Literature Review: A Roundup of Important Recent Studies

Examples of content perceived as unprofessional were: photos of applicant consuming alcohol and obviously intoxicated; photo of applicant wearing Halloween costume with negative stereotype of a specific ethnicity; profanity in status updates; and a status update detailing a patient encounter in the emergency room, with date and time included in the description.

The authors noted that applicant age, gender, board score, region of residence, number of friends and other factors showed no relationship to a lower professionalism score, thus identifying no way to predict which applicants were at risk.

Bottom line: Physicians and medical students should make themselves thoroughly aware of their online presence.

Reference: Golden JB, Sweeny L, Bush B, Carroll WR. Social networking and professionalism in otolaryngology residency applicants. Laryngoscope. 2012;122(7):1493-1496.

—Reviewed by Sue Pondrom

No Difference in Life Expectancy with HNSCC Imaging Modality

Is life expectancy in head and neck squamous cell carcinoma (HNSCC) patients with distant metastasis altered by the type of imaging used?

Background: The choice of diagnostic modality to detect distant metastasis in HNSCC has included chest X-ray, computed tomography (CT), magnetic resonance imaging (MRI) and, most recently, positron-emission tomography (PET). Recent reports have shown PET to be more sensitive at identifying occult metastatic disease than other radiographic modalities. However, it is unclear whether detection of distant metastasis by PET influences life expectancy in patients with HNSCC.

Study design: Retrospective.

Setting: Department of Otolaryngology-Head and Neck Surgery and Department of Medical Oncology, University of Michigan Health System, Ann Arbor.

Synopsis: Of 115 patients identified as having distant metastasis by surveillance imaging, 38 (33 percent) were identified by PET scan, 57 (50 percent) by CT scan, and 20 (17 percent) by chest X-ray. There were no differences in life expectancy in the patients who were identified to have distant metastasis when stratified by imaging modality.

In 55 patients who were identified as having distant metastasis discovered on imaging due to concerning symptoms, 10 (18 percent) were identified by PET, 24 (44 percent) by CT, six (11 percent) by chest X-ray and 15 (27 percent) by MRI or bone scan. There were no differences in life expectancy when stratified by imaging modality.

Bottom line: PET does not have an added benefit of prolonging life expectancy in patients with distant metastasis in HNSCC.

Reference: Spector ME, Chinn SB, Rosko AJ, et al. Diagnostic modalities for distant metastasis in head and neck squamous cell carcinoma: are we changing life expectancy? Laryngoscope. 122(7):1507-1511.