EMI Scanners: A Revolutionary Medical Innovation?

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Discussion Overview

The discussion revolves around the identification and evaluation of significant medical innovations, specifically questioning the validity of a list derived from a Health Affairs article that ranks top medical innovations. Participants explore potential replacements for items on the list and engage in a debate about the definitions of "innovation" and "discovery." The scope includes theoretical considerations of medical advancements and their historical context.

Discussion Character

  • Debate/contested
  • Conceptual clarification

Main Points Raised

  • Some participants suggest that tourniquets should replace hip/knee replacements or cataract extraction/lens implants due to their life-saving capabilities.
  • Penicillin is proposed by several participants as a replacement for SSRIs and ACE inhibitors, although its classification as an innovation is contested.
  • One participant argues that discovery by accident does not qualify as innovation, while others counter that many significant discoveries were accidental.
  • There is a discussion about the timeframe of the innovations listed, with some arguing that penicillin should not be included due to its age relative to the specified 25-30 years.
  • Participants express differing views on the definitions of "innovation" and "discovery," with some emphasizing that the intent of the researcher does not dictate the classification of an innovation.
  • One participant highlights that a majority of the top innovations listed were developed in the US, suggesting a strong history of innovation in American healthcare.
  • The historical context of the EMI scanner's development is shared, linking its invention to the success of EMI Records and the funding it provided.

Areas of Agreement / Disagreement

Participants express multiple competing views regarding what constitutes a significant medical innovation and whether certain items should be included or excluded from the list. The discussion remains unresolved, with no consensus on the definitions or the validity of the proposed replacements.

Contextual Notes

There are limitations regarding the definitions of innovation and discovery, as well as the criteria for the innovations listed in the original article. Participants reference the timeframe of the innovations and the geographical context of their development, which may affect their arguments.

mheslep
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I've read an indirect reference to a Health Affairs article that polled leading internists for the their pick of the top medical innovations:
  • MRI/CT
  • ACE inhibitors
  • Balloon angiography
  • Statins
  • Mammography
  • CABG surgery
  • H2-receptor antagonists
  • SSRIs
  • Cataract extraction and lens implants
  • Hip and knee replacements

Wanted to post this up here for comments and query: would anyone care to make replacements on the list?
 
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mheslep said:
I've read an indirect reference to a Health Affairs article that polled leading internists for the their pick of the top medical innovations:
  • MRI/CT
  • ACE inhibitors
  • Balloon angiography
  • Statins
  • Mammography
  • CABG surgery
  • H2-receptor antagonists
  • SSRIs
  • Cataract extraction and lens implants
  • Hip and knee replacements

Wanted to post this up here for comments and query: would anyone care to make replacements on the list?

Tourniquets may be a crude device but they save thousands of lives every year, especially in war torn places. Tourniquets should replace hip/knee replacements or cataract extraction/lens implants because tourniquets save lives, not merely improving them.

Also penicillin should easily replace SSRIs and ACE inhibitors.
 
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Ah, turns out the article is http://healthaff.highwire.org/cgi/reprint/20/5/30". The survey was set up by proposing 30 med. innovations and having the internists choose the top ten already listed above.

1. ___ ACE inhibitors and angiotensin II antagonists
2. ___ Balloon angioplasty with stents
3. ___ Bone densitometry
4. ___ Bone marrow transplant
5. ___ CABG
6. ___ Calcium channel blockers
7. ___ Cataract extraction and lens implant
8. ___ Fluoroquinolones
9. ___ Gastrointestinal endoscopy
10. ___ H. Pylori testing and treatment
11. ___ Hip and knee replacement
12. ___ HIV testing and treatment
13. ___ Inhaled steroids for asthma
14. ___ IV-conscious sedation
15. ___ Laparoscopic surgery
16. ___ Long-acting and parenteral opioids
17. ___ Mammography
18. ___ MRI and CT scanning
19. ___ Nonsedating antihistamines
20. ___ NSAIDs and Cox-2 inhibitors
21. ___ Proton pump inhibitors and H2 blockers
22. ___ PSA testing
23. ___ SSRIs & recent non-SSRI antidepressants
24. ___ Recent hypoglycemic agents, e.g. metformin
25. ___ Cardiac enzymes, e.g. CPK, troponin
26. ___ Sildenafil
27. ___ Statins
28. ___ Tamoxifen
29. ___ Third-generation cephalosporins
30. ___ Ultrasonography incl. echocardiography

Edit: Criterion for the thirty:
The innovations were chosen by an electronic search of the Journal of the
American Medical Association and the New England Journal ofMedicine for
the past twenty-five years, based on the frequency with which the
innovations were the principal focus of published articles. An adjustment
was made to include more recent innovations that could
have been the subject of articles for only a few years. We modified
and supplemented the resulting list according to our judgment concerning
the clinical and economic importance of particular innovations.
We do not claim that the thirty innovations chosen for the
survey are unambiguously the most important ones of the past
thirty years;
 
Last edited by a moderator:
gravenewworld said:
Also penicillin should easily replace SSRIs and ACE inhibitors.

Penicillin was detected by accident, therefor it is not an innovation.
 
greghouse said:
Penicillin was detected by accident, therefor it is not an innovation.

?


Do you know how many things have been discovered by accident?


-Plastic
-Teflon
-Viagra
-Cis-platin
-Vaccination
-Xrays
-IR
-Radioactivity
-Safety glass
-Microwave oven
-Archimedes and density


to name a few
 
Of course i know. Helium was discovered on the sun before it was discovered on earth. Some things where discovered while trying to discover something completely different as well. Discovery by accident is not classified as innovation.
 
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greghouse said:
Of course i know. Helium was discovered on the sun before it was discovered on earth. Some things where discovered while trying to discover something completely different as well. Discovery by accident is not classified as innovation.

Whatever. I am not about to get into a heated argument over semantics. IMO, there is absolutely nothing about the definition of the term "innovation" which requires the final product to be the actual intent of the researcher.
 
Ok in that case penicillin should definitely be on the list, considering the impact of it when first put in use. It should for instance absolutely replace CABG surgery.
 
  • #10
Um, penicillin has been around a lot longer than the past 25-30 years, which is the time frame specified by that article. It's talking about recent innovations, not innovations of all time (which are no longer very innovative, by definition).
 
  • #11
gravenewworld said:
Whatever. I am not about to get into a heated argument over semantics. IMO, there is absolutely nothing about the definition of the term "innovation" which requires the final product to be the actual intent of the researcher.
There's a difference between 'discovery' and 'innovation'. Much credit to those who to both, but they are not the same thing.
 
  • #12
A point highlighted in the mention of the top ten innovations nominated by the internists: 8/10 of them were made in the US. Whatever the US problems in health, lack of innovation is not one of them.
 
  • #13
Moonbear said:
Um, penicillin has been around a lot longer than the past 25-30 years, which is the time frame specified by that article. It's talking about recent innovations, not innovations of all time (which are no longer very innovative, by definition).

It wasn't specified in the first post in this thread that it had to be innovations of the last 25-30 years. Nope:wink: just as CABG surgery isn't innovative anymore, it only was when it was presented the first time and then put to use. An innovation is only innovative when it innovates its field for the first and thereby the last time.
 
  • #14
greghouse said:
It wasn't specified in the first post in this thread that it had to be innovations of the last 25-30 years. Nope:wink: just as CABG surgery isn't innovative anymore, it only was when it was presented the first time and then put to use. An innovation is only innovative when it innovates its field for the first and thereby the last time.

No, it wasn't specified in the first post, but it was specified in the follow-up post with the full article to give us context to the cited list. And, yes, innovation is probably the wrong word for the time frame specified. Invention might be more appropriate.
 
  • #15
Correction: the country of origin for the for the innovations was not listed in the original study. I picked that up elsewhere:
Innovation Driven Health Care

...the United States has produce more medical Nobel Prize winners than all other nations combined; drug companies headquartered here have created 8 of the 10 top selling drugs; and, in the 30 innovations listed by Fuchs and Sox, 8 of 10 came from the United States...
MRI and CT originated in England.
 
  • #16
Wow, I had never heard this.

As a direct result of The Beatles’ success [EMI Records], Dr Timmis claimed, the scanner’s inventor, Sir Godfrey Hounsfield, was able to devote about four years developing the scanner from its 1968 prototype, to something that could be used in a clinical setting. His work was done in the Central Research Laboratory, a facility near Heathrow airport that was part of the EMI Group. Having sold 200 million of the Fab Four’s singles, (at seven inches, almost enough vinyl to stretch the length of the equator) the Beatles’ record company, EMI, was able to fund Hounsfield to do his research and the scanner was ready be used in hospitals in the 1970’s.

Dr Timmis said that EMI’s research had initially estimated a worldwide need for only 25 of the machines, but thanks to their decision to invest in the pioneering technology, now there are thousands of the scanners worldwide being used in hospitals every day.
http://www.whittington.nhs.uk/default.asp?c=2804&t=1


One comment: EMI scanners were terrible! They were down more than they were up.