Monthly Archives: February 2015

Dr Google is watching you.

by reestheskin on 25/02/2015

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Via John Naughton.  My default position is that most personal health related material on the web or via ‘secure’ email is not private, and open to NSA / GCHQ etc.

“The business department, which oversees universities, had expected in 2010 that only 32 per cent of loans would not be repaid; that figure has now risen to 45 per cent, according to the Office for Budget Responsibility.” FT. Predictable. A shambles of a system. Politicians at their worst. [direct link to this post].

Now here’s a fresh way to talk to your students. If only

by reestheskin on 22/02/2015

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This is from the late David Carr, via John Naughton.

I grade based on where you start and where you end. Don’t work on me for a better grade — work on your work and making the work of those around you better. Show industriousness and seriousness and produce surpassing work if you want an exceptional grade.

Personal Standards

Don’t raise your hand in class. This isn’t Montessori, I expect people to speak up when they like, but don’t speak over anyone. Respect the opinions of others.

This is an intense, once-a-week immersion on the waterfront of modern media-making. If you don’t show up for class, you will flounder. If you show up late or unprepared, you will stick out in unpleasant ways. If you aren’t putting effort into your work, I will suggest that you might be more comfortable elsewhere.

If you text or email during class, I will ignore you as you ignore me. It won’t go well.

I expect you to behave as an adult and will treat you like one. I don’t want to parent you — I want to teach you.

Excuses: Don’t make them — they won’t work. Stories are supposed to be on the page, and while a spoken-word performance might explain everything, it will excuse nothing. The assignments for each week are due by start of class without exception unless specific arrangements have made based on an exceptional circumstance.

If you truly have a personal or family emergency, your welfare comes first. But nothing short of that will have any traction with me.

Christopher Bigsby’s advice for entrants to the university business:
“Do not mention contact hours. If asked, say: it depends what you mean by contact. And hours.” THE


[direct link to this post]

How well do animations work? I came across one yesterday on Alfred Wegener, and today there is a very nice one in the NEJM on yaws (remember the old medical school joke: ‘what’s yaws? Thank you, mine is a pint of bitter’. I enjoy them, and feel they stick in my mind more than just looking at some text, but would like to know more. And yes, I have looked at the multimedia textbooks, but I am still uncertain. Or perhaps this is an ill-framed question: there are animations, and animations, just as there are lectures and lectures.  [direct link to this post]

Worth a glance #7

by reestheskin on 18/02/2015

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Put that laptop away. Clay Shirky. This will run and run.

No profit left behind. I am afraid I have a visceral dislike of companies such as Pearson (despite reading the Economist and the FT). Ever since I learned that the UK Royal College’s now use Pearson testing centres for their professional exams, I have despaired at the way non-profits and the public sector lack any faith in their own ability to build things, or to realise that openness benefits all who embrace it. Copyrighting curriculums etc. It is obscene— and unnecessary. And, yes, I think the profit motive is not applicable to all human endeavour.

Stealth research, by John P. A. Ioannidis. I like the term, but is it really apposite? Anyway, much innovation has always taken place outside the formal literature. Arguably the biggest change in my clinical discipline in my career has been based on a certain degree of trial and error, and people copying others (in a good way). As Sam Shuster said, serious science takes over from relevance (sometimes, anyway).

Another couple of (here and here) papers on what is facing those who plan a career in biomedical science. I am not convinced by any of the solutions offered. But I do like the LENS format of PNAS papers— a real pleasure to read online.

Chantelle Winnie, and vitiligo.

by reestheskin on 15/02/2015

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Chantelle Winnie via the Guardian

Just pictures of melanoma, right?

by reestheskin on 14/02/2015

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There are areas of medical research that are more legitimate than others. Finding genes is OK, as is finding drugs. But other bits of the health enterprise seem immune to rational scrutiny. One area that has bugged me for years is the way hospitals, charities, professional bodies and others plaster images of skin cancer around, on the assumption that this will ‘make things better’. It might, or it might not. So here is a recent paper of ours on this topic. Take away message: if there is a fixed resource envelope, many if not most strategies may make matters worse. The abstract is below. The images will of course remain up — I am not certain the rationale is the obvious one.

Abstract: Using an experimental task in which lay persons were asked to distinguish between 30 images of melanomas and common mimics of melanoma, we compared various training strategies including the ABC(D) method, use of images of both melanomas and mimics of melanoma, and alternative methods of choosing training image exemplars. Based on a sample size of 976 persons, and an online experimental task, we show that all the positive training approaches increased diagnostic sensitivity when compared with no training, but only the simultaneous use of melanoma and benign exemplars, as chosen by experts, increased specificity and diagnostic accuracy. The ABCD method and use of melanoma exemplar images chosen by laypersons decreased specificity in comparison with the control. The method of choosing exemplar images is important. The levels of change in performance are however very modest, with an increase in accuracy between control and best-performing strategy of only 9%.

Authors: Ella Cornell, Karen Robertson, Robert D. McIntosh, Jonathan L. Rees

Full open access paper here.

Dermofit library available

by reestheskin on 13/02/2015

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Our Dermofit library is available for academic researchers. There is  a license, and a nominal fee to cover admin charges. Dermofit was funded by the Wellcome Trust, and we are continuing to commercialise some aspects of this work. The work was led by myself and Prof Bob Fisher in Edinburgh Informatics. Dermofit page here with some publications here (incomplete, as I write).

Henry marsh …will retire from full-time surgery in April at the age of 65 years. “I was going to go on longer, but I had a hissy fit with the hospital management over the dress code recently, and told them that I was not prepared to go on”, he says


This is from an interview with Henry Marsh in this week’s Lancet. His book, ‘Do No Harm‘ is, to my mind, the best written account of how medicine once worked, and how the commitment of dedicated staff to their patients (rather than ‘our NHS’) made the NHS what it once was. Sadly, no more. Essential reading for all medical students: the best career advice I can give. If people like him want to get out, we (as in patients) really are stuffed.  [direct link to this page]

Nice comment on a good article by Rich DeMillo (good==I agree with it). “It has much more to do with a lack of understanding of the idea of universal education. All those pegs in our system have to fit through the circular holes through which we force them…whether they be round, square, hexagonal, icosahedral, or whatever. We accomplish this by making the holes larger and larger. “ [direct link to this post]


‘He brought a syllabus to a gun fight and lost’

by reestheskin on 11/02/2015

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“One of the things that is extremely challenging to my teaching now is the possibility that there are some things you can learn only from experience and can’t be taught. The pathos of teaching is that some things can’t be taught – and one of them might be political judgement. I don’t think that’s a despairing thought, but it does induce humility in a teacher and make the job much more interesting.”

And what about clinical judgement?  Michael Ignatieff quoted in the THE. There is a pithy comment on the article by Steven McGannety : “He brought a syllabus to a gun fight and lost. Canada lost more.” 

Science’s dirty secrets, and MOOCs.

by reestheskin on 11/02/2015

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An article in PNAS highlighting poor standards of reproducibility of many published finding, links to a John Hopkins ‘MOOC’ on ‘Data Science’. The course includes modules on R programming, experimental design and analysis. It all looks nicely laid out, although initially I thought you had to pay to run through the course — this is however not the case. You just have to pay if you want certification. This is via the Coursera platform. I know there are other courses covering some of the same topics, and it strikes me that teaching statistics without small group interaction is a hard task. But surely we must see this approach spread to use at the undergraduate level in subjects like medicine, where the best students will be able to demonstrate that they can acquire skills without the limitations of course structures designed for those who are less capable. But more importantly, it really is not hard to imagine that this approach will be superior to our current attempts to cover topics in which medical schools appear unable to invest in teaching staff or high level materials.  I am quite optimistic about the latter but less so about such courses eradicating  dodgy science.

It’s an open question whether it is the health care industry or the educational one which is the most corrupt in this country. In comparison the legal profession, the Military Industrial Complex and telecom/cable duopolies are rank amateurs at the game of rent-extraction.

A comment by Fazal Majid on Phil Greenspun’s blog.[Link to this post]


Worth a glance #6. Holiday picks.

by reestheskin on 08/02/2015

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For the next time you use JSTOR and think about the openness of science, John Naughton’s review of the ‘Internet’s own boy’ (on BBCiPlayerfor the next few weeks, and soon in iTunes). For an earlier piece by the scholar Tim Wu see here.

MOOCs and the distance-learning mirage, by the ever insightful thinker Nicholas Carr.

The legend and legacy of Bob Marley. Students: remember not all melanomas are UVR related.

From Davos Man to Davos Bot. Automate the CEO or Vice Chancellor. In many walks of life the higher you climb, the less need there is for deep thinking, and hence the easier it should be to replace humans with robots.

And since the picture tells what I have been doing. A song from somebody whose album I first bought ‘blind’ on walking into a record shop on a skiing trip to Banff many years ago, and being unable to leave without parting with my money. Yes, there are thousands of singer songwriters, but this one has something special. There was a really cheap EP with an even better version of this tune on iTunes.

Frédéric Filloux writes in the Monday Note that  ‘For news organizations, the key challenge is to lift value-added editorial above Internet noise.’ I think this is the problem for any modern university too: it is about lifting learning above ubiquitous content. [link to this post]

Carl Djerassi dies

by reestheskin on 02/02/2015

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Well his father was a dermatologist, and he held the first patent on an antihistamine, but I knew neither of these facts before reading this obituary of the great Carl Djerassi.

Dr. Djerassi (pronounced jer-AH-see) arrived in America as World War II engulfed Europe, a 16-year-old Austrian Jewish refugee who, with his mother, lost their last $20 to a swindling New York cabdriver. He wrote to Eleanor Roosevelt, asking for assistance, and obtained a college scholarship. It was a little help that made a big difference.


I think it was Jacob Bronowski who said that most of twentieth century physics was made by the sons of cobblers, but just note the phrase: he wrote to Eleanor Roosevelt, asking for assistance, and obtained a college scholarship. If you haven’t read any of his fiction, you are missing something. (and I assume it wasn’t an Uber cab).

Worth a glance #5

by reestheskin on 02/02/2015

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Who Should Have Access to Your DNA? Eric Topol .

Prince Charles ‘silenced’ professor over row on complementary medicineEdzard Ernst No surprises here.

Draw-me! Audrey Watters on the parallels between MOOCS and correspondence courses on ‘How to draw’ and how to code (only this time, from the 1970s, for the latter)

Speaking out against the GMC. A turning point for medical regulation Authors: Hilarie Williams, Christoph Lees . I am not so optimistic. There are far too few predators for regulators.

Culture lost. More on the mess of postgraduate medical training in the UK.

Arizona State University is indistinguishable from Amazon. Sort of Club 18–30, seems to me.

But lecture capture has always riled me. The thought of filming a 3 hour lecture then slapping it onto a virtual learning system and expecting students to watch this in their own time seems more like a punishment than a good idea.

  Bex Ferriday via Stephen Downes. [link to this post]