Bell Eapen MD, PhD.

Bringing Digital health & Gen AI research to life!

What is wrong with the culture of medicine?

“What is wrong with the culture of medicine?”

I posted an article about burnt-out doctors that got lots of comments in DsB. Here is an excellent TED talk from Dr Zubin Damania, Director of Healthcare Development for Downtown Project Las Vegas.

“Medical schools are like Hogwarts where doctor wizards are trained to cure muggles using arcane contraptions like pagers (owls)”.

He has a plan to fight back against a system that can dehumanize doctors and patients alike. He is just too good. Must watch!

This article proposes telehealth as the future of healthcare delivery through virtual consultation and remote diagnosis. It will not only reduce the burden on secondary health care provision, but also improve the quality where accessibility to secondary care is limited. With the dwindling number of dermatologists in many parts of Canada, teledermatology also has huge potential. I am working on a dermatology imaging standard called DICODerm. I am planning to propose it to DICOM standards committee through Canada health infoway once it is completed. WG-19 (DICOM dermatology group) discontinued such a move long back, but when I proposed this idea in DsB I received huge support. Our ongoing work is available here. Standardization is a huge bottleneck for teledermatology systems, and if we can agree on a DICOM standard for dermatology, existing PACS systems may be used for store-and-forward teledermatology.

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The clinical context
Space-filling model of the chlorpromazine mole...
Space-filling model of the chlorpromazine molecule. X-ray diffraction data from H. S. Yathirajan, M. A. Ashok, B. Narayana Achar and M. Bolte (April 2007). “Chlorpromazinium picrate”. Acta. Cryst. E63 (4) : o1795-o1797. DOI:10.1107/S1600536807011555. (Photo credit: Wikipedia)

I recently read an article titled “Structural, phylogenetic and docking studies of D-amino acid oxidase activator (DAOA), a candidate schizophrenia gene”. (Open access, link to full text below).

This is a typical example of how over-zealous bioinformatics analysis without a clinical context can churn out garbage. The article after multiple analysis concludes that DAOA interacts with DAO. Well that is why DAOA is named DAO activator. The article also predicts that a predicted ligand of the predicted tertiary structure could be a schizophrenia drug.

If only it were all so simple! If Only….

Ref: http://www.tbiomed.com/content/10/1/3

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DermKnowledgeBASE – A Dermatology Knowledge Base with semi-automated knowledge discovery.
English: Map Summarizing Rosacea, It was creat...
English: Map Summarizing Rosacea, It was created by the author and Reem Al-Qudah using Clinical dermatology book Dahl, Mark V.; Weller, Richard E.; Hunter, John G.; Savin, John (2008). Clinical Dermatology. Wiley-Blackwell. Reference (Photo credit: Wikipedia)

For the last few weeks I have been working on DermKnowledgeBASE (DKB) that I believe is the first RDF knowledgebase for dermatology. It implements RDFS using RAP library for php. The terminology in dermatology facilitate the diagnostic process because many skin disorders have distinct features that can be represented by appropriate categories of terms. But dermatological terms are different from the traditional medical linguistics. Hence DKB is not rooted on MeSH  or any popular medical ontologies but on ONTODerm, the ontology I started developing for dermatology. I wrote about an offshoot of this project called slise before. DKB makes use of eutil webservices and whatizit from EBI. It is semi automated and can learn most of the relations on its own. But it relies on curators for confirming difficult rules. Its focus is on providing diagnostic support. Hence curators can add further information about the relevance of each feature in a particular disease. Features can be classified as pathognomonic, common, important, rare etc which helps in streamlining diagnostic accuracy. It provides a range of  functions and SOAP web services in addition to a ‘consult’ function to obtain differential diagnosis based on the description of clinical findings. It is still early days, but hopefully it may evolve into a very useful application for dermatology.

Click the banner below to access DermKnowledgeBASE:

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