Raza
@transfusion.health
🩸Physician + Researcher @UToronto. Medical decision-making, data science (stats, AI), films, and rock climbing #TMSky #Hemesky
For those wrestling with applying MINT trial and new AABB RBC MI guidelines results with nuance, I think this figure strikes a good balance for navigating the evidence base at the bedside doi.org/10.1016/j.cj... #transfusion #medsky #cardiology
October 26, 2025 at 10:46 PM
For those wrestling with applying MINT trial and new AABB RBC MI guidelines results with nuance, I think this figure strikes a good balance for navigating the evidence base at the bedside doi.org/10.1016/j.cj... #transfusion #medsky #cardiology
Classic teaching is that no post-1 hr increment points to immune refractoriness.
One important exception is device-related failures, e.g. plts going into a clotted line, a faulty dialysis/apheresis circuit, an ECMO machine, etc!
#hemesky #transfusion
One important exception is device-related failures, e.g. plts going into a clotted line, a faulty dialysis/apheresis circuit, an ECMO machine, etc!
#hemesky #transfusion
September 22, 2025 at 1:07 PM
Classic teaching is that no post-1 hr increment points to immune refractoriness.
One important exception is device-related failures, e.g. plts going into a clotted line, a faulty dialysis/apheresis circuit, an ECMO machine, etc!
#hemesky #transfusion
One important exception is device-related failures, e.g. plts going into a clotted line, a faulty dialysis/apheresis circuit, an ECMO machine, etc!
#hemesky #transfusion
I was today years old when I finally saw this masterpiece, which is an embarrassing confession as a movie buff. Absolutely blown away by the writing and pacing #filmsky
June 14, 2025 at 2:13 AM
I was today years old when I finally saw this masterpiece, which is an embarrassing confession as a movie buff. Absolutely blown away by the writing and pacing #filmsky
Can we rationalize the way we give diuretic prophylaxis before transfusion?
Colleagues @uhntoronto.bsky.social incl talented co-fellow Dr. Rotin and @jacobpendergrast.bsky.social have made a substantial stride in dose modelling to target urine output onlinelibrary.wiley.com/doi/pdf/10.1... #medsky
Colleagues @uhntoronto.bsky.social incl talented co-fellow Dr. Rotin and @jacobpendergrast.bsky.social have made a substantial stride in dose modelling to target urine output onlinelibrary.wiley.com/doi/pdf/10.1... #medsky
May 3, 2025 at 5:46 PM
Can we rationalize the way we give diuretic prophylaxis before transfusion?
Colleagues @uhntoronto.bsky.social incl talented co-fellow Dr. Rotin and @jacobpendergrast.bsky.social have made a substantial stride in dose modelling to target urine output onlinelibrary.wiley.com/doi/pdf/10.1... #medsky
Colleagues @uhntoronto.bsky.social incl talented co-fellow Dr. Rotin and @jacobpendergrast.bsky.social have made a substantial stride in dose modelling to target urine output onlinelibrary.wiley.com/doi/pdf/10.1... #medsky
Viscoelastic Testing in Post-Partum Hemorrhage
Potentially useful, understudied
HYPOcoagulability is important as well described
HYPERcoagulability is also important, poorly studied
#NATA25 #medsky #transfusion #obgyn
Potentially useful, understudied
HYPOcoagulability is important as well described
HYPERcoagulability is also important, poorly studied
#NATA25 #medsky #transfusion #obgyn
April 24, 2025 at 8:06 AM
Viscoelastic Testing in Post-Partum Hemorrhage
Potentially useful, understudied
HYPOcoagulability is important as well described
HYPERcoagulability is also important, poorly studied
#NATA25 #medsky #transfusion #obgyn
Potentially useful, understudied
HYPOcoagulability is important as well described
HYPERcoagulability is also important, poorly studied
#NATA25 #medsky #transfusion #obgyn
Intravenous Iron at Home
Dr. Elvira Bibs, reports on the Spanish experience
Better for older patients, saves hospital beds, gives a high need treatment.
Takeaway: select the right patients. Mind the logistics
"What is lacking? Courage to implement it"
#NATA25 #hemesky #medsky #transfusion
Dr. Elvira Bibs, reports on the Spanish experience
Better for older patients, saves hospital beds, gives a high need treatment.
Takeaway: select the right patients. Mind the logistics
"What is lacking? Courage to implement it"
#NATA25 #hemesky #medsky #transfusion
April 24, 2025 at 7:29 AM
Intravenous Iron at Home
Dr. Elvira Bibs, reports on the Spanish experience
Better for older patients, saves hospital beds, gives a high need treatment.
Takeaway: select the right patients. Mind the logistics
"What is lacking? Courage to implement it"
#NATA25 #hemesky #medsky #transfusion
Dr. Elvira Bibs, reports on the Spanish experience
Better for older patients, saves hospital beds, gives a high need treatment.
Takeaway: select the right patients. Mind the logistics
"What is lacking? Courage to implement it"
#NATA25 #hemesky #medsky #transfusion
Great talk to start off #NATA2025 by Dr. Paul Kalra, the investigator on IRONMAN trial for iron replacement in CHF
→ Patients feel better, and do better, with greater benefit in TSat >20%
→ No signal for increased infection related death
No brainer!
#medsky #hemesky #cardiology
→ Patients feel better, and do better, with greater benefit in TSat >20%
→ No signal for increased infection related death
No brainer!
#medsky #hemesky #cardiology
April 24, 2025 at 6:55 AM
Great talk to start off #NATA2025 by Dr. Paul Kalra, the investigator on IRONMAN trial for iron replacement in CHF
→ Patients feel better, and do better, with greater benefit in TSat >20%
→ No signal for increased infection related death
No brainer!
#medsky #hemesky #cardiology
→ Patients feel better, and do better, with greater benefit in TSat >20%
→ No signal for increased infection related death
No brainer!
#medsky #hemesky #cardiology
Neat abstract (and accompanying arXiv pre-print) on LLM agents for medical tasks at #neurips
neurips.cc/virtual/2024...
#ml #medsky
neurips.cc/virtual/2024...
#ml #medsky
April 19, 2025 at 1:47 AM
Neat abstract (and accompanying arXiv pre-print) on LLM agents for medical tasks at #neurips
neurips.cc/virtual/2024...
#ml #medsky
neurips.cc/virtual/2024...
#ml #medsky
We discuss the stats, causal inference, and visualization properties of transfusion probability curves in great a detail in the paper, and provide an R-tutorial to repeat our analyses on your data, available here:
onlinelibrary.wiley.com/action/downl...
onlinelibrary.wiley.com/action/downl...
April 10, 2025 at 3:14 PM
We discuss the stats, causal inference, and visualization properties of transfusion probability curves in great a detail in the paper, and provide an R-tutorial to repeat our analyses on your data, available here:
onlinelibrary.wiley.com/action/downl...
onlinelibrary.wiley.com/action/downl...
The math can be repeated at each Hb result to give a transfusion probability curve to study and compare lab-guided practice
The method can also be easily extended to other lab-guided clinical decisions, such as troponin → cardiac intervention, electrolyte level → replacement, and so on
The method can also be easily extended to other lab-guided clinical decisions, such as troponin → cardiac intervention, electrolyte level → replacement, and so on
April 10, 2025 at 3:14 PM
The math can be repeated at each Hb result to give a transfusion probability curve to study and compare lab-guided practice
The method can also be easily extended to other lab-guided clinical decisions, such as troponin → cardiac intervention, electrolyte level → replacement, and so on
The method can also be easily extended to other lab-guided clinical decisions, such as troponin → cardiac intervention, electrolyte level → replacement, and so on
We introduce Transfusion Probability, calculated as the proportion of results of a certain value (or range) which were followed by a transfusion
For example, if a physician saw 50 results of Hb = 7.0 g/dL, and transfused after seeing 15/50 results, transfusion probability is 30%
For example, if a physician saw 50 results of Hb = 7.0 g/dL, and transfused after seeing 15/50 results, transfusion probability is 30%
April 10, 2025 at 3:14 PM
We introduce Transfusion Probability, calculated as the proportion of results of a certain value (or range) which were followed by a transfusion
For example, if a physician saw 50 results of Hb = 7.0 g/dL, and transfused after seeing 15/50 results, transfusion probability is 30%
For example, if a physician saw 50 results of Hb = 7.0 g/dL, and transfused after seeing 15/50 results, transfusion probability is 30%
Traditional methods to study the effect of labs on decisions use the last available lab result just before the decision, e.g. pre-trasfusion hemoglobin (PreHb)
But PreHb only looks at lab values followed by a transfusion and ignores the denominator of the ones that weren't. Can be misleading!
But PreHb only looks at lab values followed by a transfusion and ignores the denominator of the ones that weren't. Can be misleading!
April 10, 2025 at 3:14 PM
Traditional methods to study the effect of labs on decisions use the last available lab result just before the decision, e.g. pre-trasfusion hemoglobin (PreHb)
But PreHb only looks at lab values followed by a transfusion and ignores the denominator of the ones that weren't. Can be misleading!
But PreHb only looks at lab values followed by a transfusion and ignores the denominator of the ones that weren't. Can be misleading!
Lab values are strong drivers of medical decisions. Can we rigorously study how labs affect clinical behavior?
We describe "Transfusion Probability"––a simple yet powerful way to study how labs influence the clinical decision to transfuse
onlinelibrary.wiley.com/doi/10.1111/... #hemesky #stats
We describe "Transfusion Probability"––a simple yet powerful way to study how labs influence the clinical decision to transfuse
onlinelibrary.wiley.com/doi/10.1111/... #hemesky #stats
April 10, 2025 at 3:14 PM
Lab values are strong drivers of medical decisions. Can we rigorously study how labs affect clinical behavior?
We describe "Transfusion Probability"––a simple yet powerful way to study how labs influence the clinical decision to transfuse
onlinelibrary.wiley.com/doi/10.1111/... #hemesky #stats
We describe "Transfusion Probability"––a simple yet powerful way to study how labs influence the clinical decision to transfuse
onlinelibrary.wiley.com/doi/10.1111/... #hemesky #stats
Clinical guidelines can do no good sitting on shelves
In @aabbupdates.bsky.social journal, co-authors and I argue that guidelines should come with an intentional plan for real-world uptake. We leverage #ImplementationScience to outline a process for doing so
onlinelibrary.wiley.com/doi/10.1111/...
In @aabbupdates.bsky.social journal, co-authors and I argue that guidelines should come with an intentional plan for real-world uptake. We leverage #ImplementationScience to outline a process for doing so
onlinelibrary.wiley.com/doi/10.1111/...
April 8, 2025 at 5:47 PM
Clinical guidelines can do no good sitting on shelves
In @aabbupdates.bsky.social journal, co-authors and I argue that guidelines should come with an intentional plan for real-world uptake. We leverage #ImplementationScience to outline a process for doing so
onlinelibrary.wiley.com/doi/10.1111/...
In @aabbupdates.bsky.social journal, co-authors and I argue that guidelines should come with an intentional plan for real-world uptake. We leverage #ImplementationScience to outline a process for doing so
onlinelibrary.wiley.com/doi/10.1111/...
Beautiful interactive visualizations of many Bayesian sampling algorithms. Makes the math come alive!
#stats #bayesian
chi-feng.github.io/mcmc-demo/ap...
#stats #bayesian
chi-feng.github.io/mcmc-demo/ap...
April 1, 2025 at 12:59 AM
Beautiful interactive visualizations of many Bayesian sampling algorithms. Makes the math come alive!
#stats #bayesian
chi-feng.github.io/mcmc-demo/ap...
#stats #bayesian
chi-feng.github.io/mcmc-demo/ap...
FARES-II: Much anticipated randomized trial @jama.com comparing Plasma to PCC in cardiac surgery (n=420)
Those in PCC arm had ↑ hemostatic efficacy and ↓ RBC transfusion
Hopefully practice-changing for many!
jamanetwork.com/journals/jam...
#transfusion #hemesky
Those in PCC arm had ↑ hemostatic efficacy and ↓ RBC transfusion
Hopefully practice-changing for many!
jamanetwork.com/journals/jam...
#transfusion #hemesky
March 31, 2025 at 3:40 AM
FARES-II: Much anticipated randomized trial @jama.com comparing Plasma to PCC in cardiac surgery (n=420)
Those in PCC arm had ↑ hemostatic efficacy and ↓ RBC transfusion
Hopefully practice-changing for many!
jamanetwork.com/journals/jam...
#transfusion #hemesky
Those in PCC arm had ↑ hemostatic efficacy and ↓ RBC transfusion
Hopefully practice-changing for many!
jamanetwork.com/journals/jam...
#transfusion #hemesky
Publication bias eats Central Limit Theorem for breakfast... #stats #medsky onlinelibrary.wiley.com/doi/full/10....
March 24, 2025 at 4:18 PM
Publication bias eats Central Limit Theorem for breakfast... #stats #medsky onlinelibrary.wiley.com/doi/full/10....
Nice study at @aabbupdates.bsky.social journal, answers a sharp clinically relevant question onlinelibrary.wiley.com/doi/full/10....
February 3, 2025 at 4:00 AM
Nice study at @aabbupdates.bsky.social journal, answers a sharp clinically relevant question onlinelibrary.wiley.com/doi/full/10....
February 1, 2025 at 9:07 PM
Interesting read in @naturecomms.bsky.social on meta-cognitive deficits in LLMs, with a good discussion of cognitive biases. Need more sophisticated, formal eval frameworks for biases in clinical decision-making www.nature.com/articles/s41...
January 25, 2025 at 6:11 AM
Interesting read in @naturecomms.bsky.social on meta-cognitive deficits in LLMs, with a good discussion of cognitive biases. Need more sophisticated, formal eval frameworks for biases in clinical decision-making www.nature.com/articles/s41...
According to very smart allergy colleagues, we should probably stop using 1st Gen anti-histamines (like Benadryl) in transfusion and hematology (some reasoning below)
Feels like a knowledge translation gap #medsky #hemesky
aacijournal.biomedcentral.com/articles/10....
Feels like a knowledge translation gap #medsky #hemesky
aacijournal.biomedcentral.com/articles/10....
January 24, 2025 at 2:48 PM
According to very smart allergy colleagues, we should probably stop using 1st Gen anti-histamines (like Benadryl) in transfusion and hematology (some reasoning below)
Feels like a knowledge translation gap #medsky #hemesky
aacijournal.biomedcentral.com/articles/10....
Feels like a knowledge translation gap #medsky #hemesky
aacijournal.biomedcentral.com/articles/10....
Spline regression is incredibly relevant for medicine, not because biology has discontinuities, rather that we create them via thresholds on which we base medical decisions
e.g. the definition of fever, neutropenia, age of insurance eligibility, transfusion thresholds, and so on.. #stats #medsky
e.g. the definition of fever, neutropenia, age of insurance eligibility, transfusion thresholds, and so on.. #stats #medsky
January 16, 2025 at 3:59 AM