Jeffrey Wagner
@jeffwagmd.bsky.social
Hospital Doc. Bald by nature. Girl Dad. Espresso in the morning, a book at night, and maybe a bike ride in between
1/5 For a century, the Method of Lewis has defined bedside assessment of congestion 🫀. But IJV height is a unidimensional surrogate for a multidimensional hemodynamic problem. My new editorial in @jgim.bsky.social explores what comes next: VEXUS 🛰️. 🧵
New JAMA review attempts to equate pulmonary congestion with systemic congestion ("volume overload") This is sloppy & often wrong Pts w/ LV failure often have pulmonary congestion w/o systemic congestion Pts w/ RV failure usually have systemic congestion w/ dry lungs CVP isn't PCWP #EMIMCC
🧵 1/5. Raise your hand if you’ve ever stared at a patient’s neck with a penlight, pretending to see the JVP while your attending nodded enthusiastically. 🙋♂️🔦 We’ve all been there. But in the POCUS era, we can do better than "guessing at shadows." My latest editorial in JGIM: #MedSky #POCUS #MedEd
From Flashlights to Probes: Do You See the JVP? - Journal of General Internal Medicine
Journal of General Internal Medicine -
link.springer.com
Today @TheNewYorker released our short documentary “Rovina’s Choice” online. It traces the ongoing effects of the sudden shutdown of US foreign aid through the story of one mother in Kenya as she seeks to save her daughter from sickness and starvation. 🎥 1/ www.newyorker.com/culture/the-...
The Shutdown of U.S.A.I.D. Has Already Killed Hundreds of Thousands
The short documentary “Rovina’s Choice” tells the story of what goes when aid goes.
newyorker.com
Oh yeah, thanks for the reminder to get that done
Benjamin Mazer@mazer.us · 10mo agoFinancial conflicts of interest subtly influencing medical decision making? Sure. Cognitive biases and entrenched practices impacting patient care? Yes. Massive global conspiracy among doctors and scientists? Seems unlikely. We can’t even complete our annual compliance modules.
Fantastic work here! Very much agree with accounting for pretest of bacteremia given heterogeneity of sepsis as a clinical entity and that quality sepsis metrics play a role in diagnostic testing over clinical judgement more than it likely should. Bravo!
Karen Williams, PharmD@kswilliamsrx.medsky.social · 10mo agoThis was a fun project, for an un-fun reason (shortage). It was incredible to work with a massive interdisciplinary team to not only pull through the shortage, but to study 'how' we did it. #PharmSky #IDSky #MedSky
Prevalence statistics inform pre-test probability. These numbers are staggering and reflect my anecdotal experience. When considering interventions, Kaiser's PHASE program implements an effective intervention but prevention efforts will be key. www.amjmed.com/article/S000...
Joel Topf@kidneyboy.bsky.social · 11mo agoCan’t stop staring at the prevalence of hypertension among young people. www.ahajournals.org/doi/epub/10....
🧵 THREAD (1/10) 🏢💨 How effective are engineering controls at stopping respiratory infections indoors? Our new scoping review in @annalsofim.bsky.social examined nearly 100 years of research to find out. The results reveal both promise and concerning gaps... Link: www.acpjournals.org/doi/10.7326/...
Engineering Infection Controls to Reduce Indoor Transmission of Respiratory Infections: A Scoping Review: Annals of Internal Medicine: Vol 0, No 0
Background: Engineering infection controls include a wide range of interventions used indoors to reduce occupants’ exposure to respiratory pathogens. Purpose: To identify and describe primary studies ...
acpjournals.org
Of the writing I have done, this was the most personal and special. A dedication to all parents who are doctors, and of course my baby girl. Out today in @annalsofim.bsky.social, “Doctor Dad”. Thank you, Dr. Lacomb for the beautiful reading www.acpjournals.org/doi/10.7326/...
Doctor Dad | Annals of Internal Medicine
acpjournals.org
🤯 this is so life changing. Thank you!!
josh farkas 💊@pulmcrit.bsky.social · last yr.did a deeper dive into GFR calc for med dosing & created an IBCC chapter ended up being simpler than I thought TLDR: 🫘 CKD-EPI-Cr-2021 is best, but it yields indexed GFR (ml/min/1.73 m2) 🫘 If body surface area is unusual, convert to the non-indexed GFR x(BSA/1.73). emcrit.org/ibcc/gfr/ #EMIMCC
Would like to see an assessment of bias for the attorney alleging medical journals are biased Also, curious about the logic of pulling NIH funding for many researchers while spending tax dollars on…well, this 🤔
Trump-Allied Prosecutor Sends Letters to Medical Journals Alleging Bias
An interim U.S. attorney is demanding information about the selection of research articles and the role of N.I.H. Experts worry this will have a chilling effect on publications.
nytimes.com
Just attended a fascinating #MedicalGrandRounds on "The Role of Medical Journals (and why I should pay)." Here are key insights on why journals like @annalsofim.bsky.social remain crucial for medical professionals in 2025. #MedSky #MedEd 🧵1/8
Such a privilege to welcome the best in the business, Editor-in-Chief @annalsofim.bsky.social , Dr. Christine Laine to @cuanschutz.bsky.social 🏔️. Looking forward to @cudeptofmedicine.bsky.social Grand Rounds tomorrow! @marishaburden.bsky.social @cudivhospmed.bsky.social
Day 2 at ACP #IM2025. Plenary about New Studies in the @annalsofim.bsky.social. AI vs MD clinical making. Let's dive in. Check the link to read the full paper #AI #HealthcareAI #MedAI #newstudy 🧵1/4
Comparison of Initial Artificial Intelligence (AI) and Final Physician Recommendations in AI-Assisted Virtual Urgent Care Visits | Annals of Internal Medicine
Background: Whether artificial intelligence (AI) assistance is associated with quality of care is uncertain. Objective: To compare initial AI recommendations with final recommendations of physicians w...
acpjournals.org
In NOLA for #IM2025, Here are some highlights from the Session on Recent Articles You Should Know About from @annalsofim.bsky.social. We are talking salt substitutes, statins beyond age 70 for primary prevention, and Denosumab versus bisphosphonates in ESKD 🧵1/10
Loved this @journalgim.bsky.social piece from a colleague and mentor @cudeptofmedicine.bsky.social. BMI categorization, BNP level, and diagnostic accuracy for volume overload. Clinical decision-making through an EBM lens. #EBM #medsky
Journal of General Internal Medicine@journalgim.bsky.social · last yr.Can #BNP be used in patients with high #BMI? This #JGIM #ClinicalVignette explores how BMI affects BNP interpretation in heart failure and how interval likelihood ratios aid in nuanced test interpretation and clinical reasoning. rdcu.be/ebywW
🧵1/9 EBM nerds! Want to sharpen your critical appraisal skills? Gain confidence in both reading and interpreting the medical literature? Let me introduce you to the #AnnalsGuidetoJournalClub - where you can learn to appraise studies alongside editors from @annalsofim.bsky.social.
Annals of Internal Medicine: Annals Guide to Journal Club
acpjournals.org
🧵 Let's talk about Right Ventricular Dysfunction (RVD) in PE - when to look for it, how to find it, and what it means for patient care. A thread and a long overdue Part 3...
Fantastic thread on recent GLP1RA study out of the VA. Very encouraging. So much coming out in this space, though many systems based questions regarding patient access as well as cost effectiveness remain. Either way, big plug for advantages integrated EHR data to do this work
F. Perry Wilson, MD@fperrywilson.bsky.social · 2y agoEvery week, I see a new study talking about this or that effect of GLP-1 receptor agonists like #ozempic. FINALLY, we have a study evaluating all the outcomes (good and bad) in one dataset. There are some... surprises. 🧵
Fantastic thread on lung POCUS utility and optimization. Diagnostic utility of this test is vast yet adoption into workflows leaves opportunity better implementation, specifically around volume assessment and patients with hypoxemia. Thank you @katiewiskar.bsky.social
Katie Wiskar@katiewiskar.bsky.social · 2y ago1/ I love love LOVE scanning the heart 😍, but when it comes to bang for your buck for ultrasound novices, lung ultrasound is such a winner 🏆 It's time for another #POCUS basics #skeetorial 🧵 Let's talk about common pitfalls in #LungUltrasound and how to correct these ✔️ #emimcc
Fantastic thread on blood gases! Highlights a common teaching point for patients that are hypoxemic. Make your clinical decisions globally based on Hx, risk factors, exam, imaging, etc. Do NOT delay decision making and anchor solely on the gas
Ben Morton@benmorton.bsky.social · 2y agoRant #5 Please don't tell me what the PaO2 is... Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings. What is the SpO2 I genially ask? In our target range? Well that's fine then. Staff member shifting uneasily, "but the PaO2..." Here we go...
🧵 Part 2 of EBM teaching on the wards @cudeptofmedicine.bsky.social Pulmonary Embolism (PE) Risk Stratification: Understanding Right Ventricular Dysfunction on CT
