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Ade Adamson, MD MPP

16 Dec, 12 tweets, 5 min read

@TODAYshow

Last year the @TODAYshow said I was wrong about sunscreen and skin cancer in Black people. Here is our latest publication in @JAMADerm showing why I was right.
Let me explain....

https://twitter.com/AdeAdamson/status/1156713820653359104

@washingtonpost

It all started with this article I wrote in the @washingtonpost challenging the idea that sunscreen would have saved Bob Marley who died of melanoma on his foot.

https://twitter.com/adeadamson/status/1133089255465607169

People seemed to be blown away by the assertion and it ended up getting picked up by the NYTimes here: nytimes.com/2019/07/26/us/…

This is when it made its way onto the Today Show where my assertions were challenged. This was a missed opportunity to educate the public by folks at the Today show! I decided to get a team together and look into all the evidence related to UV exposure and melanoma

We looked at ALL the literature related to UV exposure and melanoma published in the English language and found 13 studies that met our inclusion criteria.

Only 2 of the eleven studies showed any association of UV exposure and melanoma in people broadly defined as having skin of color.

One of those studies only showed an association in Black men. But in that same study showed NO association in any other group...not even in white people, the group in which the association has been consistently shown! see: jamanetwork.com/journals/jamad…

The other study showing an association was among Hispanic men in Chile based on latitude within the country. A major caveat is that in the city with highest number of melanomas is also home to a lot of Chileans of Croatian descent (i.e. white)

Bottom line: The link between UV exposure and melanoma in people of darker skin types likely does NOT exist. Stop the fearmongering.

Now anybody that comes at me with this nonsense, I can point them to our paper: jamanetwork.com/journals/jamad…

@FabiLopes_Derm

I could not have done this without a fantastic team which include @FabiLopes_Derm and @marcsleiman1 and others.

@MishaRosenbach

If you want more details check out the podcast about this new paper where I was interviewed by the legendary @MishaRosenbach : edhub.ama-assn.org/jn-learning/au…

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More from @AdeAdamson

Ade Adamson, MD MPP

@AdeAdamson

21 Jan

Effect of Sunscreen Application on Plasma Concentration of Sunscreen Active Ingredients: jamanetwork.com/journals/jama/… PART-2 of a study on chemical sunscreen absorbing into the blood. This is surely going to stir up more controversy. Let me break it down in this thread #tweetorial 👇🏾

@JAMA_current

In May 2019 the same group of investigators published a study in @JAMA_current asking the question: What is the concentration of chemical sunscreen that gets in the blood if used under maximal conditions (i.e. Used 4 times per day for 4 days)? Study here: jamanetwork.com/journals/jama/…

https://twitter.com/adeadamson/status/1125522416837517312

I did a #tweetorial last year on the original study and explained the history of the controversy of sunscreen safety in general:

https://twitter.com/adeadamson/status/1125522416837517312

Read 18 tweets

Ade Adamson, MD MPP

@AdeAdamson

11 Dec 19

@NEJM

Machine Learning and the Cancer-Diagnosis Problem — No Gold Standard: nejm.org/doi/full/10.10…
My latest work in @NEJM with Dr. Gil Welch in which we discuss how machine learning cannot overcome a central problem in cancer diagnosis and we suggest a way forward. #tweetorial 👇🏾👇🏾👇🏾

Machine learning (ML) is a potential powerful tool that may help clinicians deliver faster and more consistent diagnoses and improve patient care. But there are inherent limitations.

So far, most applications of ML in medicine are for visual recognition (e.g. retinal scans, chest x-rays) developed using “supervised learning,” meaning you present the computer with the ground truth and after thousands/millions of data points it gets good at recognizing “truth”

Read 14 tweets

Ade Adamson, MD MPP

@AdeAdamson

2 Oct 19

What are the Epidemiologic Signatures in Cancer? A new special report out in NEJM by Gil Welch, Barnett Kramer, and William Black is so good I had to do a #tweetorial. nejm.org/doi/full/10.10…
👇🏾👇🏾👇🏾

TL;DR -- The MAJOR takeaway doctors and trainees should get from this article is this:
Cancer incidence is an UNRELIABLE measure of cancer burden.

Using data from SEER, which essentially serves as the cancer registry of the United States, authors show trends in cancer mortality, incidence, and metastatic incidence between 1975 and 2015.

Read 29 tweets

Ade Adamson, MD MPP

@AdeAdamson

23 Jul 19

Skin cancer better diagnosed by deep learning than doctors aiin.healthcare/topics/diagnos… Press releases like these really irritate me.

Let’s a take a dive into this study. Here is a link to it: ejcancer.com/article/S0959-…

First of all, this study was not about skin cancer writ large, but about melanoma, specifically. I think that’s an important distinction.

Read 13 tweets

Ade Adamson, MD MPP

@AdeAdamson

16 May 19

Randomized phase 3 evaluation of trifarotene 50 μg/g cream treatment of moderate facial and truncal acne.
Link: jaad.org/article/S0190-…
These types of studies are so frustrating because the control arm is NOT a reflection of standard of care. A thread. #tweetorial 👇🏾

In this study investigators randomized patients to a new retinoid (trifarotene)
for acne treatment or vehicle (basically a cream/moisturizer). Of course they showed superior improvement with the new medication.

Why this is frustrating is that the differences are quite small overall. Remember this study is comparing the new drug to a MOISTURIZER. Literally putting on a moisturizer improved the acne significantly! Look at the curves above.

Read 8 tweets

Ade Adamson, MD MPP

@AdeAdamson

6 May 19

Effect of Sunscreen Application on Plasma Concentration of Active Ingredients bit.ly/2vD3w9V This provocative study in JAMA about sunscreen deserves a #tweetorial. Bear with me as I take you through the controversy and discuss sunscreen in general. 👇🏾👇🏾👇🏾

TL; DR – certain chemical sunscreens are absorbed after application; we don’t know what this means for human health. This does not mean you should abandon sunscreen use nor does it mean sunscreens are unsafe.