Artful Thinking, Teledermatology App, Genetic Mutations in Hearing Loss, Dr. Vinay Nadkarni

Art meets medicine and cell phones support skin diagnoses in this week’s roundup of research news at Children’s Hospital of Philadelphia, as our latest headlines show science can find the best partners in unlikely places. Along with a creative study on the power of art observation for ophthalmology led by Gil Binenbaum, MD, MSCE, pediatric eye surgeon at CHOP, we also cover updates from researchers developing a teledermatology app, learn about novel pathways in the gene mutations that cause hearing loss, and congratulate Vinay Nadkarni, MD, on his latest honor from the American Heart Association.

Observing Art Helps Med Students Observe in Clinical Settings

Talking about a Picasso painting might not seem like a typical med school assignment, but new research published by CHOP and the University of Pennsylvania suggests that observing art could help transform the way future doctors make observations in the clinic. CBS Philly covered the event with a video news segment aired on CBS3.

In the study published in Ophthalmology, researchers collaborated with educators at the Philadelphia Museum of Art to study whether six 1½ -hour art observation courses at the Museum would develop observational abilities that translate into improved clinical effectiveness, empathy, and patient care. Building on previous studies, the researchers assigned 36 first-year medical students to either the “Artful Thinking” course or a control group who didn’t take the formal art training. Both groups completed an observational skills test before and after the study that involved description testing as well as emotional recognition testing of retinal and facial disease photos.

For the art training course, professional art educators asked students to observe, describe, and interpret various works of art, with an emphasis on observation and introspection before making a final interpretation. They held sessions in front of works of art, group discussions, and training in visual arts vocabulary. The approach encouraged creative questioning, reasoning, and perspective taking. Results showed that students who took the training showed a significant improvement in their observational skills of retinal and facial disease compared to the controls. In a follow-up questionnaire, the students also reported that they had already started to apply the skills used in the course in clinically meaningful ways, and the success of the study has led the University of Pennsylvania’s Perelman School of Medicine to offer the Philadelphia Museum of Art course to first-year medical students in the fall 2017 semester.

“Art training could be helpful across many specialties, especially ones like ophthalmology, dermatology, and radiology, where diagnosis and treatments plans are based primarily on direct observation,” said Dr. Gil Binenbaum of the division of Ophthalmology at CHOP and senior author of the study.

Learn more in the CHOP press release and be sure to check out CBS Philly’s video coverage of the research.

Parent-Submitted Smartphone Pictures Facilitate Reliable Skin Condition Diagnosis

Earlier this year, we took a snapshot of a mobile app developed by CHOP researchers that allows dermatologists to diagnose a skin condition based on a photograph and several responses to a list of questions. In that pilot study of 198 cases, results showed that the telemedicine technology was acceptable, easy to use, and expedited care. With pediatric dermatologists in short supply (fewer than 300 board-certified physicians serve nearly 75 million children in the U.S.), the app has the potential to cut appointment wait times, which often exceed several months. This week, the research team led by Patrick McMahon, MD, pediatric dermatologist at CHOP, published the next piece to their development of the app in JAMA Dermatology. In this particular study, they investigated the accuracy of teledermatology using photographs taken by parents.

Forty families participated in the study between March and September of 2016. Comparing diagnoses made based on photographs and those made during in-person examinations, the results showed that parents could indeed take photographs of their child’s skin condition on a smartphone camera and receive a reliable diagnosis. Of the 87 submitted images, 83 percent of the time, the photograph-based diagnosis agreed with the in-person diagnosis.

“While many children’s skin conditions can be handled without input from a pediatric dermatologist, the national shortage of specialists is a known barrier to accessing care,” said Dr. McMahon in a press statement. “Our findings suggest that telemedicine could improve access for patient families who have geographic, scheduling or financial limitations, as well as reducing wait times.”

Learn more in the press release.

Genetics Experts Reveal Early Events in Childhood Hearing Loss

The family of two sibling patients at CHOP who use cochlear implants – a device that replaces the inner ear’s damaged functions – now know more about the biological mechanisms behind the mutation that caused the sibling’s hearing loss thanks to novel research led by the director of CHOP’s Genetics of Hearing Loss Clinic.

Ian D. Krantz, MD, who is also director of the Roberts Individualized Medical Genetics Center at CHOP, and a team of investigators had previously identified mutations in the ESRP1 gene as the culprit in the sibling’s condition, but they did not know what biological pathways the mutations acted upon to cause hearing loss. In the current study, published in Developmental Cell, Dr. Krantz and a team of researchers analyzed the patient’s cells and performed studies in mutant mice. They discovered that the gene mutations led to disruptions in proteins in the cochlea – the part of the inner ear that turns sound waves into electrical signals sent to the brain. The defective proteins damaged the cochlea’s signal-transmitting function. This developmental pathway has not been implicated in a human developmental condition until this study.

“Our hope is that down the road, our understanding of this critical molecular pathway will lead to novel treatments for children with hearing loss,” stated Dr. Krantz in a press release.

Dr. Vinay Nardkarni Receives AHA 2017 Award for Lifetime Achievement in Cardiac Resuscitation Science

This past week, the American Heart Association honored Vinay Nadkarni, MD, with their 2017 Award for Lifetime Achievement in Cardiac Resuscitation Science at its annual Resuscitation Science Symposium held in Anaheim, Calif. We wish the warmest congratulations to Dr. Nadkarni, who is a critical care physician at CHOP as well as medical and research director of our Center for Simulation, Advanced Education, and Innovation. The AHA awards the honor every year to recognize scientists who have made outstanding contributions in cardiac and trauma science.

Dr. Nadkarni’s work in clinical, laboratory, and simulation-based research is paving the way for next-generation resuscitation care. He has authored more than 400 peer-reviewed manuscripts and 35 book chapters related to the practice of cardiopulmonary resuscitation (CPR), critical care, and resuscitation science. Along with conducting a number of collaborative multi-center National Institutes of Health research grants, Dr. Nadnarkni was the founding pediatric member of the AHA’s National Registry of CPR, an initiative to collect resuscitation data from hospitals across the nation and create evidence-based guidelines for inpatient CPR. The National Registry of CPR formed the foundation for the AHA’s collaborative “Get With the GuidelinesÒ-Resuscitation” program, the data from which helped inform one of Dr. Nadkarni’s latest publications. In it, he and his colleagues reported the results from a large multicenter study assessing the association between acute respiratory compromise among children, cardiac arrest, and overall in-hospital mortality.

ICYMI

Recently on Cornerstone, we took a snapshot of research that investigated whether mindfulness could help mothers of babies with heart conditions as a stress-technique; met our November Research Hero for muscular dystrophy, Antonio Rosato; and welcomed a guest blog from Ayana Bradshaw, MPH, administrative director for the Center for Injury Research and Prevention about this month’s Community-Driven Research Day.

Catch up on our headlines from our Nov.3 edition of In the News:

• New Research Associates CHD Patients’ Weight with Post-Surgery Outcomes
• Distinctions in Tumor Biology Provide Insights for Precision Treatments
• Dr. Forrest Co-Investigator for New Clinical Trials Network
• Dr. Amy Goldstein Helps Establish New Mitochondrial Disease Guidelines

Keep up with our news, stories, and updates in real time by following us on Twitter, Facebook, LinkedIn, or Instagram. Or subscribe to our newsletter to get an email sent every other Friday by signing up here, or via the box on the upper right of this page.