Top Tweets for #ESICMphysio
@imran_rob Hi, Your thread is ready to read. Let's do some ACID-BASE in ICU.... #ESICMphysio #FOAMed **TWEETORIAL** Dr Duska talks to us about co https://t.co/MMgJyeGdyw
Have a good day!
You can catch all the Tweetorials (Physiology in ICU) of #ESICMphysio at https://t.co/J3TWCMas0K :) #FOAMed #FOAMcc #POCUS
Great review of all things physiology related, from @Gas_Craic! Almost as good as being at #ESICMphysio @esicm!
#foamcc #foam
ALL THE TWEETORIALS FROM #ESICMphysio:
1. Pre-conf JClub: https://t.co/W33uR6Hg96
2. RHS Heart: https://t.co/EWrZGhv3kL
3. Physics of MV: https://t.co/ibpPQOTtaK
4. Venous Return: https://t.co/uGMh765yQ2
5. Haldane & Bohr: https://t.co/PTOmbELsGz
(continued...)
Almost philosophical ! One of many key take homes from #ESICMphysio
Doctors make decisions (binary process) & can’t tolerate thought that maybe do not know deep physiology or what they're doing; physiological gain seductive in #ICU (but misleading!) physiology with no RCTs regularly associated with attribution bias
@BellomoRinaldo #ESICMphysio
Leaving Prague we would like to thank all LIVES Physiology participants! Here impact of meeting on social media & most active #SoMe users: search for #ESICMphysio & look at lot of free open access scientific content! #FOAMed #FOAMcc @Gas_Craic @FOAMecmo @ArmandGirbes @DrLeoHeunks
@ESICM THANK YOU TO ALL DELEGATES, FACULTY, We hope you enjoyed LIVES Physiology 2020. @load_dependent @avkwong @FOAMecmo @r_wiersema @Gas_Craic @ccpractitioner @hughgifford @strachanjamie @iceman_ex @JKesecioglu @ArmandGirbes @DrLeoHeunks @ESICMCEO #ESICMPHYSIO
Doctors make decisions (binary process) & can’t tolerate thought that maybe do not know deep physiology or what they're doing; physiological gain seductive in #ICU (but misleading!) physiology with no RCTs regularly associated with attribution bias
@BellomoRinaldo #ESICMphysio
@ArmandGirbes @hughgifford @gattinon @BellomoRinaldo @DrMCecconi @avkwong @load_dependent @Gas_Craic @Dr_Cit @iceman_ex Why RCTs in #ICU fail? Forgotten question for: which proportion of mortality risk is attributable to syndrome? if < 20% no demonstrable effect; crit care syndromes associated with underlying severity of illness attributable mortality risk overestimated @ArmandGirbes #ESICMphysio
Come to DUBLIN in May! 😁 For all things Sepsis... #sepsis #LIVESFORUM20 #ESICMphysio @ESICM --> https://t.co/wDwrrMEBz6
Stop doing RCTs (looking at mortality) in #ICU? why most critical care trials fail to demonstrate mortality benefit?
Mortality insensitive endpoint as heterogeneous pts do not sufficiently share pathways leading to death
@ArmandGirbes #ESICMphysio read https://t.co/PgPpHOdOrv
RCTs need
disease: defined/causing death
intervention acting on disease
measurable outcome, result of disease
(applicability)
external validation
in #ICU we characterize/define syndromes useful labels ie sepsis #AKI #ARDS but multifactorial processes
@ArmandGirbes #ESICMphysio
@LITFLblog looked at this with @DogICUma https://t.co/u1LVK9XE2K - a lot of the utility of fragility index is understanding the problems with p-values and CIntervals... #ESICMphysio
The fragility index is a measure of the robustness (or fragility) of the results of a clinical trial. The fragility index is a number indicating how many patients would be required to convert a trial from being statistically significant to not significant (p ≥ 0.05) #ESICMphysio
Some blame the heterogeneity of the patient populations studied, clustered by poorly defined, syndromic conditions with wide variations of age, genetics, comorbidities, stage and severity of illness. The subsequent noise--> finding true research signals challenging #ESICMphysio
A criticism has been that unfortunately, these major RCTs have failed to deliver on the promise of answering questions/conundrums that arise in daily practice, leaving our field a landscape littered with negative and contradictory evidence... https://t.co/gf0BD0BkWb #ESICMphysio
With this is mind, we should also look at the concept of statistical power and the RCT trial in ICM. https://t.co/kGtzgCIUOj #ESICMphysio
Many RCTs in ICU pts have not demonstrated beneficial effects of the intervention under investigation, despite good preclinical and even previous RCT evidence. Many reasons incl. problems with timing, end point selection, and heterogeneous populations. #ESICMphysio
So far these are fairly generic to medicine - nothing really specific to ICM. In 2010 - @jlvincen wrote about 'abandoning the RCT' in ICM. https://t.co/DIqUPzgnpO #ESICMphysio
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