I research/educate/make policy/practice with this: Patient goals + thoughtful use of evidence = appropriate care, sustainable health systems, and joy in work.
www.drotte.ca
Joined December 2013
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Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
Two papers.
On the left, a non-randomized, non-crossover study showing that a one-off sauna exposure significantly decreased arterial stiffness, with implications on cardiovascular health.
On the right, a randomized, crossover (more robust) study, showing no benefits on arterial stiffness or blood flow. Note the colossal difference in Altmetric score and media attention.
The media favors sensational but flawed studies over rigorous ones, distorting public understanding. #science #media
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
It’s very tempting to think that a positive screening test ‘saved a life’. But the only way we know about a mortality reduction for a population is via controlled trials. And even then we can’t predict well for individuals. Meantime, the worse a test is, the more/
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
💪 powercalc.ca 💪has now been updated. What's new? we added an option for non-inferiority trials. The tool is free to use and the lead programmer is @emil_hs. Rumour has it if you use power calc daily your muscles actually get bigger💪🤣 @pash22
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
Today's Lancet climate and health report presents 56 indicators of health and climate change across FIVE domains. (Download the report for free from the Lancet website). Here is a thread of some of the key findings. #Lancetclimate24 (1)
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
Elmo is here to listen. Elmo loves you, Mr. Andrew Garfield! ❤️ #EmotionalWellBeing
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
Cognitive errors and distortions are common in the ICU
Here are the 6 most cognitive errors I see in the ICU (and how to avoid them)
A 🧵
#medtwitter #FOAMed #cognitivebias
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
🆕For people with high #bloodpressure (BP) & chronic renal disease, evidence does NOT support lower than standard BP targets🚨
Our @CochraneLibrary systematic review looks at evidence from 6 trials involving 7,348 participants: tinyurl.com/BP-targets-renal
#SystematicReview
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
There is an IV fluids shortage (0.9% MS & LR) due to hurricane Helene.
Because of the shortage everyone should stop ordering routine maintenance fluids for the next 2-4 weeks.
Because of good medical practice everyone should stop ordering routine maintenance fluids forever.
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
🆕 TI Therapeutics Letter 151 🎺
Minimizing harms of tight glycemic control in older people with type 2 #diabetes
👉🏽ti.ubc.ca/letter151
"For most older adults (65 years or older) with type 2 diabetes who have an A1c below 7%, sulfonylureas or insulin do more harm than good"
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
has anyone worked out what % of GP work is dealing with stuff that another dept is meant to; eg dealing with results for stuff we didn't request, dealing with depts who are disagreeing with other depts whose job it is to do stuff, etc. totally, very very sadly, demoralised.
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
The Social Safety Theory of the human brain.
🧵1/14
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
Politics v interesting this week. My PhD was about conflicts of interest in healthcare. My conclusion is that transparency has been used as a ‘solution’ but unjustifiably. Transparency is often used as ‘the solution’. But it isn’t:
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
Industry influence still threatens the integrity of healthcare and harms patients.
"Educational interventions should challenge the common belief among health professionals that they are immune to commercial influence," say Alice Fabbri and @QuinnGrundy
bmj.com/content/386/bmj.q193…
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
London Ont. hospital trims administration by 14% in a bid to undo financial damage caused over recent years.
My question is, our hospitals are publicly funded and should be properly run. Why is this mismanagement allowed? What's happening at other hospitals that we don't hear about?
london.ctvnews.ca/a-tonne-of… @CTVNews
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
⚠️ Beware of low-value population screening ⚠️ #waste #overdiagnosis @TheLancet @TheLancetPH @muirgray @PopHealthLabCH @SSPHplus @IARCWHO @krebsliga @RosevdLinden @StefanoTancred3 @StephaneCullati @LessIsMoreMed @pash22
thelancet.com/journals/lance…
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
TI Portrait promo for BC family physicians and nurse practitioners! 😍
To celebrate our 30th anniversary, new TI Portrait Online subscribers are eligible for a 30% discount when registering for our annual #BestEvidence conference!
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
🧵6 reasons to register for next month's Bringing #BestEvidence to Clinicians conference:
1/ Like a 🐕 with a 🦴, we provide a scrupulous examination of #evidence to help you & your pts make more informed #SharedDecisions
👉🏾ti.ubc.ca/drugevidence24
#DrugEvidence24 #MedEd #CME
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
CRP….I’m coming for you.
Stop the daily CRP/Stop the madness
Evidence for lack of utility in infectious diseases summarized in our article below.
🧟♀️ test
Wow. It's published!
Our new article that will spark some good active discussion among ID people!
🆕️🔥 @CMIJournal by ID master @BradSpellberg & 🌟s @DrToddLee @DrEmilyMcD
Revisiting Diagnostics: ESR and CRP:It's Time to Stop the Zombie Tests
clinicalmicrobiologyandinfec…
Dr Jessica Otte, CCFP, FCFP🇨🇦 - palliative/FP retweeted
Our committee is unable to recommend lecanemab for treating mild cognitive impairment or mild dementia caused by Alzheimer’s disease.
Benefits of slowing disease progression, by 4-6 months on average, can not justify the high cost to the NHS.
Learn more: nice.org.uk/news/articles/be…
ALT New Alzheimer’s treatment lecanemab not recommended for NHS use in draft guidance.