Tatiana Prowell, MD Profile picture
May 12 5 tweets 10 min read Twitter logo Read on Twitter
In May 2019, Dr. @rschilsky & I co-chaired the #AAADV19 Workshop Plenary Session "Decentralized #ClinicalTrials: The Future is Now." An incredible group of panelists from academia, industry, govt, & patient #advocacy 👇discussed the rationale, challenges, & opportunities of DCTs. Image
No one knew yet that the #COVID19 #pandemic was just around the corner. In Mar 2020, FDA released a guidance on conduct of #clinicaltrials during the pandemic: fda.gov/media/136238/d…, & colleagues wrote about the impact on #OncTwitter trials: ncbi.nlm.nih.gov/pmc/articles/P…. /2
FDA has now released a draft guidance on decentralized #clinicaltrials for drugs, biological products, & devices covering #telehealth, remote assessments, consent, shipping of IP, & more: fda.gov/media/167696/d…. #MedTwitter #regulatory #drugdevelopment Image
So the future is truly now! Public comment period for draft guidance on decentralized #clinicaltrials open 'til 8/1/23: bit.ly/3I1AOoE.

#MedTwitter #OncTwitter #regulatory #bcsm #lcsm #btsm #crcsm #pcsm #kcsm #gyncsm #pancsm #leusm #lymsm #ALS #dementia #ASCO23 #ESMO23
Speaking as a dr to people with #cancer & as a person who has lost family to #dementia, the ability to access #clinicaltrials--even if you are too ill, too immobile, too far away, too short on sick leave, or can't afford to travel--changes everything. 🙏

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More from @tmprowell

May 12
Students from 🏠 with annual income <$50K were half as likely to be accepted to med school as students with 🏠 annual income >$200K. We all knew this was a problem, but the magnitude is shocking. We all have a role in addressing this, #MedTwitter… /1
Students from lower income 🏠 are at an educational disadvantage that begins well before college. A concrete intervention: volunteer to tutor students. I did this multiple times per month the whole time all 3 of my kids were in elem school. files.eric.ed.gov/fulltext/EJ898… /2
All of us in #MedTwitter should be teaching our kids to use their privilege to lift other students. A concrete example: one of my kids had the opportunity in 5th grade to do an independent study in which he learned to code via his amazing public school teacher, Mrs. Stansbury. /3
Read 10 tweets
Apr 9
A study from #Brazil finds 1 in 4 adults who had mild #COVID19 demonstrated cognitive deficits. The average age of study participants was 38. See what happened when they were asked to copy a diagram. We are not prepared for this. #MedTwitter #LongCovid brainfacts.org/diseases-and-d… Image
Many people are replying “I wouldn’t have been able to copy that drawing accurately even before #COVID19.” This is true. On avg, 5-8% of population are unable to reproduce this. What concerned researchers was that in this study of ppl w/ mild COVID, 25% of them could not.
There are less complex drawings that can look for more obvious visuoconstructive deficits. We often ask patients to draw a clock showing a specific time when screening for dementia. Here’s a published example of those drawings (unrelated to COVID). sistershospitallers.org/clock-drawing-… Image
Read 6 tweets
Jan 18
A survey of 20K people found the most productive people:
👉Set objectives & priorities before beginning to read, write, or plan day
👉Insist on short, focused mtgs & clear, efficient comms
👉Develop consistent strategy to handle 🌊 of msgs/tasks
hbr.org/2019/03/what-m…
2/ A couple interesting observations. Americans work more hours than much of the world but are not more productive. I suspect this is because 🇺🇸 culture values “workaholics,”
so we push through with diminishing returns.
3/ Males & females had sim productivity, but used diff strategies.
👉F: prepped next day, held brief mtgs w/ set agenda that ended with consensus & action items.
👉M: checked email less often, skipping low value msgs, kept open calendar slots, & used outlines pre- writing.
Read 4 tweets
Jan 5
🔥IMPORTANT! #MedTwitter & all workers: the @FTC is proposing to make noncompete clauses illegal. Employers would be prohibited from establishing them & forced to rescind existing ones, incl notifying past employees of the change! 👏👏 @MedicineForward nytimes.com/2023/01/05/bus…
~ 1/5 of US workers are currently under non-compete clauses. They harm workers in many sectors, incl #MedTwitter, e.g., by preventing them from taking a better position w/ another company unless they’re willing to move or travel a long way to work. 2/
#MedTwitter is often subject to noncompete clauses. Here’s why that is so important, even if you’re not a dr yourself: nytimes.com/2019/03/15/bus…

3/
Read 5 tweets
Dec 5, 2022
🧵This is a VERY brief thread about #HCWvsHunger tonight because this week has been out of control, & I still have to pack to fly to Texas for #SABCS22 on 12/5, which is TOMORROW! A longer thread will follow because I know everyone comes to Twitter for long form, lol.

1/
The last few months worried me. The economy. The numerically & emotionally depleted #MedTwitter colleagues. The very fate of this platform, which has big problems, & also has been an undeniable source of reliable info to the public during this #pandemic & community for us all.
When I thought about the work involved in doing #HCWvsHunger for a 3rd time, those things were all top of mind. Feeding hungry people is vital. It's unconscionable that some of us have full bellies while others starve when WE HAVE THE POWER TO CHANGE THAT, #MedTwitter. /3
Read 7 tweets
Nov 23, 2022
🧵 I did 10 parent teacher conferences yesterday where my kids have an A in the class & I had nothing to discuss. I used the time to tell #TeacherTwitter a few things:
👉I know you risked your own health & life, & your family’s, to come to work in a #pandemic. #ThankYou

/1
👉I know you spent 1.5 yrs teaching our kids virtually, navigating unfamiliar technology, staring at a little dot on your monitor instead of a class full of kids, not knowing if the kids with cameras off were there, wondering about the ones who never connect. #ThankYou

/2
👉I know you are now trying to teach students this year’s content, but also content that was learned & forgotten during the #pandemic…or never learned at all. And that, as you do this, your schools, & in turn you, will be held accountable for how your students are performing. /3
Read 5 tweets

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