Tag: Internet

Reading of the Week: In-person vs. Remote CBT – the New CMAJ Study; Also, Treatment & Opioids in the US, and AI & Med School Exams

July 25, 2024 /

From the Editor

In the early days of the pandemic, patients connected with us virtually from their kitchens and bedrooms – and, yes, their closets and washrooms. But as COVID-19 fades, we may wonder: what care should be delivered virtually and what should be done in person?

In the first selection, Sara Zandieh (of McMaster University) and her co-authors examine remote versus in-person CBT in a new CMAJ study. They conducted a systematic review and meta-analysis with 54 randomized controlled trials and almost 5 500 participants, addressing both physical and mental problems. “Moderate-certainty evidence showed little to no difference in the effectiveness of in-person and therapist-guided remote CBT across a range of mental health and somatic disorders, suggesting potential for the use of therapist-guided remote CBT to facilitate greater access to evidence-based care.” We consider the paper and its implications.

In the second selection, Dr. Tae Woo Park (of the University of Pittsburgh) and his co-authors explore opioid use disorder (OUD) treatment. In their JAMA research letter, they compared medication and psychosocial treatments for OUD across the United States, surveying more than 17 000 facilities and analyzing the availability of evidenced-based interventions like buprenorphine and contingency management. “Substance use treatment facilities reported significant gaps in provision of effective treatments for OUD.”

And in the third selection from CNBC, Dr. Scott Gottlieb and Shani Benezra (both of the American Enterprise Institute) describe their experiment: they tasked several large language models with answering questions from the USMLE Step 3. The average resident score is 75%; four of five AI programs surpassed that benchmark. “[These models] may offer a level of precision and consistency that human providers, constrained by fatigue and error, might sometimes struggle to match, and open the way to a future where treatment portals can be powered by machines, rather than doctors.”

There will be no Reading next week.

DG

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Reading of the Week: Should You Google Your Patients? Can Telemedicine Help with Medication Adherence?

March 14, 2019 /

From the Editor

A few years ago, a patient told me that he had won the lottery. When I expressed some surprise (and skepticism), he replied: google my name. I did, and he had won the lottery.

We google restaurant suggestions, people in the news, and our partner’s new bff.  But is googling your patients ethical? Is it advisable?

In the first selection, we look at a new paper from Psychiatric Services. Yale University’s Charles C. Dike and his co-authors consider these questions and more. They conclude: “Except in emergencies, it is advisable to obtain a patient’s informed consent before performing an Internet or social media search for information about the patient or the patient’s family and significant others.”

3888Does a good history include a good google of your patients?

For the second selection, we consider another paper from Psychiatric Services; the authors ask whether telemedicine can help with medication adherence. In this study, the University of Greifswald’s Lara N. Schulze and her co-authors use texting and phone calls. Spoiler alert: the intervention worked.

And a quick request: I’m looking for feedback on the Reading series. Please take a few minutes to complete the (anonymous) online survey: https://www.surveymonkey.com/r/GP5XXMB.

Note: there will be no Readings for the next two weeks.

DG

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Reading of the Week: I Can’t Sleep – Insomnia, Part II of II

June 16, 2016 /

From the Editor

It’s one of the most common patient complaints: I can’t sleep.

What many of our patients aspire to…

Insomnia affects 6 to 10% of the population. It’s a common problem – and often chronic. But are we mishandling insomnia?

In a two-part, two-week series, we look at the latest in insomnia research.

Last week. Fewer Pills, More Therapy. The new Clinical Practice Guidelines.

This week. Insomnia, Is There an App for That? The GoodNight Study.

This week, turning to a new paper from The Lancet Psychiatry, we consider an online insomnia program to prevent depression relapse.

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