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Anupam Jena @AnupamBJena
, 4 tweets, 2 min read Read on Twitter
Take 2 kids. One born in Aug & the other in Sept. In states with a Sept 1 cutoff for school entry, Aug-born kids are 35% more likely to be diagnosed AND medically treated for ADHD. Our study w/ @timothyjlayton @ml_barnett @tannerhicks42 in @NEJM

nejm.org/doi/full/10.10…

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2/
About 1 in 4 kids who are born in Aug wouldn’t have been diagnosed w/ & treated for ADHD had they been born in Sept

Why?

In states w/ Sept 1 cutoff, Aug-born kids are youngest in class, Sept-born oldest.

Inattentive behavior in Aug kids interpreted as ADHD vs immaturity
3/
 No Aug vs Sept effect in states without a Sept 1 cutoff

No effect for diabetes, asthma, and obesity, conditions all diagnosed by more objective criteria (ie not influenced by peer to peer comparisons made in classrooms)

Largest effect in boys
4/
This idea isn’t new. It’s been shown in the US using data from 10 years ago and in other countries. But despite this, as of 2015 these large differences still persist.

Question is whether Aug kids are over or underdiagnosed? Our data can’t definitely answer that question
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It’s Time To Rethink The Anatomy Of Physician Behavior

Our @Health_Affairs blog piece where @LisaRotenstein & I argue that the fee for service payment system, while not ideal, IS NOT the main culprit driving waste in U.S. health care. Thread for why...

healthaffairs.org/do/10.1377/hbl…
Dartmouth studies show large variation in FFS Medicare across patients that are arguably similar (at least more similar than not). The fact that doctors who are all paid same way (FFS) have such different utilization suggests it’s something about doctors not the payment mechanism
Most PCP offices don’t actually get paid for the costly services that ensue from doctor decisions, like MRIs, CTs, specialist consults. If the PCPs aren’t paid for these sometimes low value services, it’s hard to argue that financial incentives drove those decisions.
Read 6 tweets
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Reduction in Firearm Injuries during NRA Annual Conventions 1/N
Our new @NEJM study
- 20% reduction in gun injuries during convention dates vs identical days in surrounding 3 weeks
- Largest reductions in men, who comprise majority of convention attendees
nejm.org/doi/full/10.10…
2/N
 - Largest reductions in states w/ high gun ownership
- Largest reductions when convention is held in a given individual's state in a given year (hypothesis: conventions are easier to attend)
- Data: large privately insured population, ~75 million visits over 9 years
3/N
 - Mechanism: Unknown but possibly due to brief reductions in overall gun use during convention dates, e.g., due to convention attendance itself, brief closures of venues where guns may be used (ranges, hunting grounds), or lower use if gun use sometimes occurs in groups
Read 5 tweets

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You know what bugs me most about ADHD research? I mean aside from the sexism, racism, classicism and the fact that it was considered just a childhood thing that people grow out of?

So... you know what bugs me fifth about ADHD research?

The framing.
There’s so much research that’s built around the idea of preventing ADHD. So much literature around being a parent with an ADHD kid and how the parent can deal with that. And so much research explaining what’s going on in an ADHD brain in a clinical way.
And all this builds a frame where people who have ADHD aren’t really invited to share what it’s like, to use our own words, to try and help each other understand the similarities between our brains.
Read 26 tweets
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Hello fellow #ADHD-ers!! An election is coming up and I know how tedious and hard it is for us to research our ballots and get motivated. Your brain is literally fighting you. But guess what! Still not an excuse to not vote! Here are some things that will help:
LET'S BREAK DOWN THE STEPS. I'll tackle practical logistics first, ballot research second. The second thing will probably be the hardest for us, honestly.

OKAY HERE WE GO– THE PHYSICAL ACT OF VOTING:
Are you voting in person?

1. locate your polling place! bfy.tw/4fOf Google has an easy form to enter your address.

2. Use google maps to find out how long it will take to get there from where you are coming from that day.
Read 28 tweets
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@SurvivorsnetBtn @RASASC_London @survivorstrust @Danvers07943910 @ObjectUK @BrightonSurvivorsNET “In the light of a highly disturbing increase of #transphobia locally & nationally…” IF everything anybody says or does is #transphobia, of course you can say it is rising. Any reputable statistics?
@SurvivorsnetBtn @RASASC_London @survivorstrust @Danvers07943910 @ObjectUK “…so the date @Womans_Place_UK event feels like a concerted effort to make #trans ppl, & particularly #transwomen, feel #intimidated and #invalidated” Is it the position of SN that the sensitivities of #transwomen mean that #democracy should be suspended any time they say so?
@SurvivorsnetBtn @RASASC_London @survivorstrust @Danvers07943910 @ObjectUK @Womans_Place_UK #Transwomen do face special challenges but they remain #bio #logical #males but it is fine for them #Gender express as ‘women’ but with the best will in the world, they remain #bio #logically #male @WomenEqualities @Commonswomequ @PennyMordaunt @MariaMillerUK @LesleySemmens
Read 51 tweets
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I did the most #ADHD thing the other day. I took one pill then got distracted + took another, so ended up wired when one dose makes me like a "normal" person. I'm coming out as ADHD now after building a record of hard work bc there's stigma. Lmk if you have qs about pros and cons
I'm in good company with Michael Phelps and Einstein 🙂. Basically even without meds I'm able to hyperfocus on what I'm interested in accomplishing but if you ask me to do something boring I'll be incredibly inept. healthline.com/health/adhd/be…
Also #ADHD is linked with higher sensitivity to things like bright lights, sounds and textures. I was only diagnosed a few years ago and just thought before that knit turtlenecks were a medieval torture device.
Read 23 tweets
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One of the world's most remarkable ruined places is the sunken city of Thonis-Heracleion.

Once a thriving hub of the ancient world, the city was devastated by a series of environmental disasters, & now lies 6.5km off the coast in the blue waters of the Egyptian sea.
The story of its discovery began in 1933, when an RAF pilot flying off the coast of Alexandria reported a strange sight in the water.

He claimed to have seen massive ruined structures below the waves: buildings, squares & streets, a whole city lost beneath the ocean.
Divers set out to explore the spot, but they were unable to learn much or corroborate the sighting in the silty water of the Egyptian coast.

They found something, though: an enormous head of stone, larger than life, thought to be part of a statue depicting Alexander the Great.
Read 27 tweets
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Happy Sunday, fam. There is a #MusicSermon thread on today, and it's an ambitious one, so I'ma ask ya'll to cover me as I prepare. Amen. ⛪️
Doors of the church will open about 5.
Aight ya'll. #MusicSermon time. And whew, this is about to be a long one I think..
Read 108 tweets

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