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@boback @JDNewmanMD @CircOutcomes @iamritu @bnallamo @MikeTPhD @ADAlthousePhD @denniskomd @SVRaoMD @rallamee @rajkumar_chris @GreggWStone @KAlexanderMD @jspertus 22/ We are also seeing disparities by race, gender, age, and location... Women were likely to reach goals @drstaceyrosen @ErinMichos - why? Also non-whites more likely than white participants to achieve LDL-C goal at 1 year, converse to other studies.
@boback @JDNewmanMD @CircOutcomes @iamritu @bnallamo @MikeTPhD @ADAlthousePhD @denniskomd @SVRaoMD @rallamee @rajkumar_chris @GreggWStone @KAlexanderMD @jspertus @drstaceyrosen @ErinMichos 23/ Older adults had higher odds of attaining LDL goal, but lower odds SBP goal. North America had greater odds of reaching LDL and SBP goals compared to other regions.
@boback @JDNewmanMD @CircOutcomes @iamritu @bnallamo @MikeTPhD @ADAlthousePhD @denniskomd @SVRaoMD @rallamee @rajkumar_chris @GreggWStone @KAlexanderMD @jspertus @drstaceyrosen @ErinMichos 24/ Finally no association b/n medication adherence & treatment target. Adherence to lipid lowering or antihypertensive medication did not increase the likelihood of meeting LDL target (OR 0.97, 95% CI 0.83-1.14) or SBP target (OR 1.00, 95% CI 0.84-1.20) @venkmurthy @iamritu
@boback @JDNewmanMD @CircOutcomes @iamritu @bnallamo @MikeTPhD @ADAlthousePhD @denniskomd @SVRaoMD @rallamee @rajkumar_chris @GreggWStone @KAlexanderMD @jspertus @drstaceyrosen @ErinMichos @venkmurthy 25/ Must read accompanying editorial “The Goldilocks Guide to getting Medical Therapy “just right”: Insights from the ISCHEMIA trial” @rajkumar_chris
@rallamee @MikeFoley89 offer additional interpretation and guidance for Saturday, #AHA19 ahajournals.org/doi/10.1161/CI…
@boback @JDNewmanMD @CircOutcomes @iamritu @bnallamo @MikeTPhD @ADAlthousePhD @denniskomd @SVRaoMD @rallamee @rajkumar_chris @GreggWStone @KAlexanderMD @jspertus @drstaceyrosen @ErinMichos @venkmurthy @MikeFoley89 26/ Data show modest cardiovascular risk target attainment (52% of pts achieved LDL target & 75% reached SBP target at 1 yr). Efforts to do this though, seem like anything but 'modest' -- size and scope of trial tremendous. Achieving targets for OMT is v. hard in trial and IRL!
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Boback Ziaeian 🤦🏻‍♂️
@boback
TGIF: I have a @CircOutcomes #CQOSpotlight on a simulation study evaluating the impact of clinic-based processes to achieve Million Hearts 2022 goals.
@CircOutcomes @mad_sters @bnallamo @thebyrdlab @KBibbinsDomingo @CircAHA @jordanbking @markjpletcher @ValyFontil @ADAlthousePhD Manuscript was originally published in June 2019. I just needed some time to get myself organized. Link is here: ahajournals.org/doi/10.1161/CI…
@CircOutcomes @mad_sters @bnallamo @thebyrdlab @KBibbinsDomingo @CircAHA @jordanbking @markjpletcher @ValyFontil @ADAlthousePhD Intro: The authors set out to evaluate knowing what we know, what are reasonable assumptions that would be required to achieve adequate blood pressure goals per the U.S. Million Hearts goal.
Read 28 tweets
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Paul Morgan
@PaulMorganPhD
Hi #pediatricians, our work on #disparities in #disability id. was just cited by the @AmerAcadPeds in their #policy statement on the impact of #racism on children's health. Our most recent study was cited. If helpful, here is a thread of our work to date. #RacismAndHealth (1)
@AmerAcadPeds Here is the abstract and link the the study cited in the @AmerAcadPeds policy statement. journals.sagepub.com/doi/pdf/10.310…. We find that children of color are less likely to be identified as having disabilities than similarly situated students who are White in U.S. schools (2)
@AmerAcadPeds Here is an example finding. Of U.S. 4th grade students displaying clinically significant reading difficulties, 74% of White students are receiving special education. The contrasting percentages for Black, Hispanic, and American Indian students? 44%, 43%, and 48%, respectively (3)
Read 15 tweets
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Halil MD
@ihtanboga
Multiplicty in Clinical Trial is really a disturbing issue for statisticians and trialists! (and for me😬)
b/c there is no consensus on multiplicity issue: When, Why and How to deal with it?
-I’ll try to explain by using *frequentist* point of view
1/
Briefly, multiplicity is using many (multiple) comparisons. It increases the likelihood that a chance association could be deemed causal. In other words, we carry out multiple tests, it becomes highly likely that one of these tests will be significant by chance.
2/
What is the source of multiplicity?
1-Multiple endpoints (i.e. death and death+HF rehosp)
2-Multiple treatments/arms (i.e. PCI vs Med-Tx vs CABG in pts with CAD or Riv15 mg vs Riv20 mg vs ASA)
3-Multiple interim analyses
4-Multiple subgroups

3/
Read 21 tweets
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Venk Murthy
@venkmurthy
I'm trying to see if people grok the results of @apple Heart Study.

What do you think the sensitivity of the device is for an episode of AF?

(pick closest estimate)
@Apple If you need a hint... this is the slides the investigators summarized the data on.

(It may or may not have the answer)
@Apple @DrMarthaGulati @cardiobrief @drjohnm @bnallamo @mmamas1973 @ADAlthousePhD @f2harrell @onco_cardiology @purviparwani @RogueRad I'm going to wait until about 200+ votes before proceeding. This is an important tweetorial. Please build up interest by retweeting the first tweet in this thread.

Depending on time/interest, we will cover:

1. Diagnostic accuracy
2. Bias
3. Costs of trials
Read 46 tweets
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Chadi Alraies, MD
@chadialraies
Starting now - @SVRaoMD @DocSavageTJU @fischman_david @mmamas1973 @DLBHATTMD @DrMauricioCohen @djc795 #ACCIC #SCAIFIT18 #CircIntvJC #CircIntvJC
The study was an updated meta-analysis of all the RCT published comparing DES with BMS in SVG-PCI with clinically significant endpoints @SVRaoMD @DocSavageTJU @fischman_david @mmamas1973 @DLBHATTMD @DrMauricioCohen @djc795 #ACCIC #SCAIFIT18 #CircIntvJC
In this meta-analysis, six randomized controlled trials were
eligible and included 1582 patients @SVRaoMD @DocSavageTJU @fischman_david @mmamas1973 @DLBHATTMD @DrMauricioCohen @djc795 #ACCIC #SCAIFIT18 #CircIntvJC
Read 9 tweets
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Ahmad Masri
@MasriAhmadMD
1/ A long thread on LifeVest. I promise it will be entertaining. If you find any inaccuracies please let me know.

Paper of VEST published here - will discuss background to WCD and #VEST but not the trial itself nejm.org/doi/full/10.10…
2/ In 2001, FDA gave approval to Lifecor for the first WCD. Later Lifecor was acquired by Zoll (2004 agreement, 2006 acquisition). Zoll maintains a registry for prescribed LifeVests. But lets go back to the FDA approval process.
3/ Lifecor presented 2 separate prospective studies to the FDA; WEARIT and BIROAD. FDA asked for both to be combined into 1 study, and each study representing a subgroup. A total of 289 patients were included.
Read 18 tweets

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