Via John Naughton.  My default position is that most personal health related material on the web or via ‘secure’ email is not private, and open to NSA / GCHQ etc.

“The business department, which oversees universities, had expected in 2010 that only 32 per cent of loans would not be repaid; that figure has now risen to 45 per cent, according to the Office for Budget Responsibility.” FT. Predictable. A shambles of a system. Politicians at their worst. [direct link to this post].

This is from the late David Carr, via John Naughton.

I grade based on where you start and where you end. Don’t work on me for a better grade — work on your work and making the work of those around you better. Show industriousness and seriousness and produce surpassing work if you want an exceptional grade.

Personal Standards

Don’t raise your hand in class. This isn’t Montessori, I expect people to speak up when they like, but don’t speak over anyone. Respect the opinions of others.

This is an intense, once-a-week immersion on the waterfront of modern media-making. If you don’t show up for class, you will flounder. If you show up late or unprepared, you will stick out in unpleasant ways. If you aren’t putting effort into your work, I will suggest that you might be more comfortable elsewhere.

If you text or email during class, I will ignore you as you ignore me. It won’t go well.

I expect you to behave as an adult and will treat you like one. I don’t want to parent you — I want to teach you.

Excuses: Don’t make them — they won’t work. Stories are supposed to be on the page, and while a spoken-word performance might explain everything, it will excuse nothing. The assignments for each week are due by start of class without exception unless specific arrangements have made based on an exceptional circumstance.

If you truly have a personal or family emergency, your welfare comes first. But nothing short of that will have any traction with me.

Christopher Bigsby’s advice for entrants to the university business:
“Do not mention contact hours. If asked, say: it depends what you mean by contact. And hours.” THE

 

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How well do animations work? I came across one yesterday on Alfred Wegener, and today there is a very nice one in the NEJM on yaws (remember the old medical school joke: ‘what’s yaws? Thank you, mine is a pint of bitter’. I enjoy them, and feel they stick in my mind more than just looking at some text, but would like to know more. And yes, I have looked at the multimedia textbooks, but I am still uncertain. Or perhaps this is an ill-framed question: there are animations, and animations, just as there are lectures and lectures.  [direct link to this post]

Put that laptop away. Clay Shirky. This will run and run.

No profit left behind. I am afraid I have a visceral dislike of companies such as Pearson (despite reading the Economist and the FT). Ever since I learned that the UK Royal College’s now use Pearson testing centres for their professional exams, I have despaired at the way non-profits and the public sector lack any faith in their own ability to build things, or to realise that openness benefits all who embrace it. Copyrighting curriculums etc. It is obscene— and unnecessary. And, yes, I think the profit motive is not applicable to all human endeavour.

Stealth research, by John P. A. Ioannidis. I like the term, but is it really apposite? Anyway, much innovation has always taken place outside the formal literature. Arguably the biggest change in my clinical discipline in my career has been based on a certain degree of trial and error, and people copying others (in a good way). As Sam Shuster said, serious science takes over from relevance (sometimes, anyway).

Another couple of (here and here) papers on what is facing those who plan a career in biomedical science. I am not convinced by any of the solutions offered. But I do like the LENS format of PNAS papers— a real pleasure to read online.

Chantelle Winnie via the Guardian

There are areas of medical research that are more legitimate than others. Finding genes is OK, as is finding drugs. But other bits of the health enterprise seem immune to rational scrutiny. One area that has bugged me for years is the way hospitals, charities, professional bodies and others plaster images of skin cancer around, on the assumption that this will ‘make things better’. It might, or it might not. So here is a recent paper of ours on this topic. Take away message: if there is a fixed resource envelope, many if not most strategies may make matters worse. The abstract is below. The images will of course remain up — I am not certain the rationale is the obvious one.

Abstract: Using an experimental task in which lay persons were asked to distinguish between 30 images of melanomas and common mimics of melanoma, we compared various training strategies including the ABC(D) method, use of images of both melanomas and mimics of melanoma, and alternative methods of choosing training image exemplars. Based on a sample size of 976 persons, and an online experimental task, we show that all the positive training approaches increased diagnostic sensitivity when compared with no training, but only the simultaneous use of melanoma and benign exemplars, as chosen by experts, increased specificity and diagnostic accuracy. The ABCD method and use of melanoma exemplar images chosen by laypersons decreased specificity in comparison with the control. The method of choosing exemplar images is important. The levels of change in performance are however very modest, with an increase in accuracy between control and best-performing strategy of only 9%.

Authors: Ella Cornell, Karen Robertson, Robert D. McIntosh, Jonathan L. Rees

Full open access paper here.

Our Dermofit library is available for academic researchers. There is  a license, and a nominal fee to cover admin charges. Dermofit was funded by the Wellcome Trust, and we are continuing to commercialise some aspects of this work. The work was led by myself and Prof Bob Fisher in Edinburgh Informatics. Dermofit page here with some publications here (incomplete, as I write).

Henry marsh …will retire from full-time surgery in April at the age of 65 years. “I was going to go on longer, but I had a hissy fit with the hospital management over the dress code recently, and told them that I was not prepared to go on”, he says

 

This is from an interview with Henry Marsh in this week’s Lancet. His book, ‘Do No Harm‘ is, to my mind, the best written account of how medicine once worked, and how the commitment of dedicated staff to their patients (rather than ‘our NHS’) made the NHS what it once was. Sadly, no more. Essential reading for all medical students: the best career advice I can give. If people like him want to get out, we (as in patients) really are stuffed.  [direct link to this page]