Academic Conferences May Save Lives — by Keeping Big-Name Doctors Busy

Major academic conferences offer many benefits. They provide opportunities to learn new skills, share research and professional news, and bond with colleagues.

And by simply getting a hospital’s top medical experts out of town, might major conferences also save lives?

That’s the theory arising from a study published on Friday in the Journal of the American Heart Association. The study, led by scientists at Harvard University, found that heart-attack victims fare better when treated while top interventional cardiologists are away at their conferences.

The reasons for such a connection aren’t clear, said the study’s lead author, Anupam B. Jena, an associate professor of health-care policy. But it’s probably related to the fact that cardiologists of the stature to attend major conferences have high-volume, research-intensive practices, Jena said.

“All those things support an idea that it’s differences in the style of care that’s being practiced” during medical conferences, Jena said. Those differences could reflect the nonprocedural skills of cardiologists left behind, such as their habits in prescribing drugs or their efforts and ability to detect and handle a patient’s secondary ailments, Jena said.

It’s not his first study to suggest indirect and sometimes counterintuitive benefits in health care or other fields. Jena’s past work has suggested that Medicare patients fare better with substitute doctors, hospital patients experience lower mortality during facility-inspection visits, and communities suffer higher mortality rates while roads are closed for marathons.

Yet among a long list of similar analyses by other experts, there’s plenty of evidence that first-string doctors do produce better outcomes. Several studies have found that patients suffering cardiac arrests, strokes, and other such conditions do worse when treated later in the day, at night, or on weekends.

Jena’s study considered the records of more than 34,000 heart-attack hospitalizations from 2007 to 2012, with about a tenth of them occurring during the annual meetings of the American Heart Association and the American College of Cardiology.

The possibility that such studies might just reflect random variations of a particular moment and circumstance is “a real issue” worthy of reflection, Jena said.

Less Is More

Even in his study, Jena acknowledged the differences in outcomes stemmed entirely from cardiac patients who were not given stents. Among patients who did receive stents, the outcomes were essentially identical, he said. Yet the study took other steps to guard against a random finding: The researchers verified that the same effects were not seen in noncardiology patients, and confirmed that the hospitals weren’t avoiding certain types of patients during conference-related absences.

One possibility, said Gerald F. Fletcher, a professor of medicine at the Mayo Clinic in Florida, might be that leading doctors are too quick to order interventions such as stents. “A lot of these procedures are done, and they are not needed,” said Fletcher, speaking on behalf of the American Heart Association. “The less sometimes you do, the better it is.”

Jena said his data did not appear to reflect that for stents, as stent usage seemed similar between meeting and nonmeeting dates. But either way, he acknowledged, readers of such studies can draw misimpressions from journals’ tendency to publish only studies that find an interesting outcome.

Jena has his own list of unpublished studies, including analyses showing that daughters are more likely than sons to provide care to their ailing parents, that doctors tend to burnish their records by choosing healthier patients, and that Halloween doesn’t seem to aggravate rates of diabetes-related hospitalizations among children.

Such relatively unsurprising findings don’t seem to strike journals, and even many authors, as worth the bother of seeking publication, leaving the public with an unbalanced sense of research discoveries, Jena has written.

“We have plenty of really fascinating studies that have negative results,” he said. “I would love to publish them, if anyone was interested in publishing them.”

Meanwhile, at least one high-profile case showed that a cardiology conference clearly improved a patient’s outcome: The president of the American Heart Association, John J. Warner, who is also chief executive officer of UT Southwestern University Hospitals, in Dallas, almost died this past November when he suffered a heart attack inside a hotel room.

Fortunately for Warner, it happened while he was attending his association’s conference of cardiologists, in Anaheim, Calif., and a cardiologist in a room a few doors down the hallway was able to help rescue him.

Paul Basken covers university research and its intersection with government policy. He can be found on Twitter @pbasken, or reached by email at paul.basken@chronicle.com.