Discover and read the best of Twitter Threads about #RCTs
Most recents (21)
1) Welcome to a 🆕accredited tweetorial from @cardiomet_CE! We welcome back expert faculty @ChristosArgyrop to discuss screening for #CKD in pts w/ #T2D & the role of routine assessment for #microalbuminuria as an effective diagnostic, risk stratification, & patient ed tool.
2) Christos Argyropoulos MD, PhD @ChristosArgyrop is Division Chief, Nephrology @UNMHSC. #CKD is chronic #kidneydisease, #ESKD is end-stage kidney disease.
#FOAMed #nephtwitter #cardiotwitter @MedTweetorials @NephUCommunity @ISNkidneycare @KidneyDiseaseFm
#FOAMed #nephtwitter #cardiotwitter @MedTweetorials @NephUCommunity @ISNkidneycare @KidneyDiseaseFm
3) This program is intended for #HCPs and is supported by an unrestricted educational grant from Bayer. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/.
FOLLOW US for more expert-authored #tweetorials and earn #MedEd
FOLLOW US for more expert-authored #tweetorials and earn #MedEd
1/ 76 yo woman suffers an ischemic stroke in the left media territory, initial NIHSS 5. Treated with IVT. NIHSS at 24hs 3 points, new diagnosis of #AFib on the #Stroke unit monitor/ECG… 24h MRI shown belowê When would you start anticoagulation?
2/ When would you start DOAC therapy in this woman?
Let's dive into the NEWEST evidence to find the optimal timing! #StrokeCare #AFib @ELAN_Trial @FishingNeurons #ESOC2023
Let's dive into the NEWEST evidence to find the optimal timing! #StrokeCare #AFib @ELAN_Trial @FishingNeurons #ESOC2023
3/ Non-valvular atrial fibrillation accounts for about 25% of ischemic strokes. Early recurrent strokes are common, but starting oral anticoagulation too soon may increase the risk of harmful intracranial bleeding. We need a balance… or do we???
1) Welcome to our #accredited #tweetorial on clinical trial results and emerging data for treatment of Diabetes and CKD #DM in #CKD. I am Brian Rifkin MD, @brian_rifkin, from the Hattiesburg Clinic. #Nephtwitter #Medtwitter #FOAMed
2) This #accredited #tweetorial series on #kidneydisease #CKD is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance. It is not intended for US- or UK-based HCPs. Accreditation statement & faculty disclosures at ckd-ce.com/disclosures/.
3) This activity is accredited for #physicians #physicianassociates #nurses #NPs #pharmacists. Prior programs in this series, still eligible for CE/#CME, can be accessed at ckd-ce.com. FOLLOW US to learn from expert faculty!
1/ November 14th is #WorldDiabetesDay
Let’s look back at one of the most influential #RCTs for
how we given insulin in #T2DM?
the #RABBIT2 trial🐰🧵
#Insulin #MedTwitter
Let’s look back at one of the most influential #RCTs for
how we given insulin in #T2DM?
the #RABBIT2 trial🐰🧵
#Insulin #MedTwitter
2/ The #RABBIT2 study looked at the (1) efficacy and (2) safety of basal-bolus vs. sliding-scale #insulin in non-critical inpatients🏥.
Basal-bolus regimens consisted of a combo of #Glargine (basal) and #Glulisine (mealtime).
The primary outcome was average glucose🍬.
Basal-bolus regimens consisted of a combo of #Glargine (basal) and #Glulisine (mealtime).
The primary outcome was average glucose🍬.
3/ See below for a graphical depiction of how the study was performed👇:
1/🚨New Episode🚨
Aspirin for Primary Prevention: #MindtheGap Segment
What do current ACC and USPSTF guidelines say about daily low-dose #aspirin for the primary prevention of #cardiovascular disease?
🎧: apple.co/3VPRCV4
Sponsor: bit.ly/TCChoZ
Aspirin for Primary Prevention: #MindtheGap Segment
What do current ACC and USPSTF guidelines say about daily low-dose #aspirin for the primary prevention of #cardiovascular disease?
🎧: apple.co/3VPRCV4
Sponsor: bit.ly/TCChoZ
2/Throwback to medical school pathophysiology!
Remember how the #atherosclerotic process takes place in blood vessels? 🫀
Now, where does #aspirin exert its effect during this cascade? 🤔
Remember how the #atherosclerotic process takes place in blood vessels? 🫀
Now, where does #aspirin exert its effect during this cascade? 🤔
3/What do the most recent #RCTs inform us about the use of aspirin for primary prevention ⁉️
ASCEND, ARRIVE, ASPREE!
#CoreIMJournalClub 📕
ASCEND, ARRIVE, ASPREE!
#CoreIMJournalClub 📕
1) Welcome to a new #accredited #tweetorial, Update on New HFrEF Data from ESC 2022 with a Focus on Vericiguat. Our expert author is Giuseppe Galati MD, MMSc in Heart Failure, FHFA, @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) This program is supported by an educational grant from Bayer. See archived programs still open for credit at cardiometabolic-ce.com. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/.🙏 FOLLOW US !
1) Welcome to our new #accredited #tweetorial on the Pathophysiology of #DKD in #T2D: Traditional Teaching and New Insights. Our expert author is Hans-Joachim Anders, MD, @hjanders_hans from @LMU_Uniklinikum of @LMU_Muenchen
2) This #accredited #tweetorial series on the foundations of #kidneydisease #DKD through the lens of #T2D is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance and is intended for healthcare providers.
3) This activity is accredited for #physicians #physicianassociates #nurses #NPs #pharmacists. Past programs still eligible for credit can be found at ckd-ce.com. Faculty disclosures & accreditation statement are at ckd-ce.com/disclosures/. FOLLOW US!
1/7 #PREPAREII showed that a 500-ml fluid bolus does not prevent cardiovascular collapse during tracheal intubation in the ICU. I love efficient study designs - this trial had two features that in my opinion are worth replicating in future #criticalcare #RCTs (a thread 🧵):
2/7 Sample size: the authors calculated that 750 patients would be needed to detect a MCID with an 80% power. After a blinded interim analysis it became clear that the event rate is lower than expected. Smart study design feature no.1️⃣: adaptive sample size re-estimation.
3/7 The goal of sample size re-estimation is to prevent the dreaded "underpowered study" - a situation where the trial can no longer rule out that a clinically meaningful effect exists due to the signal/noise ratio in the data being to low. You can do it using both frequentist &
The @JBIEBHC Critical Appraisal Tools (CATs) are changing! This is a thread that will detail the biggest changes made and how these reflect current methodological developments in the field for #JBIMethodology month 1/7
Firstly, some background- The JBI CATs present a series of questions that ask reviewers to consider particular safeguards in the design on the study being appraised (e.g. randomisation in #RCTs). 2/7
In this format, the JBI CATs are typically completed by using these questions as a checklist (scoring each question as met, unmet etc.). However, they can also be completed as if they were a scale 3/7
1) Welcome to our new #accredited #tweetorial on the Pathophysiology of #DKD in #T2D: Traditional Teaching and New Insights. Our expert author is Hans-Joachim Anders, MD, @hjanders_hans from @LMU_Uniklinikum of @LMU_Muenchen
2) This #accredited #tweetorial series on the foundations of #kidneydisease #DKD through the lens of #T2D is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance and is intended for healthcare providers.
3) This activity is accredited for #physicians #physicianassociates #nurses #NPs #pharmacists 🇺🇸🇪🇺🇬🇧🇨🇦. Past programs still eligible for credit are at ckd-ce.com. Faculty disclosures are at ckd-ce.com/disclosures/. FOLLOW US for regular programs by expert faculty!
9) Many risk factors modulate the propensity of LDL-C to traverse the endothelium and enter the arterial intima. See 🔓academic.oup.com/eurheartj/arti….
10) It now appears that the passage of #LDL into the #intima is not a merely passive process whereby the concentration in blood & the permeability of the endothelium determine LDL accumulation.
11) It’s #Transcytosis (an active process), through a vesicular pathway involving #caveolae, scavenger receptors (#SRB1) and activin like receptor kinase 1 (#ALK1). Hence for a given blood level of LDL-C the amount of atherosclerosis is variable.
1) Welcome to @cardiomet_CE's new series on #lipid management! This is a 10-#tweetorial program, all #accredited, that will cover it all. Our first expert author is Paul Thompson MD @PaulDThompsonMD, esteemed #cardiologist from @hartfordhosp @UConn Med & now @MGHHeartHealth !
2) This #tweetorial, accredited for #CME/CE and intended for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists is supported by an educational grant from Esperion Therapeutics. See faculty disclosures at cardiometabolic-ce.com/disclosures/.
3) @PaulDThompsonMD took on education re mechanisms & use of ezetimibe & bempedoic acid. He proposes a case: 45 ♂️ w/history of inferior wall #MI treated with primary angioplasty.
1) Welcome to a new #accredited #tweetorial on a🗝️ topic in #cancer care & #vascular medicine: #VTE (#DVT and #PE). Cancer patients are at⬆️risk from their disease, their comorbidities, & often from their treatment. It's a sticky wicket & @cardiomet_CE is proud to welcome ...
2) ... one of the world's leading authorities on cancer-associated VTE as new faculty both here and on @onc_ce: Dr. Alok Khorana @aakonc of @ClevelandClinic, to talk about advances and best treatment in this space!
3) This educational program is intended for health care providers & is supported by a grant from Bristol Myers Squibb & its Alliance partner Pfizer, Inc. Faculty disclosures are listed at cardiometabolic-ce.com/disclosures/. Earn CE/#CME credit from prior programs at cardiometabolic-ce.com.
Join here tomorrow for the launch of a new accredited tweetorial on the expanding role of #SGLT2i in CV disease! Earn 0.5 CE/CME credits: physicians, nurses, pharmacists! Expert faculty @mvaduganathan. #medtwitter @academiccme #diabetesmanagement @endocrinenetwrk
1) Welcome to a Tweetorial on #SGLT2i & CV health. “Flozinators of the world, unite!” Accredited for 0.50h by @academiccme: #physicians, #nurses, #pharmacists. I am @mvaduganathan . . .
. . . and this educational activity, which is intended for healthcare providers, is supported by grants from Abbott, AstraZeneca, Bayer, Chiesi, and NovoNordisk.
1. I want to make one more point about #vaccine #RCTs and I’m open to being corrected here by someone like @nataliexdean who has worked on these trials. The point has to with being in a situation in which we have estimates of efficacy so early on in the planned 2 year trials.
2. When these trials were designed it wasn’t a sure thing that we would have efficacy estimates this early. During the #ebola vaccine trials in 2014-15 the outbreak was waning by the time the vaccine trial was underway. If we had a coordinated public health response to #COVID
3. ...then lower rates of transmission at trial sites would have meant a longer time to the relevant number of infections. As I said, I’m open to correction, but having this information so quickly seems unprecedented to me.
I'm now live tweeting from the #ISPOREurope session Much Ado About Little: Dealing with Limited RCT Evidence for Early HTA and Reimbursement Decisions with @MJSculpher, @SBujkiewicz, Eva Dietrich, Steven Palmer from @CHEyork, and @UweSiebert9
@MJSculpher starts by setting the context and introducing the speakers.
@UweSiebert9 is the 1st plenary speaker, on causal inference in #RCTs and #RWE
#ISPOREurope
@UweSiebert9 is the 1st plenary speaker, on causal inference in #RCTs and #RWE
#ISPOREurope
When do we need causal inference methoss? when there's no randomisation; or the randomisation was broken (e.g. treatment switches)
Throughout his talk, Uwe will use the example of 2nd line treatment in women with ovarian cancer who progressed
#ISPOREurope
Throughout his talk, Uwe will use the example of 2nd line treatment in women with ovarian cancer who progressed
#ISPOREurope
Thread: 1. Recent statements by @SteveFDA that @US_FDA may authorize #COVID19 vaccines before completing clinical trials are generating much anxiety and setting up a twitter storm. @Pfizer frequent messaging that it will have results on its vaccine soon isn’t helping.
2. Some prominent scientists & public health experts have called for full @US_FDA licensure before #COVID19 vaccines are distributed. I disagree with that.
3. @US_FDA standards for licensure are extremely stringent, as they should be, and they should not loosen them just because we are in a pandemic.
How we’ll we manage the first ten #COVID19 patients of 2021 (if any) hospitalized for #ARDS (compared to the first 10 patients we managed in February 2020). A multidisciplinary brain storming after managing approx 1000 such patients within the end of Apr 2020. A thread 1/ #FOAMed
2/
Not all our clinical impressions have already published evidence (but the majority was published), but our hospital #COVID19 mortality went close to zero in late April 2020 and we hope medical management accounts for at least part of these results.
Not all our clinical impressions have already published evidence (but the majority was published), but our hospital #COVID19 mortality went close to zero in late April 2020 and we hope medical management accounts for at least part of these results.
3/
More, early ECMO. We put a dozen ECMO. We feel we should have put more of them and we should have done it earlier (eg after a couple of days of invasive mechanical ventilation with no improvement). @annamarascandro
@mgcalabroMD @md_monaco @MarinaPieri4
hsr.it/news/2020/magg…
More, early ECMO. We put a dozen ECMO. We feel we should have put more of them and we should have done it earlier (eg after a couple of days of invasive mechanical ventilation with no improvement). @annamarascandro
@mgcalabroMD @md_monaco @MarinaPieri4
hsr.it/news/2020/magg…
Every state/local #Covid_19 initiative I’ve read about is making one of the following mistakes.
Thread.
Thread.
1. Ignoring community altogether and just doing apps.
Case example: Utah.
$2.75 million to purchase an app PLUS a *monthly* maintenance fee of $300,000.
(Could’ve employed 100 FTE #CHWs with this $ but who’s counting)
And the app isn’t working.
tiny.cc/bvrfpz
Case example: Utah.
$2.75 million to purchase an app PLUS a *monthly* maintenance fee of $300,000.
(Could’ve employed 100 FTE #CHWs with this $ but who’s counting)
And the app isn’t working.
tiny.cc/bvrfpz
2. Vaguely referencing “shoe leather” and community engagement but no mention of the #CHW workforce who already does that.
Case example: almost everyone.
“Cultural literacy is key to developing trust.”
(Really? Then hire someone of the same CULTURE!)
tiny.cc/80rfpz
Case example: almost everyone.
“Cultural literacy is key to developing trust.”
(Really? Then hire someone of the same CULTURE!)
tiny.cc/80rfpz
A number of media reports this week on potential treatments for #COVIDー19. @WHO is tracking these developments and will update our treatment guidelines if any evidence emerges. Right now, what is needed are high quality #RCTs@JeremyFarrar @ICMRDELHI @Chikwe_I @jarottingen @MRCza
The @WHO #Solidarity trial will test chloroquine or HCQ, lopinavir/ritonavir with and without interferon beta, remdesivir versus Standard of care in many countries round the world, in order to generate robust evidence on mortality and hospitalization of #COVIDー19 patients
The #Solidarity protocol is an adaptive clinical trial - so more arms can be added later, arms can be dropped for futility. A global data safety monitoring committee and steering committee (of international experts) will oversee the trial @WHO.
Hey @pauldadams let's thread this! A summary of four working papers on credit cards in N tweets. Especially for those interested in #HouseholdFinance #BehavioralEconomics #debt #RCTs 1/n
1 in 4 UK credit card payments are at or close to the minimum payment (US similar). Minimum payment information on credit cards appears to act as an anchor making consumers more likely to pay at or close to the minimum. How can we help consumers to pay more? 2/n
PAPER 1 - Increasing credit card payments using choice architecture: The case of anchors and prompts... 3/n
