November 05, 2011
Mozart Effect For Better Colonoscopies
In a small scale study endoscopists appeared to do better at detecting pre-cancerous adenomas when they listened to Mozart. So take along a smart phone with Mozart on it and some speakers and offer their use to your endoscopist when you are getting wheeled in for a colonoscopy.
Washington, DC -- Physicians who listen to Mozart while performing colonoscopy may increase their detection rates of precancerous polyps, according to the results of a new study unveiled today at the American College of Gastroenterology's (ACG) 76th Annual Scientific meeting in Washington, DC.
The study, "The 'Mozart Effect' and Adenoma Detection," by Catherine Noelle O'Shea, DO and David Wolf, MD, of the University of Texas Health Science Center at Houston, found adenoma detection rate—the proportion of patients undergoing screening colonoscopy in whom an adenomatous polyp is found and an important measure of a high quality endoscopic exam --increased from baseline values with music compared to without for two endoscopists whose baseline adenoma detection rates were calculated over a one-year period prior to the start of the study. The "Mozart Effect" refers to a set of research results that found listening to Mozart's music may result in significant short-term improvement in spatial temporal reasoning. Researchers used this previous theory to determine whether or not listening to Mozart while performing a colonoscopy had any impact on an endoscopist's adenoma detection rate.
In this randomized controlled trial, two endoscopists each with experience completing at least 1000 colonoscopies performed screening colonoscopies randomly assigned to music -- where Mozart was played -- or no music. Each endoscopist was unblinded to music exposure. Adenoma detection rates from this study were than calculated and compared to the baseline rates.
"Both endoscopists had higher adenoma detection rates listening to music when compared with their baseline rates," said lead researcher Dr. O'Shea.
Endoscopist #1, who was blinded to outcome, had an adenoma detection rate of 66.7 percent listening to Mozart and 30.4 percent without the music. Endoscopist #2, who was unblinded to the outcome, had an adenoma detection rate of 36.7 percent with Mozart and 40.5 percent without the music. Baseline detection rates were 21.25 percent (Endoscopist #1) and 27.16 percent (Endoscopist #2).
So endoscopist productivity varies all over the map. I wish there was a way to choose an endoscopist based on adenoma detection rate. Ditto for other docs doing other kinds of early stage cancer detection.
Any readers tried different kinds of music when writing software? I'd love to see a software coding productivity study comparing different forms of music, no sounds, normal office sounds, and assorted kinds of white noise.
Got a favorite white noise for enabling the mind to concentrate? I'm looking to try some different forms of sound background to see whether I can up brain productivity by doing so.
A better summary of the study than 'endoscopists appeared to do better...' would be 'there's this one endoscopist, and man, Mozart turns him into an adenoma-finding *beast*'. They studied two endoscopists; one of them did way better with Mozart, the other did not.
And an even better summary of the study (strangely unmentioned!): endoscopists seem to find a lot more adenomas when someone is keeping score. Notice the baselines: 21 and 27 percent, average of 24. Then the average results (Mozart or not, I'm assuming they went 50/50 for maximum significance): 43+%. That boost of 19% is bigger than the average Mozart boost of 17%. Of course, it's possible that the baselines are low and don't reflect the current level of expertise (perhaps they were calculated over the entire career and therefore include a long period when the doctors were less adept). But I'm more inclined to think that The Monitoring Effect is greater than The Mozart Effect... not that we wouldn't want to use both. If Mozart gives that big a boost to some doctors it shouldn't be hard to figure out who it works for and who it doesn't, or to try other music and see if it helps (maybe some docs would do better with Pantera, who knows?).
I thought they would have done better listening to the Butthole Surfers.
Debussy's 24 Preludes played by Walter Gieseking always work for me.
Avoid wind in the pines, rain, and ocean waves. You'll be asleep in minutes.
Fair criticism. Yes, getting monitored really does appear to help.
What's frustrating about this: As potential patients we are not in a position to choose a higher scoring endoscopist. Surely if they were getting bonuses for better performance they'd do a better job. Each of them would try Mozart or exercise or other means to raise their performance.
I like white noise because it drowns out other sounds. Depending on where you live and work that might not be a problem. But I also like certain kinds of noise because it does seem to put my mind into a more productive state.
Also, a serious composition sometimes pulls me into it and away from what I'm doing.
The best place for me for ideas though: the shower. I think up blog posts and work ideas in the shower.
'Surely if they were getting bonuses for better performance they'd do a better job.'
Well, yes. Provided of course that performance can actually be evaluated properly. In this case it looks like it can (if they find something and it's removed, I expect it can be verified that it is in fact a precancerous polyp / adenoma). I am actually curious about the composition of the patient base for this study (and colonoscopy of this type generally). Based on the study and on some other stuff referenced in the article, it appears that the odds of one of these patients having an adenoma to find are pretty high. Presumably, these people are either symptomatic or high-risk in some way and not, say, random college-aged men. This implies that the selection or screening process to decide who undergoes this procedure will actually be fairly important in limiting the possible performance of the doctor; he can't find what isn't there, no matter how good he is. It occurred to me that one possible explanation for what I thought of as the Monitoring Effect was simply that patient selection had improved over the combined timeframe of the baseline/study, leading to a population with many more polyps towards the end.
Anyway: if large bonuses were given based on straight up percentages such as were measured here, then you could see adverse selection where doctors would prefer not to do colonoscopies on healthier patients. By choosing only patients who they knew to be riddled with polyps they could presumably boost their numbers really high. Obviously, in a large hospital setting they might not have that kind of control over who they did and didn't to colonoscopies on, but normally I'm thinking that the guy who prescribes the procedure and the guy who performs it may well be one and the same. So the incentives would need to be thought through and sized appropriately. Given enough statistics I expect that it would be possible to come up with an 'expected adenoma rate' (based on medical history) and compare the doctor's performance to that, but doctors are smart enough to game such a system as well if you make the stakes high.
Let us not forget -- there have been studies on dyslectics where listening to something while working proved really distracting. I would feel this could be the opposite for certain types of brains.