Kelvin Memeh MD, MS, MBA

🇳🇬! Surgeon. Healthcare Management & Economics Researcher

[Kelvin Memeh MD, MS, MBA @DrMemeh]

The association of Neuromonitoring during thyroidectomy and the risk of recurrent laryngeal nerve injury remains controversial. Hopefully we moved the debate forward with our recent study just published in @AnnalsofSurgery https://t.co/7qfK9S4OdQ

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@cchildersmd Even beyond abdominal surgery, we are seeing prolonged OR time in neck operation. We published a paper last year on obesity’s association with prolonged OR time ( amongst other outcomes) during thyroidectomy. https://t.co/F5IeRarRd8

It’s time incentivize healthy weight!

[Timothy M. Pawlik @timpawlik]

Excited that @DrMemeh will be joining #THE @OhioStateSurg as an assistant
professor of #Surgery in the Division of Surgical Oncology. Having completed an endocrine fellowship @uchicagosurgery he will join our #endocrine 🦏 TEAM! Welcome to #BuckeyeNation! ⭕️🙌

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@PhysiciansFound @BrandeisU I am still waiting for the code to apply

[Tanaz Vaghaiwalla, MD MS @TVaghaiwalla]

Congratulations @DrMemeh on an excellent presentation of our study examining thyroidectomy-specific outcomes and BMI across multiple modeling approaches at this year’s @IAESurgeons meeting in Kuala Lumpur! #isw2024kualalumpur #isw2024 #endocrinesurgery #UMiami

[Tanaz Vaghaiwalla, MD MS @TVaghaiwalla]

Congrats @DrMemeh! Examining VSD after thyroidectomy showed no differences for rates of post op hematoma or hypocalcemia & higher rates of voice hoarseness and longer OR time. Thank you @VAsurgeons for highlighting the study! @FiemuNwariaku #AVAS2023

[Tansu Yegen @TansuYegen]

Elderly man jumps on public piano and has everyone amazed 🙌

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@cchildersmd @ZainHashmiMD @JAMASurgery Agreed 100%. Also, we should think of "triangulation" studies. As in triangulating the evidence, using a different study design/statistical method with the same or different database, if possible. Especially important for studies with results that can potentially change practice

[Kelvin Memeh MD, MS, MBA @DrMemeh]

Thank you, @doctrjp1(Jesse Pasternak), for the focus review of our paper in the Sept edition of @clinicalthyroid. While neuromonitoring should not replace good surgical skills, evidence suggests it helps reduce nerve injury rates. @TheAACE @TheAAES

https://t.co/XV1ySf3qhv

[Tanaz Vaghaiwalla, MD MS @TVaghaiwalla]

Great work by our resident Dr. Bailey Humphries @UTKnoxSurgery & my colleague @DrMemeh! Thank you @SWexner & @SurgJournal for publishing our work examining Prognostic Factors and Survival for Hurthle Cell Carcinoma!

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@BeninatoToni @AnnalsofSurgery Oh good! I perhaps misunderstood your question. Happy to connect via DM where there is no restrictions on number of characters. Thanks for engagement on here, I appreciate it.

[Kelvin Memeh MD, MS, MBA @DrMemeh]

The association of Neuromonitoring during thyroidectomy and the risk of recurrent laryngeal nerve injury remains controversial. Hopefully we moved the debate forward with our recent study just published in @AnnalsofSurgery https://t.co/7qfK9S4OdQ

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@BeninatoToni @AnnalsofSurgery Also a good number of high-volume surgeons do not use IONM - I met a good number of them at the ASA lol. But to your point, adjusting for case volume would be very helpful, and that’s we also applied the E-value method to assess for unmeasured confouding in the paper.

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@BeninatoToni @AnnalsofSurgery No, not according to the NSQIP ACS. In short, they intentionally employ random sampling to ensure that hospitals with small case volumes are well-represented in the dataset. You can read more here: https://t.co/lXF8yh8MJP

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@ButterflyThyro That’s good to know!

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@BeninatoToni @AnnalsofSurgery Great question! The NSQIP dataset documented IONM in 70% of cases. And we know l,from other studies,that only 25-40% of thyroidectomies in the US are performed by high-volume surgeons. So, I think we can safely infer that IONM is likely surgeon’s preference rather than volume.

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@Tfeend @BeninatoToni @AnnalsofSurgery Yea, but that’s been the issue. An outcome probability that low will require a large number if patients to show an meaningful difference. We evaluated 24K + patients in the dataset. There might be another way to approximate an RCT - the causal inference methodology. Game?

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@KTinsleyA @AnnalsofSurgery Good eye Tinsley! Yes, the “rare outcome” statement mostly refers to the historically quoted RLN injury rates of 1-2%. However, statistically speaking, though subject to debate, a rare outcome is that with an event probability of 0.05 . So, 0.06 ain’t that far off either 🤷🏾‍♂️😄

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@FeibiZheng @KTinsleyA @AnnalsofSurgery Also, I think that the current quoted rate of 1-2% for RLN injury only applies to high-volume surgeons. This NSQIP data is probably closer to the real rate given that only 25% of thyroid surgery are performed by high volume thyroid surgeons 🤷🏾‍♂️

[Kelvin Memeh MD, MS, MBA @DrMemeh]

@FeibiZheng @KTinsleyA @AnnalsofSurgery That is true! it’s quite possible that not every voice hoarseness reported in the NSQIP resulted from RLN injury. However, there is no reason to believe it would be reported more in one group compared to the other. We addressed this in the paper.