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Leora Horwitz Profile picture
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20 Apr, 4 tweets, 2 min read
Excited to judge the finalists for the @SocietyGIM Lipkin Award (best student/resident/fellow abstract) for the third year in a row - tune in live at 12:20p EDT today, tomorrow and Thursday to see recorded presentations and live questions. Our trainees are our future. #SGIM21
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More from @leorahorwitzmd

Leora Horwitz Profile picture
24 Feb
There is no perfect vaccination prioritization strategy, and every choice leaves out people who would really benefit from vaccine. That said, I think @GovNedLamont's new age-based strategy in CT is very sensible if primary goal is to reduce hospitalizations and deaths ASAP. /1
Context: CT has already prioritized those in congregate settings (nursing homes, corrections, group homes, homeless shelters) and those 65+. Now, plan is to go by age in ~3 wk intervals (55-65, 45-54, 35-44, 18-34), last group starts May 3. Teachers now. portal.ct.gov/Coronavirus/CO…
But, don't chronic conditions increase risk from #COVID19? Yes. (In fact, my group was among first to prove it.) So why not prioritize people with them? 1) Because age is an even bigger risk. A young person with comorbidities is still lower risk than an older one without. /3
Read 12 tweets
Leora Horwitz Profile picture
23 Feb
Today we commemorate half a million US deaths from #COVID19 - a staggering and heartbreaking figure. Millions are mourning. The only positive is that it is increasingly clear that this year will be better. A thread on #COVID19 mortality evidence:
In October we published an analysis showing that death rates among hospitalized #COVID19 patients had dropped precipitously at @nyulangone even after accounting for changes in patient mix. @jhospmedicine journalofhospitalmedicine.com/jhospmed/artic…
Since then, there has been lots of corroborating evidence. This @JAMAInternalMed paper showed that mortality rates at nearly all of 398 US hospitals improved by at least 25% in the first few months of the pandemic (28k hospitalizations) ja.ma/2MdJrTm @rm_werner
Read 8 tweets
Leora Horwitz Profile picture
17 Feb
So proud of this work led by @vincentjmajor & Erwin Wang w/@NicoleAdlerMD @hauck_kevin @AustrianMd
@yindalon @nyulangone in @nejmcatalyst. This is how to do thoughtful, collaborative integration of #AI into clinical care to create a learning health system catalyst.nejm.org/doi/full/10.10…
At baseline, only 16% of our patients hospitalized within 6 months of death had documentation of advanced care planning. @vincentjmajor & clin colleagues developed 3 predictive models for 2 month mortality, set appropriate threshold (75% PPV), and integrated into the EHR. Image
The alert was shown a max of twice, only to attending physicians. 71% agreed with the alert: 72% of those patients had advanced care planning, vs 34% of those where docs disagreed, so overall 66% of alerted patients had ACP performed. How does that compare to others? Next... Image
Read 6 tweets
Leora Horwitz Profile picture
6 Dec 20
Our new paper in @JAMANetworkOpen shows no disparity in adjusted outcomes between Black/Hispanic/White #COVID19 patients @nyulangone once hospitalized; if anything, Blacks seem to do a little better. Is this an anomaly? @gbengaogedegbe ja.ma/3n1NKhC /Thread
Actually, several other papers have now found the same. This study of 11,210 hospitalized patients at 92 @ascensionorg hospitals found no sig difference in mortality between Blacks & Whites @BYehia jamanetwork.com/journals/jaman…
This @cdcgov study of 2,491 hospitalized patients at 154 hospitals across the US confirms the findings academic.oup.com/cid/advance-ar…
Read 11 tweets
Leora Horwitz Profile picture
2 Dec 20
Yesterday the world lost a shining light, much too soon. @marjoriesue’s life was marked by tragedy – widowed early with two young children, then metastatic cancer – but she radiated joy and empathy and was an astonishingly gifted writer. In memoriam, some of my favorite pieces:
Margi was a pediatrician, writer, friend, researcher and community activist, but also a single mom who raised two extraordinary young women. Here, she wrote nicer words about other people's mothers (including mine @renalis) than I have ever said to my own:
wbur.org/cognoscenti/20…
On dating while on chemo
nytimes.com/2020/09/04/sty…
Read 16 tweets
Leora Horwitz Profile picture
29 Sep 20
My periodic reminder that WE ARE NOT GOING TO SOLVE #COVID19 THROUGH NON-VACCINE HERD IMMUNITY. For those who need more convincing, thread follows.
First, we have NEVER gotten to herd immunity without vaccine for a virus. If you are over 40, you almost certainly had chicken pox as a kid. Until vaccine in 1995, we had >4 million cases/year (& ~125 deaths) - about the same as how many kids are born each year.
In other words, EVERY NON-IMMUNE PERSON (i.e. every kid) STILL GOT IT, even though antibody rates among adults were 90-95%, and immunity is near lifelong. With circulating virus and no vaccine, most without immunity will eventually catch it even if the pop is largely immune.
Read 10 tweets

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