Lawrence Lynn
@PatientStormDoc
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Crit/Care research physician. CoAuthor of “The Physician’s War” The Battle between Physicians & Pathological Consensus https://t.co/l8sZ0gKPTI
Joined August 2012
@fluidloading @bentatoo31 @Denis_Faust @Procto_Log The story of pathological consensus and shortcutting the RCT method of Hill/Fischer with the Petty/Bone science. The lumping paradigm. The Physician’s War: The Story of the Hidden Battle between Physicians and a Science Based on Pathological Consensus
amazon.com
The hospital looks so well administrated. Yet, in the back rooms is a hidden battle for the lives of the outlier patients. This is where the rebel physicians, the master engineers of physiology...
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Electrical Rotation of the Heart An underrated concept in ECG interpretation Despite the name, “rotation” does not mean the heart is physically turning. Instead, electrical rotation refers to the position of the QRS transition zone across the precordial (V1–V6) leads. It
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The @ConjectureInst : friend or foe of public-good focused scientific advancement.
@robnormal @ConjectureInst Dynamic Pathological Consensus (DPC): a self-reinforcing collective belief system in which institutional and social incentives stabilize a scientifically erroneous framework despite accumulating counter-evidence, through mechanisms of self-indoctrination, selective validation,
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There has been enough quiet tolerance of childish insults of the perpetually conforming class.
@AlastairMcA30 @vincristine @DrSusanOliver1 He’s strong enough to escape the science monopoly and to ignore incessant ad hominem from the intellectual bourgeoisie in the elite medical peanut gallery. That alone, right or wrong, suggests very rare courage in today’s networking focused medical science class.
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All critical care docs should read this brief post in datamethods and replace pulse oximetry with high and low trained POCUS and high and low trained PAC analysis. Don’t let them discredit your tools using the results of blind Cause Agnostic RCT (CAR).
discourse.datamethods.org
Illustrative Case: The Pulse Oximetry Trial as a Cause-Agnostic RCT (CAR) Let us now consider the consequences, both beneficial and detrimental, of a cause-agnostic randomized controlled trial (CAR)....
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As the evidence exposing the failure of “science monopolies” piles up, don’t miss this true story of physicians’ battles against centralized control of medical science. https://t.co/6I8w8pFQ7V
amazon.com
The hospital looks so well administrated. Yet, in the back rooms is a hidden battle for the lives of the outlier patients. This is where the rebel physicians, the master engineers of physiology...
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Language models cannot reliably distinguish belief from knowledge and fact https://t.co/sfJ72NyoK0 via @james_y_zou et al @RichardLehman1 @raj_mehta
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If young crit card researchers tolerate a task force generation of “Sepsis 4” from SOFA-2.0, they will deserve the failed research they will produce.
Now, in the hype of the new SOFA-2.0 score, it’s time to remember that it is an ordinal variable. It is not a numeric variable. SOFA points are labels like “fine, not so fine, bad and horrible”. You shouldn’t add, divide, and subtract labels. Moreover, even if we treat it like
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Professor Pearl, I invite you (or a member of your team) to comment on the datamethods discussion below: https://t.co/htLD1HML4q The post explores how decades of focus on operational design parameters—randomization schemes, blinding, sample size, etc.—have eclipsed the causal
discourse.datamethods.org
Over on X there is a debate relevant causal inference vs RCT design. But what is an RCT? Since Bradford Hill’s landmark study we have seen the RCT morph into two species. So can we no longer speak of...
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Don’t miss this important brief thread which teaches how to end decades of waste using causal inference to prevent “cause-agnostic RCT” (CAR) in critical care research. @DrJBhattacharya @yudapearl @NIH
@doc_BLocke @icmteaching Here you see Girbs et at makes a quantum advance and these workers almost go to deep enough but still end up focusing on operational design parameters (here the dilution of power). Yet we have to go deeper than that. The fundamental mistake has been to assume that the
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Ross is spot on here. The modifiable window in ICU is narrow – much of a patient’s outcome is fixed by comorbidity, frailty, and disease biology. That’s why mortality is such a blunt tool once baseline care is good. The signal lies in how much life-support a patient actually
(4/x) When there is less ability to modify mortality (as baseline mortality rates decrease), patient (and health system) important outcome like life support duration and resolution of multi-organ failure are patient important. For our own sepsis research, our patient partners
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I’ve been called wrong, obsessed, even “cognitively stuck”—that last one left a mark. 😄 All this because, since 2012, I’ve been working to bring down the “Cause-Agnostic RCT” (CAR) for critical care syndromes, which I could see was a plague on young scientists and on progress
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Learn about the “Cause-Agnostic RCT” (CAR). The best proof available that clinicians need to learn basic cSM. @eliasbareinboim @murat_kocaoglu_ @JacobJHutton
@soboleffspaces
@NIHDirector_Jay
@yudapearl @f2harrell Please consider at least a brief temporary alliance by dispatching your mentees to study the “Cause-Agnostic RCT” (CAR), These are also known as the “Petty-Bone RCT”, after the clinicians who developed this flawed RCT design in the late 20th century.
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(7/x) What does this mean for both the management and research of septic shock? Despite decades of negative trials, we don’t have to be nihilistic. We CAN improve outcomes, but the key is in phenotyping our interventions to the patient in front of us. We need to STOP performing
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@aclong111 My dear friend lost her daughter with 3 leaving beautiful little children motherless to fentanyl and I just saw on 25 year old wonderful boy a vent a patient. He nearly died. The idea that physician’s watch all of these deaths right in front of them do not demand as a group
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For readers asking for translations of The Book of Why. Here is the list I have, Country+Publisher: US Basic Books, UK Penguin Books , SPAIN Pasado y Presente, HOLLAND Maven, FINLAND Terra Cognita, PORTUGAL Temas y Debates, JAPAN Bungei Shunju, KOREA ScienceBooks, TAIWAN
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@RWJE_BA @5_utr @yudapearl @f2harrell @JonNichEdwards @doc_BLocke @stephensenn I was sad to find out the truth about how far RCT methodology have devolved. I was so trusting. It gives me no pleasure to see that “Big RCT” as an @NIH grant rendering industry has emerged by streamlining participant finding, rendering cause agnostic RCT which generate
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Agree. I just sent @RWJE_BA back to look stuff up and he did not seem offended.
@PatientStormDoc @jasonryanmd I was often sent away to learn something I didn't know and told to report back. Active learning to aid retention. It's not bullying to tell someone to look it up!
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