Per Karlsson

MD Sweden. Clinical physiology

[Per Karlsson @PerKarl14424229]

@brianmanzella @GolfNBS We want a Brian Manzella show on shallowing

[𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 @CanesDavid]

It's intoxicating to think that whole body scans for the entire world's population will be life saving.

What I'm going to tell you is counterintuitive. You don't want it to be true.... THIS WILL CAUSE NET HARM

You don't want it to be true. I get it. I don't want it to be true either. But it is fixed probability theory (Bayes Theorem), not a difference of opinion. It's not something where you can be "in one camp" or "in another camp." It's not philosophy. It's math.

Applying a full-body scan to an asymptomatic population is like waving a metal detector over a beach covered in bottle caps and saying, "I'm not in the camp that worries about bottle caps, we'll just shovel the entire beach into a lab and sort it out later."

You're looking for a ring... but in this case all the bottle caps look like rings.

The problem isn't the sensitivity of your detector; I don't care if it's the best most advanced detector ever made. it's the mathematical certainty that the junk drastically outnumbers the treasure.

When pretest probability is near zero, Bayes' theorem dictates that the Positive Predictive Value crashes to near zero. Even if a future machine achieves a hypothetical 99% specificity, testing for a disease with a 0.01% prevalence means a 1% PPV. For every 1 true cancer you catch, you get 100 false positives.

Because a full-body scan acts as dozens of independent tests, a standard 95% specificity per organ system mathematically guarantees a false positive rate over 60% per patient. You cannot "catalog and learn" your way out of that reality without subjecting millions of healthy people to real-world harm first.

We've seen this movie before. It isn't different now just "because AI" or because "we will have more and better data" or "we'll learn" our way out of it.

Math doesn't have philosophical camps. It's just... well, boring math.

[Per Karlsson @PerKarl14424229]

@timmmess @brianmanzella Great progress. Would you mind sharing a specific drill or 'feel' that Brian gave you?

[Per Karlsson @PerKarl14424229]

@elonmusk @PalmerLuckey @venkmurthy is this true?

[Per Karlsson @PerKarl14424229]

@DrDatta_AIIMS Thanks! Understandable

[Dr. Prashant Rao @DrPRao]

Dr. Andre LaGerche presenting lab and echo data before and after a 24-hour outdoor track cycling distance world record.

I managed to find Strava data for that day…average power 246W over 24hours 🤯

[Lukasz Zydzik @lukasz_zydzik]

55 yo woman.
Have you ever seen anything like that ?

#Echofirst #CardioTwitter
@argulian @alex1708ander @KemalogluOz @DrRajeshG1 @iamritu @dr_benoy_n_shah @purviparwani @echo_stepbystep @JGrapsa @papadocardio

[🇳🇴🇩🇰Asbjørn Støylen 🇬🇱🇵🇸🇺🇦 @strain_rate]

@PerKarl14424229 Yes. Firstly, because of septal protodiasole, secondly because IVR is poorly delineated laterally, and both are relevant.
If you use Tei, i should be measured by Doppler flow, where all measures, at least in LV can be taken from one acquisition. But it is extremely load dependent

[Per Karlsson @PerKarl14424229]

@strain_rate Thanks!

[Per Karlsson @PerKarl14424229]

@YouriBekhuis Thank you! 🍾

[Per Karlsson @PerKarl14424229]

@YouriBekhuis Do you prefer saline or colloid for this purpose? Or no difference? Thanks!

[European Society of Cardiology Journals @ESC_Journals]

The in-depth review paper on central hemodynamics in #HFpEF. Supine vs. upright test? “Invasive haemodynamic assessment in HFpEF” 👉👉�� https://t.co/6h2CXIKCq3

@EJHFEiC @JanBiegus @Ppponikowski #HFA_ESC @hvanspall @ShelleyZieroth @FudimMarat @gcfmd @AlexMebazaa @jozinetm @MarcoMetra

[Per Karlsson @PerKarl14424229]

@BritoCardio @sudarshanballa @RayRcnita @ASE360 @ACCinTouch Bleb

[EHJCVI Editor-in-Chief @EHJCVIEiC]

🔥Just published under #EHJCVI 🔥

✅ Principles of Exercise-Induced Pulmonary Hypertension
✅ Association with latest guidelines
✅ Practical guide for applying the mPAP/CO slope in clinical practice

@Ph_Bertrand @S_Dhont ➡️ https://t.co/TgySAuuGaV @bernhard_gerber @JGrapsa

[Per Karlsson @PerKarl14424229]

@strain_rate @VerwerftJan Can you elaborate?

[Per Karlsson @PerKarl14424229]

@LylesNoah Four gold incoming

[🇮🇱🇩🇪Ole-A. Breithardt 🇳🇴🇺🇦 @OAB1967]

And do you know that the obstruction can also be seen in the basal septal wall by tissue Doppler? The MSSD sign...
#echofirst #CardioTwitter #hocm #tdi

[Carlos El-Tallawi, MD, FACC, FASE @HeartToProve]

@adnanalkhouli @JACCJournals @iamritu @hahn_rt @DocStrom @rajdoc2005 @ChamsiPash @AnastasiaSMihai @AlsidawiMD @DrMarthaGulati The study’s most important message is: Mitral flail is NOT pathognomonic of severe MR.
Flails are not created equal, and can be small or large depending on flail width + depth. Echocardiographers & imagers should keep this idea in mind.

Our editorial: https://t.co/YkvNiPmu1k