ken
@ken.bsky.social
made up of instincts, none of which are too keen // #icurehab #acutePT etc at NYU
Reposted by ken
There has been a lot of debate recently about the promise of real world data - the routine (observational) data collected on patients eg treatments received, clinical outcomes etc – for estimating treatment effects. But can they deliver? 1/9
#MethodologyMonday #123
#MethodologyMonday #123
August 18, 2025 at 6:35 AM
There has been a lot of debate recently about the promise of real world data - the routine (observational) data collected on patients eg treatments received, clinical outcomes etc – for estimating treatment effects. But can they deliver? 1/9
#MethodologyMonday #123
#MethodologyMonday #123
Reposted by ken
There is no scientific concept of "real world" data or evidence - there is nothing about this terminology that can't be more accurately and honestly conveyed using other accepted methodological terms.
We've frustratingly allowed "real world" to become a deceptive synonym for "observations we happened haphazardly to make". I'd say half the studies that come to me now, the majority of which are useful but modest clinical audits, will have "real world" in the proposal title. It's magic!
July 7, 2025 at 11:42 AM
There is no scientific concept of "real world" data or evidence - there is nothing about this terminology that can't be more accurately and honestly conveyed using other accepted methodological terms.
Reposted by ken
My new collection of short stories and poetry -- We Had It Coming -- is available for pre-order now! It's the best thing I've ever written and I think you all will find solace and despair in equal measure within.
www.welcometohellworld.com/my-new-book-...
www.welcometohellworld.com/my-new-book-...
June 25, 2025 at 9:54 PM
My new collection of short stories and poetry -- We Had It Coming -- is available for pre-order now! It's the best thing I've ever written and I think you all will find solace and despair in equal measure within.
www.welcometohellworld.com/my-new-book-...
www.welcometohellworld.com/my-new-book-...
Reposted by ken
These data tell a story that I think many of us already knew – that we're not delivering specialist palliative care to all the patients who could benefit from it – but the devil is in the details. Our hope is that these data will motivate and inform efforts to improve PCC delivery.
May 7, 2025 at 2:08 PM
These data tell a story that I think many of us already knew – that we're not delivering specialist palliative care to all the patients who could benefit from it – but the devil is in the details. Our hope is that these data will motivate and inform efforts to improve PCC delivery.
Reposted by ken
Specialist palliative care is super important, but only 1 in 9 hospitalized patients with common serious illnesses receive it.
Moreover, the strongest predictor of receiving palliative care isn't a patient factor at all: it's the hospital where they happen to be admitted.
doi.org/10.1111/jgs....
Moreover, the strongest predictor of receiving palliative care isn't a patient factor at all: it's the hospital where they happen to be admitted.
doi.org/10.1111/jgs....
Disease and Race‐Based Differences in Inpatient Palliative Care Consultation in Cancer and Noncancer Serious Illnesses
Background Guidelines recommend timely palliative care consultation (PCC) for hospitalized patients with serious illness, but adherence to such guidelines and variability in access are not well desc...
doi.org
May 7, 2025 at 1:37 PM
Specialist palliative care is super important, but only 1 in 9 hospitalized patients with common serious illnesses receive it.
Moreover, the strongest predictor of receiving palliative care isn't a patient factor at all: it's the hospital where they happen to be admitted.
doi.org/10.1111/jgs....
Moreover, the strongest predictor of receiving palliative care isn't a patient factor at all: it's the hospital where they happen to be admitted.
doi.org/10.1111/jgs....
@lukeoneil47.bsky.social some poor sap took me up on my rec of "Welcome to Hell World" at the hospital. Spotted this in the wild today at the nursing station
January 22, 2025 at 12:02 AM
@lukeoneil47.bsky.social some poor sap took me up on my rec of "Welcome to Hell World" at the hospital. Spotted this in the wild today at the nursing station
Reposted by ken
Let's stop encouraging novice researchers to think that lots of "data cleaning" is normal, or even a good thing. Why are we so proud of all this data cleaning!?
The need for lots of data cleaning should instead be seen as a failure to invest in data collection. In medicine, this harms patients.
The need for lots of data cleaning should instead be seen as a failure to invest in data collection. In medicine, this harms patients.
January 14, 2025 at 6:20 AM
Let's stop encouraging novice researchers to think that lots of "data cleaning" is normal, or even a good thing. Why are we so proud of all this data cleaning!?
The need for lots of data cleaning should instead be seen as a failure to invest in data collection. In medicine, this harms patients.
The need for lots of data cleaning should instead be seen as a failure to invest in data collection. In medicine, this harms patients.
Reposted by ken
Aidan Baron once described atrial fibrillation as "delirium of the heart" and I think that's especially fitting during critical illness. Like delirium, atrial fibrillation is often a secondary problem #emimcc #cardiosky
December 11, 2024 at 7:56 AM
Aidan Baron once described atrial fibrillation as "delirium of the heart" and I think that's especially fitting during critical illness. Like delirium, atrial fibrillation is often a secondary problem #emimcc #cardiosky
Reposted by ken
December 19, 2024 at 4:04 PM
Reposted by ken
Reading about how Don DeLillo was able to quit his job to write full time because rent in NYC was "only $60 a month back then." "Back then" was 1964, adjusted for inflation, the 2023 equivalent is only $576. No one destroying art and literature quite like landlords of today""
December 16, 2024 at 7:23 PM
Reading about how Don DeLillo was able to quit his job to write full time because rent in NYC was "only $60 a month back then." "Back then" was 1964, adjusted for inflation, the 2023 equivalent is only $576. No one destroying art and literature quite like landlords of today""
Reposted by ken
We present another publication-quality chapter from ShockWaves, the 1st chapter in the RHC section.
Sergio Caravita presents a masterclass on the invasive PA waveform.
Section editors: Sophia Airhart and Zach I'lGiovine
shockwaves.icu/app/page/1O3...
Sergio Caravita presents a masterclass on the invasive PA waveform.
Section editors: Sophia Airhart and Zach I'lGiovine
shockwaves.icu/app/page/1O3...
December 15, 2024 at 5:56 PM
We present another publication-quality chapter from ShockWaves, the 1st chapter in the RHC section.
Sergio Caravita presents a masterclass on the invasive PA waveform.
Section editors: Sophia Airhart and Zach I'lGiovine
shockwaves.icu/app/page/1O3...
Sergio Caravita presents a masterclass on the invasive PA waveform.
Section editors: Sophia Airhart and Zach I'lGiovine
shockwaves.icu/app/page/1O3...
Reposted by ken
The American Medical Association surveyed doctors about insurance “prior authorizations” and found:
41 prior auths per doctor per week
13 hours spent per week on prior auths
24% reported hospitalizations due to delays from prior auths
8% reported disability/deaths due to delays from prior auths
41 prior auths per doctor per week
13 hours spent per week on prior auths
24% reported hospitalizations due to delays from prior auths
8% reported disability/deaths due to delays from prior auths
December 12, 2024 at 11:26 PM
The American Medical Association surveyed doctors about insurance “prior authorizations” and found:
41 prior auths per doctor per week
13 hours spent per week on prior auths
24% reported hospitalizations due to delays from prior auths
8% reported disability/deaths due to delays from prior auths
41 prior auths per doctor per week
13 hours spent per week on prior auths
24% reported hospitalizations due to delays from prior auths
8% reported disability/deaths due to delays from prior auths
Reposted by ken
Organ perfusion assessment in the shocked patient
Right side of the diagram describes established clinical indices of global perfusion,
entailing the exam of brain, skin and kidneys
Left side of the diagram describes current US applications
Right side of the diagram describes established clinical indices of global perfusion,
entailing the exam of brain, skin and kidneys
Left side of the diagram describes current US applications
December 8, 2024 at 6:10 AM
Organ perfusion assessment in the shocked patient
Right side of the diagram describes established clinical indices of global perfusion,
entailing the exam of brain, skin and kidneys
Left side of the diagram describes current US applications
Right side of the diagram describes established clinical indices of global perfusion,
entailing the exam of brain, skin and kidneys
Left side of the diagram describes current US applications
Reposted by ken
The path toward universal healthcare probably runs through centralized electronic medical records. It’s absurd that you can’t have some kind of centralized repository of your health history, that you give new providers the ability to read from or write to as you switch providers.
December 11, 2024 at 12:12 AM
The path toward universal healthcare probably runs through centralized electronic medical records. It’s absurd that you can’t have some kind of centralized repository of your health history, that you give new providers the ability to read from or write to as you switch providers.
Reposted by ken
Intensive Care I go.bsky.app/NC7iD2K
Intensive Care II go.bsky.app/GoXVFDp
Let me know if you want to be added! Anyone who cares for or supports the care of the critically ill!
Intensive Care II go.bsky.app/GoXVFDp
Let me know if you want to be added! Anyone who cares for or supports the care of the critically ill!
November 26, 2024 at 8:18 PM
Intensive Care I go.bsky.app/NC7iD2K
Intensive Care II go.bsky.app/GoXVFDp
Let me know if you want to be added! Anyone who cares for or supports the care of the critically ill!
Intensive Care II go.bsky.app/GoXVFDp
Let me know if you want to be added! Anyone who cares for or supports the care of the critically ill!
Reposted by ken
Going Full Jasper Mode. Getting Jasperfied.
May 11, 2023 at 7:48 PM
Going Full Jasper Mode. Getting Jasperfied.
Reposted by ken
A sad day for critical care - and what a phenomenal legacy he has left us.
RIP Prof Gattinoni, a Giant ⚕️📟
www.esicm.org/obituary-luc...
RIP Prof Gattinoni, a Giant ⚕️📟
www.esicm.org/obituary-luc...
Obituary: Luciano Gattinoni - ESICM
In Memory of Professor Luciano Gattinoni
www.esicm.org
December 2, 2024 at 5:02 PM
A sad day for critical care - and what a phenomenal legacy he has left us.
RIP Prof Gattinoni, a Giant ⚕️📟
www.esicm.org/obituary-luc...
RIP Prof Gattinoni, a Giant ⚕️📟
www.esicm.org/obituary-luc...
Reposted by ken
It's Advance Base / Casiotone for the Painfully Alone Christmas Mixtape season 🎄
advancebase.bandcamp.com/album/christ...
advancebase.bandcamp.com/album/christ...
Christmas Mixtape, by Advance Base / Casiotone for the Painfully Alone
1 track album
advancebase.bandcamp.com
November 29, 2024 at 11:20 PM
It's Advance Base / Casiotone for the Painfully Alone Christmas Mixtape season 🎄
advancebase.bandcamp.com/album/christ...
advancebase.bandcamp.com/album/christ...
Reposted by ken
Attention #Medsky!! I am VERY excited to announce the Medsky Labeler! A tool that gives healthcare workers badges that tell subscribers what their area of specialty is! There’s 160+ to choose from!
bsky.app
October 11, 2024 at 3:03 AM
Attention #Medsky!! I am VERY excited to announce the Medsky Labeler! A tool that gives healthcare workers badges that tell subscribers what their area of specialty is! There’s 160+ to choose from!
Reposted by ken
Closely related: 67.32% of clinical practice is based on a paper from 1967 where a doctor made measurements on 18 patients, drew a line through the data points, and calculated a slope.
Now I've come across several instances of people writing, essentially:
'Let me provide a very rough estimate. Don't take this number literally, because it has several flaws.'
And then their number becomes cited as the canonical figure on the topic.
'Let me provide a very rough estimate. Don't take this number literally, because it has several flaws.'
And then their number becomes cited as the canonical figure on the topic.
November 26, 2024 at 5:37 AM
Closely related: 67.32% of clinical practice is based on a paper from 1967 where a doctor made measurements on 18 patients, drew a line through the data points, and calculated a slope.
Reposted by ken
State the obvious! 🏥ℹ️
High turnover of nurses and doctors suggests a potential risk for patients. Therefore, retention of healthcare staff should be a priority to improve continuity and quality of care for patients.
#medsky
doi.org/10.1136/bmj....
High turnover of nurses and doctors suggests a potential risk for patients. Therefore, retention of healthcare staff should be a priority to improve continuity and quality of care for patients.
#medsky
doi.org/10.1136/bmj....
November 26, 2024 at 10:38 AM
State the obvious! 🏥ℹ️
High turnover of nurses and doctors suggests a potential risk for patients. Therefore, retention of healthcare staff should be a priority to improve continuity and quality of care for patients.
#medsky
doi.org/10.1136/bmj....
High turnover of nurses and doctors suggests a potential risk for patients. Therefore, retention of healthcare staff should be a priority to improve continuity and quality of care for patients.
#medsky
doi.org/10.1136/bmj....
Reposted by ken
Position paper on physiology & nomenclature of dual circulation in VA #ECMO in adults
🩸retrograde blood flow & dual circulation
📖 historical & recommended nomenclature
🩸dynamic nature of mixing point
💨 differential O2 & CO2
🩺 clinical management
💨 hypoxemia & hyper/hypocapnia
#FOAMcc
🔓 rdcu.be/d0KSQ
🩸retrograde blood flow & dual circulation
📖 historical & recommended nomenclature
🩸dynamic nature of mixing point
💨 differential O2 & CO2
🩺 clinical management
💨 hypoxemia & hyper/hypocapnia
#FOAMcc
🔓 rdcu.be/d0KSQ
November 19, 2024 at 4:07 PM
Position paper on physiology & nomenclature of dual circulation in VA #ECMO in adults
🩸retrograde blood flow & dual circulation
📖 historical & recommended nomenclature
🩸dynamic nature of mixing point
💨 differential O2 & CO2
🩺 clinical management
💨 hypoxemia & hyper/hypocapnia
#FOAMcc
🔓 rdcu.be/d0KSQ
🩸retrograde blood flow & dual circulation
📖 historical & recommended nomenclature
🩸dynamic nature of mixing point
💨 differential O2 & CO2
🩺 clinical management
💨 hypoxemia & hyper/hypocapnia
#FOAMcc
🔓 rdcu.be/d0KSQ
Reposted by ken
Dexmedetomidine is used quite a lot.
However, it’s not that benign an agent.
Single centre observational study finds 15% of patients on Dexmed have a fever of >38.5.
#emimcc
pubmed.ncbi.nlm.nih.gov/33813941/
However, it’s not that benign an agent.
Single centre observational study finds 15% of patients on Dexmed have a fever of >38.5.
#emimcc
pubmed.ncbi.nlm.nih.gov/33813941/
pubmed.ncbi.nlm.nih.gov
November 19, 2024 at 11:17 PM
Dexmedetomidine is used quite a lot.
However, it’s not that benign an agent.
Single centre observational study finds 15% of patients on Dexmed have a fever of >38.5.
#emimcc
pubmed.ncbi.nlm.nih.gov/33813941/
However, it’s not that benign an agent.
Single centre observational study finds 15% of patients on Dexmed have a fever of >38.5.
#emimcc
pubmed.ncbi.nlm.nih.gov/33813941/
Reposted by ken
Great read. If you believe placebos have real healing power or if you sometimes take self report measures too seriously (if you follow, probably you do), you should read this too.
carcinisation.com/2024/11/13/a...
carcinisation.com/2024/11/13/a...
November 16, 2024 at 11:42 AM
Great read. If you believe placebos have real healing power or if you sometimes take self report measures too seriously (if you follow, probably you do), you should read this too.
carcinisation.com/2024/11/13/a...
carcinisation.com/2024/11/13/a...
Reposted by ken
I created a new feed for Acute Care Medicine 😀
The goal is to curate posts of general interest regarding acute care hospital medicine (e.g., EM, IM, CC).
If you see a great post on these topics, please *reply* with a post that says "emimcc" and the original post will appear in the feed! (1/2)
The goal is to curate posts of general interest regarding acute care hospital medicine (e.g., EM, IM, CC).
If you see a great post on these topics, please *reply* with a post that says "emimcc" and the original post will appear in the feed! (1/2)
November 11, 2024 at 1:02 PM
I created a new feed for Acute Care Medicine 😀
The goal is to curate posts of general interest regarding acute care hospital medicine (e.g., EM, IM, CC).
If you see a great post on these topics, please *reply* with a post that says "emimcc" and the original post will appear in the feed! (1/2)
The goal is to curate posts of general interest regarding acute care hospital medicine (e.g., EM, IM, CC).
If you see a great post on these topics, please *reply* with a post that says "emimcc" and the original post will appear in the feed! (1/2)