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Tag: Saurabh Jha

Running an RCT – A Conversation With the Investigators of the REGAIN Trial

By SAURABH JHA MD

It is easy for armchair activists to bash randomized controlled trials (RCTs) with clever methodological critiques. However, it takes a lot of effort and coordination to pull off an RCT successfully. In this episode of Radiology Firing Line, I speak with Dr. Mark Neuman and Lakisha Gaskins, principal investigator and research project manager of the REGAIN trial, respectively, about the logic, challenges and intricacies of conducting an RCT. The Regional versus General Anesthesia for Promoting Independence After Hip Surgery (REGAIN) trial is an ongoing pragmatic, multi-center RCT, funded by PCORI, which randomizes patients with hip fractures to regional or general anesthesia.

Guests: Mark Neuman MD MSc, is an Associate Professor of Anesthesiology and Critical Care at the University of Pennsylvania. He is a senior fellow at the Leonard Davis Institute of Health Economics. He’s a former RWJ Scholar. Lakisha Gaskins is a research coordinator with extensive experience recruiting patients for RCTs.

Listen to our conversation on Radiology Firing Line Podcast here.

Saurabh Jha is a contributing editor to THCB and host of Radiology Firing Line Podcast of the Journal of American College of Radiology, sponsored by Healthcare Administrative Partner.

Radiology in Africa

By SAURABH JHA MD

What are the challenges of getting imaging to Africa? In this episode of Radiology Firing Line, I convene a panel of experts in Africa. We discuss the challenges of bringing new technology to Africa, the new need for imaging driven by public health gains and increased longevity of Africans, the insalubrious practice of “equipment dumping”, amongst others.

Panelists:

  • Kassa Darge, MD PhD, is Professor of Radiology and Radiologist-in-Chief at Children’s Hospital of Philadelphia. He is also Honorary Professor of Radiology in the Department of Radiology at Addis Ababa University in Ethiopia.
  • Omolola Mojisola (Monica) Atalabi MBBS MBA, is Professor of Radiology and Chief of Pediatric Radiology at University College Hospital, Ibadan, Nigeria. She is President of both the Association of Radiologist in Nigeria and the World Federation of Pediatric Imaging.
  • William Sykes is the CEO of Tecmed Arica – a medical equipment, device, service and training provider in the Southern African region.

Listen to our conversation here.

Saurabh Jha is a contributing editor to THCB and host of Radiology Firing Line Podcast of the Journal of American College of Radiology, sponsored by Healthcare Administrative Partner

Venture Capitalism & Radiology

By SAURABH JHA MD 

Can radiologists make their way to Silicon Valley? In this episode of Radiology Firing Line, Ajay Kohli MD, a physician entrepreneur, explains what it takes to make a medical app.

Listen to our conversation here.

Saurabh Jha is a contributing editor to THCB and host of Radiology Firing Line Podcast of the Journal of American College of Radiology, sponsored by Healthcare Administrative Partner

Net Effect of Expanding Medicaid

By SAURABH JHA MD 

What is the effect of expanding Medicaid on overall healthcare costs and use of the emergency room? This type of question can’t easily be answered by observational studies and requires a randomized controlled trial (RCT). But an RCT isn’t easy to perform. However, a natural RCT serendipitously happened in Oregon a few years ago when Medicaid was expanded and the eligibility was deemed by a lottery system.

On this episode of Firing Line, Saurabh Jha (@RogueRad) speaks to Professor Katherine Baicker, a leading economist and the Dean of the Harris School of Public Policy, and principal investigator of the Oregon Health Insurance Experiment, about the landmark study.

Listen to our conversation here at Radiology Firing Line Podcast.

Into America: The Odds Against a Foreign Trained Doctor

By SAURABH JHA MD 

In this episode of Firing Line, Saurabh Jha (aka @RogueRad), has a conversation with Chadi Nabhan, MD MBA FACP, who is a preeminent oncologist, speaker and the Chief Medical Officer of Cardinal Health Specialty Solutions.

At the great heights of his career, and a secure American citizen, Chadi recalls the struggle and effort it took to get from Syria to Boston. He credits his journey to good luck and a tenacious drive and uncompromising desire to work in the U.S. Chadi speaks for thousands of international medical graduates to fight odds to get here.

Listen to our conversation at Radiology Firing Line Podcast.

Saurabh Jha is a contributing editor to THCB and host of Radiology Firing Line Podcast of the Journal of American College of Radiology, sponsored by Healthcare Administrative Partner.

Many Ways of Skinning a Statistical Cat

By SAURABH JHA MD 

In this episode of Firing Line, Saurabh Jha (aka @RogueRad), has a conversation with Professor Brian Nosek, a metaresearcher and co-founder of Center for Open Science.

They discuss the implications of this study, which showed that there was a range of analytical methods when interrogating the database to answer a specific hypothesis: are soccer referees more likely to give red cards to dark skinned players? What is the significance of the variation? Does the variation in analysis explain the replication crisis?

Listen to our conversation at Radiology Firing Line Podcast.

A Conversation About the Dangers of Overhydration with Professor Timothy Noakes

By SAURABH JHA MD

Professor Timothy Noakes, a South African exercise scientist and emeritus professor at the University of Cape Town who has run over 70 ultramarathons, speaks to me about the dangers of overhydration in endurance sports.

Listen to our conversation at Radiology Firing Line Podcast.

Saurabh Jha is a contributing editor to THCB and host of Radiology Firing Line Podcast of the Journal of American College of Radiology, sponsored by Healthcare Administrative Partner

How Radiologists Think

flying cadeuciiDiagnostic tests such as CAT scans are not perfect. A test can make two errors. It can call a diseased person healthy – a false negative. This is like acquitting a person guilty of a crime. Or a test can falsely call a healthy person diseased – a false positive. This is like convicting an innocent person of a crime that she did not commit. There is a trade-off between false negatives and false positives. To achieve fewer false negatives we incur more false positives.

Physicians do not want to be wrong. Since error is possible we must choose which side to err towards. That is we must choose between two wrongness. We have chosen to reduce false negatives at the expense of false positives. Why this is so is illustrated by screening mammography for breast cancer.

A woman who has cancer which the mammogram picks up is thankful to her physician for picking up the cancer and, plausibly, saving her life.

A woman who does not have cancer and whose mammogram is normal is also thankful to her physician. The doctor does not deserve to be thanked as she played no hand in the absence of the patient’s cancer. But instead of thanking genes or the cosmic lottery, the patient thanks the doctor.

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A Spoonful of Inequality Helps the Medicine go Down

The conventional wisdom in the circles I hang out in – pro-Hillary, morally conscious,happy bunnies who pretend to enjoy French wine and opera – is that the greatest scourgeon humanity after the bubonic plague is inequality of wealth. They worship Pope St. John Paul Piketty and canonize Archbishop Paul Krugman. Not only is inequality bad for its own sake, they say, it makes people ill, like medically ill.

Their premise always struck me as specious. I once took them through a thought experiment. Imagine, I said, you time travel to the Bengal famine. There was a lot of equality then – people were equally malnourished. Everyone’s ribs protruded equally because of muscle wasting from marasmus. The loss of protein from kwashiorkor made sure everyone’s belly popped out without prejudice. Starvation because of poverty is a great leveler. It cares little about gender, caste or religion. It is non-judgmental.

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