JAMA, you tried so hard and almost nailed it! The reason why the evidence gap is >14 years in clinical medicine is you are publishing breaking reviews on techniques and approaches that were all the rage… 14 years ago. B-lines - incredibly valuable. IVC collapsibility or IJ ultrasound alone are not the right approach. We are assessing complex physiology, not checking oil levels of cars!!

How can a 99% accurate medical test give you a 9% chance of having the disease if it comes back positive? 🤔 If you are in medicine this is the SINGLE most important diagnostic testing concept to know. Welcome to the difference between specificity and positive predictive value. Sensitivity & specificity are fixed test properties. These do not factor how common a disease is (prevalence) Positive Predictive Value (probability a positive test reflects having a disease) factors in prevalence and is actually more important to clinicians than sens/spec. It is harder to figure out though because we need to have a gestault for how prevalent a disease is for the EXACT patient we are seeing. If you have very low prevalence, even with a great test, most positives are false positives. This is why screening low-risk patients can result in many false positives and harm To master this, just play with the calculator yourself and you will see!!!!👇

Mentorship has been crucial for my own development. I realize not all trainees find mentors they connect with. I want to help. I am not sure if this will work... but I am starting a virtual mentor group for trainees (medical students or residents) from anywhere in the world. To join, complete this form! app.youform.com/forms/zammez… Please retweet this so all trainees see and have the chance to join! 🙏 I won't be able to accommodate everyone in this first group but I will try my best. I might also find other mentors who are interested in leading a group if the demand is high enough. As always, my DMs are open!

(1/x) Here's our paper on the medico-legal risks of #pocus 🧑‍⚖️ A better title: How not to get sued performing POCUS. A 🧵 Teaser: You can be sued performing #pocus... Please share to help spread best #pocus practices 🙏 theultrasoundjournal.springe… @arntfield @derwuk @NephroP @ArgaizR #medtwitter #foamed #foamus #meded

A diagnostic accuracy study produces a receiver operator curve (ROC) that shows an AUC of 0.72! So... is that a good test? What is a ROC and why do we need them? How come some of them are jagged and others are smooth? Here's a simple explanation: simplesage.io/blog/roc_curve…

Its nurse practitioner week! 🎉If you are interested in diagnostic reasoning, diagnostic imaging, and practice management for nurse practitioners, check out the online blog npreasoning.com/ created by @VickyS_NP . Great for anyone interested in clinical problem solving. 🧠

Nursing and NP colleagues! Do you want a resource to improve your diagnostic reasoning, differential diagnoses, and evidence based workup? Check out NPreasoning blog for weekly posts, newsletters, and webinars! npreasoning.com/blog/what-is… @RespRate16