Category: e-Vets & iPets

Stories with a focus on Veterinary Medicine & e-learning

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Self-diagnosis: v.2.0 (beta)

selfdiagnoseLast week, an 18-year old girl was reported to have diagnosed her own disease in science class at school [cnn.com]. Apparently doctors had missed the granuloma characteristic of Chron’s disease [wikipedia.org] on slides of her intestinal tissue, but the girl had later requested the slides and found the signs of inflammation herself after several years of suffering from the undiagnosed illness. Of course, self-diagnosis is not recommended for serious issues and educated doctors are always needed (even if they are sometimes wrong), but it is already probably clear to most that the age of internet has given people a lot of information (and disinformation) about medicine as well, something I’m sure the professional practicers of medicine probably have noted when their patients come in and start throwing out probable diagnoses and treatments to their illness straight out of Wikipedia.

We ourselves are the persons most concerned for our own welfare and the typical doctor in Finland has too little time for each patient [terveysportti.fi]), so there might be something that people could do themselves that could help the professionals before coming to the appointment, or afterwards if the medical condition is hard to diagnose. Of course, doctors should always call the shots since wrong diagnoses can sometimes be worse than the actual illness so it’s better to have a real doctor to blame it on if that happens! 😉 One thing that would make life easier for the patient would be if all the accumulated lab tests, x-rays etc. over the years would exist in some database that the patient him-/herself could access to better (and watch results detoriate as one gets older, ha). Something like a medical version of Nintendo’s excercise game Wii Fit [wikipedia.org].

Web tools & gene testing kits

The world of self-diagnosis is evolving on at least two fronts: diagnostics websites (sort of an evolution of the family doctor books) and the latest craze, genetic self testing kits which are more about finding about probabilities that you might get some inherited disease if you carry certain alleles in your genetic luggage.

A popular self-diagnosis help site is My electronic MD: http://www.myelectronicmd.com/

Interestingly, a Slashdot user noticed that making a query using this tool with the symptoms the 18-year old experienced (female, chronic diarrhea, fever) brings up Chron’s disease in the top 3 candidates for the diagnosis.

And let’s not forget owners of pets, there are a few similar services for veterinary medicine also (meant for vets, but pet owners could start using them as well – hopefully not too confidently):

Consultant (University of Cornell): http://www.vet.cornell.edu/consultant/Consult.asp
5-minute Veterinary Consult: https://app.vetconnect.com/5min/toc/000.htm

myemdThen there are the genetic self testing kits which bring a new dimension to a lot of things –  here’s a story on MIT’s Technology Review about the rise of these gene kits which were recently demonstrated on the first annual consumer genetics show in Boston. Imagine knowing that you carry a gene for some disesase that could with some probability shorten your life span. And imagine what your employer or insurance company could do with that information. Well, we’ll see if these kits will spread to Europe and if the whole thing is a fad or not… but if the price is right, who wouldn’t check out what his/her genome would tell about life to come – just like checking this week’s horoscope. Ask the stars, ask the amino acids…

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IT-Medi seminar 2009

Here are some notes from the annual IT-Medi seminar at Meilahti campus, organized by TUKE – the Research & Development Unit for Medical Education at the Faculty of Medicine. The seminar highlights cases where ICT is used in medical education, so of course it’s very close to the field of veterinary medicine as well and therefore highly interesting 😉

Marja and her tag cloud

Virtual skin care

Docent  Anita Remitz (HUS) presented dermatological patient cases she had worked on for the virtual patient case simulator, a slightly game-like self-testing tool that the Faculty of Medicine has built. Cases are usually presented as “Case of the month” -scenarios. In such a scenario, one dermatology case (a fairly easy one) had gotten the right diagnosis from 58% of students in general, and those who had taken the  course already had 88% right so apparently education gets under your skin! Oh, and another case contained a photo of late syphilis infection, so now I’ll know how that looks, very helpful!

Of course this is no replacement for real-life practice, but it gives the students more practice than they could get otherwise, as well as getting to see more (rare) types of cases than they would see during the hands-on training period. The virtual patient simulator also helps in educating students in making cost-effective treatments, as more inexperienced students often take a lot of unnecessary tests in order to find the correct diagnosis, but with this tool they can see the actual costs of their treatment and compare it with other students results.

The use of ICT at the Faculty of Medicine

One of the students (a first year student) was there to give  the student point-of-view of how ICT is currently used at the faculty. The lowdown: e-mail is used for all communication and therefore encumbered whereas other ways of getting information (like the intranet Alma) aren’t really working because the correct info is hard to find.  At least the course material repository DiKK (Digitaalinen kurssikirjasto) is well thought of; all the course materials students need seem to come here on time and are easily found when you know that everything is in one place.  No need to “DiKK” around!

My delightful colleagues from the ICT support network, Marja Silenti (ICT planner) and Päivi Heino (National Library of Health Sciences -Terkko) presented a couple of surveys done on the ICT use of both students (http://www.med.helsinki.fi/tuke/tiedostot/raportit/ok_08.pdf) and personnel (http://www.med.helsinki.fi/tuke/tiedostot/raportit/opk_08.pdf) at the faculty. Unfortunately not a lot of personnel participated in the survey whereas the students had been much more active. For the personnel, it seemed that despite all the support available  it was the lack of personal time required to learn new ICT tools that was the biggest obstacle to try out new educational tools.

Marja also gave a quick presentation on the different ICT tools currently offered at the university, and had chosen the tools presented based on the tag cloud in her blog – a nice touch, which worked well (see picture above)!

These teeth are okay, those kids’ bones aren’t

Antti Kämppi, dentist and teacher presented the latest version of the Clinipoint-system (now called something else) he had been involved in designing and which won the “Learning technology” award in 2008 [ok.helsinki.fi]. It is basically a system using RFID-tags [wikipedia.org] to authenticate teachers so they can electronically approve and sign student achievements – apparently a cumbersome process during the dentist training stage requiring lots of handwriting otherwise – a few thousand signatures per student, in fact. I suppose any automation of monotone administrative tasks is always welcome.

Interestingly enough there seemed to be quite a lot of initial resistance amongst teachers when introducing the system. The development process also seemed to depend a lot on Mr. Kämppis personal contacts, otherwise it could have been a much more costly project than it was now. Getting cheap but good quality custom software is always a challenge.

The busy & cheerful doctor Mikko Mattila (HUC) presented his Moodle quiz on Pediatric Orthopaedics, a field that apparently students’ didn’t get that much time to spend with (approx. 3 weeks in total). We got to do one of the  multiple choice quizzes collaboratively. Surprisingly enough it seemed that the relatively small x-ray pictures the quiz was based on provided sufficient information to work with –  analyzing x-ray pictures is something I’ve always considered next to impossible even with large screens. The quiz certainly wasn’t easy – the questions drilled us on how fractures should be treated and how successful the surgery had been. Designing good questions is of course the biggest challenge, as the participants in this course had varying proficiency levels (lots of students from other medical districts).  And, apparently the way of giving automatic feedback from the quiz wasn’t one of Moodle’s strengths, so there always seems to be compromises to be made with the tools these learning environments offer.

Links:

TUKE (Research & Development Unit for Medical Education)
http://www.med.helsinki.fi/tuke/

Virtual patient case simulator
http://www.med.helsinki.fi/tuke/palvelut/vpp.htm

Digitaalinen kurssikirjasto (DiKK)
http://oma.terkko.helsinki.fi:8080/~dikk