Discover and read the best of Twitter Threads about #ebm

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#medtwitter

I love to provide structure for my learners. A couple years ago I adopted a set of rules for rounds and ward teams. These continue to evolve.

I share them on day 1, and refer back to them frequently while on service.
👇

#TeamRules #MedEd
What are your #teamrules?
Rule 1: We treat patients, not diseases or numbers.

Always always put the disease and number into context for that specific patient. And get to know the patient.

It’s good medicine, and makes the job so much more interesting.

#SDOH #IllnessInContext #EBM
Rule 2: Rounds are done by noon.

Come prepared and we will get the work done together

Stick with the 4 Ds - decompensated, discharges, diagnostic dilemmas, the C Diff patients last. Stop wherever we are at 11:30 and finish running the list.

HT @thecurbsiders ep157

#efficient
Read 7 tweets
1/ Quelques réflexions @RecheckHealth sur la critique de l’#EBM que j’avais présentées à @MartinFierro769 @BoussageonR @cucherat @FranoisGueyffi2 @boylandry et qui montrent que si ses ennemis font ce genre de propositions #BigPharma n’aura bientôt plus besoin d’amis
2/ Le constat de récupération des instruments #EBM par #BigPharma et de leur détournement à des fins commerciales est partagé par de nombreux observateurs p.ex. Jack E James en 2017 tinyurl.com/yygrvgwa
3/ Les critiques portent notamment sur les #RCT
#BigPharma ayant (encore) besoin de #RCT avec des résultats favorables pour obtenir l'#AMM de nouveaux produits ou des extensions d’indication
Read 13 tweets
1/ Dear #medtwitter:

Please help. Let’s discuss #EBM.

- a thread. #crazypills
2/ I was commuting to work the other day when I read the results of the EXTEND trial nejm.org/doi/full/10.10…

EXTEND was stopped early after WAKE-UP was published due to “lack of clinical equipoise.”

Interesting. Let’s read WAKE-UP then, I thought.
3/ Here’s the link to WAKE-UP: nejm.org/doi/full/10.10…

Traditionally, systemic tPA has been reserved for patients with ischemic stroke who can be confirmed to have had onset of symptoms within the last 4.5 hours.
Read 19 tweets
Day 15/15 #PCPOnTheWards Two more admissions and I’m done! Going through my head:
âť“1 week or 2 week stints next year?
❗️I’ve set the wheels in motion to go up for promotion!
📖Resident brought up desire for specific #EBM “rounds.” Brainstorming if after lunch best time?
(1/ )
đź“–Morning rounds/identify question/research #evidence/present to team ~130pm. Would #housestaff buy in?
🙌🏾Daughters coming home for weekend
💪🏽Workouts need to be kickstarted
🍩Food w holes (bagels, donuts) do help team morale.
Hope you all are having a great Friday!
(2/ )
Thoughts on the post lunch brief team rounds to run evidence for our decision making, #MedTwitter? #Twitternist @COREIMpodcast @ShreyaTrivediMD @medicalaxioms @cacace_frank @LaurenKuwikMD @ORourkeJr @meggerber @SusanHingle
Read 3 tweets
Tweetorial 1 / Eficacia de la vacuna #HPV de @RecheckHealth

¿Te importaría empezar el año nuevo con un TWEETORIAL? Nuestro humilde homenaje a-@VPrasadMDMPH te guiará a través de la evidencia sobre las vacunas #HPV y lo que @Cochranecollab hizo de ella.
2/n Primero acordemos una cosa: los ensayos controlados aleatorios (ECA) son superiores a los estudios observacionales @JuanGrvas @RedeSciELO
3/n En las vacunas contra el VPH, muchos estudios observacionales publicados y los ensayos controlados aleatorios promocionados de #Gardasil #Cervarix no pudieron demostrar la eficacia esperada sin embargo. Es triste, verdadero y poco discutido. Echemos un vistazo más de cerca
Read 26 tweets
Care to kick off the New Year with a TWEETORIAL? Our humble homage to @VPrasadMDMPH will walk you through the evidence on #HPV vaccines and what @Cochranecollab made of it. Let’s first agree on one thing: RCTs are superior to observational studies
On HPV vaccines many observational studies published and hyped Randomized Controlled Trials on #Gardasil #Cervarix failed to demonstrate the expected efficacy though. It is sad, true and rarely discussed. Let’s have a closer look. @garyschwitzer @HealthNewsRevu @senseaboutsci
In 2006 @US_FDA VRBPAC Committee required @Merck to provide data and analyses on Gardasil RCTs FUTURE I and II.
Which outcome would you consider as the most relevant to assess Gardasil efficacy?
Read 22 tweets
So @getadrip deleted their tweet about IV and IM medicines for ÂŁ50, after I asked about regulatory issues.
Emails from "Richard" @getadrip are bizarre.
"We are not currently CQC registered as we do not fall within their scope and have not been informed otherwise by the CQC."
Again from @getadrip :

"All our products are MHRA approved and are prescribed by GMC Registered Doctors or Advanced Nurse Practitioners, all of whom have 10 - 25 years experience in the NHS individually.
"
And:
"There are many Vitamin Drip providers within the UK, some of which have been operating for up to 10 years, they are also not regulated by the CQC ..., please see an example below:
cqc.org.uk/location/1-353…
"
#bonkersMedicine
This is the strangest @CareQualityComm report ever.
Read 28 tweets
@TheBMA @BMANews "FRONTLINE" 4th August displays worrying prejudice. Please refer your pseudonymous ED consultant Charles Lamb to the following:

en.m.wikipedia.org/wiki/Out-group…

We no longer call people "schizophrenics", "diabetics", or "cyclists". To do so risks lazy prejudice.

1/
@TheBMA @BMANews From Lamb's article:

"Where there are cycle lanes some choose not to use them" - correct; may I refer you to the UK's unfit for purpose cycling "infrastructure" or "farcilities":

colyer.plus.com/danny/cycling/…

2/
@TheBMA @BMANews And (referring to someone riding a bike):

"After all they all look the same"

This is never an acceptable way to describe any group of human beings.

Particularly when you use dehumanising language to "other" them - this is prejudice and out-group homogeneity bias again.

3/
Read 8 tweets
In commemoration of 3 years of emailing hundreds of papers/ resources to my @OHSUIMRes ward teams & thanks to the amazing educators here and on #medtwitter #meded

My 10 greatest hits based on learner feedback:
10/ AGC “Approach to abnormal LFT” guidelines - for all those times when it’s not acute liver failure, but those LFT’s look like they need some investigating - ht Dr Jou gi.org/guideline/eval…
9/ “Normotensive ischemic acute renal failure” - can’t tell you how many times this has come in handy where I’ve slipped this to my resident, antihypertensives were backed down and a mysterious AKI disappeared; ht Dr Chiovaro nejm.org/doi/full/10.10…
Read 11 tweets

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