Saturday, February 16, 2013

Interesting conference data of the week

So tonight's the last night I'm at this conference (American Society for Bone Marrow Transplant if you're curious), so I figured it would be an appropriate moment to share some interesting data issues that came up in the sessions I went to.

The most interesting one came from a group out of Johns Hopkins, in their talk about their combined inpatient/outpatient program.  About 20 years ago now, they started to transition their transplant patients from one long inpatient stay to a shorter stay with a sort of intensive outpatient clinic follow up.  This worked really well, cut costs, helped patients feel more autonomous, etc.  What was interesting is that as they followed up on patients and how they did, they found that patients treated under this model did better on every single quality of life metric* except one: feelings about appearance.

Since there is no reason to believe they actually looked any different, the only conclusion they could reach is that the more "normal" people the cancer patients saw, the more acutely aware they were of how they looked.  When they were in the hospital, they were surrounded by other patients, but on the outside they were exposed to more healthy people.

I thought that was an interesting example of how much quality of life measures can depend on what your environment is and who you're being exposed to.  We like to act like hapiness or contentment were definitive values that are totally internally generated, but they're not.  People compare themselves to others.  We just can't help it.

*The hard health measures (recovery, blood counts, etc) were the same with either method.


  1. I immediately wondered about psychiatric populations and the subgroup that has trouble staying out of the hospital.

    1. It's an interesting debate in the transplant world: do you set up the system in a way that gives maximum autonomy to functional adults, or do you set up a more intense system that will benefit those who are not functional?

      It's actually a hard question. My best answer is we need two systems to put people in to based on compliance and resources (emotional, psychological, family). We should give maximum freedom and quality of life to those who need it/want it, but have a strong back up system for those who couldn't function before they got cancer (and see no need to start now).

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