CORE IM Profile picture
May 4 5 tweets 2 min read
1/ Welcome back to #StatswithCoreIM !

What would you tell this patient who inquires about lab cancer #screening test to help him “live longer”?

What types of bias can occur in determining whether a cancer screening test reduces mortality?
2/ Take a look at the bolded arrows below that illustrate that early detection doesn’t always mean better outcomes!

Length-time bias applies to slow-growing disease in which patients have a long phase without symptoms.
3/ Lead time bias applies to situations where patients are screened earlier, so they are diagnosed earlier, so they appear to live longer solely by nature of knowing they have the disease for a longer period of time.

Therefore, survival time⬆️⬆️
4/ How would you explain these biases to our patient?
5/ So now what? How can studies mitigate length and lead time bias?

Check out our bullets below ⬇️ and let us know if you have additional ways you think about mitigating these biases in studies

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with CORE IM

CORE IM Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @COREIMpodcast

Mar 17
1/ Welcome back to 12-Lead Thursday #MedTwitter !

Let’s get the juices flowing with an EKG! What are the major abnormalities?
2/ Yes, those are inferolateral ST elevations!

And notice the underlying rhythm of atrial fibrillation
3/ Continuing our patient story, the patient was taken emergently to the cath lab where angiography revealed...

Normal coronary arteries!
Read 9 tweets
Mar 8
1/ First and foremost, from all of us here at @COREIMpodcast, sincerest greetings for #InternationalWomensDay!

We wanted to use this opportunity to shed light on the discussion on post-menopausal hormone therapy (HT) via highlighting the important yet controversial WHI trial Image
2/ WHI followed the Nurses' Health Study, a prospective investigation that showed HT was associated with decreased cardiovascular disease (CVD) risk Image
3/ WHI, a randomized controlled trial (RCT), was believed to mitigate the effects of confounding factors better than cohort studies. WHI, in contrast to the Nurses’ Health Study, showed that HT was associated with a slightly increased risk for CVD among other conditions ImageImage
Read 9 tweets
Mar 3
1/ Good morning #MedTwitter ! It’s time for #12LeadThursday

Let’s jump in– can you decipher the EKG below to find out what’s wrong with this patient’s His-Purkinje system?
2/ If you thought left anterior fascicular block (LAFB), you were right!

What is the formal criteria for LAFB?!
✅Left axis deviation w/o LVH
✅qR pattern in lead aVL
✅R-peak time in lead aVL of 45 ms or more
✅QRS duration less than 120 ms
3/ Why do our patients get LAFB?!

Think fibrosis in the left anterior fascicle! This causes a slowed electrical conduction → EKG findings.
Read 5 tweets
Mar 1
1/ Good afternoon #MedTwitter and happy #TriviaTuesday :

What part of a plane are you most likely to come into contact with bacteria? ✈️
2/ And there you have it… the armrest!

Not what you expected? Read on
3/ We’re familiar with the ways infections can spread- contact, droplet/airborne, vector, and food/water.

We’re going to focus on contact precautions today:
Read 5 tweets
Feb 23
1/🚨New Episode & Segment Alert🚨

Grey Matters: Because medicine is rarely black and white!

Hosts: Alison Trainor, @FreedoBaggins
Discussants: @PishkoMD, Brett Carroll MD, Jeff Weinstein MD
Graphic: @samwoodworthmd

🎶 bit.ly/35hN1Fd
ACP: bit.ly/3oVhwbI
2/ Let's review some deep dives 👇

Where does the *strong rec* to anticoagulate for PE at least 1 month (if not the full 3 months) come from?!

We have natural history data tells us:
3/ How long do you hold DOACs for peri-procedure?

Let’s see what we can extrapolate from the PAUSE trial
Read 5 tweets
Feb 15
1/ Good morning #MedTwitter and welcome back to #TriviaTuesday

Let’s start with our question of the week👇 Image
2/ And the answer is: Pneumo-Ultra-Microscopic-Silico-Volcano-Coniosis

Say that 5x times fast! Image
3/ Silicosis is a lung disease caused by inhalation of silica dust.

Workers in what industries should perk your clinical ears for considering silicosis? Image
Read 6 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!

:(