Discover and read the best of Twitter Threads about #EBM

Most recents (24)

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 Image
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
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
🇮🇳#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
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
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… Image
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 Image
Read 9 tweets
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
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
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
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
@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
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
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 Image
Is hypothermia really "therapeutic" post OHCA with ROSC but still comatose? #EBM #FOAMed @PulmCrit @EMNerd_ @hp_ems @EMS1
thesgem.com/2021/07/sgem33… Image
Read 6 tweets
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
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
(1/4) This @CochraneLibrary review 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 Cochrane review - only observational data and models = low l
(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
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 ImageImage
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 ImageImage
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... ImageImage
Read 12 tweets
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
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
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
Important perspective below

When I was a foreign grad & trainee I bought into idea: I just needed to work 3x as hard to get 1/2 as far

At mid-career, my health gave out trying for:
“be the person you needed when you were younger”
& to protect students

this system does not work ImageImage
Editors of elite journal @JAMA_current question if medical racism is real

the business world gets it
@HarvardBiz
published this on #minoritiesinmedicine #blackexcellence #blm #BlackLivesMatter

#MedTwitter needs #transparency & #Accountability

hbr.org/amp/2018/08/re…
why can’t elite journals that define #EBM & #datadriven #healthcare
like @JAMA_current

focus on OUTCOMES
as experienced by PATIENTS

Why focus on LABELS certain physicians don’t like to hear?

Am a former regulator
we need quality #data by gatekeepers

medpagetoday.com/publichealthpo…
Read 8 tweets
#MedTwitter influencers show hypocrisy (advice vs actions on masks). Agree:

“unpleasant comments are ‘the nature of social media’ and holding public figures accountable is critical when they are setting an example for their ‘millions of followers.’”

insider.com/coronavirus-sh…
#tweetiatrician have even gotten death threats for pro-#vaccine #SciComm - most #MedTwitter influencers did nothing to protect vs these personal safety threats to #clinician & #doctor colleagues

@ZDoggMD & @DrToddWo did step up to help @NicoleB_MD

medpagetoday.com/special-report…
Compare above to Dr. Mike:
when medical influencers are “caught”

adds to public perception:
“doctors cannot be trusted”

“Another fan posted on Reddit: ‘I know it's your life and you can do what you want, but you have chosen to be a public figure.’”

mirror.co.uk/news/uk-news/w…
Read 11 tweets
@adamcifu - the idea that doctors should not be political is why the entire field of #pediatrics walked out on the rest of #medicine. Children don't have the luxury of "every man for himself" mindset. Also, Muslim patients' or atheist patients' autonomy at #endoflife : political
All of us are trained, in residency, on "political" dollars from #Medicare and much of our #EBM is funded by tax dollars from #NIH and elsewhere. Tax dollars are public money, managed by elected officials, who are put in place and held accountable by the political process.
Then there are seemingly extreme examples, but are they so extreme given how often horrific things happen in history & even uptick of violence in the U.S.? Should doctors opt out of protecting vs this? These camps, if formed, may utilize doctors/nurses

time.com/4574680/muslim…
Read 5 tweets
1/3 Just out: @RecheckHealth analysis and commentary Der seltsame Fall / le cas étrange / the Strange Case of the Swiss National COVID-19 Science Task Force @SwissScience_TF. Open access in Deutsch / Français / English. re-check.ch/wordpress/fr/s…
2/3 @SwissScience_TF is a group of scientists acting as a consultant to the Swiss authorities on #COVID19. Only his president should be talking to the media; is it really the case? And what are the rules of engagement of this very special board? @RecheckHealth
3/3 @RecheckHealth filed several #FOIA, and analysed ten months of communication and scientific work of the Swiss National COVID-19 Science Task Force. Spoiler alert: Houston, we have a problem. #transparenzstory #Öffentlichkeitsgesetz #PandemicScience #EBM
Read 4 tweets
1/9 Has #Gardasil approval ushered in an era of #overprevention? @RecheckHealth’s @CatherineRiva published on @thejospi an intriguing, original research piece co-signed by MD Jean-Pierre Spinosa: jospi.org/article/18180-… #HPV
2/9 The article tracks back the approval history of the first vaccine to have been granted the FDA’s accelerated approval and fast track. @CatherineRiva and MD @gipispinosa combined published documents with DAPs and correspondence obtained with a #FOIA #Gardasil #HPV
3/9 The authors of @thejospi piece sought to understand how the evaluation criteria were selected during #Gardasil approval and the impact of the FDA experts’ choices on the quality of the available evidence about the vaccine’s efficacy. #Gardasil #HPV
Read 9 tweets
Not only experience, which is important, but clinical #research does not parse out the Japanese man or woman from the South Asian man or woman on heart disease risk, epidemiology, treatment.

#EBM lacking for us then

#MedTwitter #AcademicTwitter #AcademicChatter
And then there is the question of who is white.

Iranian/Persian & Arabs are white on census.
Does the rest of America agree?

Racists & xenophobes tend to use loophole to say being anti-Muslim (whom they consider to all be Arab) is “not racist.”

latimes.com/projects/la-me…
Proving again: race is a social construct

Not until 2020 Persians really started to call selves “POC” (for self protection)

Have lots of Persian friends
Urdu culture has Farsi roots

But let’s be honest: Persians have seen selves as superior race, apart

wbez.org/stories/renewe…
Read 38 tweets
@BaeBielle @timnitGebru I was going to get there. Beat me to it.

This has never been “personal”

Cuz this is SO incredibly prevalent

People who are in the “model minority” role

Know on which side their bread is buttered

they discount the equity movement that THEY find too hard to do
they lack grit
@BaeBielle @timnitGebru another exact match
Put a name = optics

“Optics”
“Prestige”
Disdain for EBM

But
standards?
Consistency?
Transparency?
Ethics?

why *isn’t* consistent standards or ethics part of “professionalism”?

Why only optics?
Medicine is VERY real
life & death at stake
clinicians know ImageImage
@BaeBielle @timnitGebru All of these

are themes
that relate to
reputation
“optics”
control of others’ communication

silence those who ARE producing #EBM

Protect the business model & maintain a “brand” to sell a product

The issue with @timnitGebru was corporate censorship

technologyreview.com/2020/12/04/101…
Read 5 tweets

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