Three websites make up the Highlight HEALTH Network:

• Highlight HEALTH 2.0
• Highlight HEALTH
• The Highlight HEALTH Web Directory

Each of these sites has a different purpose. Highlight HEALTH 2.0 is a group effort to follow the use of Web 2.0 in health and medicine (if you’re interested in writing a review about a social health network or co-blogging about the integration of Web 2.0 technologies into health and medicine, please let us know). Highlight HEALTH promotes advances in biomedical research to encourage health literacy. Lastly, the Highlight HEALTH Web Directory is an online reference guide for reliable health and medical information.

There are more ways than ever to connect with the Highlight HEALTH Network, including email/RSS, Twitter and Facebook. If you have an internet-enabled cell phone, Highlight HEALTH 2.0 can be accessed via the mobile web.

Top 5 most popular articles

Here are the most popular articles for 2008 (top 5 based on the number of page views/number of days posted):

1. Online Patient Community Battle for Survival: MDJunction
2. iMedix: Reliable Health Search and Patient-to-patient Social Network
3. Mednar Search … and Hope said, “It is good.”
4. Following the Tweets of Health
5. Core Biomedical Research Software and Web 2.0 Tools

Thank you and Best of Health in the coming year!

Related articles

• Online Patient Community Battle for Survival: MDJunction
• Social Networks and Health
• Following the Tweets of Health
• iMedix: Reliable Health Search and Patient-to-patient Social Network
• YouTube as a Source of Health Misinformation

First: a little about me. I’m a bioinformatician working in neuro-oncology.

Last month, an article debating Scientist vs Developer in Bioinformatics was posted on Web 2.0 and Semantic Web for Bioinformaticians. I would fall into the first category (Scientist Bioinformatician), as I’m interested in testing hypotheses and discovering new knowledge.

Michael Barton wrote an entertaining article on career paths for Bioinformaticians earlier this year. In the World of Bioinformatics Quest, my character class is a Wet lab Bioinformatician (WB):

A dry lab scientist, working in wet lab, the WB is the support for all things computational biology in the laboratory. The WB is familiar enough with Perl to create simple scripts, but the real strength of the WB doesn’t lay in writing code, but rather in using tools. While most bioinformaticians are familiar, in theory, with how to find a gene of interest, the WB uses these tools day in and day out — the WB puts many to shame on basic bioinformatics. While others have their head in the clouds thinking about theories and algorithms, the WB is getting his hands dirty with real data as it is being produced.

The majority of my time is spent performing Functional and Comparative Genomics on DNA microarray data. The information I analyze is used to further our understanding of the molecular pathways altered in neurofibromatosis and to identify potential therapeutic targets.

Note that I’m an Apple user (MacBook 2.16 GHz Intel Core 2 Duo, 3 GB 667 Mhz DDR2 SDRAM), so all my core apps are for a Mac. With all of the visual data I manipulate, a good monitor is essential; I use a Samsung Syncmaster 245BW 24″ LCD monitor. Finishing out the hardware list is an Apple wireless keyboard and mouse.

Local Mac applications

GeneSpring GX

GeneSpring GX provides powerful, accessible statistical tools for fast visualization and analysis of gene expression data. Sure, there are more powerful alternatives (I hear all you R users grumbling …). Nevertheless, the ability to quickly manipulate gene lists and display gene expression patterns makes GeneSpring GX an essential core app for expression analysis.

R/Bioconductor

I use R in conjunction with Bioconductor, an open source and open development software project for the analysis and comprehension of genomic data, principally for data normalization prior to import and analysis in GeneSpring. I routinely use custom CDF ([Gene] Chip Definition File) libraries, so R/Bioconductor is absolutely essential for data preprocessing.

Microsoft Excel

Genomics analysis requires manipulation of many, many data points (100 samples x 56,000 probe sets = 5.6 million data points). Sorting, searching and organizing the data can all be accomplished with Microsoft Excel. A necessary evil.

Skim

Skim is a PDF reader and note-taker for OS X. It is designed to help you read and annotate scientific papers in PDF, but is also great for viewing any PDF file (think Preview on steroids). Unlike Adobe Acrobat, it’s FAST.

Bookends

I’ve tried a number of applications to organize and tag scientific journal articles. Keeping up is an impossible task. I’ve tried several applications (yes, I’ve even tried Papers). However, for those of us that write research articles for publication, a reference manager is an essential app. Bookends is bibliography software that can also organize PDFs. The interface isn’t flashy but it’s a powerful piece of software. You can perform PubMed searches, retrieve references and associated PFDs and create static, smart and virtual groups to organize and find information in your personal collection. And it’s FAST. Bookends uses Spotlight to search within PDFs. You can search titles, abstracts, authors, journals, dates and more. Bookends is actively supported and has a useful user forum.

Microsoft Word

Speaking of writing research articles for publication, Microsoft Word is another necessary evil. I’m writing all the time and a powerful word processor is a must.

Microsoft PowerPoint

Yes, another Microsoft app. Scientists are always talking about their research and pictures speak louder than words. Especially in my position as a Bioinformatician, I need software that allows me to display and present information; Microsoft PowerPoint is that application.

I should pause here and mention out that I’m testing Apple iWork to replace Word and PowerPoint. The entire Office suite isn’t optimized for OS X (it really runs poorly) and both Pages and Keynote — iWork apps — rival the utility of Word and PowerPoint.

Web applications/databases

I spend a great deal of time analyzing large high-throughput gene expression data sets. Each analysis involves addressing several hypotheses and establishing biological meaning from the data. I rely on a number of web applications and databases to identify genes or gene sets associated with a particular phenotype (meaning an observable characteristic) and to identify enriched biological themes, particularly gene ontology (GO) terms.

PubMed

Efficient literature search is essential to the practice of Evidence-Based Medicine and to Biomedical Research. PubMed provides free access to MEDLINE, one of the largest searchable databases of biomedical research articles. An absolute necessity.

DAVID Bioinformatics Resources 2008

The Database for Annotation, Visualization and Integrated Discovery (DAVID) 2008 provides a comprehensive set of functional annotation tools for researchers to understand biological meaning behind large list of genes. I’ve tried various other tools for functional annotation analysis, but I find DAVID the most comprehensive app on the web. DAVID is owned by the NIH and is under continuous development and improvement.

OMIM

OMIM (Online Mendelian Inheritance in Man) is a comprehensive and authoritative compendium of human genes and genetic phenotypes. The full-text, referenced overviews in OMIM contain information on all known mendelian disorders and over 12,000 genes. OMIM focuses on the relationship between phenotype and genotype. I frequently link to OMIM for genes discussed on Highlight HEALTH.

iHop

No, not the restaurant. Information Hyperlinked over Proteins (iHop) provides the network of genes and proteins as a natural way of accessing the millions of abstracts in PubMed. By employing genes and proteins as hyperlinks between sentences and abstracts, the information in PubMed becomes bound together into one navigable resource.

Web 2.0 tools

I’m using Web 2.0 tools more and more in my daily workflow. Many have become indispensable for organization and communication.

WordPress

Both Highlight HEALTH and Highlight HEALTH 2.0 run on WordPress. I’ve used WordPress for a couple of years now and (between plugins and hacks) it does everything I need it to do.

Delicious

I gave up trying to manage browser-based bookmarks some time ago. Delicious.com allows users to tag, save, manage and share web pages from a centralized source. The latest addition to my workflow is the use of the “toread” tag to find bookmarked articles of interest for later review (since emailing or saving links to the desktop is inefficient).

FreshReader

I use RSS frequently, not only for blogs of interest but also to keep up with biomedical journals (current issue table of contents RSS), PubMed searches (to keep up with the latest published research in my field of work), LinkedIn updates and news. I try not to depend on Google too much, although that can be difficult nowadays. For RSS, I use FreshReader, a web-based, server type RSS and Atom feed reader. Fed up with slow feed readers? FreshReader is FAST.

FriendFeed

FriendFeed is becoming an excellent social networking tool, since several rooms have been setup for life science researchers and programmers. In addition to being a social aggregator, FriendFeed has comment streams that allow you to contribute to the conversation. In many cases, entire discussions are held entirely on FriendFeed.

Twitter

Twitter is also becoming a useful tool to communicate with other doctors and researchers (most are also using FriendFeed as mentioned above). Twitter allows you to keep up with people that share similar interests.

If you use both both FriendFeed and Twitter, I’ve found a convenient tool. MySocialChatter.com brings FriendFeed and Twitter together in a single web page using frames and automatically refreshes every few minutes. It’s quite useful for keeping an eye on the conversation, is easy to read (compared to some desktop apps) and is non-disruptive.

… And the rest that I couldn’t live without

Other everyday applications that I couldn’t live without:

Quicksilver

Act without doing. If you use a Mac, Quicksilver is simply a must have.

Expose

Move over command-tab (that’s alt-tab for all you windows users), Expose is AWESOME.

Mail.app

Mail.app, my e-mail program of choice.

Safari

The web, Apple style. Safari with the Saft extension is my internet browser of choice. OS X optimized and FAST.

Journler

My digital notepad. Journler is a daily notebook and entry based information manager. Never again do I have to deal with miscellaneous text files scattered across my hard drive or random bits of text emailed to myself. That said however, I am looking into Evernote to supplement (and possibly replace) Journler.

iTunes

My iTunes plays mostly ambient, new age music. I frequently work with Groove Salad or Radio IO Ambient playing in the background.

Final thoughts

So, there you go. There’s many applications, but since I’m a bioinformatician that should come as no surprise. I think you’ll get a better idea of who I am and what I do from the software tools I use and rely on everyday. These are my core biomedical research apps.

Are you a physician or biomedical scientist? Is there software or Web 2.0 tools that you couldn’t live without? What are your core apps? Share in the comments below or write your own post and link back here.

Related articles

• Health 2.0 Highlights: June 6th, 2009
• Highlight HEALTH 2.0 – Year in Review 2008
• Health 2.0 Highlights: November 1st, 2009
• Sharing Genes on the Social Web: PatientsLikeMe ALS Genetics Search Engine
• Medicine 2.0 #27 – Communication is Key

Medicine 2.0 is the science of maintaining and/or restoring human health through the study, diagnosis and treatment of patients utilizing web 2.0 internet-based services, including web-based community sites, blogs, wikis, social bookmarking, folksonomies (tagging) and Really Simple Syndication (RSS), to collaborate, exchange information and share knowledge. Physicians, nurses, medical students and health researchers who consume web media can actively participate in the creation and distribution of content, helping to customize information and technology for their own purposes.

Communication amongst and between healthcare professionals and healthcare consumers is a necessary element to improve health and is critical for the delivery of optimal medical outcomes.

This edition of Medicine 2.0 covers a wide array of posts with one thing in common — Communication.

Web 2.0 Tools and Slideshows

Gunther Eysenbach’s Random Research Rants

Dr. Gunther Eysenbach presents an archiving system for Citing Blogs, Preserving Cited Webpages etc with WebCite.

Clinical Cases and Images

Do you Twitter? Dr. Ves Dimov offers A Doctor’s Opinion: Why I Started Microblogging on Twitter.

Scienceroll

23andMe presented a slideshow recently in Second Life in the latest session of the Scifoo Lives On series. Dr. Bertalan Meskó covers 23andMe in Second Life: LIVE.

Jay Parkinson+ MD + MPH

Dr. Jay Parkinson asks us to Look, posting a presentation from George Halvorson, CEO of Kaiser Permanente, about health reform.

Pharma 2.0

Bunny Ellerin writes about Within3 and the results of a survey at the American Society of Clinical Oncology (ASCO) conference. There’s no doubt that social media is Changing Physician Behavior.

Online Video

Gene Sherpas: Personalized Medicine and You

Dr. Steve Murphy writes about the upcoming second Helix Health CliniCast on genetic testing, genomic medicine and the science of accurate warfarin dosing, asking How’s that for Genomic Medicine by Press Release?

Digital Pathology Blog

The Digital Pathology Blog reports that Mayo Launches YouTube Channel with videos highlighting the latest research and treatment advances at Mayo Clinic.

WSJ Health Blog

The Wall Street Journal Health Blog discusses online doctor consults, announcing that The Doctor Will See You on the Webcam Now.

Information Tools and Tests

College@Home

Many of us might forget there’s other search tools out there besides Google. Laura Milligan provides a comprehensive list of 100 Useful Niche Search Engines You’ve Never Heard Of.

davidrothman.net

David Rothman posts An Evaluation of the Five Most Used Evidence Based Bedside Information Tools in Canadian Health Libraries, a recent study published in the journal Evidence Based Library and Information Practice.

Medgadget

Personalized Medical Search Engine: With Medgadget describes the inclusion of Medgadget in Scienceroll Search, a personalized medical search engine powered by Polymeta.com.

NursingDegree.Net

Jessica Merritt highlights a number of ways to use Google’s Personal Health Record (PHR), offering The Ultimate Guide to Google Health: 60+ Tips and Resources.

Canadian EMR

Digital records and privacy can be a mixed bag. Alan Brookstone reposts the media report UK Health Agency Loses 31,000 Patients Records.

Sharp Brains

Alvaro Fernandez writes about the Brain Age, Posit Science, and Brain Training Topics, reporting both good and bad news regarding the assessment and training of cognitive skills.

Microarray Blog

Albin Paul discusses the options for a Semantic Search Engine for PubMed — Microsoft Vs Yahoo Vs Google Vs Oracle in Semantic Web Search.

Tomographyblog

András Székely discusses TomographyBlogSearch in the Making, describing the SeekRadiology Project, a search engine for diagnostic imaging.

Doctor-patient Communication

Canadian Medicine

Graham Lanktree reviews a study of prepared patients and internet information, which finds that the Web Buoys Doctor-patient Communication.

Medical Economics

Gail Garfinkel Weiss writes how the shift from authority-based medicine to one of shared responsibility is playing out in the exam room in The New Doctor-patient Paradigm.

The iPhone

Dr Penna

Dr. Sreeram Penna provides a list of health care applications currently available for the iPhone in Mobile Medical Software for the Iphone 3g.

Efficient MD

Dr. Joshua Schwimmer also writes about potential applications on the iPhone for doctors in The New 3G iPhone, the App Store, and Doctors.

Conclusion

That concludes the 27th edition of Medicine 2.0. My thanks to everyone who submitted an article. You can find more information about the carnival as well as the hosting schedule and past editions at the Medicine 2.0 Website.

Have you written a blog post about web 2.0 and medicine? Submit it to the next edition of Medicine 2.0 using the carnival submission form.

Related articles

• Highlight HEALTH 2.0 – Year in Review 2008
• YouTube as a Source of Health Misinformation
• Health 2.0 Highlights: November 1st, 2009
• Health 2.0 Highlights: June 6th, 2009
• Health 2.0 Highlights: February 9th, 2009

March 25, 2008 will mark the American Diabetes Associations’ 20th annual American Diabetes Alert Day. As implied by “alert,” the day serves as a call to action for those individuals at risk to take the Association’s Diabetes Risk Test, and make an appointment with a healthcare provider if necessary.

Since 54 million Americans have pre-diabetes, it is crucial for those at risk to take heed from the American Diabetes Association’s Diabetes Alert Day. Those at risk include overweight individuals, those not leading an active lifestyle (not taking enough exercise), and those with a family history of diabetes. Furthermore, the American Diabetes Association recommends that people aged 45 and older be screened every three years (those at higher risk should seek screenings more regularly).

Since diabetes has no cure, affects nearly 20 million Americans (of these 6 million don’t know they have diabetes), and is the fifth leading cause of death by disease, the fear of testing positive for diabetes and the seemingly insurmountable lifestyle changes and health management requirements accompanying the disease can be quite daunting. Fortunately, the Web provides a wealth of information, and the interaction developments offered by Web 2.0 can make the quality of life of those living with diabetes a little better. With 5 — 10% of all Web searches being health related, the need for people to not only get health information, but also make it easy to access and interact with, is vital and reflects the evolving needs of Web users that Web 2.0 seeks to meet effectively.

Sites like RightHealth.com, Healia.com, Revolution Health or WebMD are excellent starting points to quickly get acquainted with the information surrounding the topic diabetes. Healia provides multi-dimensional filtered search results, whereas RightHealth algorithmically orders information from across the web and presents it in an easy-to-understand content format. Revolution Health, Web MD and RightHealth all blend the lines of information and community to offer multiple dimensions to getting information on diabetes.

From RightHealth, I learned a bulk of the facts I already mentioned in this posting, as well as what diabetes actually is: a life-long disease characterized by high blood sugar levels. The causes of diabetes can include too little insulin (the hormone the pancreas produces to manage blood sugar), a resistance to insulin, or a combination of both. Beyond this basic information, RightHealth also features easy-to-understand jump-offs to other sites, like Trusted Sources (organizations connected with diabetes that provide detailed information about the disease), and an Explore section that gives a snapshot of the language and topics used to understand diabetes.

So Health 2.0 makes getting or understanding information about dense topics easier, but that’s just the beginning. A new site, Mamaherb.com bills itself as a way ” … to find natural treatments that can really help,” by fostering a community where users share stories about what alternative treatment options have worked for them. For diabetes sufferers that want to explore homeopathic remedies, Mamaherb is an invaluable resource. A search on “diabetes” showed that people had moderate success with such natural remedies as bilberry juice, buckwheat tea, broccoli extract and buchu leaves. Where else could you get this type of deep information easily?

The key to better health for diabetics is better control over the disease by carefully monitoring their blood sugar levels. This might sound simple, but it can be surprisingly complex. Fortunately, there is Sugarstats.com, which provides an interface to, “track, monitor, and share [your] blood sugar levels and other key statistics to help manage your diabetes online.” With timelines and graphs, it becomes easier and more accessible for a diabetic to manage the trends in their blood sugar levels and target ways to reduce blood sugar levels.

The touchstone of Web 2.0 is the user. While there are the mega sites like Facebook and MySpace where one could find other diabetics to share stories and advice, there are also even more targeted community sites which serve specifically the health or diabetic communities. iMedix.com is a place where users can rate medical articles that have helped them (like Digg meets Health) and chat with other people that share similar interests. When I searched iMedix for “diabetes,” I was told that there were three people online who I could chat with and around 500 offline that also share an interest and want to talk about diabetes. Another valuable resource was icyou.com, where users post health videos, which was a great way to cut through non-health-related videos you might find on mega sites like YouTube.com. But perhaps the most valuable resource was tudiabetes.com, which is a rich and vibrant community site committed to those afflicted with or touched by diabetes.

With such resources available today with the advent of Health 2.0, and by extension Diabetes 2.0, living life with diabetes just got a little bit easier.

About the author: Matthew Krajewski is a writer for The Kosmix RightHealth Blog, which uses information obtained through the RightHealth search engine to provide insightful posts about health-related news and issues.

Additional Health 2.0, Patient Social Networks and Diabetes resources are listed in the Highlight HEALTH Web Directory.

Related articles

• Highlight HEALTH 2.0 – Year in Review 2008
• Online Patient Community Battle for Survival: MDJunction
• iMedix: Reliable Health Search and Patient-to-patient Social Network
• YouTube as a Source of Health Misinformation
• Social Networks and Health

If Web 1.0 was about being told what the best information for you was (like the flat top 10 results on Yahoo! or Google), then Web 2.0 is about giving more control to the individual and inviting them to participate in the world of information.

Letting users start conversations or organizing information to the benefit of the end user are two outputs of the Web 2.0 evolution. So what is Web 3.0?

An article in ReadWriteWeb recently attempted to define Web 3.0, the semantic web based on personalization and recommendation. Web 3.0 may become quite adept at trying to algorithmically match you romantically, like a modern version of the 1950s board game Mystery Date, and some companies have already made significant headway in recommendation and personalization, such as Pandora and their music recommendation jukebox-like interface.

Will health ever benefit from the semantic web? Perhaps. Nothing is impossible, but it’s hard to imagine a computer will ever know how to deal with queries like:

These questions deal with the core physical nature of human beings and the nuances and language to express physical experience is so wide that Web 3.0 may never build the right bridge.

However, Web 2.0 — with intelligent interaction flow — can make answering the afore mentioned questions much easier. By categorizing the scary wilds of the web for an end user, it makes searching that much smoother.

Kosmix, the creators of RightHealth, have created a categorization technology that simplifies the web. This categorization of information is important for online health search, where the nature of queries can be intensely personal.

Asking a person concerned about his/her health to plough through homogenous search results is just plain cruel. Categorize the information, build your interaction flow around that categorization, and you’ve already helped make the mystery of a health question easier to understand. Web 2.0 puts the user or the user’s needs at the center of the product, at least when it’s done right.

Being smart about categorization and interaction flow is more than just dressing up search results. Standard search results will require a user to determine for themselves what is a trustworthy source and what is plain spam. RightHealth treats the categorization of health information much like how an editorial health site would treat their articles: insuring results are relevant, trustworthy and of value to the end user.

The user interaction associated with these valuable results is just as important, exploiting the value of Web 2.0 sensibility in order to be smarter about how health searchers interact with information to better understand their health. In Health Web 2.0, the user is just as important as the information they are trying to access. Building those bridges correctly is the way to effectively evaluate the quality of a Health 2.0 website.

About the author: Matthew Krajewski is a writer for The Kosmix RightHealth Blog, which uses information obtained through the RightHealth search engine to provide insightful posts about health-related news and issues.

Additional health search resources are listed in the Highlight HEALTH Web Directory.

Related articles

• Highlight HEALTH 2.0 – Year in Review 2008
• iMedix: Reliable Health Search and Patient-to-patient Social Network
• Mednar Search … and Hope said, "It is good."
• Core Biomedical Research Software and Web 2.0 Tools
• Medicine 2.0 #27 – Communication is Key

Unfortunately, with all the reliable health information online, an equal or greater amount of misinformation also exists. An article in the Economist last year discussed the exponential increase in user-generated content, encouraged by sites such as YouTube, Facebook and Wikipedia, and its affect on healthcare [3]. The article concluded by quoting a professor at Harvard Medical School:

Many doctors, he says, “don’t get the wisdom of crowds.” But he thinks the combined knowledge of a crowd of his patients would be far greater than his own.

However, the trouble with “The Wisdom of Crowds” or “Crowdsourcing” is that a group of people connected by a network doesn’t necessarily mean they will work together as or more effectively than in traditional organizations.

… Quite simply, not all crowds are wise.

In his book “The Wisdom of Crowds”, James Surowiecki wrote the following [4]:

The smartest groups are made up of people with diverse perspectives who are able to stay independent of each other. Independence doesn’t imply rationality or impartiality. You can be biased and irrational, but as long as you’re independent, you won’t make the group any dumber.

A study published in the Journal of the American Medical Association examined “The Wisdom of Crowds” by evaluating YouTube as a source of information on immunization [5]. University of Toronto researchers searched YouTube using the keywords “vaccination” and “immunization”, and measured users interaction with the videos using view counts and viewer reviews indicated by the star-rating system. Scientists evaluated 153 videos:

• 73 (48%) of the videos were positive, meaning the central message of the video supported immunization (e.g. described the benefits and safety of immunizing, described immunization as a social good, or encouraged people to receive immunizations).
• 49 (32%) of the videos were negative, meaning the central message of the video portrayed immunization negatively (e.g. emphasized the risk of immunization, advocated against immunizing, promoted distrust in vaccine science, made allegations of conspiracy or collusion between supporters of vaccination and manufacturers).
• 31 (20%) of the videos were ambiguous, meaning the video contained either a debate or was ambivalent.

Although almost half the videos were positive and only 20% were negative, compared with positive videos, negative videos were more likely to receive a rating, had a higher mean star rating and more views.

The videos were then rated for scientific accuracy based on the 2006 Canadian Immunization Guide, which has recommendations similar to those from the American Centers for Disease Control and Prevention. None of the positive videos contradicted the Guide. However, nearly half of the negative videos (22 of 49; 45%) carried messages that did contradict the Guide. These included messages that general childhood immunization can cause autism and that scentific research supports the link between thimerosal and autism. However, perhaps the most striking data from the study was that, among the positive videos, public service announcements received the lowest mean ratings and the fewest views.

The authors comment at the end of the study that:

The video ratings and view counts suggest the presence of a community of YouTube users critical of immunization.

And that community of YouTube users is growing rapidly. According to a December 2007 report by the Pew Internet & American Life Project, the typical share of internet users going to video sites was nearly twice as large as it was in December 2006 [6].

With the pervasiveness of blogs and RSS on the Internet today, content has become a commodity. Indeed, “information overload” tends to be everywhere. With too much information and not enough time, capturing an audience’s attention is paramount. Everyone has heard the cliché: “Content is King”. In the age of Web 2.0 and YouTube, packaging, not content, has clearly become King. This is the message public health authorities and others trying to communicate accurate health information need to pay attention to: it’s not just what you say, it’s how it’s presented.

Are you a Twitter user? Tweet this!

References

1. Fox S and Fallows D. Internet Health Resources: Health searches and email have become more commonplace, but there is room for improvement in searches and overall Internet access. Pew Internet & American Life Project. 2003 July 16.
2. Research Reveals That Internet Has Become Primary Means by Which Consumers Access Health Information. WebMD press release. 2003 Feb 10.
3. Health 2.0. The Economist. 2007 Sep 6.
4. Suroweicki J. (2004). The Wisdom of Crowds: Why the Many Are Smarter Than the Few and How Collective Wisdom Shapes Business, Economies, Societies and Nations. Boston: Little, Brown, Boston.
5. Keelan et al. YouTube as a source of information on immunization: a content analysis. JAMA. 2007 Dec 5;298(21):2482-4. DOI: 10.1001/jama.298.21.2482
   View abstract
6. Rainie L. Increased Use of Video-sharing Sites. Pew Internet & American Life Project. 2008 Jan 9.

Related articles

• Social Networks and Health
• Highlight HEALTH 2.0 – Year in Review 2008
• Medicine 2.0 #10 – Medicine and the Second Generation of Internet-based Services
• Sharing Genes on the Social Web: PatientsLikeMe ALS Genetics Search Engine
• Health 2.0 Highlights: February 9th, 2009

Why the increased attention?

When a patient receives medical interventions, there may be unintended health effects in that patient’s social network, i.e. other people to whom that patient is connected. For example, treating a heart attack may cause the patient’s children to change their dietary habits, improving their health and possibly improving their future medical outlook. Knee replacement surgery may allow a wife to better care for her husband, thus improving his health. Helping someone lose weight may influence that persons friends to also lose weight. Indeed, recent scientific studies, two of which are described below, are finding that social networks are quite relevant to health.

Social network studies and health

The prevelance of obesity in the U.S. is increasing [3]. An analysis of the nature and extent of the person-to-person spread of obesity was published recently with surprising results [4]. Researchers found that an individual’s chances of becoming obese increased by 57% if they had a friend who became obese. However, the type of friendship was an important variable: persons in closer, mutual friendships have more of an effect on each other than persons in other types of friendships. Adult siblings also influenced one another, increasing the chance of obesity by 40%. The risk of becoming obese increased by 37% if an individual’s spouse became obese.

Additionally, the sex of friends and siblings was also important [4]:

… pairs of friends and siblings of the same sex appeared to have more influence on the weight gain of each other than did pairs of friends and siblings of the opposite sex. This finding also provides support for the social nature of any induction of obesity, since it seems likely that people are influenced more by those they resemble than by those they do not. Conversely, spouses, who share much of their physical environment, may not affect each other’s weight gain as much as mutual friends do; in the case of spouses, the opposite-sex effects and friendship effects may counteract each another.

The authors note that while connected individuals may share common exposure elements (e.g. environmental factors, experience of simultaneous events, genes) that cause people to gain or lose weight simultaneously, their observations suggest an important role for a process involving the introduction and person-to-person spread of obesity. The study results suggest that the acceptance of obesity can spread through social networks. The change in the acceptance of obesity may alter behavior and affect a person’s food consumption.

Another recent study examined how a spouse’s illness or death affects the subsequent risk of death of their partner. Perhaps the strongest link in a social network, a spouse’s death was found to increase their partner’s chance of premature death by about 20 percent [5]. In fact, the danger to a partner can be much higher within the first month of a spouse’s hospitalization that marks the beginning of a serious or chronic illness. According to the study authors, rising risk months or years later may reflect a decrease in social support.

Social network ties may indeed have unintended health effects in other people to whom a patient is connected. The effects may be positive or negative. An editorial in the British Journal of Medicine [1] a few years ago suggested that:

Doctors, trialists, patients, or policy makers might see reason to take them [the sum of the direct health outcome in the patient and the collateral health effects in others] into account when choosing treatment or evaluating benefit.

Web 2.0, healthcare and medicine

The first incarnation of the web, which we now call web 1.0, has been summed up as essentially all about commerce, while web 2.0 is almost all about people and participation [6]. Web 2.0 services, including social networking services, blogs, collaborative filtering, social bookmarking, taging, instant messaging and online tools specifically designed for health search will likely change healthcare as we know it today. These same technologies are expected to play an important role in the future of medicine for physicians and scientists as well as patients. Indeed, a recent review of emerging web 2.0 social networking technologies and software [7] suggests that:

… careful thinking, testing and evaluation research are still needed in order to establish ‘best practice models’ for leveraging these emerging technologies to boost our teaching and learning productivity, foster stronger ‘communities of practice’, and support continuing medical education/professional development (CME/CPD) and patient education.

A blog carnival highlighting posts between web 2.0 and medicine, Medicine 2.0, is currently published biweekly. Still a term to be precisely defined, Medicine 2.0 is the science of maintaining and/or restoring human health through the study, diagnosis and treatment of patients utilizing web 2.0 internet-based services, including web-based community sites, blogs, wikis, social bookmarking, folksonomies (tagging) and Really Simple Syndication (RSS), to collaborate, exchange information and share knowledge. Physicians, nurses, medical students and health researchers who consume web media can actively participate in the creation and distribution of content, helping to customize information and technology for their own purposes.

The tenth, jubilee edition of the Medicine 2.0 blog carnival was hosted right here on the Highlight HEALTH Web Directory Blog. There, you’ll find links to many articles that discuss Web 2.0 in health and medicine.

Health 2.0 – social networking services and health

More generally, web 2.0 empowers everyone in healthcare. The Health 2.0 wiki defines Health 2.0 as:

New concept of healthcare wherein all the constituents (patients, physicians, providers, and payers) focus on healthcare value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, and quality of health care.

In this context, Health 2.0 extends far beyond social networking. However, according to The Health Care Blog,

Our definition [of Health 2.0] is currently focusing on user-generated aspects of Web 2.0 within health care but not directly interacting with the mainstream health care system.

This means things like health search, communities (online social networks) and tools for individual and group consumer use.

What are online social networks? An online social network is a relatively new type of virtual community that is designed to allow members to build relationships with other members of the community. Web 2.0 empowers users, encouraging members to create content online to be shared with other readers. Users can post information on their profile page that is accessible by other members of the community. Additionally, these social networks also typically offer the ability to create additional personal web pages — blogs, image galleries, video clips — that help to build relationships with other members.

According to a survey by Manhattan Research, 9.9 million consumers, in addition to reading weblogs, regularly post health information online and learn from each other [8]. People are clearly using these tools.

Over the coming months, a series of review articles will be published here on the Highlight HEALTH Web Directory Blog describing a number health-focused social networks, what they have to offer and how they can affect your health. New material will also be announced on Highlight HEALTH.

If there’s a social health network you’re interested in learning more about, send me a message and let me know.

References

1. Christakis NA. Social networks and collateral health effects. BMJ. 2004 Jul 24;329(7459):184-5.
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2. Barabási AL. Network medicine–from obesity to the “diseasome”. N Engl J Med. 2007 Jul 26;357(4):404-7. Epub 2007 Jul 25.
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3. The United Health Foundation’s 2006 edition of “America’s Health Rankings: A Call to Action for People and Their Communities”.
4. Christakis and Fowler. The spread of obesity in a large social network over 32 years. N Engl J Med. 2007 Jul 26;357(4):370-9. Epub 2007 Jul 25.
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5. Christakis and Allison. Mortality after the hospitalization of a spouse. N Engl J Med. 2006 Feb 16;354(7):719-30.
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6. Barsky and Purdon. Introducing Web 2.0: social networking and social bookmarking for health librarians. Journal of Canadian Health Library Association 2006, 27, 7-8.
7. Kamel Boulos and Wheeler. The emerging Web 2.0 social software: an enabling suite of sociable technologies in health and health care education. Health Info Libr J. 2007 Mar;24(1):2-23.
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8. Forecasting the Future: Consumers 2010. Manhattan Research.

Related articles

• Medicine 2.0 #10 – Medicine and the Second Generation of Internet-based Services
• Highlight HEALTH 2.0 – Year in Review 2008
• YouTube as a Source of Health Misinformation
• Sharing Genes on the Social Web: PatientsLikeMe ALS Genetics Search Engine
• Following the Tweets of Health

Medicine 2.0 = Medicine + Web 2.0

For the uninitiated, lets begin with a general definition of the term Medicine 2.0 and the difference between it and Health 2.0.

The goal of both of these movements is the delivery of optimal medical outcomes though individualized care.

Medicine 2.0, Informatics and Personal Health Records

ScienceRoll

Why should doctors use web 2.0 in their practice? Dr. Bertalan Meskó, founder of Medicine 2.0, writes an Open Letter to the Physicians of the World, explaining how the new generation of web services will change the way medicine is practiced and healthcare is delivered.

Tech Medicine – Healthline

Dr. Joshua Schwimmer provides an excellent example of a physician using the communication tools of the web, describing A Mobile Medical Practice — Dr. Jay Parkinson.

Medical 2.0

Dr. Uri Ginzburg also writes about Dr. Parkinson and suggests other applications that would make his medical service more accessible to his patients in The New Age of the Outpatients Clinics.UPDATE: October 20th, 2007 Dr. Parkinson’s blog can be found here.

Gene Sherpas: Personalized Medicine and You

Dr. Steven Murphy, aka the Gene Sherpa, discusses his new personalized medical practice, writing About Helix Health. As most medical informatics systems are outmoded, he and his partners have developed their own electronic medical record (EMR) system.

Release Zero Blog

Peter Murray believes that heath informaticians need to address the issues of personalized health/medicine, online identity, new forms of online interaction and hyperlocality as he discusses Web Trends and Personalising Health/Medicine.

Constructive Medicine 2.0

Earlier this month, we witnessed the first of many online health management services as Microsoft launched a free, ad-supported online health portal and personal health information database. Dr. Rahul Shetty writes about the Microsoft Health Vault and his Perspectives on Personal Health Record.

Project HealthDesign

Lygeia Ricciardi also writes about the Microsoft health portal, giving us More on HealthVault: Profiling the Platform.

Kidney Notes

Google is working on their own personal healthcare site. Dr. Joshua Schwimmer presents A Stanford Medical IT Specialist Interviewed by Robert Scoble, a video conversation with a medical IT specialist who’s working with Google.

ScienceRoll

The future of patient records may be the use of 3D representations of the human body. Dr. Bertalan Meskó reviews Visualization Software of IBM for the Future of Medicine: Interview!.

Doctor’s Gadgets

Life Record has developed an emergency medical record (EMR) application that’s compatible with a web-enabled iPhone. Dr. Chris Paton covers a YouTube video demonstrating the Life Record EMR on the iPhone.

Web 2.0 Tools: Blogs, Video and More

DavidRothman.net

As Healia searches PubMed/Medline, David Rothman reviews some of its notable features. An excellent alternative to the native PubMed interface.

Business|Bytes|Genes|Molecules

Google Scholar provides a simple way to broadly search for scholarly literature. Deepak Singh questions why their search is limited to peer-reviewed publications and is Proposing a “Plus Box” for Google Scholar.

Medical 2.0

Video sharing is one of many web 2.0 tools that can be used with medicine. Dr. Uri Ginzburg presents LabAction.com, a niche video sharing tool for scientists and researchers.

GooMedic Blog

Hamza Mousa shares his own list of medical student resources, reviewing a series of Neurological Examination Videos.

Healthcare Vox

Fard Johnmar announces the launch of a bi-weekly program to chronical how the Internet, computers and other technologies are impacting health globally. Introducing … The Digital Health Revolution.

Flags and Lollipops

Connotea provides free online reference management for researchers, clinicians and scientists and recently, there have been some issues with the service. Stew discusses Connotea and Postgenomic Complaints.

MedGadget

The blog is perhaps the fundamental web 2.0 tool and many of the posts mentioned here are written by physicians. Now it appears that blogs can be cited in biomedical literature. MedGadget describes the Citation Rules for Blogs from the National Library of Medicine.

Brain Blogger

Although many physician bloggers disclose their identities, others blog anonymously. Dr. J C writes about Anonymous Physician Bloggers and his reasons for anonymity.

Nursing Online Education Database

With so many blogs out there, which one do you choose? NOEDb.org provides a comprehensive list of the Top 100 Health and Wellness Blogs and Top 25 Nursing Blogs (By the Numbers).

Shelved in the W’s

Mark Rabnett presents his own select list of English-language med student blogs. 19% of online teens blog and as they grow up they are now Blogging Med School.

Envisioning 2.0

A number of websites are available today to rate physicians. Fard Johnmar writes about Physician Rating: New Study Brings Debate to a Boil.

MedSqod: Podcasting for Medical Professionals

Have you ever wanted to make a quality medical podcast? Dr. Peter Beck writes From The Podcast and New Media Expo. Find out more about MedSqod.

Health 2.0

Health Care Law Blog

Bob Coffield blogs live from the Health 2.0: User-Generated Healthcare Conference 2007.

MedBlog.nl

Jan Martens also writes an excellent review of the recent Health 2.0 conference in SFO [an overview]. I thought the Scribe Media film that opened the conference, A Brief History of Medicine, was awesome.

Shelved in the W’s

Mark Rabnett had other thoughts about the Scribe Media video. Above all the noise and commotion of the video, he’s Scratching an Itch.

Scott Shreeve, MD

Scott Shreeve evaluates the Athena Health Internet-based business services model and maintains there is a real business model in creating value through the aggregation, analytics and advising services they provide. He takes a serious look at the Health 2.0 Business Model: “Payment Dependent on Results”.

ICYou.com

In short video clip from the Health 2.0 conference, Bob Coffield talks about business models and what will attract people to utilize new web-based services.

Social Health Networking

The Health Wisdom Blog

Unity Stoaks discusses the challenge physicians face when prescribing their patients a trusted and unbiased online resource. New Pew Study Shows Patients Turn to Internet for Health Information; Now Can We Get Docs to Do The Same?.

Little Blue Pill

Asif Shah reposts Healthcare and Web 2.0, an article from Modern Healthcare, about healthcare startups using the models of social networking sites.

MedGadget

MedGadget reports that physician-only networks are easy to penetrate and outlines a series of questions they believe need to be addressed by Sermo and other physician social networks, announcing that it’s Confirmed: Sermo is Not for Physicians Only; New Important Questions Raised.

Medical Science, Biotech and Healthcare

SharpBrains

There’s only one place where laypeople can go to learn about medical science and its implications for their lives, investments and political interests. Alvaro provides 10 Highlights from the 2007 Aspen Health Forum.

Bayblab

University teaching used to be limited to chalkboards, slides and overhead projectors. Anonymous Coward discusses innovation toady when Teaching Science with Web 2.0.

Clinical Cases and Images

Dr. Ves Dimov touches briefly on the new biochech company 23andMe and asks if You Can Carry Your Genome Information on an iPhone?.

Nursing Online Education Database

The 2008 U.S. Presidential elections are fast approaching and there are a number healthcare issues. Do you know where all the candidates stand on all the issues? NOEDb.org breaks it down for us with a Comparison: Presidential Candidates on Major Healthcare Issues.

Evolution … not just a theory anymore

Web 2.0 is not just a technological phenomenon but also a cultural one. Greg Laden explores an otherwise typical survey of political attitudes of groups of academics, believing that Health Scientists Need a Slap Upside the Head.

Tech Medicine – Healthline

Dr. Joshua Schwimmer writes about iGuard: A New Drug Safety Website, one of the first web-based services that allows you to get free personalized safety alerts and updates about your medications.

Conclusion

That’s a wrap for Medicine 2.0 #10. It’s been a pleasure to host this edition and I’d like to thank everyone that contributed articles. Be sure to take a moment and let your fellow bloggers know this issue of Medicine 2.0 is available so that everyone’s hard work can be appreciated and enjoyed by all.

Have you written a blog article about web 2.0 and medicine? Submit it to the next edition of Medicine 2.0 using the carnival submission form. The next edition of Medicine 2.0 will be hosted at The Health Wisdom Blog on Sunday, October 28th, 2007.

Related articles

• Social Networks and Health
• Highlight HEALTH 2.0 – Year in Review 2008
• YouTube as a Source of Health Misinformation
• Health 2.0 Highlights: February 9th, 2009
• Following the Tweets of Health