Physician, Humble Thyself – Humility In Medicine
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Physician humility is crucial for tackling modern healthcare challenges, building patient trust, and fostering collaboration in medical environments. However, significant challenges exist in cultivating humility and require substantial individual and collective actions to ensure the integrity of the medical profession, enhance patient care, and support healthcare providers’ well-being.
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Physician Humility: A Review and Call to Revive Virtue in Medicine. Ann Intern Med. 2024 Jul 30. doi: 10.7326/M24-0842. Online ahead of print. PMID: 39074373.
How Badly Do We Function After a String of Nights?
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Residents working in the emergency department were found to do significantly worse on cognitive tests and moral performance after working 5 consecutive night shifts compared to 5 day shifts.
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Effect of serial night shifts on the cognitive, psychomotor, and moral performance of residents in the department of Emergency Medicine. Acad Emerg Med. 2024 Jul 15. doi: 10.1111/acem.14980. Online ahead of print. PMID: 39007435
Point | Counterpoint – DL Is Not the Building Block for Learning VL
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Yesterday we looked at an argument for learning DL prior to VL. Today, we are covering the counterpoint, where this group argues that DL is not the building block for learning VL.
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COUNTERPOINT: Direct Laryngoscopy: The Building Block to Airway Expertise? No. Chest. 2024 Jun;165(6):1297-1299. doi: 10.1016/j.chest.2024.01.027. PMID: 38852967
Point | Counterpoint – DL Should Be Learned Before VL
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Today we are looking at an opinion piece published in Chest where the authors provide an argument that DL should be learned prior to VL.
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POINT: Direct Laryngoscopy: The Building Block to Airway Expertise? Yes. Chest. 2024 Jun;165(6):1296-1297. doi: 10.1016/j.chest.2023.12.035. PMID: 38852966.
For the WIN Ratio…Wait, What?
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The win ratio can be a useful study design that allows hierarchical ranking, by clinical relevance, of composite outcomes into a win, tie, or loss, but watch out for abuses of it. They can be "seductive."
Sources
Use of the Win Ratio Analysis in Critical Care Trials. Am J Respir Crit Care Med. 2024 Apr 1;209(7):798-804. doi: 10.1164/rccm.202309-1644CP. PMID: 38285595
Win Ratio: A Seductive But Potentially Misleading Method for Evaluating Evidence from Clinical Trials. Circulation. 2024 May 14;149(20):1546-1548. doi: 10.1161/CIRCULATIONAHA.123.067786. Epub 2024 May 13. PMID: 38739696
“Healthy” Machine Learning Models Could Reduce Bias
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This medical news article interview highlights the risk of biased data leading to inherently biased medical AI models. The ethics of machine learning in general and approaches to minimize bias are also touched on.
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AI Developers Should Understand the Risks of Deploying Their Clinical Tools, MIT Expert Says. JAMA. 2024 Feb 27;331(8):629-631. doi: 10.1001/jama.2023.22981. PMID: 38324320.
A Primer on Bayesian Analysis for Non-Statisticians
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Bayesian analysis is becoming more common in clinical research and offers advantages over traditional frequentist methods when used appropriately. This primer can help understand Bayesian analysis better.
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Introduction to Bayesian Analyses for Clinical Research. Anesth Analg. 2024;138(3):530-541. doi:10.1213/ANE.0000000000006696
Comparing Intubation of Critically Ill Children between APRNs and Physicians
Dr. Amal Mattu and friends have a new video course you don't want to miss. Take a look!
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Review of tracheal intubations (TIs) performed in pediatric ICUs found advanced practice registered nurses (APRNs) had a lower first attempt success compared to doctors and respiratory therapists.
Snarky Sign-outs – How to Avoid Bias During Handoff
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Our words during handoff can bias our colleagues against our patients. Here's how it happens and what we can do to improve.
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Patient Factors Associated With Biased Language in Nightly Resident Verbal Handoff. JAMA Pediatr. 2023 Oct 1;177(10):1098-1100. doi: 10.1001/jamapediatrics.2023.2581.
Experienced or Rusty? Physician Age and Patient Mortality
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Emergency physician (EP) advancing age was associated with higher 7-day patient mortality. This is a call to keep current with literature, clinical skills, and best practices.
Source
Association Between Emergency Physician's Age and Mortality of Medicare Patients Aged 65 to 89 Years After Emergency Department Visit. Ann Emerg Med. 2023 Sep;82(3):301-312. doi: 10.1016/j.annemergmed.2023.02.010. Epub 2023 Mar 23.