Internist, Professor. Author: Ending Medical Reversal, Symptom to Diagnosis. S2D Podcast. Despises gifs, loves baseball, attempts humor. Views fully my own. He.
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Jan 25, 2023 • 9 tweets • 2 min read
First "Diagnostic Test Studies" in our Medical Evidence course today. 9 slides I like (without the animations...). 1/9 2/9
Nov 30, 2022 • 9 tweets • 3 min read
Really excited to put this article out into the world. A tweetorial to summarize, but details today on @Sensible__Med.
One of my favorite points to making when teaching diagnostic reasoning it to stress that positive findings are more important than negative one.
I've believe this so strongly that it is point four on my diagnostic reasoning yellow card.
Mar 29, 2022 • 7 tweets • 2 min read
1/7 Earlier today I tweeted my displeasure with the @USNewsEducation Medical School Rankings. Since complaining about a problem without proposing a solution is whining, here are my suggestions for revising the methodology. (These are totally my opinions and reflect my biases.)
2/7 20% weight given to program directors’ rankings of schools based on experience with their own residents. Survey every PD in the US. This will produce different scores for schools for each specialty. Some schools are better for aspiring internists others for aspiring surgeons.
Mar 29, 2022 • 12 tweets • 3 min read
1/12
OK, my yearly @USNewsEducation rant. Why medical schools continue to participate in this and care about the results, I don't know. Ok, actually I know but it makes me crazy. Hope this tweetorial will make you hate the annual rankings as much as I do.
2/12
My primary complaint is that the people who use these rankings most are prospective students and the ratings have, at most, a tenuous relationship with the quality of the education that a student might expect from an institution.
Feb 3, 2022 • 5 tweets • 2 min read
Talk tomorrow on critically appraising studies of diagnostic tests. A few slides on spectrum bias. 1/5 2/5
Jan 31, 2022 • 7 tweets • 2 min read
Diagnostic test talk today in our Medical Evidence class. I'm just fond of these 7 slides... 1/7 2/7
Jan 20, 2022 • 4 tweets • 1 min read
1/4 Making it count twice (as if putting things on twitter counts for something). 4 slides (two studies) demonstrating how run in periods can impact external validity of a study. 2/4
Dec 15, 2021 • 5 tweets • 2 min read
1/5 Working on my talk on screening talk for our yearly Medical Evidence course.
This thread is sure to get the @UChiPritzker 1st years excited.😉
Pulling out the final slides for a non-traditional cancer screening public service announcement - have to write that out here.🙂
2/5 First a reminder of the USPSTF grades.
Dec 6, 2021 • 10 tweets • 3 min read
My holiday tradition for the past few years has been to repost my twitter slides when I go on the inpatient service at the start of December since I have generally run out of time and things to say. So here we go, slide a day until I run out. Day #1, 10 doodles.
Doodle 2
Jul 1, 2021 • 17 tweets • 4 min read
1/17 Stimulated by @Gladwell terrific @revhistpodcast on @usnews rankings, thought I'd re-up my thread about the harmful and worthless med school rankings that have, at best, a tenuous relationship to the quality of the education that a student might expect from an institution.
2/17 I used the USNWR methodology from their website. I focused on the “Best Medical Schools for Research” rankings though I could have attacked the primary care rankings in much the same way. usnews.com/education/best…
Apr 6, 2021 • 12 tweets • 5 min read
1/8 I caught a lot of twitter grief a couple of weeks announcing that I would debate that physicians do not have a professional duty to engage in political advocacy. The debate is over, here are my 6 points. @zacharyberger@alikhan@traependergrast@sambertpompey@KKlembczyk
2a/8 As a physician my job is to care for and advocate for my patients. I do this tirelessly. I have little left for further work in medicine. I want to spend the time that I am not caring for my patients doing other things.
Mar 30, 2021 • 12 tweets • 3 min read
Today, National Doctors' Day, in the day we worship at the alter of @USNewsEducation ranking of medical schools. I love top 10 lists (see my pinned tweet) but I despise these rankings. I hope the following tweetorial will make you hate the annual rankings as much as I do.
My primary complaint is that the people who use these rankings most are prospective students and the ratings have, at most, a tenuous relationship with the quality of the education that a student might expect from an institution.
Feb 9, 2021 • 5 tweets • 2 min read
1/5 Talked about diagnostic test studies in Critical Appraisal of the Landmark Medical Literature yesterday. Slides on the relationship of sensitivity and specificity and ROC. Nothing novel or original here but seemed worth sharing (though you'll miss my cool animations). 2/5
Feb 1, 2021 • 9 tweets • 3 min read
1/9 Started our yearly Critical Appraisal of the Landmark Literature course with the 4th years today (on Zoom, 😬). Seems like a good time for a quick tweetorial on reading RCTs. These are the studies we rely on most in medicine but they can be misleading. What would you add?
2/9 How RCTS can be misleading #1
For studies with subjective endpoints, was the control really adequate. amjmed.com/article/S0002-…
Jan 29, 2021 • 6 tweets • 2 min read
Finishing up my teaching in our Medical Evidence course this year with a talk on screening. Six slides. 1/6 2/6
Jan 8, 2021 • 4 tweets • 1 min read
A little Friday fun. 4 slides. The product of PowerPoint doodling during many a dull Zoom meeting. 1/4 2/4
Nov 20, 2020 • 11 tweets • 4 min read
1/11 A little distraction for Friday. A talk I started working on 20 years ago and then gave up on. Encouraged to return to it by @OSheaLaos. Illness found in paintings. Please add your own finds! @ms47_mindy
2/11 The one that got me started on this. Rhinophyma. Actually, the picture on the Wikipedia page for the condition!
Oct 21, 2020 • 5 tweets • 1 min read
On the occasion of meeting the nurse with whom I will now be working, five of my most memorable experiences with nurses. Please add on. 1. With my grandmother when I was 11 pubmed.ncbi.nlm.nih.gov/31282952/2. August of my internship. Berated by a cardiologist, Dr. Marcus, for, as remember it, not being sufficiently obsequious. Despite profound sleep deprivation I held it together until a nurse hugged me and said, “don’t worry, we all know he’s a &@)$%bag.” I became a puddle.
Oct 7, 2020 • 9 tweets • 3 min read
1/9 This thread is a waste of time. It will change nobody’s mind. Nobody should really care what I think—I am no expert here. But, given the response on twitter about this excellent article, I felt like I needed to articulate my thoughts. nature.com/articles/d4158…2/9 I have spent most of my career as an EBM proponent, hollering about the superiority of the RCT. Hell, @vinayprasad and I wrote a whole book about it. (No reason not to mix in a little shameless self-promotion). amazon.com/Ending-Medical…
Oct 5, 2020 • 5 tweets • 2 min read
1/5 A few more quotations from The Plague, which I continue to find strangely reassuring. These things happen and we always respond in the same way. 2/5
Aug 14, 2020 • 8 tweets • 2 min read
1/6
A tweetorial in the guise of a story.
A woman is hoping to have her elderly mother visit from out of town. She and her husband are asymptomatic and have been very careful about contacts. The mother, who is driving from Maine, is well, and has had no risk contacts.
2/6
The husband suggests that he and his wife get tested to assure that it is safe for his mother-in-law to visit. Is he being thoughtful or is he trying to get out of having her visit?
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