SOURCE OF INFORMATION FOR EMERGENT MEDICAL SCIENCE

I have previously commented on information source for medical professionals and how it should be taken from journals of various professions who have editorial boards and follow strict guidelines.  This source of information can be scarce when it comes to an emerging medical profession such as sleep medicine.  There are many universities and treatment centers currently doing studies in sleep medicine; however, the profession is expanding so fast it is hard to keep up. The relationship of sleep disorders to many medical conditions is emerging everyday.  It has influence on the entire body and on almost every pathology the body has.  There are not enough treatment centers and universities to keep up with how fast this profession is emerging.  So where does a medical professional go for information?

This is the second emerging field that I have been involved with in my carrier.  The first was Orofacial pain.  My observations are that in any emerging field, evidence based scientifically validated studies are difficult to come by.  Therefore a medical professional has to take the knowledge base that he has secured to this point and apply it to the information as it is coming in from several different sources.  He attends seminars with leaders in the field who are just starting to observe conditions that are related to sleep medicine.  He takes the known information that has been validated and apply to the new information, as well as what he has experienced, and what is known to determine if this is something he can use clinically.  I know for myself, I am involved in several studies in order to validate ideas and relationships in sleep medicine for current and future professionals.  People like me all over the United States doing these things and bringing them to seminars and lectures to the rest of the profession as the science is emerging.

The difficulty comes with an emerging science like this when faced with clinical decisions.  Medical professional wants these decisions based on fax and validated science so as not to do harm to the patient.  A medical professional must be very careful when interpreting signs and symptoms and run it through the filter of what is known to apply it to what the treatment will be.  Reason is because what is known is scarce.  Therefore it comes down to care, skill, and judgment of the medical professional as he makes his decisions as to how to treat the patient.  My only suggestion at this point to a medical professional is to make sure that one does not make conclusions of fact based on what is known.

 An example of this would be when it comes to imaging the airway.  With the new Cone Beam technology we are able to see the airway in great detail.  A patient may have a very very large airway and the logical conclusion would be that this person does not have an airway collapsing problem.  However, my experience has shown that just because the image is large they can still have a very collapsing airway.  This is because I know that the x-ray is a static image and sleep disordered breathing or a collapsing airway is a dynamic process.

I also know from experience that if the x-ray shows that the airway is very small, they have extremely high probability of having a collapsing airway at night.  Therefore when I make decisions as to what treatment should be done my next order of therapy would be to obtain a nocturnal polysomnogram to verify that indeed the airway is collapsing.  I will not use the image to tell the patient they actually have obstructive sleep apnea.  I will say that the image suggests that he does.  That is the way to use emerging technology in a new profession.

  Ronald S. Prehn, D.D.S.

RESEARCH ON THE INTERNET

The Internet has become the main stay of source of information in society today.  The plethora of information is mind boggling, but also without any type of standardization.  This is great for patients who are looking for answers to the medical problems as they read through as much information as they can.  It is difficult for patients when the information is contradictory or false or even worse yet…deceitful.  I am a big fan of information and I appreciate it when the patients do research on their medical condition when they come to my office.  Then I can engage them at that level and guide them into correct information and help them understand their condition.

However when it comes to research by medical professionals, the Internet is not a good place to go.  Most of the information on the Internet is antidotal at best and speculative and fantacy at worse.  There is some information that can be had on the Internet for a medical professional; however, it must be viewed with a jaundiced eye.  The source of information for medical professional should be in the literature, which is in the medical journals of various professions.  Medical journals have an editorial board and they filter out studies that are not valid and do not follow the scientific method.  The studies must be outcome based and follow a certain procedure and validation requirements in order to be printed in their journals.  Yes, there are many journals that are online and can be a great source for a medical professional and they know where these are.  Look for future blogs as I comment on source of information for emerging science.

 Ronald S. Prehn, D.D.S.

Motivational Speaking

Normally this term talks about the type of speaking a speaker does.  However, when I am referring to this term in this blog, I am referring to what motivates a speaker.  I just had the incredible opportunity to speak at the national sleep meeting in Seattle June 2009.  I was able to see many speakers and learn as they spoke and afterwards as to what motivates them.  I saw many different motivations for speaking.  I saw people who were speaking simply to convey information, I saw people who spoke in order to pride fully showoff or pride fully present their research.  I also saw speakers who were speaking in order to get a name for themselves.  I am not certain if they are trying to pursue a professional speaking career or if they were just looking for acceptance and prestige among the peers.  Then I saw some speakers who I admire who were speaking simply to enhance and grow the knowledge and skills of his fellow colleagues.  These speakers were motivated enough not by pride or prestige rather than by a desire to not only help the profession, but to connect with the audience in order that they may respond by becoming better dentists and health care providers for their patients.  These speakers are the ones who I admire as I watch them present.  I also watch them after the presentation as they interacted with the audience and/or interested individuals on a one to one basis.  These speakers were accessible, friendly, and very helpful to those who were seeking what he knows. These speakers are the ones that motivate change.

God Bless,

Dr. Prehn