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When Trials Find Implausible Results—The SCOT-HEART trial

Sensible Medicine

An imaging test. One group of patients with chest pain received standard stress testing; the other received standard stress testing plus a coronary CT scan (CCTA). Here is the 5-year survival curves for the composite endpoint of CV death and MI: How can a diagnostic test lead to this much benefit? Not a drug.

Tests 300
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Sepsis Screening Decreases Mortality. Well, not really.

Sensible Medicine

If sepsis screening was shown to be beneficial in one hospital, would it be beneficial in another, with an entirely different set of caregivers? Article Background With all that as background, I was excited when I saw the article Electronic Sepsis Screening Among Patients Admitted to Hospital Wards in JAMA.

Hospital 225
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Coronary Artery Calcium Trial Fails to Impress

Sensible Medicine

The Journal of the American Medical Association published an actual randomized controlled trial for coronary artery calcium (CAC). As a skeptic of this imaging test, I saw the headline and thought: finally, we will learn whether patients who have their chest radiated have better outcomes. Same with imaging tests.

Tests 210
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Friday Reflection 41: Sometimes I Just Need to Complain

Sensible Medicine

A 76-year-old woman presents to a community hospital after waking with garbled speech and right-sided weakness. Case 1: Excess An elderly woman is admitted to a community hospital with a minor stroke. The hospital does an excellent job. By the time she leaves the hospital, she has no residual symptoms. I love my job.

Follow-Up 261
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Screening for Cancer Costs Billions - I Doubt it is Worth it

Sensible Medicine

The question today is whether modern medical screening can improve on those basic lifestyle choices. For instance, the estimate includes only the initial cost of the mammogram, PSA test, and CT scan. As everyone knows, the downstream costs to evaluate positive tests likely exceed initial costs many times over.

Tests 332
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ED Nurses on How to Ask Tough Questions When Someone’s Life is on the Line

Scrubs

Every second counts when someone is having a medical emergency, and two nurses are sharing their tips on how to get necessary information from a patient when they’re struggling to communicate. They underwent various diagnostic tests, all of which came back negative. Are they allergic to any medications?

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Should Doctors Use Chat-GPT to Practice Medicine?

Scrubs

But he soon started getting messages from doctors, including some of his firm’s customers, who were incorporating the chatbot into their medical practice. “So, what tests they would order and what treatments they would order.” “So, what tests they would order and what treatments they would order.”