burns — working with many partners, including IBM — to create OPENPediatrics.org, a platform that allows physicians to share skills and resources to treat sick children. Burns described his hopes for the site in a 2014 article in Medtech Boston:

Our goal was to create something called a community of practice where instead of being broad and thin like a MOOC (Massive Open Online Classes), we would be narrow and much more deep, and the content would actually be peer reviewed by doctors and nurses who care for critically ill children, because those are essentially our primary users,” Burns says.

The site, which launched last year, offers forums for health-care workers worldwide to share experiences and a multimedia library with videos and animations — including some interactive features — on everything from nasopharyngeal suctioning to Faciltating Parent Presence During Invasive Procedures.

Burns and his team have been thinking how to leverage the platform to support research.

(A confession: I learned about OPENPediatrics through an article in Wesleyan magazine. Stanford’s Cardinal brethren on the East Coast, Wes, like Stanford fosters interdisciplinary projects and, I’m proud to say, is the alma mater of two of us in the medical school’s relatively small Office of Communication.)

Previously: Stanford undergrad works to redistribute unused medications and reduce health-care costs, Stanford Medicine X: From an “annual meeting to a global movement”  and Euan Ashley discusses harnessing big data to drive innovation for a healthier world
Photo by Intel Free Press

Health Costs, Health Policy, In the News, Media, Medicine and Society, NIH

#ACT4NIH campaign seeks stories to spur research investment

#ACT4NIH campaign seeks stories to spur research investment

ACT4NIH_Samples_FINAL

No ice buckets are involved in the latest push for investment in medical research. Instead Act for NIH: Advancing Cures Today, a Washington D.C.-based non-profit led by a former National Institutes of Health staffer, is a good ‘ol fashioned media campaign using data, stories and images, including a haunting photo of a presumably sick child captaining its home page.

The need is real. NIH funding has failed to keep pace with inflation or with investments by other nations including China. Now, only one in six research proposals, the lowest ever, are accepted, according to Act for NIH.

The campaign’s goal is simple: “We advocate an immediate, significant funding increase for the NIH, followed by steady, predictable budget growth in the future.”

Not so simple, of course, is the actual funding hike. That’s why the campaign is hunting for stories, as well as money. It urges supporters to photograph themselves besides a ACT for fill-in-the-blank poster. ACT for cancer, for hope, my grandfather, for AIDS – you name the reason to support research, action (and money) is needed.

Science released an interview with leader Patrick White today. White admitted the group lacks a formal plan, but it does have momentum, thanks to the backing by real estate developers Jed Manocherian.

It’s launch comes just in time for the 2015-16 federal budget cycle, which usually begins with the president’s budget proposal in February.

Becky Bach is a former park ranger who now spends her time writing about science and practicing yoga. She’s an intern with the Office of Communications and Public Affairs. 

Previously: How can health-care providers better leverage social media to improve patient care?, NIH network designed to diagnose, develop possible treatments for rare, unidentified diseases and Federal investments in research and higher education key to U.S. maintaining innovation edge
Photo by Act for NIH

Media, Podcasts, Surgery

CNN's Sanjay Gupta, MD: journalist, surgeon, advocate

CNN's Sanjay Gupta, MD: journalist, surgeon, advocate

Gupta - smallWhen the history about medical marijuana’s path to legitimacy is written, CNN’s chief medical reporter Sanjay Gupta, MD, may be more than a footnote. Gupta famously authored a 2009 TIME magazine column decrying efforts to legalize marijuana for medicinal purposes. In a 180-degree turnabout in August 2013, he issued an apology and said he was wrong. He wrote that he didn’t look hard enough at the “remarkable research” indicating that for some illnesses marijuana provided a relief. He told me in this 1:2:1 podcast that while he’s cautious about the impact of marijuana on some brain and psychiatric disorders, he feels that the evidence is clear for certain diseases like epilepsy, neuropathic pain and muscle spasms brought on by MS that cannabis has the power to heal.

I wanted to talk to Gupta for this special issue of Stanford Medicine on surgery not only because of his controversial yea-and-nay positions about weed as medicine but because he’s also a neurosurgeon who still spends time with patients in and out of the OR  between covering health crises around the globe. And in recognition of his clinical and advocacy skills, he was also personally asked by President Obama to consider taking the position of U.S. Surgeon General. (He turned down the offer as the timing just wasn’t right for him.)

And what about this new campaign to Just Say Hello that he launched on Oprah.com? He tells me that if we were a friendlier society – neighbor greeting neighbor –  perhaps we could heal some of the loneliness out there and become a more civilized society.

I asked Gupta, since he travels internationally, whether there’s one universal truth that he finds all human beings seek. “Most everyone wants to do good by their bodies, understand health and how they can improve the health of their family members. I think that the desire for good health and desire for improved function is a universal thing,” he told me. And in his storytelling, what impact does he want to make with the viewer?  What does he want the audience to understand about the world as seen through his eyes?  He said:

If I can explain to them that as the bombs came raining down the same family that was driving their kids to school the day before, grocery shopping after that, stopping at a bank to withdraw some money, that they are now fleeing with whatever few possessions they could garner and run for the border… that they are a lot like families in your own neighborhood… That’s really important to me as a reporter.

Previously: Stanford Medicine magazine opens up the world of surgery and The vanishing U.S. surgeon general: A conversation with AP reporter Mike Stobbe
Illustration by Tina Berning

Big data, Media, Stanford News

Stanford's Big Data in Biomedicine chronicled in tweets, photos and videos

Stanford's Big Data in Biomedicine chronicled in tweets, photos and videos

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At this year’s Big Data in Biomedicine conference, a crowd of close to 500 people gathered at Stanford to discuss how advances in computational processing power and interconnectedness are changing medical research and the practice of medicine. Another 1,000 virtual attendees joined in the discussion via the live webcast, and several hundred participated in the conversation on social media.

We’ve captured a selection of the tweets, photos, videos and blog posts about the conference on the School of Medicine’s Storify page. On the page, you’ll find an interview with Philip Bourne, PhD, associate director for data science at the National Institutes of Health, talking about on the importance of “data to the biomedicine enterprise,” news stories on how big data holds the potential to improve everything from drug development to personalized medicine, and official conference photos and twitpics from attendees. You’ll also find a conference group photo and recap of the event written by my colleague Bruce Goldman.

For those of you missed the event, and for those who want to participate again, our next Big Data in Biomedicine conference has been scheduled for May 20-22, 2015.

Previously: Videos of Big Data in Biomedicine keynotes and panel discussions now available online, Rising to the challenge of harnessing big data to benefit patients and Discussing access and transparency of big data in government
Photo by Saul Bromberger

Health Policy, Media, Public Health, Research, Technology

Lack of adoption of social media among health-policy researchers = missed opportunity

Lack of adoption of social media among health-policy researchers = missed opportunity

Despite the opportunity for connecting directly with the public and policy makers, health-policy researchers have yet to rapidly adopt social media-tools in communicating news about their work, according to a study recently published in Health Affairs.

The survey of more than 200 health and health-policy researchers (primarily MDs and PhDs) found that 14 percent of participants reported using Twitter and an estimated 21 percent used blogs or Facebook in the past year to discuss their findings. However, 65 percent of individuals utilized press releases, media interviews or other traditional media channels. Lead author David Grande, MD, MPA, said in a release that the low adoption of social media among these experts “could be a significant missed opportunity to expose a larger audience to important health news and findings.”

Grande and colleagues identified four factors preventing researchers from participating in social media: the belief that the culture of social media is frequently at odds with that of research, perceived professional risk, low confidence in ability to use social media, and uncertainties about how effective the tools are at disseminating research. Educating researchers about how to use social media and best practices could alleviate these concerns and increase adoption, said the authors. They concluded:

Public investments in research on health and health care are substantial. It is essential to maximize the returns on those investments by making research a key component of the process of developing, implementing, and refining health policies. Historically, the communication gap between researchers and policy makers has been large. Social media are a new and relatively untested tool, but they have the potential to create new communication channels between researchers and policy makers that can help narrow that gap. Determining how health researchers can best use and adapt this new technology to communicate evidence to policy makers should be a priority for universities, research funders, and scientists.

Previously: More reasons for doctors and researchers to take the social-media plunge, A reminder to young physicians that when it comes to social media, “it’s no longer about you”, How using Twitter can benefit researchers and How can physicians manage their online persona? KevinMD offers guidance
Via PsychCentral

Media, Medicine and Literature, Technology

More reasons for doctors and researchers to take the social-media plunge

More reasons for doctors and researchers to take the social-media plunge

I’ve come across so many helpful and insightful articles on medical and science professionals’ use of social media lately that I’m compelled to share a few. Last week on Wing of Zock, Cynthia Floyd Manley, associate director of public affairs and marketing at Vanderbilt University, shared nuggets from a recent conference on digital professionalism and reminded readers why maintaining a digital presence is so important for doctors. (She quoted Bryan Vartabedian, MD: “Physicians have two choices, really. They can participate in the discussion that is happening online and frame the story, or they can let someone else frame the story for them.”)

Earlier in the month, the PLOS blog Mind The Brain published a Q&A with a young scientist who uses Twitter to connect with other researchers and learn more about what’s happening in her field. She provided concrete tips for those scientists who want to dip their toes in the Twitter waters and also shared how the platform connects her with other academics:

I feel that with Twitter, my academic world expanded to include many colleagues I wouldn’t otherwise meet. I am now able to keep my finger on the academic pulse better. The information shared on Twitter is so much more current than you would find on journals or conferences. For instance, academics I follow post their latest articles on Twitter that would otherwise probably take me months to learn about. I can then ask questions of the authors themselves and chat with them. I think we all love to talk about our work!

And just today, MedCrunch featured a piece singing the praises of Twitter (which prolific blogger and social-media expert Kevin Pho, MD, calls here “the most powerful application for listening and for keeping informed about what’s happening in the science and medical communities”) and encouraging physicians to – at a minimum – create and maintain professional profiles on LinkedIn. As Susan Williams writes in her post, “defining your reputation by illustrating your credentials and your authority in your field affects two of the most important patient-doctor relationship traits: respect and trust.”

Previously: How should doctors respond to negative reviews?, A reminder to young physicians that when it comes to social media, “it’s no longer about you”, How using Twitter can benefit researchers, Advice for physicians when interacting with patients online and How can physicians manage their online persona? KevinMD offers guidance

Health and Fitness, Media, Parenting, Pediatrics, Research

Depictions of obesity in children's movies

Depictions of obesity in children's movies

As winter break approaches for schoolchildren, movie-watching in theaters or snuggled together on the couch may be on the family calendar. But while ratings alert parents to violent or otherwise “adult” content, some more hidden messages within a movie could have an impact on a child’s well-being.

A new study from the University of North Carolina at Chapel Hill focused on messages about healthy eating and obesity in films. Researchers looked at 20 of the most popular children’s movies released in the U.S. between 2006 and 2010 and found that a good number featured characters that overeat and under-exercise and/or stigmatization of overweight and obesity.

As described in a release:

Segments from each movie were assessed for the prevalence of key nutrition and physical behaviors corresponding to the American Academy of Pediatrics’ obesity prevention recommendations for families, prevalence of weight stigma, assessment of the segment as healthy, unhealthy or neutral, and free-text interpretations.

With regard to eating behaviors, the researchers found that 26 percent of the movie segments with food depicted exaggerated portion size, 51 percent depicted unhealthy snacks and 19 percent depicted sugar-sweetened beverages.

With regard to depiction of behaviors, 40 percent of movies showed characters watching television, 35 percent showed characters using a computer and 20 percent showed characters playing video games.

The authors conclude that these movies “present a mixed message to children: promoting unhealthy behaviors while stigmatizing the behaviors’ possible effects.” The study (registration or purchase required) appears in the journal Obesity.

Previously: Sugar intake, diabetes and kids: Q&A with a pediatric obesity expertTalking to kids about junk food ads and Health experts to Nickelodeon: Please stop promoting unhealthy food to our kids

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