Alright, exercise time: rather than picking out the individual things wrong with this scenario, can you describe (at a relatively high level) what your plan would be, if you were to plan this? From scratch, with today’s technology, what would be the optimal way to run this sort of study?
1) Start with a list of all hemodialysis patients in your area (city, province, or country depending on how participants you want.) The information on them should all be held in one database. (At my workplace, it’s split between two databases, only one of which I am cleared to access.) Say there are 100,000 names on the list.
2) Use a simple program to search through those names, marking true/false for various selection criteria. Even if the program isn’t perfect, say you reduce the list to 1,000 names. A human employee could then check over this much shortened list.
3) Contact the patients who qualify. Right now, the research staff have to drive to the clinic or hospital and see the patients during their dialysis in order to ‘consent’ them, or ask them whether they want to participate in the study. I don’t know how much of this is based on the regulations for medical research, but maybe the nurses could hand out pamphlets and patients could check YES or NO if they were interested in being in the study and willing to be contacted by telephone. This wouldn’t always work, but it could be helpful.
4) The consented patients need to have baseline, 6 month, 12 month and 18 month blood draws. I probably spend 8 to 10 hours a month making colour-coded packages of blood tubes to give to the nurses. What if instead we could mail them a box of blood tubes and sheets of blank labels, and send the label with patient code numbers by email? Assuming each clinic has the facilities to print, they could print the labels themselves, and use another cheat sheet we send by email to connect each patient to their number code. (For confidentiality and other reasons, the tubes can’t be stored with the patient names.) This would mean a little extra work for the staff at each clinic, but assuming most nurses can read and follow directions as well as I (not even a nurse yet) can, it would save hugely on labour overall.
5) Right now we use couriers to move blood samples to the labs. I can’t think of any ways to improve the efficiency of this step, but they probably exist.
6) Once the samples are studied, it would be nice to receive the data as a file by email, rather than as paper lab printouts that have to be entered into our database by hand, increasing the risk that an over-tired student employee like me will make an error. Some of our results appear in the main patient database under monthly blood work; another simple program could retrieve these.
7) At this point, analyzing the data is done on the computer anyway, but following this process, it might be in a more optimal format.
I’ve tried to stay within the bounds of today’s technology. Obviously research will get easier if and when portable ‘labs-on-a-chip’ can be made on desktop fabricators on location, with the results uploaded automatically into our files.
“It doesn’t feel planned.”
Alright, exercise time: rather than picking out the individual things wrong with this scenario, can you describe (at a relatively high level) what your plan would be, if you were to plan this? From scratch, with today’s technology, what would be the optimal way to run this sort of study?
OK, I’ll give it a go.
1) Start with a list of all hemodialysis patients in your area (city, province, or country depending on how participants you want.) The information on them should all be held in one database. (At my workplace, it’s split between two databases, only one of which I am cleared to access.) Say there are 100,000 names on the list.
2) Use a simple program to search through those names, marking true/false for various selection criteria. Even if the program isn’t perfect, say you reduce the list to 1,000 names. A human employee could then check over this much shortened list.
3) Contact the patients who qualify. Right now, the research staff have to drive to the clinic or hospital and see the patients during their dialysis in order to ‘consent’ them, or ask them whether they want to participate in the study. I don’t know how much of this is based on the regulations for medical research, but maybe the nurses could hand out pamphlets and patients could check YES or NO if they were interested in being in the study and willing to be contacted by telephone. This wouldn’t always work, but it could be helpful.
4) The consented patients need to have baseline, 6 month, 12 month and 18 month blood draws. I probably spend 8 to 10 hours a month making colour-coded packages of blood tubes to give to the nurses. What if instead we could mail them a box of blood tubes and sheets of blank labels, and send the label with patient code numbers by email? Assuming each clinic has the facilities to print, they could print the labels themselves, and use another cheat sheet we send by email to connect each patient to their number code. (For confidentiality and other reasons, the tubes can’t be stored with the patient names.) This would mean a little extra work for the staff at each clinic, but assuming most nurses can read and follow directions as well as I (not even a nurse yet) can, it would save hugely on labour overall.
5) Right now we use couriers to move blood samples to the labs. I can’t think of any ways to improve the efficiency of this step, but they probably exist.
6) Once the samples are studied, it would be nice to receive the data as a file by email, rather than as paper lab printouts that have to be entered into our database by hand, increasing the risk that an over-tired student employee like me will make an error. Some of our results appear in the main patient database under monthly blood work; another simple program could retrieve these.
7) At this point, analyzing the data is done on the computer anyway, but following this process, it might be in a more optimal format.
I’ve tried to stay within the bounds of today’s technology. Obviously research will get easier if and when portable ‘labs-on-a-chip’ can be made on desktop fabricators on location, with the results uploaded automatically into our files.