It feels like critical appraisal is about to have a bit of a moment... let's do it right, people!

One insurance denial for Teressa's husband stated, “your newborn does not meet the criteria for coverage.” “This is when I really start to think they’re just denying,” she recalled. “They’re not even looking. They’re just ‘deny, deny, deny.’” ➡️ Full story: www.propublica.org/article/ment...

After a North Carolina man attempted suicide twice, his wife tried to get him help at an inpatient clinic. But their insurance provider refused to cover the treatment, deeming it “not medically necessary.”

Question for folks in medicine and science: What are some of the best invited editorials you have ever read? What made them so good?

Lots of gold in this list!

🥞 #496 Hotcakes are here! 🩺 www.thecurbsiders.com We’re diving into: 🌿 CBD-induced liver injury 💉 IV iron for HFrEF 🛏️ Bedtime BP meds ✋ Carpal Tunnel & RA ❤️ FDA approval of finerenone for HFpEF ✨ featuring @paulnwilliams.bsky.social @rbganatra.bsky.social, Dr. Nora Taranto, Dr. Matthew Watto

“The study authors asked GPT 4o-mini to evaluate the quality of 217 papers. The tool didn’t mention in any of the reports that the papers being analyzed had been retracted or had validity issues. In 190 cases, GPT described the papers as world leading, internationally excellent, or close to that”

"Health Secretary Robert F. Kennedy Jr, who oversees the CDC, did not make a statement the day of the shooting. Late the following morning, more than 30 minutes after posting photos of fishing with his family, Kennedy posted condolences on his official X account..." www.nytimes.com/2025/08/09/u...

Fewer than 10% of published observational studies in this sample used DAGs to justify confounder selection. This is a huge missed opportunity for both readers and researchers. DAGs are invaluable in research design and critical appraisal.

Why do treehoppers look so weird?! Our latest paper, out this week in @pnas.org, suggests a perhaps unexpected reason - static electricity ⚡ We show that treehoppers can detect the electrostatic cues of predators and that their crazy shapes may boost their electrosensitivity! doi.org/10.1073/pnas...

Updated CAP and UTI guidelines??? Yes please!

🔥🔥Just published 🔥🔥 ATS CAP guidelines 2025 Diagnosis and Management of Community-acquired Pneumonia. An Official American Thoracic Society Clinical Practice Guideline Free access pdf #IDsky#EMIMCC www.atsjournals.org/doi/10.1164/...

Bottlenose dolphins in Shark Bay, Australia, use sponges on their beaks while hunting fish to protect them from sharp rocks while they forage at the expense of echolocation. Only about 5% of the population has mastered this culturally transmitted skill! 🧪 royalsocietypublishing.org/doi/10.1098/...

Did you know that a subset of patients with atrial fibrillation have symptoms triggered by cold drinks?! Neither did I! onlinelibrary.wiley.com/doi/10.1111/...

Wake up new cause of liver enzyme elevation just dropped

You're looking at three golden tortoise beetles (Charidotella sexpunctata). They're native to the Americas, generally the east coast of North America all the way down to Argentina. The gold coloration is structural, semi-reflective layers in the cuticle selectively reflect wavelengths of light.

I'm not saying you can't generate a hypothesis from data. I'm just saying that generating a hypothesis from the entirety of human knowledge that preceded your data is a much safer bet.

This little fart-squirrel (Mephitis mephitis) is stamping, a warning behavior before the *big show*. She's hoping to scare you off with her ferocity so she doesn't have to use her scent glands. These types of bluffing moves are "deimatic" behaviors, from Greek 'deimatóo' = "to frighten".

new IBCC chapter: constipation! most ICU patients are constipated, so we manage this on a daily basis. but our approach is often super random ("I was taught this in residency") so I tried to create an evidence-based treatment strategy for constipation...🧵 #1/7 #EMIMCC emcrit.org/ibcc/constip...

what we truly care about is tonicity (forces that pull H2O across membranes) not osmolality sodium is actually a pretty good proxy of tonicity (ie “effective” osm), maybe better than measured osm also if we start juggling sodium levels and osmolarity at the same time it gets too damn complicated

Really enjoyed this one despite @paulnwilliams.bsky.social abstaining from some top-shelf trial name-related humor with "the eagle has landed" - take a listen and see what i mean!

I had google AI create this podcast for tonight's NephJC podcast. Take a listen. Tell me what you think Would you like NephJC to produce this as a regular part of the educational package? This would not replace the irreplaceable Freely Filtered. notebooklm.google.com/notebook/8e8...

Question for my #Geriatrics #GeriSky brain trust: What are the best apps for scheduling home health aides or other elder care professionals? Something with: - A shared calendar for scheduling shifts - Hours logging - Any other features you have found useful Thx!

NEW @bmj.com research determines the incidence and prevalence of dementia in a nationally representative cohort of US Medicare beneficiaries www.bmj.com/content/389/...

Sunday sillies: "I'll allow it" edition. #math

Thanks to everybody who chimed in! I arrived at the conclusion that (1) there's a lot of interesting stuff about interactions and (2) the figure I was looking for does not exist. So, I made it myself! Here's a simple illustration of how to control for confounding in interactions:>

🎙️Brand New!!! #482 #shmconverge25 recap is here!!!!! Highlights and Pearls from SHM’s Annual Meeting 🥼🩺🩻🎰 We recap the top pearls for the hospitalist from #SHM #Converge25 hitting updates in GI, stroke, anticoagulation, perioperative medicine, artificial intelligence, and more.

🔥🔥🔥 Dr. Rahul Ganatra dishing all the pearls from #SHMConverge25 We recap the top pearls for the hospitalist from #SHM #Converge25 hitting updates in GI, stroke, anticoagulation, perioperative medicine, artificial intelligence, and more. 💊 @rbganatra.bsky.social www.thecurbsiders.com 🎙️

As disturbing as this is, this paper showcases a nice suite of fraud detection techniques:

Past-month binge drinking among young adult females in 2021-2023 was higher than among males, reversing 2017-2019 patterns, whereas males in other age groups continued to binge and heavy drink at higher rates. https://ja.ma/42pf2V6 #MedSky

Throwback to 2016! 🔙 Dr. Rahul Ganatra @rbganatra.bsky.social and this week’s guest Dr. Molly Brett! This hotcakes episode can’t be missed! 🥞 #medsky thecurbsiders.com/curbsiders-p...

What if???? 🤔 🙊 We’ll be back soon with a brand new hotcakes episode where we talk Suzetrigine for acute pain, SGLT2i and PAD, Safety of Lowering LDL, Restrictive vs Liberal Transfusion Strategy in MI revisited and more! 💊💉🎙️ ##medical #internalmed #medsky

The first person to document that light had a speed is, arguably, Danish astronomer Ole Rømer, in 1676. Our story starts with the challenge of calculating longitude. In 1598 Philip III of Spain offered a large prize for any method to accurately determine east/west coordinates for a ship at sea.

The Red Cross is explicitly allowing blood donations for people with hemochromatosis Did you know this? Apparently, this policy was updated late 2023 and was long overdue @shematologist.medsky.social #liversky

This table from @drjmluther.bsky.social needs to be disseminated more widely (We added it to our @cmaj-jamc.bsky.social 5 things for that reason www.cmaj.ca/content/196/...) #NephMadness

5.6% of CDI patients had ↓fidaxomicin susceptibility; 3 developed resistance during treatment & failed therapy; resistant strains showed RNA mutations; evidence of transmission. @abhishekdp.bsky.social

This is an emergency. Decisions at the individual level and the population level both play a role. In the current moment, how should physicians and scientists best advocate for decisions that will benefit both individuals and populations?

Superbly ambiguous sign at a restaurant in O'Hare: Alcoholic beverages MUST be consumed in the airport (do it, or else!!). Or Alcoholic beverages must be consumed IN the airport (not outside, dummy!!). Who's to say which is the correct interpretation? 🤷

Here's what the entire federal workforce actually looks like. It's mostly doctors, nurses and healthcare workers in VA hospitals, the military, and then everything else.

Friends, I have written you a book on forensic metascience. It is free. You can have it. Happy St. Valentine's Day. If you wish to give me a gift back, you can use it to cause trouble - the greatest gift of all. open.substack.com/pub/jamescla...

Things We Do for No Reason: Routine use of antibiotics for acute uncomplicated diverticulitis (UD) ⭐️Non‐inferiority of non-antibiotic management of UD supported by 2 landmark RCTs ⭐️Selective (vs routine) use of antibiotics for UD recommended by societies incl AGA and ACP doi.org/10.1002/jhm....

Changes in Incident Schizophrenia Diagnoses Associated With Cannabis Use Disorder After Cannabis Legalization jamanetwork.com/journals/jam...

Rethinking Antibiotic Prophylaxis for Spontaneous Bacterial Peritonitis in Patients with Cirrhosis ➡️Standard of care since the 1990s and is currently recommended by several major GI societies ➡️Weak supporting evidence ➡️No clear mortality benefit doi.org/10.1093/cid/... #IDSky

New retrospective eval of 1000 Karius tests Clinical impact: positive 16%, negative 2%, none 82%(!) Cx neg IE and fastidious/zoonotic/vector-borne increased likelihood of positive impact, but not immunocompromised status #IDSky @ichejournal.bsky.social pubmed.ncbi.nlm.nih.gov/39881594/

Post-hoc analysis of 📷 📷 study in MSSA/MRSA bacteremia: Persistent fever = indicator for complicated infection Fever on Day 4️⃣: aOR (3.7 (95% CI: 1.58-8.67)) mortality Fever on Day 7️⃣: aOR: (8.78 (95% CI: 2.78-27.7) 🚫 assn between ⬆️CRP/WBC and mortality #IDSky academic.oup.com/ofid/advance...

Can't wait to read

1/ Aging patients often visit the ED with undiagnosed cognitive impairment. Spotting cognitive issues here can guide critical care decisions, yet feasible tools remain underused. 🧵 🔎 Check out our latest published work here led by @jamesgalske.bsky.social: bit.ly/4jojfQM