Article Concerning the Rules for Organizing and kNowing how to Name Your clinical study Magically, or the ACRONYM article

Most scientific disciplines, at their very core, amount to a bunch of big five year olds getting together and seeing if they can make something fun happen. Trial and error is the name of the game, and medicine is no different. We call our grand experiments clinical trials. One group of patients gets the newest idea for treatment, and the other group gets either nothing or the old treatment. The race is on, and we see who wins (vast oversimplification, but the general idea is there). Those of you in the audience that are medical know much more than this of course. However, there is a little known secret to clinical trials that, in my estimation, is essential to the results of a clinical trial having a lasting impact on medicine...the name.

If you ever been involved in a medical argument, you will hear the names of clinical trials flying left and right like bullets in warfare. Conjecture and personal opinion will only get you so far. We treat based on facts, people, and we get our facts from trials. You might think that we physicians are too objective to be swayed by things like the name of the clinical trial...you'd be wrong. It's a lot easier to quote the FAME or COURAGE trial than some long sentence that actually says what the trial is investigating. Heck, even the lowly med student or resident can remember a one word name or catchy phrase. Just that much easier to whip out that latest trial during rounds and impress the attending. For those that don't know, spontaneously producing a clinical trial on the spot during rounds to either prove your point or prove someone else wrong is the holy grail of medical students. You pull this off, and you can write your ticket for that rotation. It's kind of like winning American Idol without the fuss of months of singing on national television and listening to judges make dumb comments.

You may wonder what kind of criteria there are for a "memorable" clinical trial name. Based on previous results, here are a few guidelines (not strict of course, as creativity is encouraged here):

1. Brevity is key. One word is better than two. Shorter is better...you get the picture.

2. References to mythology are not only acceptable, but encouraged. Remember your audience. We're nerds.

3. The more bold and glamorous, the better. Titles like AFFIRM, AWESOME, VICTORY are examples. Go big or go home. Picture how the title will be listed when you are accepting the Nobel...and then make it even more bold.

4. The acronym doesn't have to fit perfectly, or at all. The original idea was the one word allows you to remember the entire name of the trial. Now that the fad has taken off, investigators no longer feel the need to confined by things like the definition of the word acronym. Just name it what you want and figure out the rest later.

5. A catchy name with a medical play on words is just flat awesome. My favorite example would have to be PROVE IT-TIMI 22. The number at the end aside, this title is genius. For the non medical folk, TIMI stands for Thrombolysis in Myocardial Infarction. The name can be found everywhere now. There is a TIMI risk score, TIMI study group, etc. Other clinical trials from the same study group have the TIMI acronym, but none achieved what this one did. A good title that plays directly off the name of your study group? Please. Stop it. We're not worthy.

So there you go folks. I've given you the keys to the academic kingdom. Go forth, publish, and change the world. For you laypeople, this should give you reassurance that medicine follows fads just like normal culture does. We ain't any better; we just dress it up enough to make it sound good.

The Doctor Becomes the Patient

Like many doctors, part of what inspired me to go into medicine was spending a considerable amount of time on the wrong side of the doctor-patient relationship (that being the patient of course). Before medical school, that would make me a normal patient. Once you get some medical training, the term normal patient never applies to you. Ask anyone in the medical field. Doctors are the worst patients. Very few can handle such a drastic role change. One day you are making life or death decisions (OK, slightly exaggerated) on sick patients and the next you're asking the nurse if you can "use the potty." Quite the role reversal there. I've seen physicians-turned-patient argue with nursing staff about how they gave daily stool softeners 15 minutes too early. We really are a crazy bunch.

I've taken care of many of these patients before, and the key is let them make decisions. I'm not talking about letting them treat themselves but giving options whenever possible. They will be much more likely to go along with you if they feel that they're participating in their own care. Being given multiple options for how and where to urinate may seem trivial, but it may be what holds together the psyche of some of the most neurotic people you will ever meet (I know, I'm one of them). The fun part is that the patient usually knows exactly what you are doing. They have likely treated other patients like this themselves. You can usually share a good laugh with them once you get their initial anxiety under control. Good physicians are fairly self aware. Part of what makes them good is the ability to perfect every detail of what they do. That includes being able to "poo poo in the potty."

In other news, life is busy at the HumorMD household. We have recently had a new addition, which we are very proud of. HumorMD Jr. and I had some quality time last night. We discussed diagnosing a STEMI (type of heart attack), and he's already an expert. Maybe we'll add world renowned physician to his previously mentioned athletic prowess. I just feel bad for the other kids getting compared to him...