aladoc99

6 ms·

1.
by aladoc99 5y ago
In general it's true that being on a ventilator for two weeks carries a high mortality, but that's largely due to being sick enough to require ventilation for that duration. Presumably without effective oxygenation or airway prote
2.
by aladoc99 6y ago
I have to say, this sounds to me like trying to market an expert system for experienced woodworkers to choose the best chisel for a particular task based on the type of wood, size of the cut, etc. Practitioners have strong opinions regardin
3.
by aladoc99 6y ago
Impressive utility of the single-lead ECG recording, but I have to say that if I'm in charge, that patient's headed for bypass surgery, not stenting.
4.
by aladoc99 7y ago
Drug reps in the US quit giving away pens and coffee mugs in the US in 2008, in accord with PhRMA rules (that's the drug manufacturers' association/lobby). They got to say it was improved ethics, but it was also a mutual disa
5.
by aladoc99 7y ago
Headline is imprecise. The study is saying that higher doses of vit D do not strengthen bone more than lower doses, not that they don't strengthen bone at all, which is suggested by this headline.
6.
by aladoc99 7y ago
He rejoined the pulse-bearing mass of humanity when he received a heart transplant in 2012.
7.
by aladoc99 7y ago
My experience with such a system has been that it would quote ridiculously high prices for generic medications, so I'd simply tell patients their drug is on the $4 list at WalMart. An information source that's unreliable is worse
8.
by aladoc99 7y ago
Sorry for being obtuse. The point is that it doesn't take a physician to tell EVERY clinician calling with a patient for possible admission to send them to the ER. If the hospitalist is going to be liable for advice given on patients
9.
by aladoc99 7y ago
Not a risk, a certainty. Until this ruling, not having a physician-patient relationship was an absolute safe harbor against professional liability. It was understood that the clinician seeing the patient had the ultimate responsibility. Now
10.
by aladoc99 7y ago
Whether or not Merck "did some fraudulent science," I'd need a better source than RFKJr to believe it. Preferably a scientific source. Here's some scientific sources on Gardasil, mostly after its introduction to the US m
11.
by aladoc99 7y ago
It's worth pointing out that CT is extremely sensitive for calcium and hence bone, so that bones could be scanned at a lower Xray dose than soft tissue. 30 seconds of Googling showed a study where a whole body CT bone survey was carrie
12.
by aladoc99 7y ago
One of the truisms of medicine is that ultimately every disease and every treatment has a 100% mortality, so we can never truly save a life. What we can do is promote the quality and quantity of life. In the US, the rule of thumb is that
13.
by aladoc99 8y ago
Any patient who tells me they've got to have my private number will be told that they've got to get a different doctor. It is vitally important for me to be able to disconnect from patients and their potentially bottomless well o
14.
by aladoc99 8y ago
I have to point out the obvious confounder here. The kids who get their tonsils and adenoids out are the ones with recurrent respiratory infections to begin with. Really the only way to control for this is to randomize kids to surgery or no
15.
by aladoc99 8y ago
Although off-label marketing is inappropriate and possibly illegal, in this case I believe patients probably benefited from it.
16.
by aladoc99 9y ago
Cost-effectiveness guidelines somewhat arbitrarily state that an expense of $50,000 per year of life is reasonable, since this is the estimated average annual cost of dialysis therapy. This gene therapy is sight-saving, but not lifesaving,
17.
by aladoc99 9y ago
digital signalling
18.
by aladoc99 9y ago
'The simplest definition of a "mass casualty incident" is when you need more resources than you have.' This definition is an example of the logical fallacy called begging the question. Nobody would deny that an incident
19.
by aladoc99 9y ago
Not a surgeon or robot-user, but just by way of example, conventional wisdom in the medical world is that the best niche for robotically-assisted surgery is radical prostatectomy for prostate cancer. Conventional wisdom is that the robot pe
20.
by aladoc99 9y ago
It seems as though people are getting the idea that this was a randomized trial, where people were assigned to receive units of blood from various types of donors. However, it was a retrospective case-control study, where records from every
21.
by aladoc99 9y ago
Traditionally, cancer was considered "cured" when the patient survived 5 years without evidence of disease. We now know that quite a few cancers, including breast, have a significant rate of late recurrence, ie, after the five-yea
22.
by aladoc99 9y ago
Looking at the article in BMJ Open, I don't see that they controlled for obesity, either by BMI or any other measure. This is a huge confounder, making reflux symptoms worse and being an independent predictor of mortality. If I'm
23.
by aladoc99 9y ago
It's important to recognize that capitation provides a powerful economic incentive to provide as little care as possible. Every pill, X-ray, MRI, or surgery comes straight out of the insurer's bottom line. You'd like to see a
24.
by aladoc99 9y ago
I think the 5% includes the administrative cost of the third-party administrators as well as HHS itself. The 95% is payments to hospitals, doctors, pharmacies, etc.
25.
by aladoc99 9y ago
Not that the author of the linked piece will see this thread, but my experience has been that those patients who leave for personal reasons, as opposed to logistical reasons, e.g., changed insurance, moved away, etc. are usually not missed.
26.
by aladoc99 10y ago
"the "spray bottle" tells us that the agent was targeting respiratory system, not dermal. " I'm not sure this follows. If the cloth was impregnated with one of the binary components and the other was sprayed on the
27.
by aladoc99 10y ago
My guess is gas chromatography mass spectrometry, which yields a characteristic signature for many compounds.
28.
by aladoc99 10y ago
Off the top of my head, stress reduction and meditation are part of the Dean Ornish program, which has some evidence for slowing atherosclerosis progression. Next question is, would causing a reduction in activity in the amygdala lead to re
29.
by aladoc99 10y ago
Surgeons talk about a "look test" that refers to that certain something not captured by objective risk measures. A patient who doesn't look too bad on paper may look in person like they might not survive a haircut, let alone
30.
by aladoc99 10y ago
Every one of these proposed quality signals is prone to error. Publication history I would see as a negative quality signal. Less experience means more likely to be up-to-date on latest treatment techniques and algorithms. Reputation in the

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