haldujai

48 ms·

511.
by haldujai 3y ago
My perspective as both a radiologist and CS/AI researcher so exactly what you're proposing: 1. We don't practice in imaginary vacuums, it's easy* to identify that something looks abnormal and then refer to clinical resou
512.
by haldujai 3y ago
As for pain, I suppose that for some folks their fear of needles has more to do with the expected vs actual pain (or perhaps nothing to do with pain at all). No needles and thus one fewer excuse to avoid vaccination is a huge win IMO
513.
by haldujai 3y ago
My understanding of developing health systems (who stand to benefit the most from this) is regrettably limited but colleagues who participate in global health initiatives tell me that material costs are the biggest barrier rather than local
514.
by haldujai 3y ago
> Many vaccines require careful cold storage, which can be difficult or even impossible in some parts of the world. The adhesive patch does not need to be refrigerated. At first glance I was thinking that this is a solution in search of
515.
by haldujai 3y ago
> Point being that ancients did not use sunscreen The statement being made by others is that "ancients" applied a topical substance to protect their skin from harmful effects of the sun, most would call that sunscreen[0] but us
516.
by haldujai 3y ago
I didn't read the first link but looking at the second one this is typical nutritional pseudoscience misrepresentation of evidence, the nutritionstudies.org author states: "A large observational cohort study[1] in Sweden found tha
517.
by haldujai 3y ago
Who is defining the word "sunscreen" so narrowly to these compounds? All you are doing is listing modern formulations, some of which are not even generally regarded as safe anymore.
518.
by haldujai 3y ago
The other thing with "[specific food/drink] is [good/bad] for you" is that it's nearly impossible to study at baseline with a million confounders so it's all hypothetical pseudoscience at best. Living a life of
519.
by haldujai 3y ago
> Number Needed to Treat (NNT) seems like a great idea. Will learn more. Thanks. No problem, NNT and NNH are the most important measures we look at when deciding on interventions on a population level and easily understandable. " ht
520.
by haldujai 3y ago
I appreciate your compliment. > because no one cares to address systemic issues because no one is incentivized to. I'm not sure that's true having practiced both in the US and Canada which are both very similar. Speaking to my
521.
by haldujai 3y ago
I’m not disagreeing with your (accurate) description of proper technique at all, or that incorrect technique can result in falsely elevated office BP (due to expected physiologic responses). I just meant it may also be a factor in elevated
522.
by haldujai 3y ago
I mentioned these as you said “do whatever you think is best” and to contrast with the workflow of a mechanic. I’m not doing whatever I think is best I’m doing what the body of evidence thinks is best, adjusting to specific patient circumst
523.
by haldujai 3y ago
Not really, very few diagnoses benefit from such historical data. Any lab value flagged as abnormal is typically >95%ile meriting some form of further investigation (whether that’s continued follow up/repeat blood work or a differen
524.
by haldujai 3y ago
No physician should (and I expect would) diagnose hypertension on a single office-based blood pressure measurement. We suspect it based on the office measurement and then confirm. I last worked in primary care back in 2016 but even back t
525.
by haldujai 3y ago
White coat hypertension is also a potential contributor. https://www.mayoclinic.org/diseases-conditions/high-blood-pr...
526.
by haldujai 3y ago
> High LDL? Well, it's always been high, and stable. We don't have to treat it. Only if you particularly want to die of a major adverse cardiovascular event[0], then we don’t have to treat it. Note that treatment begins with li
527.
by haldujai 3y ago
Except physicians don’t practice independently like a mechanic and we answer to several authorities (licensing boards, specialty colleges, hospital M&M and MAC). We follow evidence-based guidelines that have looked at various outcome me
528.
by haldujai 3y ago
That was my worry as well, especially with how misrepresented the cited evidence was. I’m very supportive of the intellectually curious looking at evidence for themselves, but directly evaluating primary medical research is challenging even
529.
by haldujai 3y ago
More or less correct, healthcare in Canada is mostly “private” with a single public payer on a provincial level. One other difference is that hospitals are owned and run by the government (with slight variation between provinces) so they do
530.
by haldujai 3y ago
> Not OP, but I think the underlying meaning is that the focus on profit is primary. As in when it aligns with better patient outcomes it’s going to happen and that’s great. > But probably there are a ton of scenarios where profit is
531.
by haldujai 3y ago
> I've definitely heard "annual physical" and "annual checkup" before though. "periodic health maintenance visit" or just "periodic health check-up" is more of the newer academic/formal m
532.
by haldujai 3y ago
You posit these interventions like any of them have a shred of evidence to suggest they're effective (or that we actually have reference ranges and test accuracy for what you're suggesting) and conveniently ignore civil liberties.
533.
by haldujai 3y ago
What profit in public systems and with non-profit insurers is driving increased screening? Nihilism aside you seem to have a deep misunderstanding of evidence based medicine. While cost is a consideration in population-level screening progr
534.
by haldujai 3y ago
> Physical manipulation is cheaper than a scan tho! This relies on the assumption that the physical examination has useful sensitivity or specificity as a screening tool which is untrue. As an aside, MRI screening is not supported by evi
535.
by haldujai 3y ago
The groups driving "improving health outcomes" are not (just or even mostly) insurance companies but rather physician societies and government agencies like the USPSTF. We can also look to other national agencies from countries wi
536.
by haldujai 3y ago
> Generally, yes; for example, routine colonoscopies are not practiced in many developed countries, and it doesn't necessarily translate into any difference in overall health outcomes. One recent study is described here: This overst
537.
by haldujai 3y ago
Medicine does care about prevention, in fact we have the USPSTF who's sole focus is prevention! With respects to diet and activity, there is a grade C recommendation to provide counseling to patients without risk factors[0] and grade B
538.
by haldujai 3y ago
This is a bit of a loaded topic and the authors are intermittently conflating "annual physical" with what is now better called a "periodic health maintenance visit". Aside from semantics, a periodic health maintenance vi
539.
by haldujai 3y ago
> So taekwondo people who train to hit concrete pillars don’t get stronger from the repeated hits, do you confirm? Stress from repetitive microtrauma is not the same as a fracture (stress to failure). Increased mechanical loading (hittin
540.
by haldujai 3y ago
> After the standard of care treatment (which hasn't changed in 10 years) A lot has changed in 10 years for the 'standard of care' conventional treatments (RT + TMZ) although most active-treatment GBM cases will actually b

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