September 26, 2023
Normalizing Predictive Values for Appropriate Interpretation of Diagnostic Test Results
As clinicians, we often evaluate diagnostic test results like imaging studies to guide patient care. An important consideration is how disease prevalence in the tested population impacts the meaning of positive and negative predictive values. For example, a recent study using cardiac CT angiography (CTA) to diagnose coronary artery disease reported an excellent 99% negative…
September 21, 2023
Higher cardiac MIBG washout rates predict sudden cardiac death in CHF
A study from 2009 found that CHF patients who experienced sudden cardiac death had significantly higher cardiac MIBG washout rates than those who survived. The crossover point between the groups was 33.5%. Simply reporting group means and standard deviations does not adequately characterize the data. Providing reference values like the crossover point and odds ratios…
September 13, 2023
Big Tobacco’s Surprising Role in Duke University’s Medical Prominence
Duke University is now one of the premier medical institutions in the world. Their hospital and medical school rank among the global elite. However, the origins of Duke’s medical prominence have an unexpected connection to the tobacco industry. James Buchanan “Buck” Duke made a fortune pioneering cigarette rolling machines for mass production. He used this…
September 9, 2023
Finding Strength Through Gratitude
In this article, I reflect on how cultivating gratitude has helped me and can help other healthcare providers overcome burnout and continue serving patients with compassion. I share a story deeply meaningful to me of a dying patient who continues to teach us important lessons about finding peace and maintaining strength of spirit when facing…
September 7, 2023
The Limits of Education for Heart Health
We all know eating healthy and exercising is good for our hearts. But knowledge alone isn’t always enough to change behaviors. A recent study found educating patients about cardiovascular risks led to some improvement in meeting ideal health metrics. However, the changes fell far short of the goals set by the American Heart Association. This…
September 5, 2023
The Value of Standardized Predictive Values in Diagnostic Testing
This letter to the editor published in the Journal of Magnetic Resonance Imaging discusses the usefulness of standardizing the predictive value of diagnostic tests. The author, Dr. Thomas F. Heston, argues that presenting predictive values standardized to a disease prevalence of 50% is more clinically useful than using the Predictive Summary Index. He explains that…
Incidental Detection of Giant Cell Arteritis in PET/CT Scans for Renal Carcinoma
A case study involving a 71-year-old male undergoing 18F-FDG PET/CT scans for renal carcinoma staging revealed incidental findings of giant cell arteritis. The patient was administered 370 MBq of 18F-FDG, and the scan spanned from the base of the skull to the mid-thighs. Increased tracer uptake was observed throughout the aorta, corroborating the patient’s known…
September 4, 2023
Prompt Engineering: A Crucial Skill for Using AI Chatbots in Medical Education
A new study explores prompt engineering, a method to get the most useful responses from AI chatbots like ChatGPT. Properly crafted prompts yield good answers while poorly written ones give poor results. Although AI chatbots have potential for personalized learning and patient simulations, prompt engineering is key to overcoming inaccuracy and bias. This article provides…
September 3, 2023
The Role of Electrocardiography in Predicting Cardioversion Outcomes for Atrial Fibrillation
Cardioversion is a common treatment for atrial fibrillation, a cardiac arrhythmia affecting millions. However, the success of this procedure is not guaranteed and often depends on various factors such as patient age and existing heart conditions. Recent research has delved into the electrocardiographic markers that could serve as predictors for successful cardioversion. The study, although…