Dr. Chang Quoted in Washington Post Regarding Hearing Damage from Noise

The Washington Post on April 8, 2013, published a story about how loud noises can lead to hearing loss, even in young teenagers.

Dr. Chang was liberally quoted throughout this informative article.

"...That’s according to Christopher Chang, an ear, nose and throat doctor at Fauquier ENT Consultants in Warrenton, who sees patients every day with hearing-related issues. “What he’s hearing is way too loud, because it’s concentrated directly into the ear itself,” he says of my son, adding that the anatomy of the ear magnifies sound as it travels through the ear canal." 

"And when someone turns the music up louder? Well, in short spurts, that’s okay. Loudness is only one part of the equation. How long you’re exposed to loud noises also affects your risk. “The biggest concern is that teens and 20-somethings are using music players so regularly,” Chang says. 

"Cheap earplugs that you can buy at the drugstore offer some protection, Chang says. In addition, there are specialized ear plugs, such as ones for hunters that amplify low-level sounds and block out gunshots. Musicians’ earplugs reduce noise with higher fidelity than the muffling effect that regular plugs have: You want to hear the music that you and your orchestra mates are playing, after all."

Read the entire article here.

Source:
Hearing loss may be caused by cities’ noises and music that’s played too loud. Washington Post 4/8/2013.

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Government Sponsored Studies Not Getting Published

Yale researchers published a study on whether NIH-funded studies get published after research completion.

The researchers examined all clinical trials after Sept 30, 2005 funded by NIH and registered within ClinicalTrials.gov maintained by the US National Library of Medicine.

Shockingly, among 635 clinical trials completed by 31 December 2008, only 46% (294 studies) were published in a peer reviewed biomedical journal within 30 months of trial completion. The median period of follow-up after trial completion was 51 months (25th-75th centiles 40-68 months) and 68% (432) were published overall.

Why aren't more of these completed studies being published???

It was already known that industry-sponsored studies had only a 40% publication rate. One can rationalize that such pharmaceutical-sponsored studies that do not reveal promising results do not get green-lighted for publication, but such a bias should not technically occur with government sponsored trials.

However, it just may be that there may be political pressure that may influence whether one study gets published and another does not (much like what has happened with climate research which allegedly has gotten smothered by unfriendly political forces).

It is also possible that researchers just do not prioritize publishing being more interested in doing the research and not so much the writing up of their results... OR their research findings have gotten rejected by journals for publication.

OR... maybe the unpublished studies are just THAT bad such that the research is literally unpublishable... which I find hard to believe given getting NIH grants to do the research is difficult and highly competitive.

In any case, there MUST be more effort to publish research findings for many reasons, key among them being:

1) Even if the study shows no results, that in itself is meaningful (if a drug did not work, than everyone should know that)

2) Duplicate studies would not occur which one can argue would be wasteful. Why reinvent the wheel when it already has been done? (there is a role for repeating studies, but should be done in a setting of being AWARE of repeating the research)


Reference:
Publication of NIH funded trials registered in ClinicalTrials.gov: cross sectional analysis. BMJ. 2012 Jan 3;344:d7292. doi: 10.1136/bmj.d7292.

Publish or... Don't. Yale Alumni Magazine. Page 32. March/April 2012.

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For a Physician, When is the Best Time To Tweet or Publish a Blog?

According to professional bloggers and tweeters, timing of content publication is important in order to maximize getting noticed and shared. From a general topics viewpoint (not healthcare specific; data taken from here):

• 4PM Eastern is the best time to Tweet
• Friday is the best day to Tweet
• 9AM Eastern is the best time to Facebook share
• Saturday and Sunday are the best days to Facebook share
• In the morning is the best time to blog
• Publishing a different blog article multiple times throughout the day is better than once per day

However, I've always wondered if such "rules" similarly apply to healthcare content as by their very nature, people tend to search a problem after seeing their doctor or seeing/reading it on the news.

Ever since I've been monitoring my website statistics starting in 2005, I've noticed some undeniable trends of "when" website activity occurs which presumably reflects "when" healthcare keyword searches occur.

For any given 24 hour period of time (graph shown below is for Nov 14-15, 2011), my ENT practice website got THE most activity between noon and midnight; peak activity being from noon - 3PM.

On a weekly basis (graph shown below is for Mon Nov 14 - Sun Nov 20, 2011), the greatest activity is Monday thru Wednesday after which web traffic drops off almost 50% by Saturday before bouncing back up 100% on Monday.

Such statistical fluctuations have been true for the past 5 years I've been tracking this stuff.

Now I certainly can't explain the "why" this phenomenon happens without more google analytics data from more healthcare websites, but I certainly can take advantage of this knowledge as it pertains to ENT problems (though I suspect that what is true for ENT is true of other health problems when it comes to web traffic).

How can I take advantage of this knowledge?

People are CONSTANTLY adding to the content found on the web, all vying for the attention of eyeballs. Being the first is important as it seems to me that google values original content (not copies that appear later), but just as important is "when" the content first appears as one would like to ride the wave of when healthcare keyword searches occur.

Overall, the holy grail is to come up with great original content, be the first to publish it, but publish it at the right time.

Great, Original Content

Good content is king and #1 in the priority of getting noticed. If your content stinks, being first and when you publish won't matter.

Be the FIRST to Publish

I can't prove it and I don't have supporting evidence for it, but it seems that google does prefer content that appears "first" over copies that appear later. The prime example is Associated Press articles that are syndicated and re-published over a wide variety of different newspaper websites throughout the world.

If google encounters the same exact article 100 times, how does it rank one over the other?

I suspect, it ranks based on two factors:

1) "Popularity" of the website publishing the content
2) Being the first to publish

Obviously, an individual only has control over timing. Take advantage of it.

WHEN to Publish

Though being the first to publish is important, the timing of when to publish is also extremely important. It's almost like surfing... You want to be the first to stake out a place to ride a wave... but you need to be where the waves are.

Given the dramatic... but consistent... fluctuations in healthcare web activity, it is better to wait and publish when people are actively searching. It is more likely to get noticed and hopefully shared, emailed, liked on facebook, tweeted, etc. Going viral is the goal all content publishers dream of.

So, WHEN is the golden moment to publish?

It is around 11AM on Mon, Tues, and Wed based on my limited data.


Conclusion

Now, do I even follow my own advice?

Not necessarily... I tend to go with the "be the first" rule regardless of the time, not because I feel it more important than the timing of publication, but it's just that I have so much other things to do (like taking care of patients), that if I come up with an idea to write about, I just publish it and not worry too much about timing.

BUT, if I do have a moment, I WILL tend to publish things timed between 11AM and 3PM during the week.

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