I stole this response from that thread on TwittX, but it’s too good not to share. The tower is clearly a brotherhood of Nod reference.

This was not uncommon in the shipyard areas of Glasgow and Dundee.

➡️ Do not prescribe short-acting beta2 agonists to people of any age with asthma without a concomitant prescription of an ICS. [BTS/NICE/SIGN 2024]

I have similar feelings every time I go to conference, those of sonder, and Douglas Adams' Total Perspective Vortex.

I asked your question. The answer was that the normal range is not very variable, 0.4-0.5. So go with your local ULN.

And why 50?

This is the problem, as you say. Ours is 0.01-0.4. But we use 0.3 for some Biologics and 0.15 for others. Uncertainty leads to these non-decisions. There’s nuance here, and it’s hard when the phenotypes are so different. I’ll ask the question. To me, >0.4 is abnormal.

I can try! “Above lab normal range” was suggested at one point. I’ll interrogate the ringleaders.

Never prescribed it. (TBF it wasn’t SMC approved)

People didn’t stop their atrovent/combo vent when they started the Spiriva: they went into urinary retention, I recall.

There was one NIV machine in the RIE in 2001, in a big wooden box. So it had just snuck in. I’ll give you LAMA, now I think of it. I think Spiriva came in around 2002…?