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usnehal's profile
Umbereen S. Nehal, MD, MPH
Umbereen S. Nehal, MD, MPH
Umbereen S. Nehal, MD, MPH
@usnehal

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Umbereen S. Nehal, MD, MPH

@usnehal

MIT Sloan fellow, fmr Chief Med Officer & Medicaid med director, Top Voice 4x, data nerd, activist, MedEd, humanist, contrarian,Tweets personal, RT🚫endorsement

Cambridge, MA
nehalgroup.com
Joined May 2009

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    1. Timothy Caulfield‏Verified account @CaulfieldTim 16 May 2018

      No surprise. IVF & acupuncture? Doesn't work (but how could it?): https://jamanetwork.com/journals/jama/article-abstract/2681194?redirect=true&utm_source=STAT+Newsletters&utm_campaign=d212c12457-MR&utm_medium=email&utm_term=0_8cab1d7961-d212c12457-116322369 … "#acupuncture vs sham acupuncture at the time of ovarian stimulation & embryo transfer resulted in no significant difference in live birth rates." @gorskon @EdzardErnst @skepticpedi

      6 replies 20 retweets 35 likes
    2. Umbereen S. Nehal, MD, MPH‏ @usnehal 16 May 2018
      Replying to @CaulfieldTim @gorskon @EdzardErnst

      It’s important to be consistent in how we talk about studies. No single study is ever a definitive. Communicating one study as truth is how we got vaccine phobia. That regimen of acupuncture did not work for that outcome in that population. Null hypothesis not rejected.

      1 reply 0 retweets 4 likes
    3. Umbereen S. Nehal, MD, MPH‏ @usnehal 16 May 2018
      Replying to @usnehal @CaulfieldTim and

      IVF itself is a lot of hocus pocus. There are constant individualized changes to treatment regimens, trial of error, “n of 1” interpretation of past cycles in the individual. Little is evidence-based. Let’s not use different standards for trust in IVF vs acupuncture.

      2 replies 0 retweets 1 like
    4. Timothy Caulfield‏Verified account @CaulfieldTim 16 May 2018
      Replying to @usnehal @gorskon @EdzardErnst

      Well, let's mix in scientific plausibility (life force energy flowing through meridians) and all the other studies that suggest acupuncture largely placebo theatre... (another recent eg http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD013010/full …), skepticism seems justified. And onus on those claiming benefit...

      1 reply 1 retweet 12 likes
    5. David Brooks MD‏ @drdavebrooks 16 May 2018
      Replying to @CaulfieldTim @EdzardErnst and

      Exactly right ! Biological plausibility based on current state of scientific knowledge not ancient “wisdom” or pseudoscience postulates. Think of the $ wasted on implausible Zamboni Rx for MS

      1 reply 0 retweets 3 likes
      Umbereen S. Nehal, MD, MPH‏ @usnehal 16 May 2018
      Replying to @drdavebrooks @CaulfieldTim and

      Well, to be devil’s advocate, there was a time that the world being round or landing on the moon seemed “implausible.” In an age of loss of faith in science, valid concerns about peer-review or industry influence or profit motive, scientists need to cultivate more humility.

      9:03 AM - 16 May 2018
      • 1 Retweet
      • 3 Likes
      • AnnBlairKennedy DrPH Marina Gamba Peer Review Bot
      7 replies 1 retweet 3 likes
        1. New conversation
        2. Timothy Caulfield‏Verified account @CaulfieldTim 16 May 2018
          Replying to @usnehal @drdavebrooks and

          There was a time when we thought there was a life force energy running through meridians, there was four humours, that earth was the centre of the universe, etc... So, yes, knowledge moves forward. Let's not go backwards.

          1 reply 0 retweets 12 likes
        3. Timothy Caulfield‏Verified account @CaulfieldTim 16 May 2018
          Replying to @CaulfieldTim @usnehal and

          Agree, there are many problems with knowledge production process (holding a workshop on point tomorrow!). What is needed is better science, trustworthy/independent sources of information, etc., not an embrace of more questionable therapies.

          1 reply 0 retweets 10 likes
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        1. Umbereen S. Nehal, MD, MPH‏ @usnehal 16 May 2018
          Replying to @usnehal @drdavebrooks and

          Thing is, the outcome of live birth is a very ambitious one in the first place. LBW, VLBW, preterm labor, etc.... so many outcomes to measure. Live birth is just one of many important birth outcomes. If acupuncture is someone’s form of self care.. *shrug*

          0 replies 0 retweets 0 likes
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        1. Umbereen S. Nehal, MD, MPH‏ @usnehal 16 May 2018
          Replying to @usnehal @drdavebrooks and

          The basis of acupuncture does not make sense to me. I still get it. I make my grandmom’s ginger tea when I am sick, my self TLC. I also never say the “Q” word when working a shift. Several women I know froze their ova, despite lack of evidence it improves live birth.

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        2. Umbereen S. Nehal, MD, MPH‏ @usnehal 16 May 2018
          Replying to @usnehal @drdavebrooks and

          One well proven mediator of health outcomes is stress. We live in a stressed out world. We also know loneliness shortens lives and kills. Maybe acupuncture helps people go somewhere they feel “cared for”? Maybe it connects them to community or a positive memory. *shrug*

          1 reply 0 retweets 0 likes
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        2. Umbereen S. Nehal, MD, MPH‏ @usnehal 16 May 2018

          Evidence is always evolving. We know a fraction of what is true. Instruments/measurement are limited by our own limitations or current knowledge. And much of what we consider true now may or may not remain true. So, let’s just stick to not rejecting the null hypothesis.

          2 replies 0 retweets 0 likes
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        2. Alan Levinovitz‏Verified account @AlanLevinovitz 16 May 2018
          Replying to @usnehal @drdavebrooks and

          Humility is extremely important, and I share your concerns about financial COIs in medical science. But that doesn't mean we can't identify characteristics of interventions that make them implausible. Unlike claiming the earth is round, claims that a single intervention 1/2

          1 reply 3 retweets 7 likes
        3. Alan Levinovitz‏Verified account @AlanLevinovitz 16 May 2018
          Replying to @AlanLevinovitz @usnehal and

          can address a wide variety of ailments with totally different etiologies have existed for centuries, and characterize something as a panacea. We have reason to be suspicious of panacea claims--like COIs!--in a way that we don't with claims about the earth being round. 2/2

          2 replies 1 retweet 13 likes
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