Prof Darrel Francis ☺ Mk CardioFellows Great Again Profile picture
Cardiologist, Scientist. I separate taking my work seriously (I do) vs myself seriously (I don't) Ideas my own (best ones stolen from my amazing PhD students)
Anil Gopinath Profile picture UnChatUnChat Profile picture Steve Granier Profile picture Rui J. Cerqueira, MD, MSc Profile picture Jojoba Profile picture 9 added to My Authors
1 Aug
Should we do PCI in patients with stable coronary artery disease?
Young Guillaume Marquis-Gravel took on this topic at a recent meeting of #CVCTForum. He brought together a wide range of research expertise: DJ Moliterno, P Jüni, YD Rosenberg, BE Claessen, RJ Mentz, R Mehran, DE Cutlip, C Chauhan, S Quella, SG Goodman and Faiez Zannad
He somehow melded together all these diverse opinions, and even got a little contribution from me, to produce a very helpful summary of where we are in research, and WHY it is so difficult to answer the questions we really are curious about.

sciencedirect.com/science/articl…
Read 80 tweets
28 Jul
Prize for the first person to spot what went wrong here.

(First author is an old friend so I am sure she won't mind me pointing it out. Great study! All publicity is good publicity Valentina!)
Bit tricky on that, so let me make it easier:
Answer in the morning from @drgrahamcole who pointed it out to me.
Read 93 tweets
25 Jul
Dear Nobel Prize Committee,

I would like to claim my Nobel Prize please.
For curing cancer.

Can you post me my medal, or do I have to come and collect it in person?

#FOAMED #MedTwitter #Tweetorial
Thank you to @RicardoPetraco and @mshunshin for drawing this to my attention, but I will have the Nobel on my own thanks, as I am the boss. You guys are basically just Rosalind Franklin.

The method of curing cancer I have developed is as follows.
You know the BP pills that you are mostly taking?

Well, take them at night.

That's it.
Read 91 tweets
20 Jun
Aha!

Grigoris, our colleague from our ORBITA partners in Essex Cardiothoracic Centre, sets up a challenge.

Can anyone suggest one? I know I have my favourite.
Nice suggestions!
My favourite is this trial, unique in many ways.
Read 13 tweets
20 Jun
Oooh a sizzler here, from the lab of John Spertus!

Could it really be true that we PCI docs are telling porkie-pies about whether our patients have angina?
Why do you think this happens?
Read 22 tweets
15 Jun
It is my sad duty to announce that a source has informed me...
of the sad demise of the second most innovative company in medical research.
The Surgisphere corporation, a long time competitor of Francis Industries in the cutting edge science of "making shit up"ology, has today gasped it's last and gone out of business.
Read 6 tweets
14 Jun
"What have the Romans ever done for us?"
============================

[A cautionary tweetorial from ORBITA-HQ. #Foamed]

Actually, their biggest contribution was not the roads, or the baths, or the sewage system, or aqueducts, or the many other things that first jump to mind.
In my opinion, their standout contribution to us in healthcare is that of the learned doctor Caecilius.

Faced with the tedium of having to classify his slaves for work capacity, he found age and sex too simplistic. He created an extra component for the effort they could make.
In the modern era of political correctness, we rarely speak of his innovation, erupting in rage when he saw young slaves standing about idly.

"Nonne Juvenes Habitus Ambulatio?"
Read 26 tweets
12 May
A colleague from Italy sent this link (I can't find the tweet so I can't properly credit them, sorry).

It is updated daily, and is from Italy's Istituto Superiore di Sanità.
Note the regular weekend dips in the TEST results (greeny blue).

But when you ask people to describe when their SYMPTOMS started, the curve is much smoother (bluey blue).
The curves are both coming down nicely with the benefit of lockdown, but they very importantly point out to ignore

the last few greeny ones (as tests are in progress) and a LONGER time range of bluey ones (as future positive-testing patients may project symptoms back to here).
Read 18 tweets
11 May
What do you think of this reasoning?
Question 1.

If *most* (i.e. 51% or more) healthcare workers are getting Covid infection in the same way as the general population, how high can the rate in healthcare workers be, consistent with that?
Hint

Suppose everyone in the world gets Government Furlough cheques of £100/week.

Suppose I get these same Government Furlough cheques.
But also my parents give me some money every week.

How high could my total income per week be, consistent with the above?
Read 31 tweets
10 May
Today's Tweetorial is courtesy of my friends Thomas Treibel, Charlotte Manisty, and James Moon!

First the challenge.

What do you make of this?
Options
Well I couldn't understand the graph.

Fortunately the implausibly patient Dr Charlotte Manisty (who is an ORBITA-HQ escapee to Bart's Hospital --- come back soon Charlotte!) explained it to me a few times, until I got it.
Read 81 tweets
9 May
Fun puzzle to limber ourselves up for tomorrow's tweetorial.

Squares have area 1 (even the purple one which is a bit long in the face).

What is the area of the big rectangle, and why?

I won't give the source yet as she has received lots of correct answers.
My way which I can understand but is not the most elegant (there are some beautiful geometric solutions).
What is the length of this hypotenuse (long side of the right angled triangle)?
Read 22 tweets
9 May
"Why oh why is NIAID, in their new trial of baricitinib, giving remdesivir to both arms? We will never find out about interactions between remdesivir and baricitinib."

Wondering this?
Could it be:
If you voted for "Known not to interact" you are a dimbo.

Remdesivir was designed for Ebola and stuff.

Baricitinib was designed for inflammatory conditions like Rheumatoid Arthritis.

Met many people with both?
No?
Well that's why the Rheumebola-1 trial didn't recruit well, doh
Read 86 tweets
2 May
One terrifying possibility from the NIAID press release, pointed out to me by @venkmurthy
Did they say "randomized to remdesivir" or "who received remdesivir"?
Science is about focusing on the CORRECT details.

Facing the wall of bullshit that has been reported in the media about COVID, proper scientists know to ignore almost all of it.

Science is like windshield on a roadster.

Without it you end up with a faceful of crap.
Read 43 tweets
29 Apr
Confused by the Corona news on this wondrous day, after fending off weeks of intravenous laser bleach and chloroquisade te pointes?

Two (2) [TWO] trials reported on the same day.

Let's have a look!
2 Different trials on Remdesivir, an antiviral originally developed for Ebola, but having theoretical reasons to work in Covid.
Trial 1.

Chinese RCT in the Lancet today.
237 patients randomized. Unfortunately 2:1, which contributed to inadequate power. Also they ran out of patients as Covid settled down in Hubei.

Non-significant trend to speeding up recovery.
Read 71 tweets
26 Apr
Suppose, Alice and Bob, two ORBITA HQ PhD students, ask to be put on the same project, so they can spend more time with each other, within the bounds of social distancing rules (and decorum).
Alice takes on the problem of calculating SENSITIVITY of a new Coronavirus test.

Bob, the SPECIFICITY of that test.

Will they be running the new Coronavirus test on the same group of people? (i.e. will they have lots of chances to bump into each other accidentally?)
I used to ask this question on the panel for Academic Clinical Fellowships, before it got banned by the other panelists for being "too annoying".
Read 31 tweets
24 Apr
I think we are too polite about IDEAS.

We should be polite to people, even when they are occasionally a bit wayward (Ahem..alhotra).

But ideas don't have feelings. So instead of the below, I would wish Dr Birx would have said,

"No, each of those is a completely insane idea."
Why do you think she said "I haven't heard of them being used", instead of being clear that this was crazy?
I don't imagine anyone particularly wants to be seen standing next to the village idiot who has accidentally been made president as part of an elaborate practical joke.

She canNOT be desperate for that job. I am sure there are less embarrassing jobs to do.
Read 10 tweets
21 Apr
Now, I am at last ready to give Public Health England a kicking.

We actually need to ignore them on a particular issue, and do the exact opposite, and here is why.
As you recall, we looked at why PHE were 100% wrong in their obviously-wrong, pitifully weasel-worded guidance that was immediately disproved by reading the references that they themselves provided.

At the time, I felt sorry for them. I assumed they were rushing around, trying to help people.

I assumed the recommendation to do CPR without putting PPE was simply an oversight, and they hadn't had *time* to correct it.
Read 10 tweets
21 Apr
We have failed in our science education of people at large. Many not only do not understand where knowledge comes from but cannot even begin to comprehend it, when it is explained to them.
We do need a way to answer people who are stuck in this situation.

It is agonising for them because they feel that science is a religion, which scientists and doctors "worship" for unclear reasons.

They actually think they are being deprived of something.
They think the medical profession "know" that medreservoir or chlorophyll are lifesaving drugs, which cruel, heartless docs are withholding from dying patients.

THAT is why we need to fight back against ignorance. This is an information emergency, of our own making.
Read 13 tweets
18 Apr
Ah, now I know what FHRS means.

"Fooled by Horseshit Regarding 'Severe' "
(I am reliably informed by @vish_luther one of our EP clever-docs that Felix Yang has a good sense of humour, so won't mind me using his tweet as a stepping-off point)

You know how sometimes companies pay you to be in an experiment?

If you are super-keen, YOU can pay THEM.
Well, thanks to thousands of affluent and mostly elderly sponsors, we have the wonderful Diamond Princess dataset.

EVERY PASSENGER was tested, some several times.

301 were found to have the coronavirus.
Read 40 tweets
17 Apr
This is the funniest thing on earth.

Now we know why the finance industry are in such a mess. The people who charge you money to lose your money, are busily doing it.

Moronic commentary too. Let me explain.
A starter question.

How is this relevant to the utility of rEmDe (lets call it by half a name until the company provides the missing half of the trial)
Now I know why Syed Gardezi was laughing at me in the hospital this morning.

"Hey Prof, the Remdesivir people got your message about not having an unblinded control arm!"
Read 70 tweets
15 Apr
I've realised that some highly educated people find formulae like this difficult to understand.
Yet at the same stage we studied that level in math, we were also studying "water is H2O" in chemistry and "the heart has 4 chambers" in biology.

Somehow we don't find the latter two things baffling now.
What is the formula for this shape?
Read 30 tweets