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gorskon's profile
David Gorski, MD, PhD
David Gorski, MD, PhD
David Gorski, MD, PhD
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@gorskon

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David Gorski, MD, PhDVerified account

@gorskon

Surgeon/scientist promoting science in medicine and exposing quackery. Editor of Science-Based Medicine. My opinions do NOT represent those of my employers.

Michigan, USA
sciencebasedmedicine.org
Joined October 2009

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    1. David Gorski, MD, PhD‏Verified account @gorskon 11 Apr 2020
      Replying to @aribindi @NPR

      He plans on publishing his results to add to the research on #COVID19. That’s experimentation and he should have gotten IRB approval.🙄🤦🏻‍♂️pic.twitter.com/B0vI08LTlc

      1 reply 4 retweets 62 likes
    2. Vamsi Aribindi‏ @aribindi 11 Apr 2020
      Replying to @gorskon @NPR

      IMO the line between tracking outcomes/quality improvement and research is not always as distinct as we would like. If a surgeon adopts a ligasure for thyroidectomies, tracks OR times and bleeds, and then decides to publish them, is that research that requires a prospective IRB?

      3 replies 0 retweets 4 likes
    3. Nataniel Lester-Coll, MD‏Verified account @DrLesterColl 12 Apr 2020
      Replying to @aribindi @gorskon @NPR

      IRB member here. This is absolutely human subjects research and requires IRB approval.pic.twitter.com/7Izw841Zi0

      2 replies 0 retweets 22 likes
    4. Vamsi Aribindi‏ @aribindi 12 Apr 2020
      Replying to @DrLesterColl @gorskon @NPR

      https://irb.research.chop.edu/quality-improvement-vs-research … Other IRBs would seem to disagree with you. Yes, he would need approval for a retrospective review before he published the data. Most IRBs wouldn't require a prospective one.

      2 replies 0 retweets 3 likes
    5. Nataniel Lester-Coll, MD‏Verified account @DrLesterColl 12 Apr 2020
      Replying to @aribindi @gorskon @NPR

      Thank you for providing a link which very clearly deliniates the difference between QI and research. Giving a drug to human subjects for the purpose of “knowledge-seeking” intended to “answer a question or test a hypothesis" that "may put subjects at risk” is…research, not QI.pic.twitter.com/ohhv7FTs7D

      1 reply 0 retweets 12 likes
    6. Vamsi Aribindi‏ @aribindi 12 Apr 2020
      Replying to @DrLesterColl @gorskon @NPR

      If you read one of the articles posted earlier, Dr. Robin Armstrong states he is doing what he would want done "for his mother or father". Which implies rather strongly he is giving the drug for the purpose of treating his patients, with answering a research question secondary.

      4 replies 0 retweets 1 like
    7. This Tweet is unavailable.
    8. Vamsi Aribindi‏ @aribindi 12 Apr 2020
      Replying to @HawkguyClint @DrLesterColl and

      ? I'm part of a project right now to improve informed consent in pediatric surgical populations. Our plan was to use a new video, wrist band, and other procedures to improve communication of a surgery's details to parents.

      1 reply 0 retweets 0 likes
    9. Vamsi Aribindi‏ @aribindi 12 Apr 2020
      Replying to @aribindi @HawkguyClint and

      For 6 weeks prior to implementation, we collected data on how much parents understood the surgery. Then we intervened, and tried to collect data for 6 weeks after (COVID made that a problem).

      1 reply 0 retweets 0 likes
    10. Vamsi Aribindi‏ @aribindi 12 Apr 2020
      Replying to @aribindi @HawkguyClint and

      The IRB actually ruled at first that despite a clear intervention and data collection, what we were doing is not human subjects research. We later got another approval once we started to write up the results.

      2 replies 0 retweets 0 likes
      David Gorski, MD, PhD‏Verified account @gorskon 12 Apr 2020
      Replying to @aribindi @HawkguyClint and

      That’s because it was about improving process based on best practices and evidence-based practice. How can you not see the difference between that and giving patients an unproven drug, some without proper informed consent? SMH.🙄🤦🏻‍♂️

      9:34 AM - 12 Apr 2020
      • 2 Likes
      • Nataniel Lester-Coll, MD Barbie Siesta
      2 replies 0 retweets 2 likes
        1. David Gorski, MD, PhD‏Verified account @gorskon 12 Apr 2020
          Replying to @gorskon @aribindi and

          I know what I’m talking about, too. I served for three years as associate director of a statewide QI initiative for breast cancer care.

          1 reply 0 retweets 3 likes
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        2. Vamsi Aribindi‏ @aribindi 12 Apr 2020
          Replying to @gorskon @HawkguyClint and

          Because it's fundamentally no different. I don't want to defend a crazy Trump supporter who's practicing bad medicine. But I believe the same core principles that give him the right to do what he's doing are what underly a large part of our clinical practice.

          1 reply 0 retweets 0 likes
        3. Vamsi Aribindi‏ @aribindi 12 Apr 2020
          Replying to @aribindi @gorskon and

          The right to make decisions based on incomplete evidence and without clear guidelines, because no guideline covers every situation. The right to decide what practices to adopt and what drugs to prescribe for your patients, even if no RCT level evidence is available.

          1 reply 0 retweets 1 like
        4. Show replies

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