A meta-analysis of 5 contemporary trials found no improvement in outcomes with beta blocker therapy after myocardial infarction with normal EF (≥50%)

Conservative dialysis strategy shows promise for AKI-D The LIBERATE-D trial found that this approach led to better renal recovery at discharge vs thrice-weekly dialysis (64% vs 50%) Although adjusted CIs were nonsignificant and deaths were numerically higher

ICIs for NSCLC illustrates caution in broadening trial eligibility In ECOG 0-1, trials show overall survival gain (65% vs 50% alive at 18 mos w/ chemo) In ECOG 2+, excluded in trials & typical of hospitalized adults, survival is just ~4 mos x.com/EvidenceRounds...

Many FDA-approved drugs receive indications broader than pivotal clinical trials, most notably for patient fitness While broader labels can extend access, absolute benefits may be smaller or absent altogether, especially for sicker & more impaired hospitalized patients

The rise in early-onset cancer in the US, including colon cancer, is less an epidemic of disease & more an epidemic of diagnosis The lack of a substantial rise in deaths, despite significant rising incidence strongly suggests increased diagnostic scrutiny & overdiagnosis

Routine use of gabapentin for postoperative pain is not supported by evidence In a large multicenter double-blind RCT of patients undergoing major surgery, gabapentin did NOT improve pain, opioid use, length of stay, or quality of life confirms a prior meta-analysis

Following the topline SNAP trial results, a new multicenter trial found cefazolin noninferior to cloxacillin for MSSA bacteremia, with fewer adverse events Given its safety, convenience, and lower cost, cefazolin should be considered first-line therapy for MSSA bacteremia

You're gonna wanna follow this Will be the single best way to have your finger on the pulse of what matters in hospital medicine and inpatient medicine more broadly

This study seems riddled with selection and detection biases and I can't see how any knowledgeable expert could just take the results at face value and conclude a doubling of risk of long-covid with reinfection.

We had our first OFF site Division retreat last week! Incredible energy, connection & culture building Plus iconic SF views & food :) UCSF DHM based at ZSFG is becoming the best academic Division of Hospital Medicine in the country And not just for a safety-net We're hiring btw

Recent FDA actions on Covid vaccines: 1. Novavax approved (👏) 2. Narrowed indications for all (pros and cons) 3. Called for clinical trials (👍) No doubt we're relying too much on old data to inform clinical practice. Some thoughts on what we gain… and what we risk. blogs.jwatch.org/hiv-id-obser...

Medicaid Patients with Type 2 Diabetes Face Hurdles Getting Cardioprotective Meds

🚨New Study in Annals🚨 GLP1ra & SGLT2i are the only diabetes meds that reduce heart attacks & death But can't work if can't prescribe TLDR 40% Medicaid enrollees have restricted access to GLP1 & 25% to SGLT2i much state/plan variability GLP access plateaued in '22 bit.ly/3Y72K2z

🚨New Study in Annals🚨 GLP1ra & SGLT2i are the only diabetes meds that reduce heart attacks & death But can't work if can't prescribe TLDR 40% Medicaid enrollees have restricted access to GLP1 & 25% to SGLT2i much state/plan variability GLP access plateaued in '22 bit.ly/3Y72K2z

Shared without comment.

I've been thinking more and more about evidence-based diagnosis Penned this piece with Gurpreet & Oanh on the SSRN preprint server titled: Striving for Diagnostic Excellence: "The Median Is Not the Message" Tell me what you think

Agree. Not enjoyable so far. Place is great if you like echo chambers, especially ones that celebrate an assassination because of the industry. Thought the selling point was more sanity and compassion? Will lurk time to time to see if gets better, but find me at the other place

Here. But really there