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s_r_constantin's profile
Sarah Constantin
Sarah Constantin
Sarah Constantin
@s_r_constantin

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Sarah Constantin

@s_r_constantin

Math/ML/data-science person now working on solving aging...and helping with COVID19?! Founder, LRI and Daphnia Labs. Married to @oscredwin

Be
srconstantin.posthaven.com
Joined February 2019

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    1. Sarah Constantin‏ @s_r_constantin Mar 11
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      Sarah Constantin Retweeted Stephen Pimentel

      It’s quite common for a “standard” medical treatment to work no better than older treatments or none at all.https://twitter.com/StephenPiment/status/1237598764023476225 …

      Sarah Constantin added,

      Stephen Pimentel @StephenPiment
      When Evidence Says No, But Doctors Say Yes https://www.propublica.org/article/when-evidence-says-no-but-doctors-say-yes …
      2 replies 0 retweets 19 likes
      Show this thread
    2. Sarah Constantin‏ @s_r_constantin Mar 11
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      The article treats this as a case of inadequate regulation — that the FDA is too willing to approve ineffective treatments, and that new liberalizing reforms will allow more ineffective treatments to market.

      1 reply 0 retweets 7 likes
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    3. Sarah Constantin‏ @s_r_constantin Mar 11
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      You could just as easily interpret it the opposite way: Kefauver-Harris (the law that requires drugs demonstrate efficacy as well as safety) doesn’t work, so it’s raising the price of new treatments for no public benefit.

      1 reply 0 retweets 12 likes
      Show this thread
    4. Sarah Constantin‏ @s_r_constantin Mar 11
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      I also disagree with framing this as a case of stubborn or avaricious doctors deliberately refusing to do what’s best for patients. I think it’s far more common that medical professionals (and the rest of us!) assume “standard & officially recommended” means “evidence-based.”

      1 reply 0 retweets 12 likes
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    5. Sarah Constantin‏ @s_r_constantin Mar 11
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      I know firsthand, from meeting my father’s surgeon, that when you’re in a life-or-death situation, the trappings of authority are *very* psychologically compelling and it’s hard to ask tough questions of the guy in the white coat. “This is standard.” “Oh ok.”

      1 reply 0 retweets 13 likes
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    6. Sarah Constantin‏ @s_r_constantin Mar 11
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      And there’s the usual bias (not just by doctors but by the rest of us) towards believing medical treatment can do more than it can. The narrative is “when you’re sick, a doctor can make you well.” We want to be fussed over and fixed; we’re disappointed by “go home and rest.”

      1 reply 0 retweets 5 likes
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    7. Sarah Constantin‏ @s_r_constantin Mar 11
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      When a TV show like House MD wants to show that a doctor is a brave maverick, they show him breaking the rules to give patients risky treatments — never breaking the rules to leave patients alone.

      2 replies 2 retweets 13 likes
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    8. Sarah Constantin‏ @s_r_constantin Mar 11
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      It takes effort to give fair consideration to “what if this *doesn’t* work? How does this procedure or drug compare to *doing nothing*?” When the evidence is ambiguous, err on the side of LESS treatment.

      1 reply 0 retweets 4 likes
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    9. Sarah Constantin‏ @s_r_constantin Mar 11
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      I sometimes fantasize that to really fix this problem we’d need more opportunities to get caring personal attention *with no* drugs or surgeries.

      2 replies 1 retweet 10 likes
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      Sarah Constantin‏ @s_r_constantin Mar 11
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      Like, if someone is sick with something there’s no effective treatment for, they should still get to rest up in a special healing environment and temporarily have other people take care of their needs.

      8:30 AM - 11 Mar 2020
      • 11 Likes
      • Raymond Visakan Veerasamy Fork From Home Watson Ladd smug bitch dog rat Jason Crawford selentelechia ian hines Made in Cosmos 💫 Maria Górska-Piszek
      1 reply 0 retweets 11 likes
        1. New conversation
        2. Sarah Constantin‏ @s_r_constantin Mar 11
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          I loved giving birth in a hospital — because there were nice nurses around who encouraged me & helped me to the potty when I was too weak to stand. I fucking *loved* having the friendly company and the reassuring structure of a familiar (medical) culture.

          1 reply 0 retweets 8 likes
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        3. Sarah Constantin‏ @s_r_constantin Mar 11
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          But you know what? It cost me thousands of dollars, even with health insurance. And I had a perfectly healthy birth that didn’t need much medical intervention. Why am I paying thousands of dollars for, mostly, *company*?

          1 reply 0 retweets 9 likes
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        4. Sarah Constantin‏ @s_r_constantin Mar 11
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          (Yeah, it’s a bit less risky to have a hospital birth than a home birth, and it makes a big difference in an emergency. But in most cases, you’re fine either way.)

          1 reply 0 retweets 4 likes
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        5. Sarah Constantin‏ @s_r_constantin Mar 11
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          Doctors and nurses should not be the only professional be-nice-to-you-when-you’re-sick-ers. Medical hospitals should not be the only place you can go when you need caretaking.

          4 replies 0 retweets 11 likes
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        6. Sarah Constantin‏ @s_r_constantin Mar 11
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          Before they could treat TB with antibiotics, they took sick people to sanitariums. Basically no effective medicine went on there, just rest, care, a change of scene, and natural beauty. This fundamentally makes sense to me, given a disease medicine doesn’t know how to treat yet.

          2 replies 0 retweets 14 likes
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        7. Sarah Constantin‏ @s_r_constantin Mar 11
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          (Plus it’s good for public health! Keeps sick people from infecting others!)

          1 reply 0 retweets 6 likes
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        8. Sarah Constantin‏ @s_r_constantin Mar 11
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          Immune function affects how well you recover from *a lot* of diseases; and it responds to stress. “Be nice to sick people and make their lives easier” is not pseudoscience; it makes a measurable difference.

          1 reply 4 retweets 21 likes
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        9. Sarah Constantin‏ @s_r_constantin Mar 11
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          Obligatory topical tie-in: hospitals are gonna be overwhelmed with COVID19. Some people who get the disease need specialized equipment you can only get in an ICU to survive. Far more people are just gonna be, y’know, sick. Laid up, contagious, unable to get much done.

          2 replies 0 retweets 7 likes
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        10. Sarah Constantin‏ @s_r_constantin Mar 11
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          We have *terrible* infrastructure as a society for dealing with “a lot of people need to rest up.” They’ll be clogging hospitals, they’ll be trying to push through and go to work, etc.

          1 reply 0 retweets 8 likes
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        11. Sarah Constantin‏ @s_r_constantin Mar 11
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          It’s a measure of how good or bad we are at translating wealth into leisure, to see how well or poorly we can adapt to “lots of people are sick in bed.”

          1 reply 0 retweets 10 likes
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        12. End of conversation

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