Tracing a Personal Journey Linking Music, Art, Physics and Clinical Medicine

Here I trace my personal journey linking music, art, physics and clinical medicine in a new article, exploring holistic connections, finding symmetries between sound waves, visual art, and quantum phenomena. This has led me to integrate artistic, scientific and humanistic viewpoints, seeing medicine as continuing his musical creativity.

Citation: Heston, Thomas F. (2023). The Beholder - A Symphony of Life in Medicine. International Journal of Scientific Research. 2023;12(12):1-2. https://doi.org/10.5281/zenodo.10246612 

Coronary calcium and normal myocardial perfusion

 Among patients with normal myocardial perfusion on cardiac testing, higher coronary calcium scores are associated with increased patient age and hyperlipidemia. Even with normal perfusion, around 10% of patients had concerningly high calcium scores above 400. Assessing coronary calcium may provide additional risk information.

Citation: Heston T, Merrill J, Bengel F, Wahl R. Coronary calcium scores in patients with normal myocardial perfusion. Journal of Nuclear Medicine. 2009;50(Suppl 2):1160. 

DOI: 10.5281/zenodo.10230802 

URL: https://jnm.snmjournals.org/content/50/supplement_2/1160

The Ethical Significance of Statistics in Medical Research

 A new review article examines the pivotal role statistics plays in upholding research integrity and patient safety. It scrutinizes common statistical errors in medical studies, like p-hacking and neglecting limitations. Using historical examples, it demonstrates how such errors have resulted in flawed conclusions causing public harm, including with hormone therapy research. Recommendations encompass more statistical rigor by ethical review boards assessing proposals, requiring open access data to enable peer review and mandating an ethical discussion. Overall, properly applying statistical principles is an ethical obligation, ensuring findings are valid, generalizable and reproducible.

Citation: Heston TF. Statistical Ethics in Medical Research: A Narrative Review. Jour Clin Med Res. 2023;4(3):1-10. http://dx.doi.org/10.46889/JCMR.2023.4308 

Beware Statistically Significant Findings in Isolation

 Statistical tests answer a narrow, mathematical question - is there likely a real difference between group means? But science aims to produce clinically useful knowledge to benefit individual patients. This nuclear medicine study serves as a sobering reminder that statistical significance does not reliably predict clinical usefulness.

While group averages may differ in a statistically compelling fashion, typical cutoffs misclassify a full third of healthy individuals. So a statistically significant finding applied blindly in clinical practice, without further consideration of its clinical implications, is prone to harm individuals.

The mathematical abstractions of statistics have undeniable value. But statistical significance is easily misinterpreted as clinical importance when groups are viewed as interchangeable with individuals. As this study shows, what seems persuasive in aggregate often breaks down at the individual level. Statistical findings should be interpreted judiciously, with due consideration of clinical context and implications.

Citation: Heston TF, Wahl RL. How often are statistically significant results clinically relevant? Not often. J Nucl Med. 2009;50(Suppl 2):1370. https://zenodo.org/doi/10.5281/zenodo.10198933

The Efficacy of Smoking Cessation Strategies: A Meta-Analysis

A meta-analysis published in 1993 reviewed research on the effectiveness of various smoking cessation interventions. The analysis found that interventions delivered in clinical settings were more effective than those implemented in community settings. Among the most effective strategies were brief counseling from a healthcare provider, nicotine replacement therapy, workplace smoking bans, and increased tobacco excise taxes. While the meta-analysis sheds light on the short-term efficacy of different approaches, more research is still needed to understand their long-term outcomes. Overall, the findings underscore the importance of incorporating smoking cessation initiatives into comprehensive tobacco control programs.

Citation: Heston TF. Smoking cessation strategies: a meta-analysis. Southern Medical Journal. 1993;86(Suppl):S36. doi:10.5281/zenodo.10120006

Addressing Gender Bias in Heart Attack Treatment

 Despite increased awareness, gender bias persists in how women with heart attacks are diagnosed and treated versus men. Delays in ECG and ICU admission for women can negatively impact outcomes. Protocols and training must be updated to eliminate disparities. Improving heart attack care for women will improve outcomes for all.

Citation: Heston, T. F., & Lewis, L. M. (1997). Gender bias in acute myocardial infarction. The American Journal of Cardiology, 79(6), 844. https://doi.org/10.5281/zenodo.10095950

Impact of Self-Monitoring on Weight Reduction

This study delves into the impact of self-monitoring on weight reduction in participants of a hypertension prevention trial. The research, involving 32 overweight individuals, focused on the effectiveness of a 14-week dietary and exercise regimen. The findings reveal that consistent food logging and initial BMI are crucial in predicting weight loss success. The study's intervention, comprising professional-led sessions, aimed at a modest caloric deficit and increased physical activity. The outcome demonstrates a clear link between self-monitoring habits and weight loss, providing valuable insights for health professionals and individuals aiming for weight management.

Citation: Heston, T. F. (1992). Predictors of weight loss in a hypertension prevention program. Southern Medical Journal, 85(Supplement), 3S-31. https://doi.org/10.5281/zenodo.10079949