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Blogging for a Radiologist: An Easy Method for Web Site Building and Information Exchange
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Sumer Kumar Sethi, Senior Resident, Radiology LADY HARDINGE MEDICAL COLLEGE, DELHI, INDIA
Send letter to journal:
sumerdoc{at}yahoo.com Sumer Kumar Sethi
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Editor: In response to the article "Informatics in Radiology (infoRAD): HTML and Web Site Design for the Radiologist: A Primer” by Ryan et al (1), I would like to submit my experience with another easy method for building a Web site known as “blogging” (maintaining a Web log). As a radiologist, I use my blog (www.sumerdoc.blogspot.com, or www.indianradiology.com) to post interesting cases from my routine practice along with any interesting abstracts I come across during my day-to-day work. Sometimes, to interest readers, I put up a few cases as image quizzes and have seen a tremendous response. Blogs are like small, unofficial newspapers that circulate among diverse readers. As a physician, I have an opportunity to share my experiences with colleagues, medical students, and patients. For a radiologist in particular, as radiology is an image-based science, a blog is a satisfying endeavor in that you can share your experiences with others instantaneously instead of going through the complex and time-consuming process of getting them published in a journal. I agree that some would question the quality control in such publication, but, ultimately, only good-quality work survives. In this effort, I used the following free Web sites: www.blogger.com (for building the blog) and www.hello.com (for posting images). The success of this project can be measured by the fact that in the last full year of “rad-blogging,” more than 20,000 visitors came to the site from all over the world, with thousands of queries from patients, colleagues, and many interested students. To conclude, rad-blogging might well be the coming premier method for informatics in radiology (infoRAD), and it might revolutionize the way information is exchanged in radiology. Reference 1. Ryan AG, Louis LJ, Yee WC. Informatics in radiology (infoRAD): HTML and Web site design for the radiologist: a primer. Radiographics 2005; 25:1101-1118. Dr Ryan responds: I thank Dr Sethi for his interest in our article (1), for his stimulating comments, and for giving us the opportunity to address issues outside the scope of the original article. He is to be congratulated for his very successful site, which achieves many of the goals stated in our article for a radiologist constructing a Web site, attracting many visitors and promoting the specialty. I have a number of comments to make, however, on Dr Sethi’s recommendations, some of which I would not be happy to promote. The company at www.blogger.com that Dr Sethi recommends certainly offers a painless way to set up a Web page, permitting the introduction of text, images, and multimedia file formats. There is no doubt that it is a facile means for sharing interesting cases and getting almost instantaneous feedback from a wide readership. I would categorize this as a “ready-made” means of producing a Web page, with the disadvantage that one has little say or choice in the appearance of the page. As Henry Ford once said, “Any color so long as it’s black.” I have some reservations about recommending this method to the radiologist who wishes that his or her Web site serve as a means by which patients can find out about the services the radiologist offers and on whose pages advice might be given. The crux of the issue is the degree of interactivity one permits on one’s site, specifically the use of message boards. Although patients frequently share personal details on the Web through support sites such as www.breastcancer.org/ or through diaries chronicling their own battle with illness, this is usually in the spirit of shared experiences rather than true patient consultation. I may be wrong, but it seems unlikely to me that a patient, particularly in the early stages of an illness, would want or be satisfied with an online consultation with a physician the patient has never met. Even more unpalatable is the idea of a physician offering advice to a patient in such an open format, given the immediate loss of confidentiality. Such a physician leaves himself or herself open to challenge, in the courts if the advice proves incorrect or if the patient comes to some harm (ie, without actually attending the physician [or any physician] for a consultation). Generic advice offered on general medical Web sites is relatively protected from such challenges; however, advice given on a named physician’s or practice’s Web site or blog would be much more liable to constitute a duty of care, particularly in response to a patient’s specific query. Similarly, message boards may be useful for sharing information and having “online feedback,” but they are fraught with danger in the setting of a Web site that promotes a practice. There is a very real risk of other users posting their “advice” on your blog, which the unsuspecting or “net-naďve” patient may read as your advice. Unsavory comments or dangerous “advice” placed by unwelcome visitors may appear uncensored on your site, for which you are personally responsible. Even though the sites created at blogger.com permit the “owner” of the site to edit and delete such unsavory or dangerous comments, the comments in question remain as your property until you delete them. Blogging may well become the default means by which unofficial communications take place on the Internet in the near future; however, the emphasis remains on “unofficial.” With regard to blogs replacing journals, I would disagree outright. Blogs are likely to replace newsletters and newspapers in years to come, but this reflects the content of those publications (ie, reportage framed and intermingled with subjective opinion). Such “reporting” can never replace objective peer review in the sphere of science. The argument that “only good work survives” does not hold water given the number of questionable medical practices that have survived for centuries with no basis in science and no evidence to support their use. Published work of poor quality may take some time to be disproved, and in the meantime patients suffer because of erroneous conclusions. The clear way forward is the expeditious online publication of full peer-reviewed articles as supported by the National Institutes of Health (NIH) (and required of publications produced with NIH grant aid), and to make the findings as accessible as possible to the widest audience. Although searching PubMed produces few results for “blog” (six relevant articles of 24), “weblog” (one article), “web log” (eight entries of varying relevance), and “blogging” (four articles) (none of which were in Radiology, RadioGraphics, AJR, or JVIR), Web logs are currently being used in exciting and innovative ways in some practices. The key issue is using the Web as a means of exchanging and transferring data in real time and using highly secured and role-specific access. Burke and White (2) in particular have spearheaded an exceptionally innovative system whereby selected data on each patient in the pediatric cardiac intensive care unit at the Miami Children’s Hospital are uploaded in real time together with intermittent updated photographs of the infant, so that any member of the team can access the data from any Internet-enabled device (laptop, handheld, or mobile phone) by using 128-bit encryption and role-specific access (predefined when each new team member is registered as a user). This team has found that the real-time updating of outcomes data in particular has had a positive effect on morbidity and mortality numbers and contributes meaningfully to ongoing prospective data harvesting for research purposes. On the associated Web site open to the public (www.pediatricheartsurgery.com), the outcomes for all procedures performed are posted for all parents to see prior to their child’s undergoing surgery. Other workers (eg, large research groups [3] or PACS administrators [4]) are using Web logs as an Internet-based chalkboard to keep each other updated on progress on separate portions of ongoing projects. The latter group trialed a commercially available “blog” package, Invision Power Board, and found it provided an efficient and effective means of allowing communication among all personnel involved. It is likely that such innovations will continue to emerge; however, for the foreseeable future secure access rather than open access will remain the norm. References 1. Ryan AG, Louis, LJ Yee, WC. HTML and Web site design for the radiologist: a primer. Radiographics 2005; 25:1101-1118. 2. Burke RP, White JA. Internet rounds: a congenital heart surgeon's Web log. Semin Thorac Cardiovasc Surg 2004; 16:283-292. 3. Sauer IM, Bialek D, Efimova E, Schwartlander R, Pless G, Neuhaus P. "Blogs" and "wikis" are valuable software tools for communication within research groups. Artif Organs 2005; 29:82-83. 4. Mongkolwat P, Kogan A, Koh J, Channin DS. Blogging your PACS. J Digit Imaging. 2005; Published September 2 [Epub ahead of print]. |
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