My research idea -- please don't steal it.

[MirkoCrocop]

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I want to get a little feedback about this awesome research idea I have -- maybe I'll submit it to USCAP.

So you get one guy to measure biopsies (n=whatever; we'll say 10 for our purposes) and another person to estimate the measurements.

You get a third person to measure the biopsies.

We compare the accuracy of the initial guy and the estimator to the third measurer.

My null hypothesis is that there will be no statistical difference between the estimator and the first measurer.

I can see my title now, simple, succinct, yet right to the point:

"You Don't Have to Measure Biopsies with a Ruler."



Do you think my research project will generate any interest at national meetings/Stowell-Orbison award?

The only problem is my SDN identity will be revealed when I do any platform presentations.

 

[TMZ2007]

Funny. Does anyone actually measure their biopsies? Anything (except for distance to margins) less than 1 cm gets estimated (by me). Who cares if those fragments of tan soft tissue are 0.6 x 0.4 x 0.3 cm anyway?

 

[Arctic Char]

Funny. Does anyone actually measure their biopsies? Anything (except for distance to margins) less than 1 cm gets estimated (by me). Who cares if those fragments of tan soft tissue are 0.6 x 0.4 x 0.3 cm anyway?

i like it. i think i started eyeballin it after the 2nd biopsy i grossed

 

[Ombret]

The only problem is my SDN identity will be revealed when I do any platform presentations.

You mean when you collect the Nobel Prize. 😀

Why not? I think many people would be interested in seeing your results. I would check that it hasn't been done already. You would need to control for the skill level of the estimator. Get all your co-residents to give their estimates and correlate with PGY level. See how your PA does too. I assume you meant that the third person would use calipers or some really precise measuring tool as a gold standard. Harder to measure is the value (medical... legal... psychological...) of the measurements. How precise do you need them to be, and how precise are we currently, anyway?

Of course there are at least two types of AP resident projects, the practice-changing ones (utility of three frozen levels versus two, etc.) and the more biologically driven ones. I think for people trying to build up scientific bona fides, the practice-changing projects are not all that useful, but when you are wondering if you need to cut in 30 blocks of omentum or just 5, you sure will be glad that someone did that study (now I am giving away my own golden goose).

Your no-ruler project has a great shot of getting in at USCAP because you can submit it as "quality assurance", a category that gets next to no submissions. As to awards, I wouldn't hold my breath, they tend to go to a project with "legs", scientifically speaking.

 

[Gene_]

Results: The measurement varies depending on who is doing the measuring (or eyeballing) and what mood they are in.

Do the project if it interests you. That's what research is all about, isn't it?
I think USCAP is a possibility, but not a certainty. You could always save it for CAP/ASCP or some other meeting if it doesn't go to Vancouver.

 

[yaah]

I don't think that project would get much attention. It isn't really a significant finding. If you can extrapolate some clinical significance out of it (which is unlikely to happen with a biopsy measurement) then it might.

 

[pathstudent]

Anyone who measures biopsies is a major dweeb. During residency we were actually taught to describe them, i.e. color and appearance (glistening, dull, etc...) . AYFKM! What a waste of time.

 

[veo1]

I can see my title now, simple, succinct, yet right to the point:

"You Don't Have to Measure Biopsies with a Ruler."

Do you think my research project will generate any interest at national meetings/Stowell-Orbison award?

I think Mirko is just being sarcastic guys and brings up a very good point. It seems like 99.9% of the 'research' in pathology these days is pure junk. Most of the posters at USCAP aren't actually published and those that are only serve as CV filler for academicians. Its amazing how much time/money is wasted in useless projects. If ppl would put that much time and effort into improving our profession and the current job situation (i.e. cutting the number of residency positions) we'd be so much better off. Hell if we could just get one person to work on upgrading the abpath website (looks like something from the 90s..really) we'd be better off.

 

[Ombret]

A couple of years ago someone had a USCAP abstract where they determined what fraction of USCAP abstracts turned into publications. I think the answer was about one third. That's pretty good considering that some papers may get presented a couple of times (this year I'll present my gene chip data, next year the follow-up data on the same patients). And some projects are never going to make it past the abstract stage.

I don't know if this abstract I'm talking about ever got into print.

Everyone is always talking about how ****ty path research is, but I think this is itself missing the point. The price of getting one good, useful, interesting finding is that you are going to get ten or 100 pointless ones alongside (and if these were totally unpublishable, no one would stay in the game). There are tons of other examples. What's the price of training one successful MD/PhD scientist, $250,000? No, ten times that, because out of ten trainees probably only one will really succeed, and you can't know which one a priori. Why do birds have so many baby birds, when 90% are just going to get eaten? It's because you have to make ten to have a chance at one succeeding.

 

[gbwillner]

I want to get a little feedback about this awesome research idea I have -- maybe I'll submit it to USCAP.

So you get one guy to measure biopsies (n=whatever; we'll say 10 for our purposes) and another person to estimate the measurements.

You get a third person to measure the biopsies.

We compare the accuracy of the initial guy and the estimator to the third measurer.

My null hypothesis is that there will be no statistical difference between the estimator and the first measurer.

I can see my title now, simple, succinct, yet right to the point:

"You Don't Have to Measure Biopsies with a Ruler."



Do you think my research project will generate any interest at national meetings/Stowell-Orbison award?

The only problem is my SDN identity will be revealed when I do any platform presentations.

Are you talking about prostate biopsies? And measuring the length of the biopsy at the scope? And measuring the length of CA and percentage? Because that's the only useful angle of your project that I can see. For example, what difference is there in measuring the length of CA in a specimen vs. approximating the % in a given sample.
If you mean measuring a gross specimen, you have to measure the Bx (either with a ruler or with your eye- it doesn't matter so long as it's accurate) as a matter of record for the specimen. I don't think ANYONE will tell you that if a specimen is 0.2 cm in length you really need a ruler to make that call. You've seen that length a million times.

Also, in order to make your study significant, get ready to review/prospectively look at about 1K biopsies. Otherwise your study will just add to the trash that is pathology research.

 

[gbwillner]

If ppl would put that much time and effort into improving our profession and the current job situation (i.e. cutting the number of residency positions) we'd be so much better off. Hell if we could just get one person to work on upgrading the abpath website (looks like something from the 90s..really) we'd be better off.

Ahh... so we should basically have residents cash in their research time to write the ACGME as to why they (the same residents) should be fired from their jobs and go do something else?

 

[icpshootyz]

Maybe your first few weeks of grossing you measure biopsies w/ a ruler. But after you've got the length of a centimeter imprinted on your brain you should be able to measure all small biopsies by eye without a ruler.

 

[deleted314957]

I want to get a little feedback about this awesome research idea I have -- maybe I'll submit it to USCAP.

So you get one guy to measure biopsies (n=whatever; we'll say 10 for our purposes) and another person to estimate the measurements.

You get a third person to measure the biopsies.

We compare the accuracy of the initial guy and the estimator to the third measurer.

My null hypothesis is that there will be no statistical difference between the estimator and the first measurer.

I can see my title now, simple, succinct, yet right to the point:

"You Don't Have to Measure Biopsies with a Ruler."



Do you think my research project will generate any interest at national meetings/Stowell-Orbison award?

The only problem is my SDN identity will be revealed when I do any platform presentations.

who does?

 

[KCShaw]

Evidently someone does, or there wouldn't be an urge to..complain/comment about it. Is there any published study indicating size matters? Number? I believe there are for some sources, like breast and prostate, with size being the size of the core needle being used. There may even be something about breast core "total" length, adding all the cores together. No idea whether the methods describe "estimating" those measurements. Can't say I've read any of those relevant studies, though, so maybe it was all a hoax.

Except for margins and similar things that need to be precise for staging purposes, etc., I used to estimate a lot of measurements. Even with a ruler most measurements are "estimates", seeing as how tissue is generally pliable/elastic and can change in size with extent of fixation, how you hold it, how much tension you place on it, how curled around it is, whether you've already cut it apart, etc.

 

[BU Pathology]

I want to get a little feedback about this awesome research idea I have -- maybe I'll submit it to USCAP.

So you get one guy to measure biopsies (n=whatever; we'll say 10 for our purposes) and another person to estimate the measurements.

You get a third person to measure the biopsies.

We compare the accuracy of the initial guy and the estimator to the third measurer.

My null hypothesis is that there will be no statistical difference between the estimator and the first measurer.

I can see my title now, simple, succinct, yet right to the point:

"You Don't Have to Measure Biopsies with a Ruler."



Do you think my research project will generate any interest at national meetings/Stowell-Orbison award?

The only problem is my SDN identity will be revealed when I do any platform presentations.

I review abstracts for USCAP, as well as many other meetings. The results from this project would probably not be accepted as an abstract, since they would not be of sufficient importance to the field of pathology. Pathology research is important and does improve the pratice of medicine, but the minimal impact of your findings would not make it a strong candidate for acceptance. You should be encouraged to keep thinking of new ideas, but think bigger.

Daniel Remick, M.D.
Chair and Professor of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center

 

[MirkoCrocop]

My internet persona is slightly embarrassed, as this has gotten slightly awkward -- I made this thread as a joke, but I take the blame because I wrote it a little too seriously.

 

[KCShaw]

The sad thing is that there's a thread of reality running through it which drove some oddly interesting discussion. There's tongue-in-cheek and there's outright joking. I'm pretty sure I've heard junior residents threaten to do the same kind of study for the same kind of reasons, to be perfectly honest.

 

[Ombret]

Some practice-changing studies are truly helpful. A while back in the Archives, someone figured out where floaters come from--the bucket versus the cutting station versus the stainer. Is this important science that will make you the chair of pathology someday? No, but it does help you know what to do in your daily work. I might add that for most residents, the tools, time and resources available do not lend themselves to grand biology projects. This is how people get funneled into doing quality assurance and brown stain studies.

 

[2121115]

No need to measure smalls. Just measure the cassette and know how far apart the divits are on the cassette. Memorize this. Then just put the biopsy in the cassette and you've got a measurement.

No need to measure with a ruler or guess at it.

 

[deleted314957]

No need to measure smalls. Just measure the cassette and know how far apart the divits are on the cassette. Memorize this. Then just put the biopsy in the cassette and you've got a measurement.

No need to measure with a ruler or guess at it.

the derms ( and others who do skin excisions) get paid different cpt's based on size of excision and they don't like it if they say 2.8 cm and you say 2.3 cm. that is why our dermpaths have a "disclaimer" at the end of the gross that size of the excision specimen may not equal the in-vivo measurement.

 

[yaah]

The sad thing is that there's a thread of reality running through it which drove some oddly interesting discussion. There's tongue-in-cheek and there's outright joking. I'm pretty sure I've heard junior residents threaten to do the same kind of study for the same kind of reasons, to be perfectly honest.

Sometimes the most creative studies come from consideration of every day or obvious or "silly" questions. But this idea is not quite there yet.

 

[veo1]

I think Mirko is just being sarcastic guys and brings up a very good point. It seems like 99.9% of the 'research' in pathology these days is pure junk. Most of the posters at USCAP aren't actually published and those that are only serve as CV filler for academicians. Its amazing how much time/money is wasted in useless projects. If ppl would put that much time and effort into improving our profession and the current job situation (i.e. cutting the number of residency positions) we'd be so much better off. Hell if we could just get one person to work on upgrading the abpath website (looks like something from the 90s..really) we'd be better off.

Did anyone read my post?!! His post was exuding sarcasm. Are you guys all so brainwashed that you take anything this ridiculous seriously?!!! I agree with your point Mirko. The volume of junk research out there is really staggering.

 

[Ombret]

OK, on my planet that's called trolling.