Two stories in the most recent issue of Pitt Med magazine (Fall 2014) feature CCM faculty and projects. The cover story discusses the challenges and rewards of large, multi-center trials and cites studies by Dr. Derek Angus (ProCESS) and Dr. David Huang (ProACT). The article, entitled “Big is Beautiful: Large Trials can Divulge Unexpected Results” and authored by Jenny Blair, also discusses the importance of a paper, authored in 2001 by Critical Care Resident (’87) Emanuel Rivers, which Dr. Angus calls “the shot heard ‘round the world.” The “Rivers protocol,” as it is now known, challenged the long-held belief that sepsis was a terminal condition, but for a time was the only evidence available to consult in treating of sepsis. That was until the ProCESS trial (completed in May 2014), run by Dr. Angus and Dr. Donald Yealy, among others, which determined that the options for treatment of sepsis were more numerous that initially understood. The article describes this development—of a small, clinical trial being tested and clarified by a subsequent large trial—as a necessary, though somewhat arduous, system. The article also mentions another large trial, ProACT, led by Dr. Huang, which seeks to determine whether testing for procalcitonin can help clarify the decision-making process for prescribing antibiotics.
Another feature in the issue of the magazine, “An App a Day Keeps the Doctor Away,” addresses the increasing role of technology in health, and introduces the new Center for Research on Media, Technology, and Health at the University of Pittsburgh. The article also highlights multiple apps that could potentially be useful in addressing certain medical issues—like helping smokers quit, reminding Parkinson’s patients when to take their medications, or helping orthopedists more accurately diagnose ACL injuries. Another of these apps, ThinkSepsis, developed by Dr. Christopher Seymour and collaborators in the Clinical and Translational Science Institute, seeks to raise the awareness of first responders in considering whether a patient may be exhibiting symptoms of sepsis. Because, as authors Kristen Crosby, Sally Ann Flecker, and Elaine Vitone write, “every one-hour delay in the treatment of sepsis increases the risk of death by 7 percent,” the value of “thinking of sepsis” is that much more useful—especially when talking about first responders, whose awareness of sepsis, Seymour says, “is so lacking.” Dr. Seymour and his team hope to have a prototype of the app developed sometime in the upcoming months.
Derek C. Angus, MD, MPH, FRCP, is the Chair of the Department of Critical Care Medicine, and has secondary appointments in Medicine, Health Policy and Management, and Clinical and Translational Science. He is also the Director of the CRISMA Center.
David T. Huang, MD, MPH, is Associate Professor in the Department of Critical Care Medicine, and Director of the Multidisciplinary Acute Care Research Organization (MACRO).
Christopher W. Seymour, MD, MSc, is Assistant Professor in the Department of Critical Care Medicine.