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Full list of Publications
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Biomedical Informatics
100 BIOMEDICAL FACTOIDS
This page contains 100 factoids from the field of
biomedicine. There are about 180 additional pages in this
series.
This page has no value as a treatment guide or as a diagnostic
guide. It is merely a collection of interesting pieces of
information collected over the years. It has no connection with
any of the books published by the author and linked from this site.
This page is provided "as is", without warranty of any kind,
express or implied, including but not limited to the warranties
of merchantability, fitness for a particular purpose and
noninfringement. In no event shall the author or copyright
holder be liable for any claim, damages or other liability,
whether in an action of contract, tort or otherwise, arising
from, out of or in connection with the software or the use or
other dealings in the software.
© 2007 Jules J. Berman
1
USING COMPUTERS TO DETERMINE PLAGIARISM.
Walter Stewart and Ned Fader have a computer program that compares
the frequency of matches of 30 letter strings in 2 different publications
as a quantitative test for plagiarism.
--------------------
Stone R. Court test for plagiarism detector?
Science 254:1448 (inclusive), 1991.
key words: administration, applications, ethics, informatics, research, JB
2
INADEQUACY OF DEATH CERTIFICATES.
Death certificates in many countries (in this case, England and Wales).
typically solicit information concerning the direct cause of death.
Conditions that contributed to the patient's death but that were
not the direct cause of death are often omitted.
But the contributing conditions are often the most important diseases
from a public health and epidemiologic standpoint.
The authors suggest expanding the information required
on the death certificate.
--------------------
Ashworth TG. Inadequacy of death certification: proposal for change.
J Clin Pathol 44:265-268, 1991.
key words: administration, autopsy, database, epidemiology, JB
3
HOW ACCURATE ARE DEATH CERTIFICATES?
The authors compared death certificates with autopsy data.
The overall discrepancy rate was close to 50%.
For immediate causes of death, discrepancies were observed
in one quarter of cases.
For major diseases other than the immediate causes of death,
discrepancies were seen in about one third of cases.
The authors draw 3 conclusions:
1. Death certificates contain unreliable information.
2. Death certificate reliability has not improved between 1976 and 1986
(i.e., not improved by newer imaging techniques).
3. Death certificates do not seem to be completed
using autopsy information even when that information
is available to the clinician.
--------------------
Bjornsson J, Jonasson JG, Nielsen GP. The accuracy of death certificates.
Lab Inv 66:106A (inclusive abstract), 1992.
key words: administration, autopsy, JB
4
HOW ACCURATE ARE DEATH CERTIFICATES?
In 29% of deaths there was a major disagreement in the underlying
cause of death between autopsy report and death certificate.
Deaths due to neoplasms had a higher diagnostic reliability
than other types of diagnoses, with a sensitivity of 87%
and a positive predictive value of 85%.
According to the authors, autopsy data is seldom seen or utilized.
--------------------
Kircher T, Nelson J, Burdo H. The autopsy as a measure of accuracy
of the death certificate. New Engl J Med 313:1263-1269, 1985.
key words: administration, autopsy, JB
5
AUTOPSY.
Good review of the role of the autopsy.
--------------------
Hill RB, Anderson RE. The evolving purposes of the autopsy:
twenty-first century values from an eighteenth century procedure.
Perspect Biol Med 32:223-233, 1989.
key words: administration, autopsy, JB
6
WHAT CONSTITUTES A MEDICAL EXAMINER'S (AUTOPSY) CASE?
Rules vary with locality.
Most jurisdictions have rules similar to those below:
1. All DOA's (dead on arrival to hospital).
2. Death without medical attention.
3. Death < 24 hours after admission.
4. Death possibly related to suicide, homicide or any criminal act.
5. When attending physician is unable to state cause of death.
6. Accidental death.
7. Death in O.R.
8. Drug or chemical-related death.
9. Sudden or unexpected death in a previously healthy person.
key words: administration, autopsy, JB
7
REGIONAL AUTOPSY CENTERS.
Dr. Hutchins suggests that in the future, autopsies should be performed
at regional autopsy centers staffed by pathologists trained at autopsy,
where autopsies can be performed safely, and where the information
obtained from autopsies can be used effectively for epidemiologic
and research purposes.
--------------------
Hutchins GM. (Comment) CAP Today 6:44-45, 1992.
key words: administration, autopsy, legal, JB
8
PERFORMING AN AUTOPSY WITHOUT PERMISSION FROM THE NEXT OF KIN.
In Alabama, an autopsy was performed on an executed prisoner,
despite the objections of the father.
The father was awarded $15,000.
--------------------
Associated Press. Father of executed prisoner wins $15,000 autopsy suit.
New York Times, April 26, 1991.
key words: administration, autopsy, medicolegal, JB
9
IF YOU'RE LESS THAN TWO FEET FROM THIS SCREEN, YOU'RE PROBABLY NEARSIGHTED.
Nearsightedness is a disease of modern living, with reshaping of the eye,
due to constant focussing on near objects, such as books.
People who are constantly focussing on far objects
(e.g., sailors searching the horizon) are less prone to myopia.
Keravision Incorporated, Santa Clara, California, has government approval
to begin human trials on a ring-shaped corneal implant
that may correct vision problems by altering the shape of the cornea.
The operation can be done on an outpatient basis, and,
unlike radial keratotomy, is reversible (i.e., the ring can be removed).
--------------------
Fisher, LM. An implant that corrects the cornea's curvature.
New York Times, F8, May 26, 1991.
key words: administration, computers, hardware, JB
10
THE DANGER OF BAD HANDRWRITING BY PHYSICIANS.
The American Medical Association says that doctors' indecipherable
prescriptions are causing dangerous and costly illnesses.
The AMA found that prescription errors are the leading cause
of iatrogenic problems, which occur in nearly one in 25 hospital patients.
--------------------
Associated Press. Indecipherable RX: Danger. Chicago, June 13, 1994.
key words: administration, error, entry, database, statistics, accuracy, JB
11
FEDERAL DEFINITION OF SCIENTIFIC MISCONDUCT
"Misconduct" is defined in the regulations adopted by the
Foundation in July 1987, which appear in the Code of Federal
Regulations (CFR) at 45 CFR 689. They were revised in May 1991.
key words: administration, ethics, conduct, standards, fraud, JB
12
SCIENTIFIC FRAUD:.
It involves doing the following to scientific reports:
Fabricating.
Falsifying.
Plagiarizing.
It does not include errors in judgment or different interpretations of data.
--------------------
Constance, H. New rules on misconduct. Science 245:593 (inclusive), 1989.
key words: administration, ethics, medicolegal, JB
13
SCIENTIFIC MISCONDUCT.
This lecture given by the Chairman of the Subcommittee on Oversight
and Investigation of the U.S. House of Representativies,
is a superb disourse on current issues of scientific misconduct,
and gives specific attention to the cases of Robert Gallo,
David Baltimore, John Darsee (Harvard Medical School), Stephen Breuning
(U. of Pittsburgh) and alleged deficiencies of a Cleveland Clinic
investigation led by Bernadine Healy.
--------------------
Dingell JD. Shattuck lecture: misconduct in medical research.
New Engl J Med 328:1610-1615, 1993.
key words: fraud, administration, ethics, medicolegal, JB
14
SCIENTIFIC MISCONDUCT.
Congressman Dingell found common features of the misconduct cases
he investigated:
1. In most cases, misonduct occurred over a period of years, ignored by
colleagues who were in a position to recognize the misconduct.
2. In most cases, the whistle-blower was treated badly.
3. Self-policing mechanisms within the Universities failed.
4. NIH scientific integrity offices were disinclined to pursue their job.
5. Media coverage of the cases contained many items of misinformation.
--------------------
Dingell JD. Shattuck lecture: misconduct in medical research.
New Engl J Med 328:1610-1615, 1993.
key words: administration, ethics, medicolegal, JB
15
GRANT ADMINISTRATOR VERSUS GRANT OFFICER.
A grant officer is the person in the granting agency
who monitors expenditures of the grant, making sure
that they fall within agency guidelines and grant specifications.
A grant administrator is the person in the institution receiving the grant
who helps the principal investigator plan the budget,
spend the money, and follow the guidelines of the granting agency.
key words: administration, funding, JB
16
PROGRAM OFFICER.
The person at the granting agency who coordinates the selection
of projects to be funded, and who ensures that the projects
are successfully completed.
key words: administration, funding, JB
17
WHAT IS A PRINCIPAL INVESTIGATOR?
Granting agencies view the principal investigator as the person
who initiates the proposal, and who is responsible for the implementation
of the proposal once it is funded.
The principal investigator is not necessarily the person
who does the work of the proposal, or is even involved
with the proposal on a daily basis.
Perhaps for this reason, the principal investigator has other titles
that can be used interchangeably, including:
Project director.
Program director.
These latter terms do not imply that the person who receives the grant
actually does any investigating (i.e., research).
key words: administration, funding, JB
18
WHO PAYS THE GRANT ADMINISTRATORS WHO WORK IN UNIVERSITIES?
Grant administrators are paid by `indirect costs'.
Therefore, it is in the interest of the grant administrator
to increase the number of grants.
--------------------
Sladek FE, Stein EL. Grant budgeting and finance: getting the most
out of your grant dollar. Plenum Press, New York, 1981.
key words: administration, funding, JB
19
R-SERIES (INVESTIGATOR INITIATED) RESEARCH AWARDS AT THE NIH (PHS).
R01 ... Regular individual research project.
R03 ... Small research grant.
R23 ... New investigator award (no longer funded).
R29 ... FIRST Award (First Independent Research Support and Transition Award,
the replacement for the R23).
R35 ... Outstanding investigator grants.
R37 ... MERIT Award (Method to Extend Research in Time Award;
award for exceptional investigators that lengthens the grant award period).
R43 ... Small business innovative research grants (SBIR).
R44 ... Small business innovative research grants (SBIR).
key words: administration, funding, JB
20
N,P-SERIES (INVESTIGATOR INITIATED) RESEARCH AWARDS AT THE NIH (PHS).
N43 ... Contract equivalent of R43.
N01 ... Research and development contracts.
P01 ... Research program project grants
for large interdisciplinary research programs.
P30 ... Center core grants.
P41 ... Biotechnology resource grant program.
U01 ... Cooperative agreements which are partnerships
in research with the NIH.
key words: administration, funding, JB
SHOULD EST'S BE PATENTED WHEN THEIR FUNCTION AND UTILITY IS NOT KNOWN?
EST = Expressed sequence tags and correspond to sequenced pieces of
cDNA. Though it is generally agreed that EST's should be patented when
their function and utility is demonstrated, there is controversy over
whether a patent is merited or of value to society when the sequence is
known but the function is unknown.
The author suggests that keeping inventions in the public domain
typically results in delay or abandonment of commercialization.
Further, even though the function of the EST (gene fragment) is not
known, it may have value as a diagnostic tool or as a treatment
tool (e.g. preparing antisense molecules) when the EST is expressed only
in certain disease states.
--------------------
Poste G. The case for genomic patenting. Nature 378:534-536, 1995
key words: administration, funding, patent, science, genetics, JB
21
WHY MEDICAL TECHNOLOGY INCREASES THE COST OF MEDICAL CARE.
Because people will pay almost anything to improve their only chance
at staving off death, they will pay substantially more money
for even modest improvements in medical technology.
For instance a company may successfully market a device
that improves treatment by a 5% margin, even when it entails
a 100% increase in costs to the patient.
--------------------
Gaylin W. Faulty diagnosis. The New York Times, Sunday, June 12, 1994.
key words: administration, HCFA, JB
22
DO DOCTORS REDUCE THE INCIDENCE OF DISEASE?
Good physicians, according to the author, the cofounder and president
of the Hasting's Institute, increase the percentage of the population
with illness, because doctors allow people to live longer and thus
develop more illnesses.
The expensive chronic diseases of the United States are relatively rare
in nations with low life expectancy.
Furthermore, medically related technology increases
the number of disease entities.
Before the invention of the lens, there was no such disease
as presbyopia and there were no ophthalmologists.
--------------------
Gaylin W. Faulty diagnosis. The New York Times, Sunday, June 12, 1994.
key words: administration, health care, costs, JB
23
HEALTH COSTS NEAR THE END OF LIFE.
15% to 20% of the total medical care dollar is consumed
in the last 60 days of life.
--------------------
Dehner LP. Review of Cundiff D (ed), Euthanasia is Not the Answer.
A Hospice Physician's view. Mod Pathol 7:406 (inclusive), 1994.
key words: administration, health care, finance, economics, cost, JB
24
HMO OVERHEAD
A number that is often repeated (but for which we have no verifying data
and for which we can not site a source, so please do not accept it as
factual) is that HMO's have about a 70% overhead. We have heard of one
HMO that spent 19% of its take from Medicaid on the salaries of its
three owners
key words: administration, health maintenance organization, JB
25
BENEFIT OF QUALITY ASSURANCE
This study would suggest that with the exception of some improvement in
patient satisfaction and reduced Caesarian section rates, QA programs in
hospitals have made no difference in patient care outcome all at an
annual cost of $400 million.
--------------------
Oberman L. Quality quandary: little clinical impact yet. AMA News,
April 25, 1994
key words: administration, improvement, JCAHO, JB
26
PROPER TEXT FORMAT.
Standard reference for presentation of the printed word.
NOT used by the Lightning Hypertext of Disease.
--------------------
Turabian KL. A Manual for Writers of Term Papers, Theses and Dissertations.
Fifth Edition. The University of Chicago Press, Chicago, 1987.
key words: administration, informatics, book, lightning, JB
27
INDEXING BY KEY-WORDS IN THE NATIONAL LIBRARY OF MEDICINE.
Greater than 2 million dollars is spent by the NLM
on journal keyword indexing.
44 full time equivalent (FTE in government parlance,
what everyone else would call employees) personnel
are required to do the job.
--------------------
Hersh W, Greenes R. Information retrieval in medicine: state of the art.
MD Computing 7:302-311, 1990.
key words: administration, informatics, JB
28
THE VALUE OF PUBLICATIONS.
In the arts and humanities, 98% of published articles are uncited
(in the 5 years after publication).
Biological sciences do much better, with only 41.3% of papers going uncited.
The most cited field is physics, with 36.7% of papers uncited
5 years after publication.
--------------------
Hamilton DP. Research papers: who's uncited now? Science 251:25, 1991.
key words: administration, informatics, JB
29
ARE PUBLICATIONS IMPORTANT?
The Institute for Scientific Information (ISI) indicated that 55%
of the papers published between 1981 and 1985 in journals indexed
by the institute received no citations in the 5 years
after they were published.
ISI's database covers only the top 4,500 journals
out of nearly 74,000 scientific journals in existence.
--------------------
Hamilton DP. Publishing by - and for? - the numbers.
Science 250:1331-1332, 1990.
key words: administration, informatics, JB
30
FOR RESEARCH USE ONLY.
Many diagnostic reagents are advertised with the caveat `For research
use only,' or even `Not for diagnostic use,' when the intended use
for the reagents is most commonly diagnostic.
What does this mean to the laboratory that wants to use these reagents?
Typically, it means that the reagent has not been licensed (approved)
by the FDA for diagnostic purposes.
But if a laboratory director, upon reviewing the scientific literature
and after performing appropriate controls, feels that the reagent
is useful, the lab director should employ it.
In pathology, a diagnosis should never be based on the results
of a single laboratory test.
Consideration of many factors, including clinical circumstances,
should influence a diagnosis.
Similarly, results of a test performed with reagent that is sold
`for research use only,' should prompt the user not to reach
a diagnosis on the basis of the lab test performed with the reagent,
but to integrate information from that lab test, along with
other relevant information, to reach a diagnostic conclusion.
key words: administration, JB
31
COMPETENCY TRAP.
A sign of poor management.
Occurs when a department gets good at a certain technique,
and avoids attempting any new methods, preferring to exercise
their one working technique in all situations.
If the newer methods have advantages over their old method,
the department will fall behind competitors who have made
the effort to learn new processes.
--------------------
Friedman BA. Laboratory information systems and the competency trap.
In: Greenes RA, ed. Proceedings of Symposium on Computer Applications
in Medical Care. New York: IEEE Computer Society Press, 12:659-662, 1988.
key words: administration, JB
32
WHAT IS PATHOLOGY RESEARCH?
The role of research by pathologists is different
from that in other medical disciplines primarily because pathologists
have a wide variety of lesions presented to them
(i.e., they don't usually have to arrange funding for clinical studies),
and because all pathology departments have laboratory facilities
available to the pathologist (i.e., they don't usually have
to get funding to build a laboratory).
Hence, most pathology research is done with materials at hand.
Dr. Silverberg presents a lucid description
of the types of research conducted by surgical pathologists
and of the value of that research.
--------------------
Silverberg SG. The surgical pathologist as researcher.
Am J Clin Pathol 75 (Supplement):453-456, 1981.
key words: administration, JB
33
HOW DO YOU JUDGE THE WORTH OF A SCIENTIFIC PUBLICATION?
This tongue-in-cheek letter makes some very astute observations
about the value of counting citations to judge scientific merit.
`Reviews are used to bury the literature and rewrite history.
This is done by comprehensively recording all references in the first
review, and then referring back to the first review by stating that
`the earlier literature has been reviewed by whomsoever.'
Thus reviews can generate, either knowingly or accidentally,
an eclecticism that tosses good science out of the running.'
Three types of bad papers get cited often. They are:
`...(i) the `suspected fraudulent paper,'
(ii) the `controversial paper,'
and (iii) the `pizzazz paper.''
--------------------
vonBorstel RC. An analysis of citation analysis. Science 251:1546,
(29 March) 1991.
key words: administration, JB
34
AMERICAN SOCIETY OF CYTOLOGY.
130 South 9th Street.
Suite 810.
Philadelphia, PA 19107.
key words: administration, JB
35
SIGNING OUT THE NONDIAGNOSTIC CYTOLOGY REPORT.
In our opinion, whenever a diagnosis of inconclusive or suspicious
is rendered, it should be accompanied by an explanatory comment
that guides the clinician to do something further.
For instance, if a specimen is too degenerate or too scanty
to call positive, the comment should include a request
for additional material.
In many laboratories, all diagnoses of "inconclusive" are reviewed
at some interval (e.g. 3 months) to determine that addItional material
has been received by cytology or by the histology lab.
If no additional material is received, a follow-up letter is sent
to the clinician as a reminder that an inconclusive diagnosis was rendered.
key words: administration, JB
36
CYTOTECHNOLOGIST POSITION CALLED ONE OF THE WORST.
The author cites an article in the July 1990 Working Woman,
in which cytotechnology is described as one of the ten worst
professions for women.
In particular, the author cites the article as saying that
cytotechnologists have `the burden of making hundreds of life-and-death
judgments all day long for a starting salary of less than $20,000 a year.'
--------------------
Haigler B. CAC (American Society of Cytology Cytotechnology
Advisory Committee) Address. The ASC Bulletin 29:13-16, 1992.
key words: administration, JB
37
HOW MANY CYTOTECHNOLOGISTS ARE THERE?
As of August, 1991, there were 9,800 registered cytotechnologists.
Of those 9,800, there are only 5,200 dues-paying members,
so the number of employed cytotechnologists may be significantly
lower than 9,800.
About one of 4 cytotechnologist positions are vacant (in 1992).
--------------------
Haigler B. CAC (American Society of Cytology Cytotechnology Advisory
Committee) Address. The ASC Bulletin 29:13-16, 1992.
key words: administration, JB
38
WHO PAYS THE DOCTOR BILL FOR SMOKERS?
According to these authors, the smokers pay for their health bill
through excise taxes on cigarettes.
Alcoholics, though, do not pay sufficient excise taxes on liquor
to cover more than half of their health bill.
--------------------
Manning WG, Keeler E, Newhouse JP, Sloss EM, Wasserman J. The taxes of sin:
do smokers and drinkers pay their way? JAMA 261:1604-1609, 1989.
key words: administration, JB
39
HOW COURTS USE PATHOLOGISTS AS EXPERT WITNESSES.
The author notes that the way trials are conducted polarizes
expert witnesses as adversaries (defense versus prosection).
Judges may designate impartial expert witnesses to serve the court
(neutral court consultants), but they rarely do.
--------------------
Craighead JE. The pathologist as an expert witness. Arch Path Lab Med
116:488-489, 1992.
key words: legal, medicolegal, law, administration, JB
40
MEDICARE.
A program administered by Social Security to provide medical care
for the elderly.
key words: administration, JB
41
PATHOLOGISTS DO MORE THAN PROVIDE DIAGNOSES.
The authors note that pathologists can help clinicians
with valuable information about lesions in addition to diagnoses.
Prognostic information can be obtained from information on cell ploidy,
tumor cell proliferative activity, steroid receptor status, determination
of occult micrometastases, immunologic phenotypes of tumor cells,
presence of gene amplification, etc.
--------------------
Saccani Jotti G, Bonadonna G. The pathologist and the clinical oncologist:
a new effective partnership in assessing tumor prognosis. Eur J Cancer
Clin Oncol 25:585-598, 1989.
key words: administration, JB
42
HOW DO COMMUNITY HOSPITAL PATHOLOGISTS SPEND THEIR TIME?
On average:
Surgical pathology, 34.6%.
Autopsy pathology, 6.7%.
Cytology, 8.8%.
Clinical pathology, 18.0%.
Teaching, 6.0%.
Research and development, 2.3%.
Laboratory administration, 17.5%.
Hospital administration, 2.9%.
Other, 3.2%.
--------------------
Smith RD, Benson ES, Anderson RE, Tholen D. Some characteristics
of the community practice of pathology in the United States.
National Manpower Survey of 1987. Arch Pathol Lab Med 113:1335-1342, 1989.
key words: administration, JB
43
ARE PATHOLOGISTS AT RISK FOR DEVELOPING TUBERCULOSIS?
In this survey of pathologists and pathology technicians in Japan,
both groups are at high risk for tuberculosis.
--------------------
Sugita M, Tsutsumi Y, Suchi M, Kasuga H, Ishiko T. Pulmonary tuberculosis.
An occupational hazard for pathologists and pathology technicians in Japan.
Acta Pathologica Japonica 40:116-127, 1990.
key words: administration, JB
44
HOW OFTEN DO PATHOLOGISTS CUT THEMSELVES?
72 individual injuries corresponded to one injury for every 2,629 surgical
specimens grossed and one injury for every 37 autopsies performed.
The opposing area consisting of the thumb, index, and middle fingers
of the nondominant hand were particularly vulnerable.
--------------------
O'Brian DS. Patterns of occupational hand injury in pathology.
The interaction of blades, needles, and the dissector's digits. Arch Pathol
Lab Med 115:610-613, 1991.
key words: administration, JB
45
THE HEALTH OF PATHOLOGISTS.
The study identified members of the Royal College of Pathologists
(4,512 members).
Mortality was lower among pathologists compared with the general population
of England and Wales.
There were more deaths due to suicide among pathologists than among
the general population (observed 13, expected 4.9).
--------------------
Hall A, Harrington JM, Aw TC. Mortality study of British pathologists.
American Journal Indust Med 20:83-89, 1991.
key words: administration, JB
46
ROLE MODELS IN PATHOLOGY.
More than half of the first year pathology residents who responded
to a survey indicated that they were influenced by a role model pathologist
when they decided to make pathology their career.
The typical role model was a male pathologist, about 47 to 48 years old.
--------------------
Vance RP, Prichard RW, Smith RD. Recruitment of pathology trainees.
Recent trends from the 1989. Association of Pathology Chairmen's Survey
of first-year pathology residents. Arch Pathol Lab Med 115:1097-1106, 1991.
key words: administration, JB
47
DEMOGRAPHICS OF FIRST YEAR PATHOLOGY RESIDENTS (1989 SURVEY).
Mean age, 30.1 years.
Women account for 38% of residents.
Foreign medical graduates account for 23% of residents.
MD/PhD's account for 7.8% of residents.
--------------------
Vance RP, Prichard RW, Smith RD. Recruitment of pathology trainees.
Recent trends from the 1989. Association of Pathology Chairmen's Survey
of first-year pathology residents. Arch Pathol Lab Med 115:1097-1106, 1991.
key words: administration, JB
48
HOW MUCH TIME IS SPENT IN TRAFFIC JAMS?
It is estimated that Americans spend 2 billion hours each year
in traffic jams.
There is a prediction that this will rise to 4 billion hours by 2005.
--------------------
Wieman C. Road work ahead: how to solve the infrastructure crisis.
Technology Review, pp. 42-48, January, 1993.
key words: administration, JB
49
FOSTERING IDEAS.
`One of the most formidable barriers to creativity is criticism.'
Managers tend to focus on the flaws of an idea rather than its potential.
--------------------
Kiely T. The idea makers. Technology Review. January, pp. 32-40, 1993.
key words: administration, JB
50
WHAT IS A BRAINSTORMING SESSION?
A group activity in which people think of as many ideas relating
to a topic as possible.
Judgments are deferred until all of the ideas have been put forward.
Then the ideas are evaluated and prioritized.
Brainstorming was developed by Alex Osborn in 1938.
--------------------
Kiely T. The idea makers. Technology Review. January, pp. 32-40, 1993.
key words: administration, JB
51
BRAINWRITING.
Ideas are written by the members of a team in a way that preserves
anonymity and then all the written suggestions are reviewed
by all the members of the team.
Members are expected to build on the written suggestions.
This technique can be easily adapted to a computer bulletin board.
--------------------
Kiely T. The idea makers. Technology Review. January, pp. 32-40, 1993.
key words: administration, JB
52
CODE OF FEDERAL REGULATIONS (CFR).
The CFR is an annually published collection of federal regulations,
many of which involve grant management.
It is composed of a set of more than 50 softbound volumes.
Institutions that receive grants should have access to the CFR.
key words: administration, JB
53
COMMERCE BUSINESS DAILY.
A daily newspaper from the Department of Commerce
containing announcements of bidding opportunities
for government services, including research contracts.
key words: administration, JB
54
COST SHARING.
When you receive a grant from the federal government,
you (usually the institution) are typically asked
to contribute something to the total cost of the project.
When this contribution is requested in the form of cash,
it is referred to as a `hard match'.
key words: administration, JB
55
NATIONAL TECHNICAL INFORMATION SERVICE (NTIS).
A U.S. government agency that produces and releases reports
generated by government-funded research.
key words: administration, JB
56
DISAGREEMENT AMONG PATHOLOGISTS IN CLASSIFYING LYMPHOMA.
There was disagreement among pathologists in classifying lymphomas
in 25% of cases.
There was disagreement among pathologists in benign versus malignant diagnosis
in 6% of cases.
--------------------
Jones SE, Butler JJ, Byrne GE, Coltman CA, Moon TE. Histologic review of
lymphoma cases from the southwest oncology group. Cancer 39:1071-1076, 1977.
key words: administration, JB
57
THE NATIONAL CANCER INSTITUTE'S CANCER INFO SERVICE.
1-800-4-CANCER.
key words: administration, JB
58
1993 NATIONAL HEALTH CARE COSTS IN THE U.S.
About $900 billion.
--------------------
Burner ST, Waldo DR, McKusick DR. National health expenditures projections
through 2030. Health Care Finance Rev 14:1-15, 1992.
key words: administration, JB
59
REDUNDANT PUBLICATION.
There is little consensus on what constitutes redundant publication.
The New England Journal has run several series of letters where
accusations are bounced around accusing one author or another
of duplicating publications in different journals (for the most recent,
see New Engl J Med Oct 29, 1992, p. 1316).
In a 1989 editorial Angell and Relman suggest that if 2 articles overlap
and could have been more concisely presented as one article,
then a redundant publication has occurred.
--------------------
Angell M, Relman AS. Redundant publication.
N Engl J Med 320:1212-1214, 1989.
key words: administration, journals, JB
60
ARE ALL MEDICAL EXAMINERS EQUAL?
In West Texas, lawyers estimate that scores of cases will be appealed,
because of alleged incompetence of a pathologist.
An examination of the pathologist's work may indicate that
about 100 autopsies were faked.
The pathologist was sentenced to 10 years of probation and 200 hours
of community service and was ordered to pay about $17000 in restitution
of autopsy-related fees.
--------------------
Suro R. Impact of a pathologist's misconduct ripples through
West Texas courts. The New York Times, Sunday, November 22, 1922.
key words: administration, legal, forensic, coroner, autopsy, JB
61
THE NATIONAL PRACTITIONER DATA BANK.
The National Practitioner Data Bank is a registry of physicians and dentists
who settle or lose malpractice claims, or who have adverse actions
against their priveleges (that extend beyond 30 days).
There is no minimum settlement or judgment fee for entry in the data bank.
If a physician loses or settles any claim, there will be a data bank entry.
The Data Bank began collecting data in September 1990.
When a physician requests privileges at an institution, the institution
reviews any data bank entry as part of the credentialing process.
--------------------
Ankney RN, Coil JA, Kolff J, Esper E. Physician understanding of
the National Practitioner Data Bank. Southern Med J 88:200-203, 1995.
key words: administration, legal, medicolegal, JB
62
CONSENT TO SETTLE CLAUSES OF MALPRACTICE POLICIES.
All claims that are lost in court or "settled" are reportable
to the National Practitioner Data Bank.
This means that if a physician is named in a lawsuit, and a hospital
administrator settles the claim out of court, the action is reportable
to the National Practitioner Data Bank.
This means that in certain cases, it may be in the physician's interest
to stop an out-of-court settlement. Malpractice policies may have
``consent to settle'' clauses that define the rights of a doctor
to intervene in the settlement of a lawsuit.
--------------------
Ankney RN, Coil JA, Kolff J, Esper E. Physician understanding
of the National Practitioner Data Bank. Southern Med J 88:200-203, 1995.
key words: administration, legal, medicolegal, JB
63
PRIVELEGE DENIAL AND THE NATIONAL PRACTITIONER DATA BANK.
When a physician's request for hospital privileges is denied,
based on lack of competence, the hospital is required to report
their action to the National Practitioner Data Bank, because this
is considered an adverse action.
So, physicians should realize that actions involving the application
of hospital privileges are serious issues that can affect
the physician's record.
--------------------
Ankney RN, Coil JA, Kolff J, Esper E. Physician understanding
of the National Practitioner Data Bank. Southern Med J 88:200-203, 1995.
key words: administration, legal, medicolegal, JB
64
PUBLIC ACCESS TO THE NATIONAL PRACTITIONER DATA BANK.
Proposals have emerged that give consumer groups and the general public
access to the data bank.
The Clinton plan would make public data on physicians with 2 or more files.
Once made public, file entries could appear in newspapers or any public media.
--------------------
Ankney RN, Coil JA, Kolff J, Esper E. Physician understanding
of the National Practitioner Data Bank. Southern Med J 88:200-203, 1995.
key words: administration, legal, medicolegal, JB
65
LAWSUITS AGAINST OBSTETRICIANS.
73% of obstetricians have been sued at least once,
and the average obstetrician has 8 lawsuits.
--------------------
Ryzen E. The National Practitioner Data Bank problems and proposed reforms.
J Leg Med 13:409-462, 1992.
key words: administration, legal, medicolegal, JB
66
LEGALITY OF ABORTION IN THE USA.
Abortion has been legal in all 50 states since 1973.
This was the year that the Supreme Court ruled that state laws
prohibiting first and second trimester abortions were unconstitutional.
key words: administration, legal, medicolegal, JB
67
THE EFFECTIVENESS OF MEDLINE SEARCHES.
In an impact study of 1,158 Medline searches, interviewers found 86%
of their searches were effective (i.e., 14% of searches were ineffective).
--------------------
Siegel ER, Lindberg DAB, Rapp BA, Wilson SR. Evaluating the impact
of medline using the critical incident technique, In: Medinfo 92.
Lun KC, Degoulet P, Piemme TE, Rienhoff O, eds., Elsevier, North-Holland,
pp 1287-1292, 1992.
key words: administration, library, medline, computer search, JB
68
THE ETHICS OF PRENATAL TESTING FOR NON-LETHAL DISEASES.
Genetic tests for inherited skeletal abnormalities are currently
being developed.
These tests identify genetic disorders that are neither lethal
nor excessively debilitating nor painful.
Their main effect is to produce people that look different
from other people and who may require some surgery.
Is it ethical to provide prenatal tests for these syndromes?
--------------------
Angier N. Family of errant genes is found to be related to variety
of skeletal ills. The New York Times, C1, Tuesday, Nov 1, 1994.
key words: administration, marker, screening, test, legal, ethical, JB
69
FDA APPROVAL OF SOFTWARE DEVICES.
In the 1990 Act (that replaces the 1976 Medical Devices Act),
it is relatively easy for software devices to be approved by the FDA.
Once approved, however, the manufacturers must carefully document
any defects or problems resulting from the software use
(post market surveillance).
Hospitals must report deaths related to medical devices directly to the FDA.
Failure to file an incident report might invite liability action
against the hospital for any subsequent incident where a patient
is hurt by the device.
Manufacturers must report changes in the devices (including software
changes that might effect patient safety).
--------------------
Brannigan VM. Software quality regulation under the Safe Medical Devices Act
of 1990: Hospitals are now the canaries in the software mine. Symposium
on Computer Applications in Medical Care 15:238-242, 1991.
key words: administration, medicolegal, JB
70
IS DIAGNOSTIC SOFTWARE A DEVICE REGULATED BY THE FDA?
Yes, according to the FDA.
The definition of a device used by the FDA is an instrument intended
for use in the diagnosis of disease or other conditions, or in the cure...
or prevention of disease (excerpted from USCS 321, 1991).
Software that is used to guide an instrument or interpret measurements
of an instrument or that provide diagnoses themselves would all
be considered devices that must be registered with the FDA.
--------------------
Brannigan VM. Software quality regulation under the Safe Medical Devices
Act of 1990: Hospitals are now the canaries in the software money.
Symposium on Computer Applications in Medical Care 15:238-242, 1991.
key words: administration, medicolegal, JB
71
TASK FORCE ON THE STATUS OF NIH INTRAMURAL WOMEN SCIENTISTS.
Some NIH statistics:
Number of tenured male MDs at NIH 483 and their average salaries $89K.
Number of tenured female MDs at NIH 71 and their average salaries $85K.
Number of tenured male PhDs at NIH 473 and their average salaries $74K.
Number of tenured female PhDs at NIH 118 and their average salaries $65K.
--------------------
Cohen J. Glossy strategic plan hits the streets.
Science 260:888, May 14, 1993.
key words: administration, medicolegal, JB
72
LIVER DONORS VERSUS LIVER TRANSPLANT RECIPIENTS.
30,000 U.S. patients die each year from liver failure.
There are 3,000 available liver donors each year.
--------------------
Langer R, Vacanti JP. Tissue Engineering. Science 260:920-926, 1993.
key words: administration, medicolegal, JB
73
INDICATIONS FOR AUTOPSY.
Comply with medical examiner requirements.
Clarify puzzling cases.
Delineate suspected or unsuspected medical conditions.
Provide useful information to the family.
Reassure survivors with negative findings.
Collect statistical data.
Define environmental and occupational hazards.
Provide legal and forensic information.
Enhance clinical, pathological, and medical education.
key words: administration, medicolegal, postmortem, JB
74
MEDICAL EXAMINER (ME) CASES.
These are cases shoule be reported to the ME:
Unexplained or unusual circumstances surrounding death.
All homicides.
All suicides.
All deaths following abortion.
All deaths due to poisoning (homicidal, suicidal or accidental).
All deaths following accidents, whether or not injury was the primary cause
of death (e.g., patient hospitalized for treatment of fractures sustained
in an automobile accident who dies in hospital of a myocardial infarction
still needs to be reported).
When no physician is in attendance.
When the attending physician refuses to sign the death certificate.
key words: administration, medicolegal, postmortem, JB
75
OBTAINING CONSENT FOR AN AUTOPSY.
Legal consent for autopsy may vary in different jurisdictions.
In general, the order of consent is:
Surviving spouse, if none, then,
Adult children, if none, then,
Parents, if none, then,
Brothers and sisters, if none, then,
A relative who assumes custody of the body.
If none of the above exist, the chief-of-staff
can give administrative consent.
key words: administration, medicolegal, postmortem, JB
76
PERFORMING AUTOPSY WITHOUT CONSENT.
If the medical examiner office determines that a death
falls under its jurisdiction, the family can not refuse.
key words: administration, medicolegal, postmortem, JB
77
PATIENTS KILLED IN NEW DRUG TRIAL.
5 of 15 patients died from toxic effects of the experimental drug
dialuridine (used for hepatitis B). 2 of the 15 were saved from death
by liver transplants.
Earlier tests of the drug also resulted in patient deaths,
but the scientists conducting the tests failed to report the deaths
because they did not think the deaths were drug-related.
Dr. Jay Hoofnagle was chief scientist in the latest clinical trial.
Dr. Kessler, director of the FDA, noted that deaths in drug studies
must be reported only if the deaths are linked to the drug.
Dr. Kessler issued a report recommending that all deaths occurring
in a study should be reported, even if the deaths are not considered
to be related to the experimental drug under study.
--------------------
After deaths, FDA is proposing stiffer rules on drug experiments.
The New York Times, p. A1, Tuesday, November 16, 1993.
key words: administration, medicolegal, research, administration, JB
78
CYTOTECHNOLOGIST VERSUS CYTOTECHNICIAN VS CYTOPATHOLOGIST VS CYTOLOGIST.
In the Lightning Hypertext of Disease, we use the word cytologist
to refer generically to all the above.
key words: administration, nomenclature, JB
79
SHOULD THE PATHOLOGIST ADVISE THERAPEUTIC APPROACHES.
According to these authors, the surgical pathologist may comment
on the expected biology of a lesion, and may list therapeutic options,
even designating a preference.
However, the report should always make it clear that the final decision
must take all of the clinical story into consideration,
and must be made by the clinician.
--------------------
Rosai J. Ackerman's Surgical Pathology, 7th edition.
Mosby, St. Louis, p. 11, 1989.
key words: administration, pathologist, JB
80
COSTS AND BENEFITS OF CERVICAL SCREENING
The authors note that recent (1988-1993) statistics of cervical
screening in Bristol, England compared to earlier statistics (1981-1986)
from the same region showed a large jump in the incidence of mild and
moderate dyskaryosis (dysplasia), from 8.3/1000 to 26/1000, without a
similar increase in severe dysplasia.
It would seem that a growing fear of missing any dysplasia or borderline
lesion may be leading to overdiagnoses and a reduction in the benefit
of cervical screening.
--------------------
Raffle AE, Alden B, MacKenzie EFD. Detection rates for abnormal
cervical smears: What are we screening for? Lancet 345:1469-1473, 1995
key words: administration, prevention, cytology, papanicolaou, cervix, JB
81
INFORMATION EXPLOSION IN SURGICAL PATHOLOGY.
The number of papers relevant to histopathology in 1990 was 36,780
a 293% increase since 1966.
This increase is greater than the increase in the number
of all published papers since 1966 (189%).
--------------------
Cross SS, Macgillivray F. Has there been an information explosion
in histopathology? J Clin Pathol 45:724-725, 1992.
key words: administration, publication, JB
82
AUTHORSHIP ON SCIENTIFIC PAPERS.
There are no fixed rules on who gets to be listed
as an author on a completed work.
In general, a listed author should have complete knowledge of the paper
and should make an important contribution to the paper.
Authors should be listed in the order of the value
of their individual contribution to the paper (i.e. least valuable
contributor should be listed last)
In 1986, a paper was published in a Japanese journal listing 193 authors.
A partial reference to this paper follows:
--------------------
Soejima R, Matsushima T, Kawane H, Niki Y, Kawanishi M, Nakahama C, Hino J,
Saito A, Nakayama I, Tomizawa M, et al. Comparative study of MK-0787/MK-0791
and piperacillin in respiratory tract infections. Kansenshogaku Zasshi
60:345-377, 1986.
key words: administration, publication, research, JB
83
FOLLOWUP ACTIVITIES.
When a cytology case is signed out with a diagnosis that would normally
prompt further diagnostic action on the part of the physician that
submitted the specimen, it becomes the responsibility of the cytology
department to determine that additional material arrives.
This serves both to check that the original cytologic diagnosis was correct
and to insure that the patient is not lost to followup.
key words: administration, QA, JB
84
PROSPECTIVE REVIEW OF SURGICAL PATHOLOGY CASES
The authors undertook a peer review of every surgical pathology case
before it was released (finished).
They detected 32 major errors (1.2% of all cases reviewed).
The authors concluded that this type of review is worthwhile.
--------------------
Lind AC, Bewtra C, Healy JC, Sims KL. Prospective peer review in
surgical pathology. Am J Clin Pathol 104:560-566, 1995
key words: administration, quality assurance, JB
85
HOW CERTAIN IS YOUR POSITIVE?
The authors suggest that breast FNA reports should include a comment
on the level of diagnostic certainty (e.g., probable carcinoma
or definite carcinoma).
--------------------
Casey TT, Rodgers WH, Baxter JW, Sawyers JL, Reynolds VH, Page DL.
Stratified diagnostic approach to fine needle aspiration of the breast.
Am J Surg 163:305-311, 1992.
key words: administration, report, JB
86
INSTITUTIONAL GRANTS.
In addition to funding distributed to individual investigators,
NIH grants institutions money for construction, training,
center and program support, and other purposes of the institution.
--------------------
Ginzberg E, Dutka AB. The Financing of Biomedical Research.
The Johns Hopkins University Press, Baltimore, p. 35, 1989.
key words: administration, research, funding, JB
87
HOW MUCH MONEY DO YOU SPEND EACH YEAR ON RESEARCH?
In 1987, the per capita U.S. expenditure on biomedical research was $66.58.
--------------------
Ginzberg E, Dutka AB. The Financing of Biomedical Research.
The Johns Hopkins University Press, Baltimore, 1989.
key words: administration, research, funding, JB
88
NEGOTIATING INDIRECT COSTS.
Indirect costs are costs that research accrues that can not be attributed
to a single researcher.
Examples of indirect costs include medical center libraries,
engineering facilities, animal facilities, etc.
Universities negotiate their indirect costs.
This is usually done with negotiators from the Department of Defense,
because other government agencies honor the decision reached
by the DOD negotiating team.
Most indirect cost rates fall between 40% to 100% of the grant award.
key words: administration, research, JB
89
MEMORANDA OF UNDERSTANDING.
Universities may compose Memoranda of Understanding that propose
indirect costs added to the University's established indirect cost rates.
--------------------
Volkers N. Definine the terms of indirect costs.
J Natl Cancer Inst 83:1289 (inclusive), 1991.
key words: administration, research, JB
90
HOW CONGRESSIONAL FUNDS ARE DISTRIBUTED TO RESEARCH INSTITUTIONS.
Congress and NIH decided to use peer review of individual
investigator grant requests to as the basis for distributing
appropriated funds for biomedical research.
An alternative possibility, considered but dismissed, was to allocate
research funds to recipient institutions to be subdivided
among their departments.
This proposal required Congress to come up with a fair way
of allocating funds to the different research centers.
--------------------
Ginzberg E, Dutka AB. The Financing of Biomedical Research.
The Johns Hopkins University Press, Baltimore, p. 35, 1989.
key words: administration, research, JB
91
MEGABUCK SCIENCE.
In a book review (May 6, 1993, Nature), Arnold Pacey wrote that
Norbert Wiener was critical of megabuck science in his book written
about 40 years ago and recently republished.
Paley writes, `Although he concedes that this kind of research is sometimes
necessary, he deplores the tendency to regard it as the norm.
Scientists working in a team, each looking at a separate facet
of a problem, may well throw light on detail, but they are no more
likely to make fundamental discoveries than monkeys with typewriters.'
--------------------
Wiener N. Invention: the care and feeding of ideas. MIT Press, Cambridge, 1993
key words: administration, research, JB
92
THE COST OF PREVENTIVE MEDICINE.
The Centers for Disease Control estimates that 5% of the total
annual health care cost is devoted to disease prevention.
--------------------
Centers for Disease Control. Estimated national spending on prevention:
United States, 1988, MMWR Morb Mortal Wkly Rep 41:529-531, 1992.
key words: administration, research, JB
93
UNFUNDED RESEARCH IN PATHOLOGY, MEDICINE AND SURGERY.
The prevalence of unfunded research in the areas of pathology,
internal medicine and surgery was compared by counting the number
of funded and unfunded papers in the 10 most-cited journals
for each field of medicine.
Unfunded articles accounted for 60% of the articles by pathologists.
Unfunded articles accounted for 62% of the articles by internists.
Unfunded articles accounted for 74% of the articles by surgeons.
--------------------
Berman JJ, Borkowski A, Rachocka H, Moore GW. Unfunded research
by pathologists, internists and surgeons.
Modern Pathol 7:162A (inclusive), 1994.
key words: administration, research, JB
94
POSTDOCS MUST BE MENTORED.
Dr. Margaret Jensvold sued the NIH, charging that she was descriminated
against and deprived of an adequate mentor experience from her supervisor.
Specifically, she complained that she was handed insignificant projects
and was sometimes excluded from important meetings and conferences.
She won her case in Baltimore U.S. district court,
but was awarded only token damages.
--------------------
Myers M. Researcher wins case over denial of mentoring: woman accused NIMH
of bias. The Sunpapers, Saturday, April 2, 1994.
key words: administration, research, legal, JB
95
DO SCIENTISTS WORK IN LABORATORIES?
In her provocative essay, Gina Kolata examines the phenomenon of scientists
leaving the laboratory to become science managers.
According to this article, once a scientist obtains a grant, the actual work
of the grant is done by others (postdocs, technicians, graduate students,
junior staff), and the scientist retreats to the office to write new grants,
write papers and administrate the laboratory.
--------------------
Kolata G. Labs, a scientist's foreign country. The New York Times,
April 4, 199, Education Section, p. 19.
key words: administration, research, science, JB
96
ADVICE FOR THE MEDICAL REVIEWER.
The author provides very good advice for those wishing
to write review articles.
He notes a common deficiency, the failure to specify how articles
included by the review are identified, selected, and validated.
In fact, most reviewers do not use any scientific methods to assess
and synthesize information.
The author suggests that all review articles identify the gaps
in current knowledge and the areas that deserve future work.
--------------------
Mulrow CD. The medical review article: state of the science.
Ann Int Med 106:485-488, 1987.
key words: administration, research, statistics, meta, analysis, JB
97
WORKPLACE INJURIES.
Ouch. Wearing a ring can be hazardous to your health.
--------------------
Kay S, Werntz J, Wolff TW.
Ring avulsion injuries: classification and prognosis.
J Hand Surgery 14:204-213, 1989.
key words: administration, safety, JB
98
HOW PROTECTIVE ARE YOUR SURGICAL GLOVES?
After a series of autopsies, gloves were examined for punctures:
8.3% of gloves were punctured.
31.8% of these punctures went unnoticed when they occurred.
--------------------
Weston J, Locker G.
Frequency of glove puncture in the post mortem room.
J Clin Pathol 45:177-178, 1992.
key words: administration, safety, JB
99
EMPLOYMENT OF SCIENTISTS IN THE U.S.
According to the U.S. Bureau of Labor there are:
144,000 chemists and chemistry professors.
127,000 life scientists.
58,000 geologists and earth scientists.
38,000 physicists.
2.2 million computer programmers.
--------------------
McCormick D. Taking a calculated opportunity. Nature 366:489-491, 1993.
key words: administration, science, JB
100
WHO MAKES A GOOD REVIEWER OF SCIENTIFIC PAPERS.
It would seem that high academic rank is a handicap for a journal reviewer.
High ranking academics tended to turn in hasty, superficial reviews.
The best reviewers were junior ranking members of prestigious academic
institutions with fellowship training in clinical research methods.
--------------------
Taubes G. Reviewing the reviewer. Science 262:26(inclusive), 1993.
key words: administration, science, research, peer review, unfunded, funded, journal, JB
Last modified: December 5, 2006