VR/AR May Help Physicians Overcome Cognitive Biases To Admitting Errors

MedicalResearch.com Interview with:

Jason Han, MD Resident, Cardiothoracic Surgery Hospital at the University of Pennsylvania

Dr. Han

Jason Han, MD
Resident, Cardiothoracic Surgery
Hospital at the University of Pennsylvania

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The inspiration for this study comes from my personal experience as a medical student on clinical rotations. Despite having been a victim of a medical error while growing up myself, I found it extraordinarily difficult to admit to even some of my smallest errors to my patients and team. Perplexed by the psychological barriers that impeded error disclosure, I began to discuss this subject with my advisory Dean and mentor, Dr. Neha Vapiwala. We wanted to analyze the topic more robustly through an academic lens and researched cognitive biases that must be overcome in order to facilitate effective disclosure of error, and began to think about potential ways to implement these strategies into the medical school curriculum with the help of the director of the Standardized Patient program at the Perelman School of Medicine, Denise LaMarra.

We ultimately contend that any educational strategy that aims to truly address and improve error disclosure must target the cognitive roots of this paradigm. And at this point in time, simulation-based learning seems to be the most direct way to do so, but also remain hopeful that emerging technologies such as virtual and augmented reality may offer ways for students as well as staff to rehearse difficult patient encounters and improve.

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New Technology May Allow Topical Delivery of Anti-VEGF Drugs For Macular Degeneration

MedicalResearch.com Interview with:

Dr Felicity de Cogan PhD</strong> Institute of Inflammation and Ageing University of Birmingham

Dr Felicity de Cogan

Dr Felicity de Cogan PhD
Institute of Inflammation and Ageing
University of Birmingham

MedicalResearch.com: What is the background for this study?

Response: The University of Birmingham has a unique approach to developing technologies. By locating chemists, engineers, biologists and clinicians in the same department it revolutionised the way research problems are solved.

Initially, Felicity de Cogan was researching cell penetrating peptides (CPP) and their uses in microbiology. However, after joining forces with Neuroscientists, Dr Lisa Hill and Professor Ann Logan at the National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC) together with the clinicians and Vision Scientists, Dr Mei Chen and Professor Heping Xu at the Queen’s University Belfast it became evident that there was huge potential to deliver drugs in the eye. This was the start of the project and it developed rapidly from there.

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Virtual Reality Environments Can Advance Psychiatric Treatment and Research

MedicalResearch.com Interview with:

Jessica Maples-Keller Emory University School of Medicine.

Jessica Maples-Keller

Jessica Maples-Keller
Emory University School of Medicine.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:  This manuscript is a review of the use of Virtual Reality (VR) technology within psychiatric treatment. VR refers to an advanced technological communication interface in which the user is actively participated in a computer generated 3-d virtual world that includes sensory input devices used to simulate real-world interactive experiences. VR is a powerful tool for the psychiatric community, as it allows providers to create computer-generated environments in a controlled setting, which can be used to create a sense of presence and immersion in the feared environment for individuals suffering from anxiety disorders.
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Do Our Genes Influence Our Attraction to Social Media?

MedicalResearch.com Interview with:

Chance York, Ph.D. Assistant Professor of Mass Communication Kent State University

Dr. Chance York

Chance York, Ph.D.
Assistant Professor of Mass Communication
Kent State University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This research used twin study survey data from the Midlife in the United States (MIDUS) to investigate the relative influence of genetics and environment on social media use.

While the research cannot directly examine the gene-level influence on social media behavior, I was able to leverage known levels of genetic relatedness between identical and fraternal twins to suss out how much genetic traits and environmental factors impact frequency of using social media.

The results showed that between one- and two-thirds of variance in social media use is explained by genes, while environmental factors (parental socialization, peers, work, school, individual characteristics, etc.) explained the rest. In other words, this very specific communication behavior—social media use—is partially guided by our genetic makeup.

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Using Virtual Reality To Teach Medical Student Empathetic Communication Skills

MedicalResearch.com Interview with:
Frederick W. Kron, MD

President and Founder of Medical Cyberworlds, Inc
Department of Family Medicine,Ann Arbor, MI and
Michael D. Fetters, M.D., M.P.H., M.A.
Professor of Family Medicine
University of Michigan

MedicalResearch.com: What is the background for this technology and study?

Dr. Kron: Communication is the most important component of the doctor-patient relationship. I know that through research, but also through personal experience. As a cancer survivor, I’ve seen first-hand the difference that outstanding communication skill can make to a vulnerable patient.

At the beginning of the project, we asked medical educators about the challenges they had in assessing and training communication competency. They told us that technical skills are easy to teach and assess, but communication skills are mainly behavioral skills that involve verbal and nonverbal behaviors, facial expressions, and many other cues that pass between patient and provider. That’s hard to teach and assess. Activities like role play with standardized patients (SPs) have been widely used, but it’s impossible for SPs to accurately portray these behaviors, or for faculty to fully assess the nuanced behaviors of both learner and patient. Supporting this idea is a lack of evidence proving that SP encounters translate in behavioral changes or transfer into clinical settings.

Developments in virtual reality provided us with a great opportunity for assessing and teaching of communication behaviors. Working with a national group of experts, we created computer-based Virtual Humans that interact with learners using the full range of behaviors you’d expect from two people talking together. They are so behaviorally realistic and compelling, that they trigger emotional responses in learners, and make learners want to learn so they can do their best.

Dr. Fetters: Our team has particular interest in doctor-patient communication in the context of cancer. There are many critical aspects of cancer communication: breaking the bad news to the patient, negotiating sometimes conflicting family opinions about treatment, and communication among team members about the patient’s care, just to name a few. We’ve begun building out those scenarios in the technological platform we developed, Mpathic-VR.

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Noninvasive Patch Test Can Improve Clinical Diagnosis of Melanoma

MedicalResearch.com Interview with:

Laura Korb Ferris, MD, PhD</strong> Associate Professor, University of Pittsburgh Clinical and Translational Science Institute Director of Clinical Trials, Department of Dermatology University of Pittsburgh Medical Center

Dr. Laura K. Ferris

Laura Korb Ferris, MD, PhD
Associate Professor, University of Pittsburgh Clinical and Translational Science Institute
Director of Clinical Trials
Department of Dermatology
University of Pittsburgh Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We found that a non-invasive adhesive patch applied to the skin over a pigmented skin lesion allowed us to capture enough genetic material from the lesion to analyze and predict if that lesion is likely to be melanoma, meaning a biopsy is warranted, or if it is likely benign, meaning the patient would not need a skin biopsy.

In this study, we asked dermatologists to use their clinical judgement to decide if they would recommend biopsying a skin lesion based on photos and information about the lesion and the patients, such as the patient’s age, personal and family history of skin cancer, and if the lesion was new or changing. We then provided them the read out of the gene test and asked them how this influence their decision. We found that with this test result, dermatologists were more accurate in their decision making, meaning they were more likely to recommend biopsy of melanomas and less likely to biopsy harmless moles than they were without the test. This is important as it means this test has the potential to reduce the number of unnecessary skin biopsies performed, saving patients from undergoing a procedure and having a scar as a result, without increasing the risk of missing a melanoma.

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Human Stem Cells Can Be Used For 3-D Printing of Tissue Stuctures

MedicalResearch.com Interview with:

Sang Jin Lee, Ph.D. Associate Professor of Wake Forest Institute for Regenerative Medicine Wake Forest School of Medicine Wake Forest University

Dr. Sang Jin Lee

Sang Jin Lee, Ph.D.
Associate Professor of Wake Forest Institute for Regenerative Medicine
Wake Forest School of Medicine
Wake Forest University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: I received my Ph.D. in Chemical Engineering at Hanyang University, Seoul, South Korea in 2003 and took a postdoctoral fellowship in the Laboratories for Tissue Engineering and Cellular Therapeutics at Harvard Medical School and Children’s Hospital Boston and the Wake Forest Institute for Regenerative Medicine where I am currently a faculty member. My research works have focused on development of smart biomaterial systems that support the regenerative medicine strategies and approaches. These biomaterial systems combined with drug/protein delivery system, nano/micro-scaled topographical feature, or hybrid materials that could actively participate in functional tissue regeneration. Recently my research works utilize 3D bioprinting strategy to manufacture complex, multi-cellular living tissue constructs that mimic the structure of native tissues. This can be accomplished by optimizing the formulation of biomaterials to serve as the scaffolding for 3D bioprinting, and by providing the biological environment needed for the successful delivery of cells and biomaterials to discrete locations within the 3D structure.

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AI Can Be Embedded With Universally Accepted Human Biases

MedicalResearch.com Interview with:

Aylin Caliskan PhD Center for Information Technology Policy Princeton University, Princeton, NJ

Dr. Caliskan

Aylin Caliskan PhD
Center for Information Technology Policy
Princeton University, Princeton, NJ

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Researchers have been suggesting that artificial intelligence (AI) learns stereotypes, contrary to the common belief that AI is neutral and objective. We present the first systematic study that quantifies cultural bias embedded in AI models, namely word embeddings.

Word embeddings are dictionaries for machines to understand language where each word in a language is represented by a 300 dimensional numeric vector. The geometric relations of words in this 300 dimensional space make it possible to reason about the semantics and grammatical properties of words. Word embeddings represent the semantic space by analyzing the co-occurrences and frequencies of words from billions of sentences collected from the Web. By investigating the associations of words in this semantic space, we are able to quantify how language reflects cultural bias and also facts about the world.

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Sonoillumination May Expand Skin Types That Can Be Treated With Laser Therapy

MedicalResearch.com Interview with:

Paul J.D. Whiteside, doctoral candidate and Dr. Heather Hunt, assistant professor of bioengineering University of Missouri

Dr. Heather Hunt and Paul Whiteside

Paul J.D. Whiteside, doctoral candidate and
Dr. Heather Hunt, assistant professor of bioengineering
University of Missouri

MedicalResearch.com: What is the background for this technology? What are the barriers to the use of conventional laser treatment of tattoos?

Response: Traditional laser treatments rely on the concept of selective photothermolysis (laser-induced heating) to specifically target certain structures for treatment, while leaving other parts of the skin unaffected. The problem with traditional laser treatments is that the laser needs to transmit through the epidermis, which acts as a barrier to laser transmission both due to its reflective properties and because it is filled with light-absorbing melanin, the pigment that gives our skin its color. Sonoillumination acts to change the properties of the epidermis temporarily using painless ultrasound technology, thereby allowing more laser light to penetrate deeper into the skin to impact desired targets, such as hair follicles, tattoos, and blood vessels. Funding for clinical trials is currently being sought to provide evidence for what we surmise may be benefits of this technology relative to traditional laser treatments. These benefits may include being able to treat darker-skinned people more effectively, being able to provide laser therapy with less risk of scarring or pigment changes, and being able to do treatments with less discomfort, fewer treatments, and lower laser energy settings.

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One Drop | Mobile APP Leads To Improved A1c in Diabetes

MedicalResearch.com Interview with:
Chandra Y. Osborn, PhD, MPH
VP, Health & Behavioral Informatics
One Drop
Informed Data Systems, Inc.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are over 1,500 mobile apps for people with diabetes, but minimal evidence on their benefit. The One Drop | Mobile app launched in April 2015. Users manually and automatically track their blood glucose and self-care activities via One Drop’s | Chrome glucose meter, other Bluetooth-enabled meters, CGMs or other health apps. Users leverage One Drop’s food library, medication scheduler, automatic activity tracking, educational content, recipes, health tips, user polls, and peer support (‘likes’, stickers, and data sharing), and can set blood glucose, medication, carbohydrate intake, and activity goals, receive data-driven insights to draw connections between their behaviors, goals, and blood glucose readings. They can also self-report and track their hemoglobin A1c (A1c) and weight.

In July 2016, we queried data on ~50,000 people using One Drop | Mobile. In March 2017, we queried data on >160,000 users. Only users who had entered an A1c value when they started using the app, and entered a second A1c at least 60 days apart, but no more than 365 days apart, were included. In July 2016, people with diabetes using One Drop | Mobile reported a nearly 0.7% reduction in A1c during 2-12 months of using One Drop. In March 2017, users reported a 1.0% reduction in A1c for the same timeframe. A more recent diabetes diagnosis and using One Drop to track self-care activities was associated with more A1c improvement.

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Diabetic Retinopathy: OCTA May Improve Staging, Diagnosis and Monitoring

MedicalResearch.com Interview with:

José Cunha-Vaz, M.D., Ph.D. Emeritus Professor of Ophthalmology University of Coimbra, Portugal President of AIBILI Association for Innovation and Biomedical Research on Light and Image Editor-in-Chief of Ophthalmic Research Coordinator, Diabetic Retinopathy and Retinal Vascular Diseases, European Vision Institute Clinical Research Network (EVICR.net)

Dr. Cunha-Vaz

José Cunha-Vaz, M.D., Ph.D.
Emeritus Professor of Ophthalmology
University of Coimbra, Portugal
President of AIBILI
Association for Innovation and Biomedical Research on Light and Image
Editor-in-Chief of Ophthalmic Research
Coordinator, Diabetic Retinopathy and Retinal Vascular Diseases,
European Vision Institute Clinical Research Network (EVICR.net) 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this study, we evaluated the clinical utility of quantitative measures of microvasculature in optical coherence tomographic angiography (OCTA). Although several studies have demonstrated the potential value of measures of microvasculature in the management of diabetic retinopathy (DR), our study uses the ROC curve to compare the overall value of different approaches. In this age matched population with a range of disease, the mean vessel density measured in the SRL had the highest AUC, indicating that it is best among the methods tested at differentiating normal eyes from eyes with diabetic retinopathy.

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Virtual Realty Clarifies Location of Empathy in the Brain

MedicalResearch.com Interview with:
Indrajeet Patil PhD

former PhD student at SISSA, Trieste and
currently a postdoctoral researcher at Harvard University

MedicalResearch.com: What is the background for this study?

Response: Human societies are built on mutually beneficial cooperation, which relies on our prosocial and altruistic impulses to help each other out. Psychologists have been trying to understand the psychological basis of altruistic behavior for a while now, but studying costly altruism – a kind of helping behavior in which the altruist pays a heavy price to help others – has been difficult to study in lab settings given the ethical problems associated with creating any paradigm where participants stand to get hurt. Thus, the question is how do you study the motivation behind acts that involve a very high risk of physical injury to the self while helping others? Such situations are common in emergency contexts where people can be faced with the choice of either saving their own life or risking it to save someone else’s life.

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