Kidney Notes

The above figure compares long term survival in a subgroup of...

2012-05-30T20:02:00.001-04:00

The above figure compares long term survival in a subgroup of a trial that was published in Circulation in 1980. This was a randomized controlled trial of just over 1000 patients with known cardiovascular disease who were treated with medical therapy alone. The patients were randomized to two treatment groups and were followed for 5 years. In the primary analysis, there was no statistically significant difference in survival between the two groups. However, a subgroup analysis that compared only patients with 3-vessel disease and LV dysfunction at baseline (~200 patients in each group) found that the outcomes were significantly better in group B (p=0.025).

So what was this treatment that was so successful in reducing mortality in group B? There was no treatment. The patients were randomized to the two groups and then simply followed with usual therapy. This study was designed to show the danger of subgroup analyses and why they should be taken with a grain of salt. When the authors looked deeper into the data, it became apparent that the patients in group B were not as sick as those in group A and that the survival difference was non-significant in a multivariable analysis. However, when they further stratified the patients by only including those with no history of congestive heart failure, the difference between the groups became more significant and remained significant in the multivariable analysis (p=0.01).

(Via the Renal Fellow Network.)

David Newman refers to this as a “satanic secondary endpoint”.

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"Now, I have a great universal answer whenever anyone asks me how to make great coffee: Get a burr..."

2012-05-30T11:55:00.003-04:00

“Now, I have a great universal answer whenever anyone asks me how to make great coffee: Get a burr grinder, get an AeroPress, and subscribe to Tonx.”

- Marco

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"‘If you’re under a tree and something drops on your head, don’t look up with your..."

2012-05-30T11:55:00.001-04:00

“‘If you’re under a tree and something drops on your head, don’t look up with your mouth open.’ — C.”

- @joshuaschwimmer

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"I think our daughter’s made-up language ‘pantusois’ is actually the proto-language..."

2012-05-27T01:47:00.001-04:00

““I think our daughter’s made-up language ‘pantusois’ is actually the proto-language of Basque.””

- @joshuaschwimmer

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Central Park Americana Lens, DC Film, No Flash, Taken with...

2012-05-26T17:32:00.000-04:00

Central Park

Americana Lens, DC Film, No Flash, Taken with Hipstamatic

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jayparkinsonmd: It’s a little wonky, but here is the state of...

2012-05-24T16:28:00.000-04:00

jayparkinsonmd:

It’s a little wonky, but here is the state of primary care in America. From the WSJ.

Dr. Hammond’s practice roughly broke even last year, with a profit of $29,261. The practice distributes its profit as bonuses to staff. Dr. Hammond says the practice operates on such a thin cash cushion that if a doctor or one of Westminster’s two physician assistants were gone for more than two months, it wouldn’t be able to make its payroll. Also, the clinic hasn’t been able to pay off around $86,000 in long-term debt, though it didn’t borrow to pay for its recent upgrades, including around $100,000 it spent to install the electronic medical records. “Any day, the bottom can drop out,” he says. “We could be bankrupt next month.”

Last year, the clinic took in $2,115,101 in total revenue and barely inched into the black. In 2010, the practice lost money.

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"A first for me: yesterday I sat down next to a patient of mine on the bus. We double-taked, laughed,..."

2012-05-23T15:34:00.001-04:00

“A first for me: yesterday I sat down next to a patient of mine on the bus. We double-taked, laughed, & I snipped off his hospital wristband.”

- @joshuaschwimmer

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Robert F. Kennedy Bridge (2) Roboto Glitter Lens, BlacKeys B+W...

2012-05-22T22:47:00.005-04:00

Robert F. Kennedy Bridge (2)

Roboto Glitter Lens, BlacKeys B+W Film, No Flash, Taken with Hipstamatic

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Robert F. Kennedy Bridge, NYC Americana Lens, DC Film, No Flash,...

2012-05-22T22:47:00.003-04:00

Robert F. Kennedy Bridge, NYC

Americana Lens, DC Film, No Flash, Taken with Hipstamatic

Posted on infosnack.

"The best advice often sounds totally obvious."

2012-05-22T22:47:00.001-04:00

“The best advice often sounds totally obvious.”

- @joshuaschwimmer

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Currently reading Design Is a Job.

2012-05-22T14:32:00.001-04:00

Currently reading Design Is a Job.

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Surreal shadows from the #solareclipse ekai, instagr.am

2012-05-21T21:38:00.000-04:00

Surreal shadows from the #solareclipse
ekai, instagr.am

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Sushipedia completes the “reference” folder. (Taken...

2012-05-21T13:29:00.001-04:00

Sushipedia completes the “reference” folder. (Taken with instagram)

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Ukrainian Institute Buckhorst H1 Lens, Float Film, No Flash,...

2012-05-20T12:47:00.001-04:00

Ukrainian Institute

Buckhorst H1 Lens, Float Film, No Flash, Taken with Hipstamatic

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5th Avenue, Dusk Helga Viking Lens, Blanko Freedom13 Film, No...

2012-05-20T04:33:00.000-04:00

5th Avenue, Dusk

Helga Viking Lens, Blanko Freedom13 Film, No Flash, Taken with Hipstamatic

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Two Hundred Years of Surgery

2012-05-19T14:21:00.003-04:00

Two Hundred Years of Surgery:

It would take a little while for surgeons to discover that the use of anesthesia allowed them time to be meticulous. Despite the advantages of anesthesia, Liston, like many other surgeons, proceeded in his usual lightning-quick and bloody way. Spectators in the operating-theater gallery would still get out their pocket watches to time him. The butler’s operation, for instance, took an astonishing 25 seconds from incision to wound closure. (Liston operated so fast that he once accidentally amputated an assistant’s fingers along with a patient’s leg, according to Hollingham. The patient and the assistant both died of sepsis, and a spectator reportedly died of shock, resulting in the only known procedure with a 300% mortality.)

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4 - 5 cups a day? That’s all? No problem.

2012-05-19T14:21:00.001-04:00

4 - 5 cups a day? That’s all? No problem.

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Empathy

2012-05-17T20:02:00.003-04:00

Empathy:

Understanding that people don’t buy things because of their demographics — nobody buys something because they’re a 25-30 year old white male with a college degree — but rather, because they go about living their life and some situation arises in which they need to solve a problem… and so they “hire” a product to do the job. This is a big “ah ha” to many folks when they first hear it; but when you really boil it down, the true power of this is in giving people in business a frame with which to exercise empathy. In fact, both Akio Morita of Sony and Steve Jobs were famous for never commissioning market research — instead, they’d just walk around the world watching what people did. They’d put themselves in the shoes of their customers.

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Depleting your iPhone’s battery midday is one measure of...

2012-05-17T20:02:00.001-04:00

Depleting your iPhone’s battery midday is one measure of productivity, I guess. (Taken with instagram)

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The World Aeropress Championship

2012-05-15T10:18:00.001-04:00

Marco Arment:

The AeroPress recipe (really) at the World AeroPress Championship (yes, really) that took home the Gold AeroPress (these are all real things) this year is remarkably simple.

The World Aeropress Championship Blog:

Charlene’s Method

wet the filter thoroughly

put it on the Aeropress filter

18.30 grams of coffee, grind coarsely

use the normal, non-inverted method

85°C, 250 grams water

about 40 grams of blooming water ( +/- 30 sec)

then poor the rest of the water and press, not pressing all the way

then serve. simple!

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"Physicians are specifically trained to look for problems. The purpose of diagnosis is to identify..."

2012-05-14T18:20:00.001-04:00

“Physicians are specifically trained to look for problems. The purpose of diagnosis is to identify what is wrong with a patient’s health. As a consequence, we spend a lot of time thinking and talking about what is ill, incorrect, out of order, defective. Our worldview can shift so that we overlook what is healthy, robust, flourishing, hopeful.”

- Informal Curriculum: Lesson 5.

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Ukrainian institute Adler 9009 Lens, Kodot XGrizzled Film, No...

2012-05-12T00:48:00.001-04:00

Ukrainian institute

Adler 9009 Lens, Kodot XGrizzled Film, No Flash, Taken with Hipstamatic

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That head-tilt thing when you spot something puzzling? That thing that’s so universal that...

2012-05-11T08:32:00.001-04:00

That head-tilt thing when you spot something puzzling? That thing that’s so universal that both humans and dogs do it? I love that.

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Church ladder

2012-05-10T19:17:00.001-04:00

Church ladder

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Password size does matter

2012-05-10T17:33:00.001-04:00

Password size does matter:

Character-for-character, password length is more important for security than complexity. Requiring complexity but allowing passwords to remain short makes passwords more vulnerable to attack than simply requiring easier-to-remember, longer passwords.

For everyone using six- to nine-character passwords with “complexity,” I appreciate it. I get paid to break in to systems for a living, and you make my job easier.

Posted on infosnack.