It’s not that it’s a spiral - one of my favorite types of graphs is the Condegram spiral. (Named after Mark Conde)
It’s used in astronomy/meteorology to show changes the Earths magnetic fields (Kp index) & is used to visualize space weather.
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Another awesome spiral graph - and one of the best examples of #dataviz ever IMO - is the Rose plots by Florence Nightingale.
These 1858 plots show the causes of mortality in Crimean war & make a compelling case that for improving conditions (particularly shelter in winter). 3/
I also really like circular or spiral dendrograms. Take a look at this beautiful 🌀 graphic showing the evolution/domestication of yeast.
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So if I like 🌀graphics so much why do I viscerally dislike this NYT COVID spiral? 5/
The beauty of Nightingale & Conde’s spirals is they show *granular* data. You can clearly see the sudden changes in deaths or solar activity.
The NYT graphic *averages* the data - this makes it look smooth but it also makes the surges in cases more subtle & harder to see. 6/
Another problem is how the NYT graphic plots cases: above & below the spiral.
Compare to the Condegram, which only goes above the spiral.
Humans are better at perceiving height than width. Just look at these two lines of identical length. Which case is easier to discern? 7/
To illustrate this point: Compare the NYT COVID spiral to the same data presented linearly.
Is it obvious that the green🟩line is more than twice as wide as the blue 🟦 line? 8/
Bottom line: this plot from the NYT distorts the data through unnecessary smoothing & plotting on both the inside & outside of the spiral. This has the effect of making it hard to see the true increase in cases. A missed #dataviz opportunity.
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As a bonus - here are few more of my favorite spiral #dataviz:
A 1850 plot by William Farr showing a (spurious) relationship between temperature & cholera cases in London. Correlation doesn't equal causation but it's still a compelling spiral graphic.
Not a spiral but another of my all time favorite ID dataviz examples: a plot showing polio cases in the US from 1931 to 1955.
Look how it combines granular data from each state/each week, along with monthly averages, and a heatmap for emphasis. 😍
Did he have a head CT? What did it show?
Did he have stitches? Tetanus shot?
The NYT ran nonstop stories about Biden’s health after the debate but can’t be bothered to report on the health of someone who was literally shot in the head?
To the people in the replies who say it’s impossible because of “HIPPA” 1. I assume you mean HIPAA 2. A normal presidential candidate would allow his doctors to release the info. This is exactly what happened when Reagan survived an assassination attempt. washingtonpost.com/obituaries/202…
My advice to journalists is to lookup tangential gunshot wounds (TGSW).
Ask questions like:
- what imaging has he had?
- what cognitive assessments?
- has he seen a neurosurgeon or neurologist?
- he’s previously had symptoms like slurred speech, abnormal gait - are these worse?
If you intubate you need to read the #PREOXI trial!
-n=1301 people requiring intubation in ED/ ICU were randomized to preoxygenation with oxygen mask vs non-invasive ventilation (NIV)
-NIV HALVED the risk of hypoxemia: 9 vs 18%
-NIV reduced mortality: 0.2% vs 1.1%
#CCR24
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Hypoxemia (SpO2 <85%) occurs in 10-20% of ED & ICU intubations.
1-2% of intubations performed in ED/ICU result in cardiac arrest!
This is an exceptionally dangerous procedure and preoxygenation is essential to keep patients safe.
But what’s the *BEST* way to preoxygenate? 2/
Most people use a non-rebreather oxygen mask, but because of its loose fit it often delivers much less than 100% FiO2.
NIV (“BiPAP”) delivers a higher FiO2 because of its tight fit. It also delivers PEEP & achieves a higher mean airway pressure which is theoretically helpful! 3/
Results from #PROTECTION presented #CCR24 & published @NEJM.
- DB RCT of amino acid infusion vs placebo in n=3511 people undergoing cardiac surgery w/ bypass.
- Reduced incidence of AKI (26.9% vs 31.7% NNT=20) & need for RRT (1.4% vs 1.9% NNT=200)
Potential game changer!
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I work in a busy CVICU & I often see AKI following cardiac surgery.
Despite risk stratification & hemodynamic optimization, AKI remains one of the most common complications after cardiac surgery with bypass.
Even a modest reduction in AKI/CRRT would be great for my patients. 2/
During cardiac surgery w/ bypass, renal blood flow (RBF) is reduced dramatically. This causes injury, especially in susceptible individuals.
But what if we could use physiology to protect the kidneys?
Renal blood vessels dilate after a high protein meal increasing RBF & GFR! 3/
77 yo with respiratory distress, RR 30, SpO2 80% on non-rebreather at 15 lpm
CXR & TTE are unrevealing
pH 7.58 / PaCO2 24 / PaO2 >500 / HCO3 22
MetHb 0% CarboxyHb 0%
The ABG looks like this:
The answer is sulfhemoglobinemia.
Sulfhemoglobinemia is a *permanently* modified hemoglobin associated with exposure to TMP/SMX, dapsone, phenazopyridine, & other amino & nitro compounds.
It has an altered oxy-hemoglobin dissociation curve.
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Sulfhemoglobinemia is easily confused with methemoglobinemia. Both have very dark colored blood & present with cyanosis. Diagnosis typically requires a specialized lab.
Spoiler: you may have heard that SulfHb is green. It isn’t really. You’re thinking of Vulcans’ blood.