COMMENTARY

April/May 2003: Tell Me, Does Size Matter?

Priscilla Scherer

Disclosures

April 10, 2003

Introduction

We are heavy into conference season and, with it, conference coverage. Conferences take place year-round, of course, but they cluster most heavily in spring and fall. In the next few weeks, reports from AES, Stroke, ASN, APS, and AAN will be spilling out of the Conference Coverage bucket on the Medscape Neurology & Neurosurgery home page.

In the beginning (of Medscape conference coverage), the idea was to post reports from conferences by the next day or sooner, to provide a sense of virtual attendance to all those who couldn't attend. This was especially important at the meetings we attended early on -- the first I worked on was the International AIDS Conference in Geneva, Switzerland, a meeting that was and is possibly the most provocative of medical meetings, with thousands of presentations, hundreds of demonstrations, never a dull moment anywhere. You could count on every major newspaper and television network running at least 1, if not 2 or 3, significant stories about the conference proceedings every day during the conference and sometimes for days afterwards. Scientific discovery was treated as breaking news. And lots of reality and fact got lost there. So, Medscape positioned itself as the place you could go to separate the hype from the science. And in that climate and on that topic, it was important to get the science out as soon as possible.

But all conferences aren't like that one (and even that one isn't quite as compelling as it was when we believed a cure was around the corner, albeit a distant one). Thus, conference coverage of neurology meetings is not reported "next day" and, indeed, differs from one meeting to the next, depending on many variables, including size and putative importance of the meeting.

Medscape conference coverage still naturally follows its mission to keep physicians and other healthcare professionals up to date on the latest advances and what they mean, aside from the hype. In that regard, our mission is similar to that of most medical societies, academies, and associations. You'll find it in almost all of their mission statements, on the Web sites, etc. Some societies -- the American Pain Society and American Epilepsy Society, to name but 2 -- not only talk the talk, but also walk the walk, by cosponsoring our conference coverage. They recognize and are enthusiastic about the breadth of the audience we bring (several million worldwide) to their cutting-edge research and education programs.

We judge a meeting's importance by different yardsticks -- the most cutting-edge research is probably presented at the smaller, more specialized of the subspecialty meetings, whereas AAN and AANS bring together big guns and small, bench scientists and clinicians for networking (a regular Medscape contributor has described AAN as "primarily a meet-and-greet") and, yes, receiving knowledge about advances and wisdom from expert guidelines committees. Some meeting reports come with an added bonus of CME credit. And some topics (human genome research, for example) demand reporting by virtue of their importance to humankind, medicine, and scientific inquiry.

One important yardstick for deciding which meetings to cover is what we think you want and what you tell us you want. We pay attention to the news, the trends in neurology and neurosurgery journals, the controversies debated in hospital corridors and at grand rounds presentations. And we hear from you -- in conversations at these very meetings we're covering or via others involved in specific subspecialties; sometimes you send emails or make comments at the end of CME activities. Please know that we want to hear from you; we want you to actively participate with us in the Medscape dialogue on neuroscience and medicine.

So tell us what you think about neuro conference coverage on Medscape. Should we do more? Less? Should we do it differently? Would you like to see more information from the smaller subspecialty meetings? How crucial is it to your practice to read expert opinion about research presented at the mega-meetings, such as AAN and AANS? Or are news reports enough? Do you think the coverage is more or less balanced than the news? Is it important to you to earn CME credit from our coverage, or would you read it regardless? What meetings have we missed that should be covered?

Before you write, please take a good look at our most recent meeting coverage. Already, we've posted reports from the American Epilepsy Society's 56th Annual Meeting that clarify intriguing research on neurostimulation and the ketogenic diet for patients with intractable seizures, as well as new data supporting the use of topiramate and levetiracetam as monotherapy for seizures.

Another recent posting is the comprehensive report on viral and host factors involved in the neuropathogenesis of HIV infection from the 10th Retrovirus Conference, a highly scientific meeting bringing together the top HIV/AIDS scientists in the world. In this review, Justin McArthur, from Johns Hopkins School of Medicine in Baltimore, Maryland, discusses the fine points of new discoveries about CNS HIV disease and their implications for treatment as well as the understanding of other diseases.

In their coverage of the 28th International Stroke Conference, Steven Levine and David Brown report the graduate medical education Accreditation Council's approval of interventional neurology as a new fellowship track for neurologists in training, and also discuss the future of stroke care, including endovascular approaches to intracranial disease, stem cell transplantation, and hypothermia.

Also check out Rohit Bakshi's report from the American Society for Neuroimaging's 26th Annual Meeting. This is a relatively small society with an international membership. The research presented by this group has wide applicability for many neurologic disorders, adding an even deeper view inside normal processes and pathology in the brain. Dr. Bakshi highlights new neuroimaging findings across the spectrum, from autism to stroke, and explains their clinical applicability.

Within the next few weeks, you can look forward to reports from meetings of the American Pain Society, AAN, and the National Human Genome Research Institute (you can't get much smaller than that!).

Again, please tell us what you think about conference coverage as well as other aspects of the Neurology & Neurosurgery site. Address them to neuroeditor@webmd.net.

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