For those of you not there, you missed a doozy today. Besides some board review and M&M, we had a great senior lecture by Dr. Sadia Hussain, a EM-CCM lecture by Dr. Elizabeth Abram (the summary of which will be posted at a later date), and a lecture on bayesian analysis by Dr. Adam Aluisio
We’ll start with Dr. Hussain’s senior lecture “Women in Medicine”, which, to be honest, made me angry.
Pearls!1. There was a huge gender gap in medical school until 2005
2. Now we have a gender gap in academic leadership positions
3. There is a pay gap between new physicians and it’s getting worse…
4. Studies show women are more likely to be indirectly aggressive to other women. Madeline Albright “there is a special place in hell for women who don’t help other women”
5. 52% of female faculty report experiencing sexual harassment versus 5% in males. Environments with strict policies against sexual harassment have lower rates of sexual harassment.
6. Women have come a long way in medicine, but important differences still exist…and this is wrong!
Secondly and lastly, our research expert Dr Aluisio gave a fantastic talk on statistics (paradox recognized…but true)
Pearls!1. Clinical context is key bayesian analysis
2.All tests have false results and carry risks
3. Patients with probabilities of disease below the test threshold or above the treatment threshold do not require further diagnostic tests
Check out Dr. Z’s paper here
References
Downey, A. Think Bayes Bayesian Statistics Made Simple, Green Tea Press Needham, 2012, Massachusetts,9 Washburn Ave Needham MA 02492
Fagan TJ. Nomogram for Bayes’s theorem N Engl J Med Jul 31, 1975; 293(5):257
Akobeng, A. Understanding diagnostic tests 2: likelihood ratios, pre- and post-test probabilities and their use in clinical practice. 2006. ActaPædiatrica ISSN 0803–5253
PaukerSG, Kassirer JP. The threshold approach to clinical decision making. N Engl J Med. 1980; 302: 1109–17.
Zehtabchi, S. and Kline, J. The Art and Science of Probabilistic Decision- making in Emergency Medicine ACAD EMERG MED May 2010, Vol. 17, No. 5
Kline, J et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria, Journal of Thrombosis and Haemostasis, 6: 772–780
The Christopher Study Group Investigators. Effectiveness of Managing Suspected Pulmonary Embolism Using an Algorithm Combining Clinical Probability, D-Dimer Testing, and Computed Tomography, JAMA, January 11, 2006—Vol 295, No. 2
Brought to you by Dr. Andrew Grock, Dr. Carl Alsup, and Dr. Jay Khadpe
andygrock
- Resident Editor In Chief of blog.clinicalmonster.com.
- Co-Founder and Co-Director of the ALiEM AIR Executive Board - Check it out here: http://www.aliem.com/aliem-approved-instructional-resources-air-series/
- Resident at Kings County Hospital
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