Novel strategies in science communication: Fiction or future?

Guest blogger, Tjitske van Engelen (details below) writes…

It is Friday night eight ‘o clock. Everybody tunes in via online podcasts, live feed webpages or plain old television. And there he is; the man of the hour. Respected by fellow man for his charismatic behavior and loved by women for his enchanting smiles. The well-known jingle introduces the vibrant young show host whilst he enters the stage. Tonight will be a night to remember. It is one of these shows that everybody will talk about during the Monday morning coffee break. No way you are not watching. It is the quarter-finals: ‘thrombosis in neonates’ versus ‘fluid resuscitation in the critically ill’. A Norwegian versus a South-African researcher. The jury consists of one hundred participants with no prior knowledge of the fields of research. The contestants are scored as usual based on the three pillars of the show. First, did I learn something new? Secondly, can I repeat what I have learned? And thirdly, does it make me want to learn more? In the beginning, many contestants made a rookie mistake: too much information squeezed in the set three-minute-pitch. It was rather funny, to hear them stumble over their difficult words. Who has ever heard of macrophages before? Well, only two of the jury members, as it turned out. However, after last week’s show (‘antibiotic resistance’ versus ‘genetics and infection’) the number of Google hits for meticillin-resistant Staphylococcus aureus were sky high, adding to the third pillar of the show. Apparently people wanted to learn more after the engaging talk of the young scientist who explained her strategies to reduce the use of antibiotics. She has won an additional 30 seconds of pitch time for her semi-finals, kindly donated by Google. Fiction or future?

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Evaluating the economic value of the CDC CRE Toolkit

Continuing the theme of CPE (or CRE if you prefer) Toolkit evaluation, a US research group has performed a modelling study to evaluate the economic impact of the US CDC CRE Toolkit. Curiously, whilst all approaches generated cost savings eventually, hospitals acting independently rather than as a co-ordinated region resulted in faster but ultimately smaller cost savings.

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Procalcitonin-guided antibiotics for respiratory tract infections (part 2)

Two weeks ago I posted a blog about an impeccable NEJM study on the effects of procalcitonin (PCT) on antibiotic use in patients with lower respiratory tract infection. I stated that this RCT was one of the first diagnostic studies in this disease area targeting the correct patients and ended by an invitation to identify the fatal flaw. Last week one of the PhD students (Valentijn Schweitzer, absent when the paper was discussed in our journal club) told me that searching a fatal flaw was not needed; as the RCT was unnecessary in the first place. Here is why. Continue reading

Evaluating the CPE Toolkit

A research group at Bristol in collaboration with PHE have just published an evaluation of the CPE Toolkit. I don’t think any of the findings are especially surprising, confirm that the Toolkit is not implementable in acute NHS hospitals, but provides useful information and guidance to build a local CPE policy.

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Making terminal disinfection BETR part II: another perspective

Marc recently posted about the second clinical outcome findings from the BETR-D study, recently published in the Lancet Infectious Diseases. Marc contended that the team may have been ‘blinded by the [UV] light’ in reaching the conclusion that enhanced terminal room disinfection led to a hospital wide reduction in acquisition of key pathogens. Here, in the spirit of healthy academic debate, I offer another perspective.

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Procalcitonin-guided antibiotics for respiratory tract infections

Every day thousands of physicians worldwide are facing the dilemma whether “to treat or not to treat this coughing patient with antibiotics”. A test that safely discriminates a bacterial from a non-bacterial cause is the holy grail, and some feel that procalcitonin (PCT) is just that. Results from multiple – mostly European – studies and meta-analyses pushed them in that direction. Yet, we are not that often sure of the causative pathogen, and diagnostic research in the absence of a gold standard is tricky business. And now there is this marvelous study that perfectly addresses that uncertainty and questions all prior PCT evidence, and that was discussed in our PhD journal club. Continue reading

The antipathy against SDD explained

With the first paper on Selective Digestive Decontamination in ICU patients published in 1983, this year marks the 35th anniversary of one the fiercest controversies in intensive care medicine, infection prevention and clinical microbiology. To celebrate this, Intensive Care Medicine published 3 editorials called the “Antipathy against SDD is justified”: 1 arguing Pro, 1 Con and 1 wasn’t sure. If the contents of these editorials had been patients, a (good) physician would have called them “diagnostic”. SDD is where clinical epidemiology becomes psychology and sociology. Continue reading