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Jonathan Philp Lee’s fatter and less attractive cousin Mrs C Rupert wilson Bekki Hills Balazs (🦋cannulaservice.hibalazs.net) Liz Peecock Ash Paul @medicalmodelwithabriochebun Eileen Molloy Mary Springchicken Dr Steve Taylor Phil Steart 🇺🇦 🏴󠁧󠁢󠁳󠁣󠁴󠁿 ⚽️ Dr Shivam Sharma Dr Sandeep Bansal Burnt Toast Meg 👨‍👩‍👦‍👦👩🏻‍⚕️🇮🇳🇬🇧🏏🎥(BlueSky Name👇) Richard Fitzgerald 💙 🦀 Charlotte Jay Dr Rachel Clarke Caesarnotsalad Eilidh 🦀 Jo Franklin DoctorsVote Adam Skeen ExplosiveEnema Erin 𝗗𝗿 𝗔𝗷𝗮𝘆 𝗠 𝗩𝗲𝗿𝗺𝗮 platinumpizza™ GMCharlatan 🦀 Ann-Marie Opone 💙💖💛 Erin Gourley Dr Peter Dilworth 💙 #Woke #GTTO 😷 Blue Tick👀 George Reid The Med Reg permanentlyexhaustedpigeon NHS2Tier Dr Ross Nieuwoudt Parody RCGP - Not a Doctor or PA Dr David Nicholl The NHS Whistleblower Wise Owl PS TIVA Tim kc isc Bethany Kelly, DSN, QN 🇺🇦 Dr Kevin O'Kane 🇺🇦 Pill Counter Kel 😷 🦇 🦎 Dru if you’re going to run a system red hot with hospitals that are too small with completely inadequate bed numbers, poor flow and weak IT systems then your staff have to be trained to within an inch of their life. You can’t also manage the risk of light touch training.

Observing many researchers using the same data and hypothesis reveals a hidden universe of uncertainty pnas.org/doi/10.1073/pn… via Nate Breznau et al

Brian Haynes, PJ Devereux and I present the rationale behind the third key principle of #EBM: evidence alone never is sufficient for decisions, #patient values and preferences always crucial. Or as this #BMJ article put it, evidence doesn’t make decisions, people do.

Interesting snapshot of growth in clinical AI publications in China NEJM AI (TLDR rapid growth but lagging in the highest visibility journals) and in which institutions.

I am very glad to see this. China is looking to create a new primary care system with 500K new GPs by 2030. Training this workforce in patient-centred care is impossible without AI, which needs to be patient-driven and improvisatory. KK Cheng Charlotte Blease, PhD David Fraile Navarro

Articulate Medical Intelligence Explorer (AMIE) from Google and Google DeepMind that specializes in diagnostic medical reasoning and clinical conversations … it’s designed to conduct multi-turn, longitudinal dialogues w/ HCPs, simulating real-world patient consultations.

What's happening? asks this box. A good question. Such a comfort that the US Constitution has all those checks and balances.

Thread-leaved water-crowfoot 🤍💚💛 I love its submerged hanks of soft weed, and bright flowers above. It is a form of aquatic buttercup and a good sign of the health of a river 💙💚🤍

Pharma capture means that drugs which slightly extend the course of old age dementia can be portrayed as a positive good. In what way? I am honestly baffled by this. NICE has made the right decision.

Yup, spot on Richard (RichardLehman1 ! Well done to NICE for taking this sensible decision! All those pelting stones at NICE should follow Robert Howard to understand the true value of these drugs NHS England Welsh Government Health and Social Care Office of the Chief Executive NHSScotland Health and Social Care Northern Ireland

"I am in blood stepped in so far that, should I wade no more, returning were as tedious as go o'er." I wonder in what part of the world the next Macbeth should be set.

In clinical & research circles, and in my ageing brain, thinking about placebos is pretty rudimentary. Yet clearly your circle has done advanced work. Please send us reading suggestions Charlotte - and glad you enjoyed Krakow. Raj Mehta Andrew Papanikitas

Who can call these pauses? AI is a fact.

And there are some studies on how LLMs can actually help (including virtual patients for practice) -- THOSE are the areas we should focus on. Ultimately, we need a lot more research on this field -- because the stakes are VERY high (for medicine, and for ed more broadly).

This is a revised transcript of my inaugural lecture. The art of navigating uncertainty: norms, nature, and poetic wisdom tandfonline.com/doi/full/10.10…

It is inevitable and might be as profound as the cognitive impact of writing. Humankind lost a lot when bards no longer sang 10,000 line poems from memory to fireside gatherings. And then there was printing... And radio. But on we go.

Richard Lehman Raj Mehta Andrew Papanikitas Yes but as you also realize... it's twitter. Issue remains: placebos play a key epistemic role, yet are variously interpreted. They are supposed to be measuring instruments but are imperfectly devised with downstream consequences for EBM and patients

And there are plenty who despite excellent palliative care die in pain and/or distress both in hospitals and hospices. Death is a 24 hour business. Palliative care isn’t… (for good reasons and bad..)