Saurabh Jha
@RogueRad
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Radiologist interested in stories & algorithms
Joined December 2013
Thank you for @KBibbinsDomingo for the opportunity to talk about AI &.radiology. I’m glad your fondest memories during residency call was talking with the radiologist about clinical uncertainty!.
Cardiothoracic radiologist and associate professor of radiology @Penn @RogueRad recently joined JAMA Editor in Chief @KBibbinsDomingo to discuss how AI could play a crucial role in improving access to medical imaging in diverse settings.
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I told my father, who is a physician in the NHS, & over 70 & has retired or should have retired, to stay at home during the pandemic & just retire. This was his response. Stubborn man
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Raise your hands if you have never watched a single episode of Game of Thrones.
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A shout out to the CT tech who, when seeing the dissection in descending aorta, continued scanning into the abdomen, rather than asking permission to extend the scan. The tech broke protocol. Good medicine means breaking rules.
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Flight attendant: Is there a doctor onboard?. Dad: *nudging me proudly*, he, my son, is a doctor . Me: I'm a radiologist . Flight attendant: Are you a doctor? . Me: Clinically correlate.
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So, today I rejected a paper because it had “in times of COVID-19” in the 1st paragraph.
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Please don't ask for my PowerPoint two weeks before my talk, because I won't give it, because I haven't made it.
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My 12-year old son said “dad, I hope the discoverer of the mRNA vaccine gets the Nobel prize for medicine, economics & peace.” I thought I’d instantly share it on Twitter.
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A shout out to all the J1-visa holders taking call today. A Thanksgiving tradition.
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Writing a case report, and I just wrote "electrophysiologists were shocked by the finding" - should I modify this line? Is it too corny?.
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Never argue with a statistician on Twitter. You’ll always be underpowered. No matter how much of an alpha you think you are, you’ll walk away with both tails between your legs.
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Dexamethasone is like an Indian uncle - always around, often useless, sometimes helpful.
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And it happened. A radiology request with an emoji. “Can you please compare the nodule to prior CT? :)” This is the beginning of the end.
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I don’t know who needs to hear this. But radiologists are real doctors. Thank you.
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Advice from my mother for me to get through the pandemic. “Stay at home. Don’t go drinking with your friends. Read more.” Oddly, same advice I got when I was 18.
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The unsung heroes of the pandemic - CT technologists. Continuously in the frontline & who, after scanning patients with suspected COVID, clean the entire scanner inch by inch.
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To put this in perspective. Your ATM card works in Outer Mongolia, but your EHR can't be used in a different hospital across the street
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I’m thinking of making my radiology reports more conversational. “As you know these multifocal alveolar opacities could be anything. But as you might have guessed, they’re most likely pulmonary edema”.
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An Indian doctor and a Pakistani patient. A story of two migrants to Britain. My father's story. A story of old NHS. Doctor Sahib
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After personally discussing CT with pulmonologist, and listening to a comprehensive history, we agreed that the ground glass opacities could be caused by anything.
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Lots of chest CTs with the history “COVID-19 survivor.” Lungs look mangled.
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British doctors told to avoid medical terminology. Don’t say “aneurysm.” Say “big bad ass aorta which can burst anytime.”.
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All biostatisticians should spend an evening in the emergency department and try to make clinical decisions using continuous variables and linear and logistic regression.
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To whomsoever it may concern,.Economy of words in a radiology report does not mean economy of effort in assessing scan. Thank you. A succinct radiologist.
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So, my mother who is in India has COVID. My father in London has COVID. My son in Philadelphia has COVID! All at the same time! All vaxxed. All boosted. It’s no one’s fault. They did everything they reasonably could. Everyone else did everything that’s reasonably possible.
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Looks like many doctors have deleted their "why India dodged the virus" tweetorials. That's unfortunate. We'll never learn why theories which turned out to be wrong were thought to be right.
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Elizabeth Warren would never mistake atelectasis for pneumonia.
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My prediction for 2021. A book will be published saying US over reacted to COVID. Another one will say lives were lost because of delayed reaction. Both books will be bestsellers.
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Plasma joins T cells & hydroxychloroquine as Republicans. Prednisone remains solid Democrat. Remdesivir started on the right, quickly moved to the left, & has now signed as an independent.
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Shout out to the radiology resident who used "despite" and "furthermore" in the radiology report. Bravo. You shall never be replaced by AI.
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Just rendered a 2nd opinion on the size of the ascending aorta. The radiologist from St. Elsewhere measured it as 4 cm. I remeasured using sophisticated 3 D techniques as 3.9 cm.
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Next Nobel Prize in medicine should go to Medical Twitter. We should all share it and put it on our CVs. One for all and all for one. No competition. Just collaboration. Tweetopia.
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I’m going to start an institution called “Institute of Healing.” I’ll convene 50 experts who never practiced medicine. Then we’ll write a 10, 000 word document with 1000 citations with links to 100 meta analyses. We’ll conclude “doctors must make eye contact with patients.”.
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MRI request - “please correlate with recent CT.” Referring clinicians strike back.
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Take home message of 100 years of radiology: pneumonia looks like atelectasis.
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I just convinced an unvaccinated, vaccine hesitant, dear friend to get vaccinated. Want to know what I said? No, no Kaplan-Meier curves. No p values. I said "vaccine lai lai chutiyai". He got his 1st shot today :).
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Happy 125th birthday radiology. On December 22nd, 1895, Wilhelm Röntgen took the 1st x-ray, of his wife’s hand. She reportedly said “I have seen my death”
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My candid conversation with John Ioannidis about the COVID-19 pandemic, his views and misrepresentation of his views
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I’m not offended by Apu. For 2 reasons. First, he’s not offensive. Second, he’s a historical pride - many Indians in the UK who became millionaires were expelled by Idi Amin. They started off as small shop owners. I’m proud of Apu, & the generation he represented.
If true, it's pretty sad. The Simpsons after years of standing up for their comedic freedom. Have kowtowed to political correctness.
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Disciplining healthcare workers for wearing masks has to be the lowest point of hospital administrators. Can they sink lower?
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Dear radiologists, if we can't even standardize a hashtag for our largest meeting how do we expect to standardize radiology reports? #RSNAMMXVIII #RSNA2018 #RSNA18 #2018RSNA #RSNA2018AD.
@JohnLaprise @RichDuszak @AmineKorchiMD @RSNA @RadiologyACR @radiology_rsna @StanfordRad @BWHRadEdu @radiologynation @frankgaillard @RogueRad @FalgunChokshiMD @CincyKidsRad @PennRadiology @RadiologyInfo_ @healthhashtags We're pretty sure that #RSNAMMXVIII is the preferred hashtag and not #RSNA18 👍.
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Children: "I'll tell your mom". Adults: "I'll tag your employer".
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Give a man a fish and you feed him for a day; give fish a billing code and the man won't stop fishing.
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Not even God can exclude mild pulmonary edema on a portable chest radiograph.
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The best way of saving hours and hours of time researching something is to deliberately say something factually incorrect on Twitter. Within seconds, you'll be corrected.
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Reviewing a paper. The term "game changer" appears in the 1st paragraph. Should I reject it?.
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4 stages of Twitter. 1. Wow - people are following me!.2. Why aren’t more people following me????.3. I just spotted someone not following me 😡.4. I need my own podcast 🤔.
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An interview with Dr. Jonathan Cusack - the doctor who single handedly stuck up for Dr. Bawa-Garba against lawyers and regulators. A modern day unsung hero #BawaGarba.
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Person 1: The glass is 1/2 empty.Person 2: The glass is 1/2 full . Radiologist: though the glass is half empty I can’t entirely exclude that it’s half full.
😒 Person 1: The glass is 1/2 empty. 😊 Person 2: The glass is 1/2 full. 👩🏻🦰 Anesthesia: When did you drink that?.
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As a general rule, the more people that are tagged on an email to ensure a task gets done, the less likely the task will get done.
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The secret to camaraderie & teamwork in the old NHS - the hospital pub. A trip down memory lane. Cheers
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British doctor, #ManjulaArora suspended because she misuses "promise". @gmcuk goes after her for lying & bringing medical profession into disrepute! Tribunal suspends her for misconduct. No, this isn't a Monty Python sketch! Read. Laugh. Weep. Weep more
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When did you realize COVID was a monster of a problem that’d affect your life substantially? For me, March 1st, 5 days after I booked spring break holiday. Answer honestly!.
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Heading to Namche Bazaar from Lukla. #ProjectKhumbu - collaboration between @PennRadiology @qure_ai @MinXray_Inc & local Nepalese physicians to bring AI-enabled imaging to remote areas in Nepal
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Largest radiology meeting in Chicago next week. Thankfully, radiologists naturally social distance because we’re awkward & have no friends. Also, we’re faceless so a mask is no big deal.
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A quote, not mine, though I wish it was. "If doctors were allowed to prescribe placebo, without saying it was placebo, we could cut healthcare costs by 20 %.".
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The continued obsession with the denominator, when the numerator speaks for itself, is bizarre.
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I’m holding a webinar for Americans who want to learn how to pronounce Indian names correctly. As homework, please practice these this name: Vangipurapu Venkata Sai Laxman.
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Any radiologist who claims they can distinguish ground glass opacities from corona virus from ground glass opacities from the dozen other causes is p-hacking.
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Stuffed turkey with naan and mango pickle. I just reversed 500 years of colonialism in one bite.
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To my colleagues in cardiology. Thanks for keeping things in rhythm
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What if rad reports were written like clinic letters? “Dear Dr. Smith, thank you for referring this delightful 65 year old retired plumber for CT scan. I’m pleased to say his aorta lit up like a lightbulb, as it’s supposed to. Though his prostate is a bit large, I’ve seen larger”.
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If two radiologists disagree it’s better to toss a coin than ask a third radiologist.
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Soon there’ll be a generation of doctors who have never read House of God or watched Godfather. I find that terrifying.
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An Indian quits medicine to become NBA referee. An Indian chooses basketball over cardiology!
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Whenever someone prefixes "I'm not an infectious disease or epidemiology expert", you can be sure they have a lot to say about COVID.
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The “one vaccine dose” vs “two doses” debate is probably the most civil academic debate in this pandemic, probably because the issue hasn’t become politicized, yet.
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To err is homicide. The unfortunate case of Dr. Dr. Hadiza Bawa-Garba. (a very painful piece to write about) #BawaGarba @Jeremy_Hunt @gmcuk.
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If the lockdown continues into May I’ll be forced to do a TikTok video.
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After much thought. Given the politicization & toxicity of Twitter. And its potential for creating division. I have decided not to leave it. And keep checking my timeline.
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Is medicine the only field where the most influential are those who practice the trade the least?.
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Just congratulated someone for a great grand rounds only to find out it’s next week. How does one recover from this?.
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Spoke with a radiologist from Seattle. Experienced chest radiologist. Things are tough, he says, but not apocalyptic - sorry, no fear mongering in this thread. (thread).
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Anyone interested in running an RCT comparing kale to spinach for all-cause mortality? It’ll cost a $billion. In the end we’ll conclude we need shared decision making to fine tune individual preferences.
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Radiologists are sharing positive COVID cases - which is educational. Please also share false positive COVID cases - which you called COVID but it turned out to be something else. They're instructive, too.
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A private company has banned the head of state. This isn’t communism. This is capitalism.
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Just put up our Christmas tree. I checked with our 5000 Hindu gods for permission first. Vishnu said “go ahead. He’s one of us”.
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By all means lawyers, go after bad doctors. But please labour to make a distinction between a bad doctor & a bad outcome. They’re not the same thing #Bawagarba.
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Since everyone is diagnosing Trump from their armchair, I thought I would, too. I believe he has 12 mm adrenal nodule in the lateral limb of his left adrenal gland which is 24 HU on unenhanced CT. Consider MRI, if clinically indicated.
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The recent feedback to my poking fun at every specialty, including my own, has convinced me that I need to poke more fun. Doctors take themselves far too seriously, even more than economists - which is saying something.
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The surest way to kill empathy is for ACGME to make it a milestone.
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Trump should be given convalescent plasma from @BorisJohnson, for a truly Bollywood drama. “Yeh dosti”.
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When an infectious disease physician & an orthopedic surgeon are both in the reading room, the hardware is probably infected.
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Coronavirus on chest radiograph. “fourth chest radiograph showed basilar streaky opacities in both lungs, a finding consistent with atypical pneumonia“ - consistent with just about anything
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Many can't believe India will soon be vaccinating 10 million a day. To understand that, you have to understand how large scale wedding is organized in India, often in last few days. Or how India pulled off 2010 Commonwealth games, against all odds.
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It’s fair to say that this tweet slightly backfired - pun unintended.
Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves.
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