Discover and read the best of Twitter Threads about #EBM

@LandmarkTrials

Landmark trial thread🧵

This series of tweets will be about key trials studying SGLT-2 inhibitors in heart failure. While initially studied for DM, these meds were shown to improve CV outcomes in CHF patients, regardless of DM status.

#MedEd #EBM #CardioTwitter #clinicaltrials

1) DAPA-HF trial:
Among patients with a reduced EF, the risk of worsening heart failure or death from CV causes was lower among those who received dapagliflozin vs placebo.

Link: nejm.org/doi/full/10.10…

2) DELIVER trial:
Dapagliflozin reduced the combined risk of worsening heart failure or CV death in patients with heart failure and a mildly reduced or preserved EF.

Link:
nejm.org/doi/10.1056/NE…

Read 7 tweets

Colin West

@ColinWestMDPhD

1/ The colonoscopy trial reported in @NEJM is being widely reported as suggesting that colonoscopy is not effective for colon cancer screening. This is not the correct interpretation of these results. #EBM #evidencebasedmedicine #epitwitter
nejm.org/doi/full/10.10…

2/ This study’s results do not demonstrate that colonoscopy is effective, but also do not demonstrate that it is ineffective. Why? Because only 42% of those in the screening arm actually had a colonoscopy!

3/ What *does* this study show? Only that a screening program involving an invitation to get a one-time colonoscopy modestly reduced colon cancer cases but did not reduce colon cancer deaths or overall mortality at a median of 10 years of follow-up.

Read 15 tweets

Mike Putman

@EBRheum

Epic editorial just published in @jrheum re:@ACRheum 2019 osteoarthritis recommendations

In short, ACR took the (correct!) stance that we should recommend AGAINST hyaluronic acid

This somewhat understandably upset companies that produce this voodoo. So they wrote an editorial!

Right up front, we get the "I'm not biased, you're biased!" accusation

It's pretty rich for authors who literally worked for and actively own stock in OrthogenRx (a purveyor of fine hyaluronic acid) accuse others of "bias"

Oh, also, OrthogenRx "funded" this editorial

Really - who needs funding to write an editorial? It's like 1200 words and a figure. I've written tweetorials that long while driving

I suppose it was nice to have AOIC LLC, which OrthogenRx funded, make your figure, edit your paper, add refs, and submit the article

Read 5 tweets

Raj Mehta

@raj_mehta

1/ Thread on Analyzing Physician Thought Processes with Conditional Probability

One important aspect of #EBM is to help physicians calibrate their probabilistic reasoning and improve their clinical judgement.

We will walk through one example from study highlighted below.

2/ The Study:

The basis of this thread is this interesting paper on physician probability estimates of medical outcomes:

jamanetwork.com/journals/jaman…

3/ Key concepts:

Difference between Independent vs dependent events
en.wikipedia.org/wiki/Independe…

Conditional Probability
en.wikipedia.org/wiki/Condition…

Summary of Probabilities (picture)

Read 15 tweets

cardio-met

@cardiomet_CE

1) Welcome to a new #accredited #tweetorial, Prevention and Management of Heart Failure in T2 Diabetes: The Cardiologist’s Perspective! Our expert author is Giuseppe Galati MD, MMSc in Heart Failure, @GiuseppeGalati_ , Consultant #Cardiologist #HeartFailure & #Cardiomyopathies

2) @GiuseppeGalati_ is at San Raffaele Research Hospital, Milan 🇮🇹 @SanRaffaeleMI. This program is intended for #healthcare professionals & is accredited for 0.75h CE/#CME credit for #physicians #physicianassistants #nurses #nursepractitioners #pharmacists 🇺🇸🇨🇦🇬🇧🇪🇺.

3) @cardiomet_CE is supported by educational grants from AstraZeneca, Bayer, Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly Company, & Chiesi. Earn credit from archived programs at cardiometabolic-ce.com. Disclosures at cardiometabolic-ce.com/disclosures/.🙏 FOLLOW US !

Read 56 tweets

JBI

@JBIEBHC

On #IND2022 we reflect on JBI’s origins as the ‘Joanna Briggs Institute for Evidence Based Nursing’ and the continuing importance, 25 years on, of evidence-based nursing research and clinical practice
#JBIEBHC 🧵 1/7

Quality healthcare services require that clinical decision-making in #nursing is based on evidence, particularly in standardising and aligning healthcare practices with evidence at the point of care. JBI was founded by Emeritus Professor Alan Pearson to address this very need 2/7

‘When I was involved in setting up JBI in the 1990s, #EBM was increasingly adopted across the world, but #EBN was in its infancy. Since then, JBI has played a stellar role in developing great models and systems to support the implementation of evidence into nursing practice' 3/7

Read 7 tweets

Felicittina se pose des questions🤨⁉️🔎±φ

@felicittina

🇮🇳#Inde
1. Le travail de sape de l'OMS a fini par payer…
Jusqu'au 23 déc, on trouvait uniquement cela sur le site @MoHFW_INDIA, section "Hospitals"
web.archive.org/web/2021122318…

2. Avec un lien vers ce protocole, où on trouvait, page 11:
mohfw.gov.in/pdf/UpdatedDet…

3. Mais le 24 déc. @ICMRDELHI & @aiims_nd, organes de conseil et de recherche, beaucoup plus sensibles aux arguments de l'OMS, ont enfin réussi à faire référencer leurs recommandations, sans toutefois réussir à faire disparaître le protocole complet.

Read 7 tweets

Dr. Daria

@Dr_Daria_

THREAD : Du vécu des #soignants durant la crise sanitaire : aspects émotionnels et #biaiscognitifs face au #covid. Reflexions issues de mon experience de terrain, n'a pas la prétention d'être une enquête qualitative. Echo au post de @linternedegarde et aux derniers Spaces. 1/20

Le système n'était deja pas frais. Manifs, manque de moyen. Au début de la crise et à chaque 1ere vague (puisquelles sont arrivée en décalé ds les Dom-Tom):Le déni initial a rapidement laissé place au choc de la confrontation au réel du covid. La roulette russe.L'incertitude 2/20

Toutes les régions ont connu la saturation de leurs moyens au fur et à mesure des vagues successives, et avec elle la disparition progressive des manifestations de soutien, renforcement narcissisant, bien que pas tjr bien reçu, face a l'épreuve de l'inconnu. 3/20

Read 23 tweets

MedEdTwagTeam

@MedEdTwagTeam

1/ Happy #TweetorialTuesday from @ChrisDJacksonMD!

Hi #MedTwitter, I’m Chris Jackson. Honored and pumped to join @JenniferSpicer4, @GStetsonMD, and @YihanYangMD to share my love of #MedEd with you all through the @MedEdTwagTeam

A brief intro…

2/ I’m a current @UTHSC_Medicine senior APD of curriculum, assistant clerkship director @UTHSCMedicine, academic general internist @RegOneHlthFDN @CCHSmemphis

You may have seen me on #MedTwitter with my threads on #EBM or interactions via @primarycarechat

3/ I became interested in #MedEd after meeting inspiring role models & mentors @AU-UGA Medical Partnership: @3owllearning, Dr. Howard Cohen and @UTHSC_Medicine: Dr. Jim Lewis

After residency, I joined @UTHSC_Medicine faculty with a specific interest in ambulatory education

Read 9 tweets

ganesh srinivas

@thisis_drgsp

38yr old male who is case of stable CKD since 2008 with creatinine of 3 & small size kidneys... his kidneys worsened due to covid in March and creatinine went upto 6...told him to be in close follow up ..he didn't listen and started taking ayurvedic medicine

Now creatinine went upto more than 14 & urea 350, not just that his hemoglobin which was in good range during all these years drop down to 4gm and his platelets also very low ..less than 50thousands .. probably due to his bone marrow is also damaged due to these medicines

He was taking these four bottles since last 6 months....they r not cheap Even though..the cost of these 4 bottles is equal to chemotherapy drugs. This is not the story of this patient alone...this is the story of thousands of patients who were lured by these alternative medicine

Read 10 tweets

Indranil Mallick

@indranilsays

A Sunday reflection and rant about the way prostate cancer treatment is evolving and its implications on my practice.
I am a clinical oncologist in India, and I've been treating PRCA patients with radiation and systemic therapy for 11 years.
1/n 🧵

Considering that I also treat HN and GI, prostate treatment has been very different, in terms of philosophy and intensity.
I love treating prostate cancer precisely because of this difference in approach.
2/n

More than 80% of the patients I see are high-risk, node-positive, or metastatic.
And they are middle-class retired Indian men, who value their independence and free time.
They are also predominantly asymptomatic or mildly symptomatic.
3/n

Read 20 tweets

Peter Tennant

@PWGTennant

It's worrying for a new NICE guidance to be delayed and undermined on the grounds it doesn't match 'clinical experience'.

If the scientific evidence always matched 'clinical experience', there'd be no point to research or evidence based medicine... 🤔

#EBM #EpiTwitter

https://twitter.com/RobertHMcMullen/status/1428375470731636738

If 'evidence based medicine' is working there should be REGULAR occasions when the 'evidence' not only disagrees with 'clinical experience' but actively contradicts it.

Wherever 'clinical experience' is allowed to overrule 'scientific evidence', we return to quackery.

'Clinical experience' can be extremely misleading, and history is littered with examples. That's why we take a wider dispassionate view and aim to update practice based on science. This principle is the main distinction between contemporary medicine and 'medicine' of old.

Read 8 tweets

Chris Zalesky

@cczalesky

@emresidents family! Let’s have a little #journalclub 🧵from the EMRA Research Comm. Agitation is super common problem(~2mil presentations per year) so what’s in your 🧰 to care for these patients? Let’s talk about it!📢
📄: IM Droperidol vs IM Olanzapine for Agitation in the ED

The journal: @AnnalsofEM
The paper: pubmed.ncbi.nlm.nih.gov/33846015/
The author: @jonbcole2

Before we dive in 🤿 what do you reach for when you need an IM medication for acute agitation? 🚑💉

Read 19 tweets

Ken Milne MD

@TheSGEM

Hypothermia not superior to normothermia in OHCA for patients sill comatose. #paperinapic by the talented @KirstyChallen #FOAMed #EBM
thesgem.com/2021/07/sgem33…
@NEJM @RCEMLearning @stemlyns

thesgem.com/2021/07/sgem33…

Therapeutic? thesgem.com/2021/07/sgem33…

Read 4 tweets

Sustainable Seas

@Sust_SeasNZ

And now for #seaweed with Rob Major @Cawthron_NZ #NZMSS2021

Why seaweed? It can mitigate pollution, provide habitat for marine life, support fish popns and reduce climate impacts #loveseaweed

There is hype behind seaweed: It is being sold as a silver bullet to the worlds problems. We don’t want to overdeliver so how can we achieve a seaweed sector? The answer is #EcosystemBasedManagement or #EBM

Read 11 tweets

Ken Milne MD

@TheSGEM

Patient has ROSC after OHCA but is comatose. What's your target temperature in the ED? #EBM #FOAMed thesgem.com/2021/07/sgem33… @First10EM @emcrit @NEJM @ACEPNow @srrezaie @stemlyns

The 5 Step Process:
1-Vote on the twitter poll
2-Retweet the twitter poll
3-Read the primary pub (TTM2 trial) nejm.org/doi/full/10.10…
4-Check out the TheSGEM.com appraisal
5-Earn your CME credits sgem.ccme.org

Is hypothermia really "therapeutic" post OHCA with ROSC but still comatose? #EBM #FOAMed @PulmCrit @EMNerd_ @hp_ems @EMS1
thesgem.com/2021/07/sgem33…

Read 6 tweets

Michaël Laurent🕺🕺

@MichalLaurent11

Proud 🤩 to present our preprint on the use of #CO2 monitors in hospital: background, pilot data and protocol for an RCT.
A #COVID19 🧵 @trishgreenhalgh @mjb302

https://twitter.com/medrxivpreprint/status/1393260001939140609

While Belgium is about to become one of the first countries to mandate #CO2monitors in bars, no evidence supports their use, which is particularly problematic in clinical medicine #EBM. How are CO2 levels in hospitals? What does the literature say? @HuffmanLabDU @j_g_allen

Widely varying results have been reported, with values >1000 p.p.m. up to 3000 p.p.m. in low-income setttings vs. excellent values in high-resource settings
@DRTomlinsonEP @ColdProofUK @vanranstmarc @mdc_martinus @PedroFacon
sciencedirect.com/science/articl…
mdpi.com/1660-4601/17/4…

Read 15 tweets

Serena Tinari

@serenatinari

(1/4) This @CochraneLibrary review

https://twitter.com/CochraneLibrary/status/1393170994026713088?s=20

is based on modelling and observational studies. In other words, LOW level of evidence. The #Covid era has trashed well-established standards and practices. What does this mean? cc @RecheckHealth @CatherineRiva

(2/4) Throughout this crisis, public health authorities put the world in stand-by without knowing if that would make sense. Instead of quality studies to assess the effectiveness of non-pharmaceutical interventions, we are left with low level of evidence. #evidencefreepandemic

(3/4) In less than two years, clinical medicine and a robust evidence-based approach indeed seem to not count anymore. But there is a good reason why #publichealth policies need solid evidence. It's because all interventions come with downsides. #GIJNHealthGuide

Read 4 tweets

L Corral-Gudino (tutorCyLlo)

@Luis_Corral_Gud

Decía Pennac en #comounanovela que "No es un libro de reflexión sobre la lectura, sino una tentativa de reconciliación con el libro”
A veces no sabemos trasmitir que la #EBM no es necesidad, sino disfrute personal
Con sus derechos
@drmiguelmarcos @rafabravo @vbaosv @jdelpinomont

Pues el primer derecho en la EBM es a no usarla, y centrarse en otro tipo de transmisión de conocimiento, las guías, los manuales... pero ojo, que la MBE siempre le está esperando

El segundo derecho es a comenzar a leer el artículo por la conclusión. Años insistiendo en el material y métodos, que es genial, pero al final, si no te llama, no te llama...

Read 12 tweets

L Corral-Gudino (tutorCyLlo)

@Luis_Corral_Gud

Otra de las herramientas que ha popularizado la #EBM es la interpretación de los test diagnósticos.

Y para darle una vuelta a su explicación voy a volver a mis orígenes. Las ovejitas.

"Test de antígeno y COVID desde la EBM"

@drmiguelmarcos @boticariors @mpericacho

1/20

De forma simplista se tiende a pensar que un test que da POSITIVO es que uno tiene la enfermedad o condición a estudio.

Y si da NEGATIVO, pues que uno está “sano”.

Nada más lejos de la realidad

2/

La interpretación de un test diagnóstico depende de 2 cosas:

1) la probabilidad de padecer la enfermedad de la que partimos
Es decir, necesitamos valorar a nuestro paciente, sospechar una condición y entonces pedir una prueba para confirmarla

3/

Read 21 tweets

Umbereen S. Nehal, MD, MPH

@usnehal

Word “racism” silenced, actively, by #MedEd #MedTwitter #healthcare “#professionalism” & “communication” labels

Saying “racism” offends or “hurts feelings” > actual #BLM deaths

If #professionalism itself is racist -makes sense that word suppressed
@FutureDocs

https://twitter.com/FutureDocs/status/1385228009473515523

What @ayshakhoury experienced pushes out & silences many

If the editors of @JAMA_current resist hearing word “structural racism” then they certainly are not publishing papers using that word

@DrAlethaMaybank @RheaBoydMD @FutureDocs @TIME #BlackintheIvory #MedTwitter @bmj_latest

Journal gatekeeping: men
Behavior gatekeeping: women/HR

#accountability only for white men
-> we miss “Amy Cooper” in #academia, #HR, #professionalism #compliance

insidehighered.com/advice/2020/06…

@DrAlethaMaybank @RheaBoydMD @FutureDocs @TIME #BlackintheIvory #MedTwitter @bmj_latest

Read 18 tweets

Discover and read the best of Twitter Threads about #EBM

Most recents (24)

Related hashtags

Discover and read the best of Twitter Threads about #EBM

Most recents (24)

Related hashtags

Did Thread Reader help you today?