What makes a good biomarker?

The last decade has seen an extraordinary amount of effort devoted in biomedical research to the field of biomarkers. There have been some notable successes with novel markers being adopted into clinical practice bringing clear clinical benefit to some patients — particularly with the increasing numbers of medicines being approved with companion diagnostics. However, it is fair to say that there has not yet been the numbers of clinically valuable biomarkers brought to medical practice that the research effort would seem to warrant. This paper evaluates examples of successful biomarkers, markers which might be considered partial successes and a few problematic examples and ar-gues that more effort spent in the validation phase of marker development, and less in the discovery phase might be a more efficient way to allocate research resources.

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Biomedical Research and Clinical Practice

10.15761/brcp ◽

2020 ◽

Keyword(s):

Clinical Practice ◽

Biomedical Research

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Integral Metatheory in the Time of COVID: Implications for Medical and Nursing Teaching and Practice

International Journal for Human Caring ◽

10.20467/humancaring-d-20-00027 ◽

2021 ◽

pp. HumanCaring-D-20-00027

Author(s):

Stephen J. Darcy

Keyword(s):

Nursing Education ◽

Clinical Practice ◽

Patient Care ◽

Medical Practice ◽

Potential Application ◽

Illness Experience ◽

Comprehensive View ◽

Practice Of Medicine ◽

Basic Concepts ◽

Interpretive Framework

Ken Wilber's integral metatheory is an interpretive framework that can that be applied to the clinical practice of medicine and medical and nursing education. It offers a comprehensive view of the patient illness experience superior to current models of patient care and may provide a valuable guide for nursing and medical practice and teaching. This article seeks to explain some of the basic concepts of integral metatheory and show their potential application to practice and teaching using the current COVID-19 pandemic as an illustrative model.

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Physicians’ requirements and expectations of future Artificial Intelligence applications for healthcare – a web-based survey in German university hospitals (Preprint)

10.2196/preprints.26646 ◽

2020 ◽

Author(s):

Oliver Maassen ◽

Sebastian Fritsch ◽

Julia Gantner ◽

Saskia Deffge ◽

Julian Kunze ◽

...

Keyword(s):

Artificial Intelligence ◽

Clinical Practice ◽

Patient Care ◽

Biomedical Research ◽

Positive Attitude ◽

Patient Data ◽

University Hospitals ◽

Web Based ◽

Wide Range ◽

Medical Disciplines

BACKGROUND The increasing development of artificial intelligence (AI) systems in medicine driven by researchers and entrepreneurs goes along with enormous expectations for medical care advancement. AI might change the clinical practice of physicians from almost all medical disciplines and in most areas of healthcare. While expectations for AI in medicine are high, practical implementations of AI for clinical practice are still scarce in Germany. Moreover, physicians’ requirements and expectations of AI in medicine and their opinion on the usage of anonymized patient data for clinical and biomedical research has not been investigated widely in German university hospitals. OBJECTIVE Evaluate physicians’ requirements and expectations of AI in medicine and their opinion on the secondary usage of patient data for (bio)medical research e.g. for the development of machine learning (ML) algorithms in university hospitals in Germany. METHODS A web-based survey was conducted addressing physicians of all medical disciplines in 8 German university hospitals. Answers were given on Likert scales and general demographic responses. Physicians were asked to participate locally via email in the respective hospitals. RESULTS 121 (39.9%) female and 173 (57.1%) male physicians (N=303) from a wide range of medical disciplines and work experience levels completed the online survey. The majority of respondents either had a positive (130/303, 42.9%) or a very positive attitude (82/303, 27.1%) towards AI in medicine. A vast majority of physicians expected the future of medicine to be a mix of human and artificial intelligence (273/303, 90.1%) but also requested a scientific evaluation before the routine implementation of AI-based systems (276/303, 91.1%). Physicians were most optimistic that AI applications would identify drug interactions (280/303, 92.4%) to improve patient care substantially but were quite reserved regarding AI-supported diagnosis of psychiatric diseases (62/303, 20.5%). 82.5% of respondents (250/303) agreed that there should be open access to anonymized patient databases for medical and biomedical research. CONCLUSIONS Physicians in stationary patient care in German university hospitals show a generally positive attitude towards using most AI applications in medicine. Along with this optimism, there come several expectations and hopes that AI will assist physicians in clinical decision making. Especially in fields of medicine where huge amounts of data are processed (e.g., imaging procedures in radiology and pathology) or data is collected continuously (e.g. cardiology and intensive care medicine), physicians’ expectations to substantially improve future patient care are high. However, for the practical usage of AI in healthcare regulatory and organizational challenges still have to be mastered.

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Ethics in Medical Practice and Research

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v10i1.37100 ◽

2021 ◽

Vol 10 (1) ◽

pp. 54-56

Author(s):

Pramod Kattel

Keyword(s):

Clinical Practice ◽

Treatment Group ◽

Medical Practice ◽

Human Subject ◽

Codes Of Conduct ◽

Basic Sciences ◽

Medical Practitioners ◽

Medical Curricula ◽

Trained Personnel ◽

Standard Of Practice

Ethics is a moral guide that helps the treatment group to be treated with due respect and care following the standard of practice. It also helps the research to be conducted without or minimal harm to the population under study. Besides ethics, clinical practice and research are guided by some nationally and internationally accepted principles or codes of conduct. The human subject under treatment or study should be respected to the utmost level and should be performed by trained personnel. The importance of ethics starts before studies so should be kept in medical curricula starting from basic sciences so that medical practitioners become acquainted from the beginning of the study.

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Conscious Mechanisms in Movement11Much of the research reported here and the preparation of the paper were supported by a Laura Spelman Rockefeller award from the University of Iowa and a biomedical research support grant (FR–07035) from the General Research Support Branch, Division of Research Resources, the Bureau of Health Professions, Education and Manpower Training, National Institutes of Health to J. A. Scott Kelso. Stephen A. Wallace was supported by Grant 704-01 from the Illinois Department of Mental Health and Developmental Disabilities. We express our thanks to David Goodman, who assisted in the background work for this paper.

Information Processing in Motor Control and Learning ◽

10.1016/b978-0-12-665960-3.50010-4 ◽

1978 ◽

pp. 79-116 ◽

Cited By ~ 13

Author(s):

J.A. Scott Kelso ◽

Stephen A. Wallace

Keyword(s):

Mental Health ◽

Developmental Disabilities ◽

Biomedical Research ◽

Health Professions ◽

Health Professions Education ◽

National Institutes Of Health ◽

Research Support ◽

University Of Iowa ◽

The University ◽

Research Resources

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Adrenal incidentaloma

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.0529 ◽

2011 ◽

pp. 781-788

Author(s):

Massimo Terzolo

Keyword(s):

Clinical Practice ◽

Medical Practice ◽

Adrenal Mass ◽

Adrenal Incidentaloma ◽

Specific Diagnosis ◽

Incidental Discovery ◽

Definition Of ◽

Adrenal Disease ◽

Ct And Mri

Adrenal incidentaloma is an adrenal mass that is discovered serendipitously with a radiological examination performed for indications unrelated to adrenal disease (1). The incidental discovery of an adrenal mass has become an increasingly common problem, because of the widespread use of ultrasonography, CT, and MRI in clinical practice (2, 3). These techniques have greatly improved their power of resolution over recent years, thereby increasing the possibility of detection of tiny adrenal lumps. Several factors hinder a clear characterization of the phenomenon ‘adrenal incidentaloma’, which may be considered as a byproduct of technology applied to medical practice. Adrenal incidentaloma is not a single pathological entity and the likelihood of any specific diagnosis depends both on the circumstances of discovery and the applied definition of incidentaloma. Unfortunately, published reports are inconsistent in applying inclusion and exclusion criteria for these various factors, making the results difficult to interpret. A further issue is the lack of specific clinical features of the patients carrying an adrenal incidentaloma.

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The role of diagnosis in medical practice and society

The Medical Model in Mental Health ◽

10.1093/med/9780198807254.003.0002 ◽

2019 ◽

pp. 17-33

Author(s):

Ahmed Samei Huda

Keyword(s):

Clinical Practice ◽

Medical Practice ◽

Clinical Information ◽

Relevant Information ◽

Access To Healthcare ◽

Social Effects ◽

Health Statistics ◽

Social Functions ◽

Teaching And Research

Organization of knowledge is needed to help doctors learn and recall information in their clinical practice. Diagnostic constructs help, providing prototypes against which doctors can diagnose patient conditions. They then seek to confirm or disprove this diagnosis by searching for relevant information. Attached to these diagnostic constructs are information such as causes, prognosis, and treatment. Diagnostic constructs are provisional and should be changed if information suggests they are incorrect. They also aid communication between professionals for teaching and research, and have important social functions such as providing access to healthcare, determining eligibility for welfare, offering administrative and payment functions, and collecting health statistics. Some social effects of diagnostic constructs can be harmful, such as stigma. Diagnostic constructs are included in broad diagnostic formulations including relevant clinical information.

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