Arvind Singhal

Consultant Cardiologist at Frimley Park Hospital | Here to learn - views my own

[Arvind Singhal @arvsinghal]

Our review on Digital Health in Heart Failure published by @radcliffeCARDIO @ProfMartinCowie. Open Access!

We discuss telemedicine, remote monitoring, apps and wearables and machine learning
https://t.co/7Q1HiJphFQ

[Arvind Singhal @arvsinghal]

@drjohnm @gcfmd I disagree that it's a similar population. PARADISE was LVSD or transient pulmonary oedema, but many of the LVSD were asymptomatic. Post MI asymptomatic LVSD is not heart failure, the prognosis is better and event rates were lower than PARADIGM

[Arvind Singhal @arvsinghal]

@thomasforth @TomChivers I would have assumed that "devolve fiscal and policy powers to cities and regions" would be more consistent with your writing and less with the standard policy wonk?

[Arvind Singhal @arvsinghal]

@jfdwolff @TheSGEM Just to add, as Jacob alludes to, healthcare professionals obviously do have skin in the game, be it genuinely caring about the patient, or if not there are still professional consequences for making mistakes

[Arvind Singhal @arvsinghal]

@jfdwolff @TheSGEM Agree, this slide goes entirely against the whole idea of human factors (which aviation is great at) by blaming individuals rather than the systems in which they operate

[Arvind Singhal @arvsinghal]

@djc795 @drjohnm Absolutely. I'm only saying this as a non-IC observer but I thought there was an element of operator dependence in practice (maybe I'm wrong). I'm interested in whether the criteria in the trials reflect the practice of most ICs and whether unmeasured "skill" plays a part

[Arvind Singhal @arvsinghal]

@djc795 @drjohnm Given that different people will use IVUS in different ways (and will make different decisions based on the data they get from it) presumably it's hard to extrapolate to individual practice?

[Arvind Singhal @arvsinghal]

@richardbogle But I can understand the logic of mandating some level of GIM in the final 2 years of training. Most cardiologists will be in DGHs and if you've spent all of your final 3 years in a tertiary centre on a speciality rota you might struggle

[Arvind Singhal @arvsinghal]

@richardbogle I think is a mistaken assumption that final year trainees need to focus on GIM because they will be on the medical take as a consultant, which is at odds with PCI rotas and increasing specialty 7 day cover. I think the GIM focus should be more ward-based for later training

[Arvind Singhal @arvsinghal]

@DevanSinha @lukerobertblack I'm not sure I understand, Nuffield is showing a 4% CPI cut since 2008/9. Is the NHS employers data total remuneration? Interested in the methodology as previously there were lots of non EWTD compliant jobs/rotas so I don't know how this is taken into account

[Arvind Singhal @arvsinghal]

@DevanSinha @lukerobertblack Out of interest what are you using for your doctor pay calculations.
Nuffield Trust has a much smaller cut in real terms pay using CPI, and I think it would probably be smaller/neutral with CPIH
https://t.co/a96jL7AfNW

[Arvind Singhal @arvsinghal]

@valhumphreys51 Conscious sedation by a trained professional (which can be a sedation trained nurse) is perfectly safe, and I think a lot of health professionals here are massively overreacting, and it allows patients to get sedation more readily

[Arvind Singhal @arvsinghal]

@dnunan79 @BoussageonR Would a reasonable analogy be:
I flip a coin 10 times, 6 heads, 4 tails.
Were there more heads than tails? Yes
Does the coin tend to land heads? Inconclusive.
I think the sampled clinicians are interpreting the question as the latter which is more relevant

[Arvind Singhal @arvsinghal]

@daisychristo I think an obvious area for a national exit exam and university comparisons is medical schools, and yet there's been massive resistance to this (despite I think a strong public interest argument)

[Arvind Singhal @arvsinghal]

@zackferguson Congrats!

[Arvind Singhal @arvsinghal]

@residentadviser The supposed victims of most "cultural appropriation" are usually delighted about said appropriation. Eg if someone wore an Indian inspired dress, most actual Indian women would love it

[Arvind Singhal @arvsinghal]

@jo3hill @restate_thinks @BeaconRosie @AliceKSemark A big factual error - you write that doctors choose a specialty eg Cardiology after 2 years, but that's not correct, you can only do a medical speciality such as Cardiology after 5 years of general training, and it is mandatory to also do internal medicine at the same time

[Arvind Singhal @arvsinghal]

@DrWillWatson Completely agree. I feel like cardiometabolic is in vogue right now, but I can't imagine obesity treatments helping slim, elderly HFpEF patients (who I think are probably the majority of HFpEF in clinic)

[Arvind Singhal @arvsinghal]

@botzarelli While I was there my comp changed from blazers (which you could buy from anywhere as long as you stitched on the school badge) to jumpers you could only buy from one place that looked tacky, were way too warm in summer and had no storage

[Arvind Singhal @arvsinghal]

@bogdienache Presumably you've seen this study https://t.co/tgIBIkM5WI which I thought was a neat nocebo demonstration for statins