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Comment Re:Flawed study (Score 2) 136

It's an observational study. MOST observational study conclusions end up failing to be reproduced in prospective studies - for reasons you point out.

The end point was 30 day mortality. Readmit rates were unchanged. The latter is typically a better discriminator for 'bad care' - if the patient has to come back to the hospital in a month for the same reason, you can argue that you should have done something different (doesn't always work, but it seems to be a valid generality).

30 day mortality suggests (but does not prove) that a strong possibility is that older doctors where less likely to be aggressive. That can be appropriate or inappropriate care depending on the patient and condition.

All in all, this is *very* preliminary (as the authors duly point out). Unfortunately, it seems to be on the road to the the Medical News de jour and will be plastered about the Internet as the unvarnished truth.


Comment Re:Someone check what he's invested in (Score 2) 1044

There is a big difference between $3000 (moderate DSLR) and $30000 (base electric vehicle). Your analogy also falls a bit flat in that there are lots of other bits of the transportation infracstructure that work off of petroleum rather than electrons. In eight years your aren't going to see electric based container ships, 18 wheelers and aircraft.

Will electric make deep inroads into consumer driving? Sure. Eventually. Will automated driving replace meatbags? Probably. Eventually.

Not in a decade. Maybe 20 or 30 years but not in a decade.

Comment Re:Hopefully they'll allow more RAM (Score 2) 232

Anything from 2013 to 2015 can be upgraded to 16 GB - not the ultimate of 32 or 64 but it IS a laptop.

16 GB in my 2015 MBP is fine. 8 is really limiting the machine. YMMV.

But come on, a minimal processor refresh is not particularly exciting nor unexpected. Maybe some ports this time. Or at least a custom sleeve with dongle pockets.

Comment Re:General VLAN... (Score 0) 200

And I'd wager you are wrong.

Yes, having all of your medical records in one place sounds wonderful and lifesaving and all that but the reality is that you are unlikely to die from a doctor not having your old records. You might take a medication that didn't work before (or did), you might get a CT scan you didn't really need and the doctor might have a better idea of who you really are medically, but these don't translate into life or death issues.

Even the scary 'allergy' issue isn't all **that** important. First off, most people's description of allergies are incorrect. Several studies have indicated that the most common misdiagnosis in American medicine is 'penicillin allergy'. Even if you are allergic to a drug, we can reverse those problems pretty quickly. And you can always be allergic to a drug that you've never had or even one you've had before so you still have to be on the lookout for problems.

Secondly, even the imperfect recollections of patients are often enough to get you on the right track. If they aren't, there is the fax machine and the phone. Not sexy, but functional.

Frankly, the way we've implemented EHRs has been a nightmare. Yes, you can give the nice new ER doc all of the information - all 200 pages of useless verbiage about who did the test and when they signed off on it. After. Each. Fucking. Test. Result. Copypasta of histories so you have six of the same stories on paper. Did anyone actually read them? Did anyone other than the original author actually talk to the patient? No useful summation, just a core dump of whatever is on the database.

That's when the computers are actually working....

Comment Re:This doesn't seem like much to brag about... (Score 2) 102

Atrial fibrillation is characterized by being 'irregularly irregular'. It is really pretty easy to identify, at least for humans and even EKG machines. The mathematical algorithms are well known and well characterized. The major difficulty that the iWatch has is that it is only using one EKG lead.

But even three lead monitors have no problems with that.

But yes, it has some useful medical implications. "Paroxysmal" atrial fibrillation is when the underlying rhythm is normal but occasionally jumps into afib. That is medically important since the heart doesn't pump normally and the patient can feel weak and tired and it increases the likelihood of a blood clot. The rate of strokes (due to blood clots) from paroxysmal afib is no where near 15% but it is a large number because it's a common abnormality. Having your watch warn you of that is potentially useful.

Of course, I'm going to tell you to take one aspirin and call me in the morning.

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