Can Google Glass make you a better surgeon?

Advocates of Google Glass in surgery are apparently desperate to find some use for the device.

An article headlined "Google Glass makes doctors better surgeons, Stanford study shows" concluded that the study offered "compelling preliminary evidence that the head-mounted display can be used in a clinical setting to enhance situational awareness and patient safety."

Using an app capable of displaying vital signs on Google Glass in real time, 7 surgical residents recognized critical desaturation in simulated patients having procedures under conscious sedation 8.8 seconds faster than a control group of 7 residents relying on standard monitors. Glass-wearing residents also became aware of hypotension 10.5 seconds before the control group.

Not mentioned in the article but present in a linked abstract of the paper not yet submitted for peer review was this pearl—neither difference was statistically significant.

This evidence is not that convincing. Even if the difference had been statistically significant, it is surely not clinically important.

How seeing vital signs on Google Glass is better than relying on the simple alarms that are built in to every monitor is not clear. Either way, you must stop the operation and look up to see the vital signs.

In a brief video accompanying the article, a surgeon can be seen rather clumsily activating and resetting the app on his Google Glass. The time required to perform these maneuvers apparently was not discussed.

The article, probably written directly from a press release, took a comedic turn with this sentence, "One test demanded that the resident perform a bronchoscopy, in which the surgeon makes an incision in the patient’s throat to access a blocked airway." But bronchoscopy does not involve making an incision in the throat or anywhere else.

If you would like to hear a different side of the Google Glass story, check out this video review from GeekBeatTV entitled "Google Glass is the worst product of all time." You can forward to the 3:45 mark to get past the woes of wearing prescription glasses with Google Glass and hear about the poor battery life, the balky commands, the system crashes, and more.

Google Glass in the OR: Not ready for prime time

The Royal London Hospital and the Barts and The London School of Medicine and Dentistry presented the first live-streamed surgical procedure in the UK. The operation was an extended right hemicolectomy with resection of a metastatic liver lesion.

I was able to view the entire broadcast portion of the surgery live, and you can see it if you click  [2/27/15 Addendum: The link to the video has been taken down. Sorry.]

Here is what I thought about the event.

Annoying things about medical reporting

1. An article in Time magazine is headlined "It's Not You, Doctors Are Just Rude."

The first sentence of the article is " Doctors-in-training are in need of a dose of compassion."

It describes a paper from Johns Hopkins and the University of Maryland about intern communication behaviors. Interns were watched by trained observers.

Although interns were pretty good about touching patients and asking open-ended questions, they only introduce themselves 40% of the time and explained their roles only 37% of the time. They also sat down with patients just 9% the time.

Observations were made on 732 patient encounters, but only 29 first-year internal medicine trainees were involved.

The abstract did not explain whether these first-year interns had received any training in communication ("interpersonal skills and communication" is one of the 6 ACGMA core competencies), nor did it state at what point in their first year the study was done.

The headline of the piece in Time is a bit misleading since it suggests that all doctors are rude. Similarly, the first sentence of the article somehow brings in compassion.

The study was not about rudeness or compassion; rather it was about communication.

Maybe Johns Hopkins and the University of Maryland need to do a better job of teaching its interns, and maybe Time magazine needs to do a better job of reporting.

2. An article from a website called iMedicalApps gushes with excitement about the fact that Google Glass can be used by a surgeon to view continuous vital signs while operating.

It could be that Google Glass is going to revolutionize medical care, but I don't think it's going to be useful in the context of a surgeon looking at vital signs while she is operating.

You cannot concentrate on the operation and look at a Google Glass display of vital signs.

When I was operating, I was fully focused on the procedure. I depended on the anesthesiologist to alert me to any significant changes in the patient's vital signs.

If I wanted to know what the vital signs were, I simply asked the anesthesiologist. For me, that low-tech action was adequate.

3. Here's a headline from the Los Angeles Times. "Walk this way: Men slow down when sex is at stake."

This one is about a study from PLOS One that looked at 11 male and 11 female college students who walked around a track alone, with a significant other or with friends of the same or opposite sex. The study found that men walked significantly more slowly when they were paired with a female romantic partner compared to walking with another man or a woman who was simply a friend.

The authors concluded following: "Because the male carries the energetic burden by adjusting his pace (slowing down 7%), the female is spared the potentially increased caloric cost required to walk together."

This finding supports the idea that men are helping their romantic partners conserve energy and thus promote reproductive success. This is apparently a big issue in hunter-gatherer societies who walk long distances. It's not quite so clear why college students walking 400 meters would do the same thing. The authors speculated that it might be an evolutionary issue.

Regarding the article, a woman who follows me on Twitter said, "Not my hubby, tho we do have 2 kids."

Sorry LA Times, this one's not about sex, but I guess it makes for a better headline.