Tuesday, November 08, 2011

The SCAD ladies set an example

John Novack, from Inspire.com, a place that organizes online patient communities around various diseases and conditions, sent me this link to a great online report entitled, "The SCAD Ladies Stand Up: Stories of Patient Empowerment."

From the introduction: 

The “SCAD Ladies” story is an extraordinary one: women with a rare heart disease self-organized online and began studying their disorder. This patient initiated effort led to physicians at the Mayo Clinic launching new research to learn more about spontaneous coronary artery dissection (SCAD).

The first essay is by Sharonne Hayes, a Mayo doctor, who notes:

Enter “patient-initiated” research. Still in its infancy, this may prove to be the new “gold standard” for the study of uncommon medical conditions.

It stands to reason that the people most highly motivated to support or to even initiate investigations of a rare condition are those personally affected and their close relatives. Our experience with the “SCAD ladies”, Katherine Leon and Laura Haywood-Cory and their online “heart sisters”, provides an example of successful patient-driven, social networking–enabled research. Our pilot and ongoing studies demonstrate that if a large organized group of patients self-identify and present themselves to researchers as study participants, a major barrier to rare disease research can be eliminated.

Delivering a patient-prioritized research agenda to potential investigators, as was done by the SCAD group, also may serve as an incentive for busy clinician-investigators and help convince them to commit to a new line of research or to this unfamiliar study methodology. Many organized patient advocacy groups have developed research agendas. However, the highly engaged and committed women who prompted the SCAD study, linked only via the Internet, demonstrated levels of sophistication and specificity in their patient-initiated research questions that were on par with those developed by formally organized groups. They had clearly done their research, and as a result, allowed this researcher to more clearly visualize the potential of success.

Check out the other essays from patients, which follow in the report.  They are well worth reading.


e-Patient Dave said...

This is indeed an important moment in the unfolding reality of patient engagement. For students of healthcare transformation there's a LOT going on here.

The big news broke in August in the WSJ: When Patients Band Together: Using Social Networks to Spur Research for Rare Diseases; Mayo Clinic Signs On.

The Society for Participatory Medicine happily jumped on it, on e-Patients.net: Rare disease patient community and Mayo explore trial with far-flung patients.

Note that in addition to the patient-initiated aspect of this research, there's also the issue of whether it's possible to aggregate "long tail" patients for rare disease research. This issue has been a HUGE inhibitor for such diseases, I've heard.

On the WSJ, somebody commented, advocating for universal care: "I find it a disgrace that in today’s world, these women who are and have been so gravely ill, have had to become their own advocates in order to improve their diagnoses." Susannah Fox of Pew Internet posted an as-usual-insightful follow-up, flipping the observation: When Patients Band Together: Far From a Disgrace. Her point is that the real story here isn't "Healthcare failed people so they had to do it themselves," it's "At the fringes of healthcare, when science was out of answers, these patients could connect - and they changed what's possible."

Tellingly, the Mayo Clinic listened. I can't wait for the day when all healthcare providers will do so, as eagerly as Mayo!

Anonymous said...

This is indeed a wonderful story, but for me it goes beyond just health care. What struck me most profoundly was the reminder that the Internet (and Google search) has so fundamentally changed how we relate to the world.
I think years from now when the studies are done it will be recognized as a primal shift in human social organization.

nonlocal MD