Discover and read the best of Twitter Threads about #Grade

Most recents (8)

Cochrane review met 'meta-analyses' van allerlei preventiemaatregelen tegen respiratoire infectieziekte, wat de cijfers WEL/NIET betekenen en waarop je moet letten bij de data-interpretatie. 🧵omdat sommigen hier absurde uitspraken over doen in de media
cochranelibrary.com/cdsr/doi/10.10…
Ik start met waarom ik het woord meta-analyse tussen haakjes heb gezet. Dat komt omdat het gebruik van een meta-analyse methode niet altijd een volwaardige meta-analyse betekent en vaak gewoon data aggregatie is, wat @cochranecollab vaak doet. Lees verder: charifazemouri.com/updates/2997qe…
Overal score van de studies ziet er niet best uit, kijk eens hoeveel rode bolletjes: dat geeft aan dat er twijfel is aan de methodologische kwaliteit van de studies. We kunnen daarom niet met zekerheid zeggen of de studieresultaten t gepoolde effectmaat betrouwbaar is.
Read 16 tweets
As part of the @ILCOR_org Pediatric life support taskforce we reviewed evidence for accuracy of tests for predicting GOOD neurological outcome following #Cardiacarrest in children
🧵of key DRAFT recommendations.
🔗costr.ilcor.org/document/clini…

#Pedsicu #NeuroPICU
#Prediction of good neurological outcome is a key role for #PedsICU clinicians in #postarrestcare phase of #chainofsurvival.
Improving prognostic #uncertainty may help clinicians choose treatments, counsel families, and answer accurately, "Will my child be OK?“
#NeuroPICU
The #PLS taskforce conducted a #systematicreview of literature reporting prognostic tests used in children after cardiac arrest.
Four types of tests were evaluated:
*Clinical examination
*Blood biomarkers
*Electrophysiology
*Brain Imaging
#PedsICU #NeuroPICU #CPR
Read 17 tweets
We enjoyed the first one so much, we thought we'd go again. Our second #WorldEBHCDay #Tweetorial we want to showcase is the infrequent times when you may need to upgrade the certainty you have in your evidence when following the #GRADE approach @JBIEBHC @WorldEBHCDay (1/8)
Evidence from observational studies and non-randomised experimental studies is (under most-circumstances) initially classified as low. However, there are rare occasions when these studies may provide higher than low certainty in the evidence #Tweetorial #WorldEBHCDay (2/8)
There are 3 determinants to consider when raising the certainty in the evidence. A large magnitude of effect, a dose response gradient and the effect of plausible residual confounding #Tweetorial #WorldEBHCDay (3/8)
Read 8 tweets
For #WorldEBHCDay we wanted to share our first #Tweetorial about the 5 determinants to consider when downgrading the certainty that we have in our evidence from RCTs when following the #GRADE approach @JBIEBHC @WorldEBHCDay (1/8)
Certainty in the evidence starts as high when following the #GRADE approach. However it may be necessary to downgrade the certainty in this evidence. We do this by assessing the following 5 determinants Guidance: shorturl.at/qxB68 #Tweetorial #WorldEBHCDay (2/8)
Study limitations. Consider the methodological quality of the included studies providing evidence of a particular outcome. Consider how each study contributes to the magnitude of effect and downgrade conservatively Guidance: shorturl.at/aepO1 #Tweetorial #WorldEBHCDay (3/8)
Read 8 tweets
Catch yourself when you say “risks vs. benefits” because you aren’t making a fair comparison.

In @JAMA_current ja.ma/336Lj4Y
& podcast ja.ma/2FAGKI2

@eliowa @drjohnm @d_spiegel @zeynep @VPrasadMDMPH

Why we say it and what we think is better below...
This building block of clinical decisions biases by framing uncertain harm vs. certain benefits and nudges towards treatment

Written with
@DKorenstein @ldscherer
(Over 2 years, i'm embarrassed to admit)
Clearly, the words physicians use have
a critical function in this communication

Referring to harms as “risks” emphasizes that
the unfavorable outcome may or may not happen,
whereas there is no parallel language that highlights
the equally probabilistic nature of “benefits.”
Read 8 tweets
Background: Healthcare workers are at ⬆️ risk for #COVID w/o adequate #PPE (20-30% of cases). In #GI, upper scopes are aerosolized-generating procedures (AGPs) & therefore even ⬆️ risk for #COVID. Lower scopes also = ⬆️ risk 2/2 some e/o AGPs w/bx + fecal oral spread. 2/13
Rec 1: Wear N95s (or better) for all upper scopes REGARDLESS of #COVID status. (Strong rec, mod quality evid). Why? Testing is inadequate & w/community spread, take universal precautions. If rapid testing for endo pts is avail, prioritize #N95s for known COVID 3/13
Read 13 tweets
Iván Solà nos cuenta en la Jornada @CochraneIberoam la importancia de CENTRAL como registro de ensayos clínicos
Registro especializado Cochrane Iberoamericanos ImageImage
Iván Sola nos habla de la elaboración de recomendaciones rigurosas como #GRADE. @cochranecollab ha adoptado la propuesta GRADE para evaluar l calidad de la evidencia
Read 3 tweets
#THREAD

1} My Dear Friend Geri,

With all due respect to current #NonProfits serving Refugees & Immigrants - their Branding & Messaging are #Tragically #Weak.

#OurAmericanKids🇺🇸 are BEING #SCAPEGOATED & #WE, the Liberals of #OurCountry we call the United States of America...
2} ...get OUR #Truthful-#Propaganda #LUNCH handed to us - #EVERY #DAMNED #TIME there's a watershed political issue.

My opinion as a 25-year #Duke MBA-trained-#Strategist, is that "Dreamers" is a well-intentioned, but desperately INEFFECTIVE MONIKER for #OurAmericanKids. Scapegoats for American Fascists
3} My dog #Sadie is a very #Active #Dreamer. Hitler #Dreamed about ruling an #AryanPlanet.

Un-@realDonaldTrump dreams of building a wall "SO fucking HIGH," that planes can't #LAND in #Texas without traveling 100-miles North of our Southern Border - just to pull a #giant U-ey✈️ Hitler Dreamed of an Aryan Planet-Earth.U-Turn in the sky
Read 22 tweets

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