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Salud 2.0 y Medicina 2.0: controversias

Health 2.0 and Medicine 2.0: Tensions and Controversies in the Field. By Benjamin Hughes, Indra Joshi, Jonathan Wareham. J Med Internet Res 2008;10(3):e23.

Abstract:

Background: The term Web 2.0 became popular following the O’Reilly Media Web 2.0 conference in 2004; however, there are difficulties in its application to health and medicine. Principally, the definition published by O’Reilly is criticized for being too amorphous, where other authors claim that Web 2.0 does not really exist. Despite this skepticism, the online community using Web 2.0 tools for health continues to grow, and the term Medicine 2.0 has entered popular nomenclature.
Objective: This paper aims to establish a clear definition for Medicine 2.0 and delineate literature that is specific to the field. In addition, we propose a framework for categorizing the existing Medicine 2.0 literature and identify key research themes, underdeveloped research areas, as well as the underlying tensions or controversies in Medicine 2.0’s diverse interest groups.
Methods: In the first phase, we employ a thematic analysis of online definitions, that is, the most important linked papers, websites, or blogs in the Medicine 2.0 community itself. In a second phase, this definition is then applied across a series of academic papers to review Medicine 2.0’s core literature base, delineating it from a wider concept of eHealth.
Results: The terms Medicine 2.0 and Health 2.0 were found to be very similar and subsume five major salient themes: (1) the participants involved (doctors, patients, etc); (2) its impact on both traditional and collaborative practices in medicine; (3) its ability to provide personalized health care; (4) its ability to promote ongoing medical education; and (5) its associated method- and tool-related issues, such as potential inaccuracy in enduser-generated content. In comparing definitions of Medicine 2.0 to eHealth, key distinctions are made by the collaborative nature of Medicine 2.0 and its emphasis on personalized health care. However, other elements such as health or medical education remain common for both categories. In addition, this emphasis on personalized health care is not a salient theme within the academic literature. Of 2405 papers originally identified as potentially relevant, we found 56 articles that were exclusively focused on Medicine 2.0 as opposed to wider eHealth discussions. Four major tensions or debates between stakeholders were found in this literature, including (1) the lack of clear Medicine 2.0 definitions, (2) tension due to the loss of control over information as perceived by doctors, (3) the safety issues of inaccurate information, and (4) ownership and privacy issues with the growing body of information created by Medicine 2.0.
Conclusion: This paper is distinguished from previous reviews in that earlier studies mainly introduced specific Medicine 2.0 tools. In addressing the field’s definition via empirical online data, it establishes a literature base and delineates key topics for future research into Medicine 2.0, distinct to that of eHealth.

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Diseminación de Ciencia que usa Acceso Abierto: un compendio de literatura seleccionada sobre Acceso Abierto

Science Dissemination using Open Access: a compendium of selected literature on Open Access. By Enrique Canessa and Marco Zennaro, eds.


“…..Open Access means aims to remove restrictions that exist on the access to articles and knowledge to the world-wide scholarly community, in particular to those in developing countries. Scientists in these countries still have difficulty in publishing their work due to the lack of access to the network, to their institutional economic difficulties or to the lack of awareness of available Open Access solutions.  

The visibility, usage and impact of researchers' own findings can increase with Open Access, as does their power to find, access and use the work of others. 

This book aims to guide the scientific community on the requirements of Open Access, and the plethora of low-cost solutions available. A compendium of selected literature on Open Access is presented to increase the awareness of the potential of open publishing in general. 

The book also aims to encourage decision makers in academia and research centers to adopt institutional and regional Open Access Journals and Archives to make their own scientific results public and fully searchable on the Internet….”

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Diseminación eficaz de conclusiones de investigación: una compilación de ensayos

Effective Dissemination of Findings from Research – a compilation of essays. By The Institute of Health Economics (IHE), Alberta Canada, 2008.

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Genética

Genome-Wide Scan on Total Serum IgE Levels Identifies FCER1A as Novel Susceptibility Locus by Stephan Weidinger, Christian Gieger, Elke Rodriguez, Hansjörg Baurecht, Martin Mempel, Norman Klopp, et al. PLoS Genet 8(4).

Abstract: High levels of serum IgE are considered markers of parasite and helminth exposure. In addition, they are associated with allergic disorders, play a key role in anti-tumoral defence, and are crucial mediators of autoimmune diseases. Total IgE is a strongly heritable trait. In a genome-wide association study (GWAS), we tested 353,569 SNPs for association with serum IgE levels in 1,530 individuals from the population-based KORA S3/F3 study. Replication was performed in four independent population-based study samples (total n = 9,769 individuals). Functional variants in the gene encoding the alpha chain of the high affinity receptor for IgE (FCER1A) on chromosome 1q23 (rs2251746 and rs2427837) were strongly associated with total IgE levels in all cohorts with P values of 1.85×10−20 and 7.08×10−19 in a combined analysis, and in a post-hoc analysis showed additional associations with allergic sensitization (P = 7.78×10−4 and P = 1.95×10−3). The “top” SNP significantly influenced the cell surface expression of FCER1A on basophils, and genome-wide expression profiles indicated an interesting novel regulatory mechanism of FCER1A expression via GATA-2. Polymorphisms within the RAD50 gene on chromosome 5q31 were consistently associated with IgE levels (P values 6.28×10−7−4.46×10−8) and increased the risk for atopic eczema and asthma. Furthermore, STAT6 was confirmed as susceptibility locus modulating IgE levels. In this first GWAS on total IgE FCER1A was identified and replicated as new susceptibility locus at which common genetic variation influences serum IgE levels. In addition, variants within the RAD50 gene might represent additional factors within cytokine gene cluster on chromosome 5q31, emphasizing the need for further investigations in this intriguing region. Our data furthermore confirm association of STAT6 variation with serum IgE levels.

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Determinantes de Estado de Salud: Modo de vivir, Ambiente, Recursos de Asistencia médica y Eficacia

Health Status Determinants: Lifestyle, Environment, Health Care Resources and Efficiency. By Isabelle Joumard, Christophe André, Chantal Nicq and Olivier Chatal
ECONOMICS DEPARTMENT WORKING PAPERS No. 627. Organisation for Economic Co-operation and Development 04-Aug-2008 

 
“….This paper aims to shed light on the contribution of health care and other determinants to the health status of the population and to provide evidence on whether or not health care resources are producing similar value for money across OECD countries.

First, it discusses the pros and cons of various indicators of the health status, concluding that mortality and longevity indicators have some drawbacks but remainthe best available proxies. 

Second, it suggests that changes in health care spending, lifestyle factors (smoking and alcohol consumption as well as diet), education, pollution and income have been important factors behind improvements in health status. 

Third, it derives estimates of countries’ relative performance in transforming health care resources into longevity from two different methods – panel data regressionsand data envelopment analysis – which give remarkably consistent results.

The empirical estimates suggest that potential efficiency gains might be large enough to raise life expectancy at birth by almost three years on average for OECD countries, while a 10% increase in total health spending would increase life expectancy by three to four months…..”

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