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Thank you to everyone who tuned in to today's NCS Virtual Journal Club (#NCSVJC). Read the article to participate in today's polls and discussion questions: https://t.co/Y0a9DUeU8G

#NCSVJC Q5: Performance of the flexible ML models improved with addition of data points like ECG, demographics, and arrival data. These may contribute to some degree of bias in the model results. As ML and AI capabilities continue to grow, what are some strategies that we can employ to mitigate bias in these predictive tools? https://t.co/QK2r7J9bfz

#NCSVJC Q4: Which of the following do you consider the greatest barrier to implementing ML tools in your current clinical setting? https://t.co/QK2r7J9bfz
1) Lack of high-fidelity data
2) Difficulty w/ integration of data across EMR & multiple devices
3) Limited funding
4) Regulatory or ethical concerns
#NCSVJC Q2: What potential benefits or challenges do you foresee in integrating ML models like XGBoost into your practice? https://t.co/Y0a9DUeU8G

This month's #NCSVJC is now beginning! Join the discussion on machine learning in neurocritical care, moderated by Dr. Andrew Nguyen. Learn more about how to participate: https://t.co/uWD2rJR2Of
Join us for #NCSVJC today! We’ll be discussing the article “Machine Learning Based Prediction of Imminent ICP Insults During Neurocritical Care of Traumatic Brain Injury” @neurocritical
@neurocritical It is unclear if propofol is more cost effective than midazolam, but certainly has a shorter shelf life once opened and more stringent storage requirements. /2
@neurocritical Agree likely many factors as mentioned. As well as indication for sedation/IMV, choice behind agents, confounding toxic-metabolic encephalopathy, etc.
#NCSVJC
🧠 Do you care for patients with acute brain injuries?
🫁 What is your sedation strategy with mechanical ventilation in these patients?
Join the #NCSVJC discussion to learn more about practice variations worldwide and impact on outcomes!
#NCSVJC is about to begin! Follow us for questions posted started shortly and hourly and discuss in the replies with colleagues. Learn more about how to participate and read the article: https://t.co/JXxXQMDZdD

#NCSVJC Q5: Recognizing the observational nature of this analysis, what would be your ideal design for a future trial comparing sedation strategies in ABI patients? Where should we go from here https://t.co/IYoU4D8Mfz

#NCSVJC Q4: Given the independently associated longer ICU stay with midazolam, but no difference in mortality, what are the practical and ethical implications of using midazolam as a first-line agent in resource-limited settings? Should ICU LOS be prioritized over mortality in these decisions? https://t.co/LQdgf7yHrE

#NCSVJC authors respond to today's discussion! What are your thoughts?
@neurocritical From the author: To some extent, guidelines are already adapting. Notably, in this cohort, 75% of patients in middle income countries presented with TBI vs. 40% in high income countries, and there were significantly fewer SAH. /1
#NCSVJC Q3: Patients sedated with midazolam had significantly higher rates of VAP. Could this be a reflection of the pharmacokinetics of midazolam impeding daily sedation interruption, or might there be confounding variables such as weaning protocols or ICU nurse-to-patient ratios? https://t.co/3CIzOC3hyG

#NCSVJC Q2: The study highlights substantial differences in sedative choice between high-income and middle-income countries. How do you think international guidelines should adapt to these realities—especially considering cost, drug availability, and storage logistics—without inadvertently promoting inequities in care? https://t.co/3CIzOC3hyG

#NCSVJC Authors respond...tune in and join the discussion on today's article!
@neurocritical From the authors: Potentially both. A caveat of prior studies is that they were not focused exclusively on ABI and included a general ICU population or cardiac etiologies. /1
#NCSVJC Q1: Given that there were no statistically significant differences in IMV duration between sedation strategies after adjustment, how should clinicians interpret these findings in light of prior studies suggesting potential benefits of propofol? Could the lack of difference reflect appropriate titration in neurocritical care settings or limitations in the dataset’s granularity (e.g., sedation depth, dosing protocols)? https://t.co/LQdgf7yHrE

#NCSVJC is about to begin! Follow us for questions posted started shortly and hourly and discuss in the replies with colleagues. Learn more about how to participate and read the article: https://t.co/JXxXQMDZdD

Join us tomorrow on X for #NCSVJC! This month's discussion is on international sedation practices in mechanically ventilated ncc patients, moderated by Dr. Pravin George. Learn more about how to participate: https://t.co/JXxXQMDZdD

Join us tomorrow on X for #NCSVJC! This month's discussion is on international sedation practices in mechanically ventilated ncc patients, moderated by Dr. Pravin George. Learn more about how to participate: https://t.co/JXxXQMDZdD


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