FatherOf4, husband, MedEdDreamer, GIMproud, HMproud, love a good puzzle (of any kind)
Omaha, NE
Joined January 2023
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#HospitalMedicine 101
What is difference between "failure to thrive" , "frailty" , and "malnutrition" in adults?
Follow the thread 👇for some🧠food
@BrownJHM
Acute dizziness is the most classic high entropy problem space, wrought with semantic noise.
Ironically, we’d be better at managing *uncertainty* if this term had a bit more precision.
Emergent ⏰ vs entropic uncertainty😵💫 is a start for undifferentiated problems.
6/6
Notice prognostic reasoning will guide how long it’s safe to wait.
If stable, time is a luxury ⏰ but mostly for emergent complexity
🔑 knowing when waiting won’t improve diagnostic yield is an advanced skill
As it requires recognition of high entropy problem spaces
5/6
Both types of complexity demand management amidst uncertainty.
1️⃣ as Emergent uncertainty unfolds, no addt’l *dx* action is required (eg partial SBO on CT, NG tube placed)
2️⃣ High entropy demands *dx* action if you want a clearer picture (eg endometriosis eluding MRI)
4/6
1️⃣ Emergent uncertainty resolves w/ recursive assessmts (eg serial abd exams). If pt is stable, the pixels become more clear with a tincture of time
2️⃣ Entropy may only resolve w/ advanced testing, requiring a targeted approach to demystify the unknown (eg laparoscopy)
3/6
1️⃣ Emergent uncertainty is the data desert ready to declare itself. It will be differentiated, just not yet. Info requires patience - it’s coming ⏰
2️⃣ Entropy is data rich but bc key features overlap, they resist dx classification, obscuring the possibilities 😵💫
2/6
There are 2 types of ‘undifferentiated’ in clinical unknowns
1️⃣ Emergent uncertainty ⏰
2️⃣ High entropy 😵💫
The first will declare itself, the second may not without a targeted approach 🧵
1/6
#Uncertainty
#DxEx
#MedTwitter
#EBM #Guidelines
What is the bigger harm in translating #evidence to practice in medicine?
50%
Under application
50%
Over application
2 votes • Final results
50%
Under application
50%
Over application
2 votes • Final results
Cory Rohlfsen retweeted
LIBERATE-D results! 🥳 @Research_Inter
In hospitalized patients with AKI, prn > scheduled dialysis for renal recovery
A Conservative Dialysis Strategy and Kidney Function Recovery in Dialysis-Requiring Acute Kidney Injury jamanetwork.com/journals/jam…
Cory Rohlfsen retweeted
it’s MUCH harder to become a better
communicator than it is to learn
information; and yet most doctors
spend a LOT more time on learning info
and far less on better communication.
you need BOTH to be excellent.
#MedTwitter #PathTwitter
Cory Rohlfsen retweeted
Which gives you a greater sense of pride? standing on the podium at a meeting presenting new data or sitting in the audience watching a mentee standing on the podium presenting new data?
#MedTwitter
Amlodipine & Gaba-ergic rx are 2 💊 routinely prescribed by unsuspecting docs leading to more #entropy than any other 💊 on the formulary.
Kudos to the docs who halt cascades in their tracks by considering this risk up front.
What other meds are ‘dirty drugs?’
After a wonderful weekend at #ICRE2025 I watched this movie which I found bizarre at first.
Then I got to ch 5 of @sapinker book ‘Common Knowledge’ & realized it answers how many levels of mentalizing are required until the common bond of #Friendship becomes #commonknowledge.
#MedTwitter
The way doctors atone for their mistakes is to try to learn something from them.
And to teach others so the mistake is not repeated.
This is my attempt to make something positive from an otherwise horrible outcome👇
open.substack.com/pub/sensib…
‘Multi degree lanyard wearing professionals enjoy a frictionless privilege’
Let’s get back to #Civildiscourse
#ICRE2025
This diagnostic reasoning question has been asked many times over the past 30 years but #AI is a game changer in #MedEd
Come find out how and why at 11:30am today to learn more about novel quantitative signatures of #diagnosticexcellence ; Rm 205B
#DxEx
Would love to see some wise and friendly faces! Lots of potential in this stigmatized space.
@Midwest_MedPeds @VipsMDMEd @CincyIM @ConorDassMD @javeedsukhera @Mud_Fud