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grepmeded's profile
GrepMed
GrepMed
GrepMed
@grepmeded

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GrepMed

@grepmeded

Image Based Medical Reference: Sharing crowd-sourced checklists, algorithms, decision aids, #PhysicalExam #POCUS, and more - by @GeraldMDMD + @k00bideh

Sacramento, CA
grepmed.com
Joined March 2018

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    1. GrepMed‏ @grepmeded Apr 9
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      Anyone listen to this @StanfordMed grand rounds? Can someone explain to my non-Stanford brain how they can claim their PCR has ~96% sensitivity based on concordance/repeatability when everyone else is reporting ~70% sensitivity for their tests? https://youtu.be/Xm76adKULY4?t=2540 … (~42:0)

      1 reply 3 retweets 6 likes
    2. Eric Strong‏ @DrEricStrong Apr 10
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      Replying to @grepmeded

      Here is the explanation from the Stanford pathology lab.pic.twitter.com/VVEOOwhaxp

      1 reply 3 retweets 4 likes
    3. GrepMed‏ @grepmeded Apr 10
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      Replying to @DrEricStrong

      🙏 was sent this before- still doesn’t make sense to me. Even if the laboratory assay is v sensitive it seems the clinical test would be far less sensitive because of sampling/handling errors. This seems it could give clinicians a false sense of security if untrue.

      1 reply 0 retweets 1 like
    4. Lumos SK‏ @SkLumos Apr 10
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      Replying to @grepmeded @DrEricStrong

      The higher false negative rates seems to be a result of bad sample collection rather than reflecting the true sensitivity of the test.

      1 reply 0 retweets 1 like
    5. GrepMed‏ @grepmeded Apr 10
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      Replying to @SkLumos @DrEricStrong

      Right but they're saying clinical sensitivity (vs lab sensitivity) of the test which is what I see as an ordering clinician, which I would interpret to include sampling error... no other lab is claiming 96%sn/100%sp which seems almost absurd to take at face value.. 🤷

      1 reply 0 retweets 1 like
    6. Eric Strong‏ @DrEricStrong Apr 10
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      Replying to @grepmeded @SkLumos

      I agree with your skepticism. In addition to the sampling error issue, the whole idea of using a test repeated at same later point as its own gold standard has always seemed problematic to me.

      2 replies 0 retweets 3 likes
    7. James Barnes‏ @JamesBarnesMD Apr 10
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      Replying to @DrEricStrong @grepmeded @SkLumos

      Agree, this can only determine dependency. It is not adequate gold standard. 96% concordance could be useful if more information was provided (?insight into utility of repeat test). Sampling error as source of low sensitivity is purely hypothetical without further experiments.

      1 reply 0 retweets 2 likes
    8. GrepMed‏ @grepmeded Apr 16
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      Replying to @JamesBarnesMD @DrEricStrong @SkLumos

      Another week, another @StanfordMed grand rounds (~4m mark) claiming their PCR tests have 96% sensitivity 100% sp, in contrast to every other lab in the country (~70-80%). Seems like a dangerous false reassurance to healthcare workers. 🤷‍♂️https://youtu.be/M3h10h4npbU 

      2 replies 0 retweets 1 like
    9. Eric Strong‏ @DrEricStrong Apr 16
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      Replying to @grepmeded @JamesBarnesMD @SkLumos

      I am personally practicing as if our test has the same sensitivity as everywhere else. The downside to false negatives is too great to do otherwise.

      1 reply 0 retweets 3 likes
    10. James Barnes‏ @JamesBarnesMD Apr 16
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      Replying to @DrEricStrong @grepmeded @SkLumos

      At Santa Clara Valley we are using Stanford’s test also. The same document you had posted was circulated to some degree to us and O’Connor and I fear the effect it could potentially have on doctors decision-making since it seems this info is it’s way around the area

      1 reply 0 retweets 2 likes
      GrepMed‏ @grepmeded Apr 17
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      Replying to @JamesBarnesMD @DrEricStrong @SkLumos

      As the letter was sent to nursing staff I worry they will let their guard down with these reassurances, esp since they spend so much more time at the bedside. 🤷‍♂️

      9:50 AM - 17 Apr 2020
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