People, URLs and related tags from this week's #nhssm

Involved ...
@GemmaAt_CMHCSWS @colinwren @a_double_tt @shirleyayres @amcunningham @Sasha_Taylor @dean_jenkins @salma_patel @claireOT @AliHandscomb @dgfoord @SR_disrupt @clarkmike @S_Amani @medicalmarbles @nhssm @JamesGoodyear1 @BenWagenaar @CompareSoftware @BecomingANurse @Ermintrude2 @ajax_63 @carlplant @trishgreenhalgh @timolloyd @manickmanda @Katie_Bacon @thirdratehero @PublicisDHealth @Health_Bright @hmshale @GeorgeJulian @davewhitby @elbunglio @RonanTKavanagh @RiseUpUK @NetworkLouIse @patientopinion @markhawker @DigMedCom @InHealthAssoc @mrcthompson @doctorinsulin @markmccartney59 @Susie8lue @TheNiceLadyDoc @RachelleIM @GPWales @TwentyGotoTen @JBBC
 
Top resources ...
http://nhssm.org.uk/tonights-nhssm-chat-empowering-patients-through-apps-next-steps-mapsandapps1-caremaps/
http://hale.dh.gov.uk/2012/02/29/maps-and-apps-for-health-and-care-what-next/
http://twitpic.com/8q4zr0
http://t.co/VTNwe5MR
http://salmapatel.com/healthcare/an-overview-of-healthcare-apps-in-the-uk-presentation-notes
http://www.facebook.com/pages/Nurseshift/126020640853135
http://www.scoop.it/t/healthcare-apps/p/1329241262/health-app-design-and-evaluation-service-launched-by-coventry-university
http://josephfreeman.posterous.com/an-app-a-day-keeps-the-doctor-away

Related tags ...
#careapps #mapsandapps #mapsandapps1 #caremaps #publicsectoronline

The chat will be archived on nhssm.org.uk  

Top resources recently discussed in #MedEd

Collaboratively filtered list of the most cited resources in #MedEd tweets over the last week or so.

I've been working on a web-based app that analyses Twitter chats. If someone goes to the bother of posting a link into their tweet and using a tag (such as #MedEd for Medical Education) then this is a vote, a +1, a 'like', for that URL. The more times the link is posted the more popular it is. The trick is getting that information out of the Twitter stream which requires serious automation. That's the tool I've been developing.

The list below highlights what the #MedEd community has been interested in recently. Great to see the British Thoracic Society (@BTSLearning) on Twitter!

http://www.slideshare.net/suzanakm/palliative-care-what-every-medical-student-should-know
http://blog.paulderoos.com/learn-with-and-from-patients/
http://jewishworldreview.com/0212/free_med_school.php3
http://www.kevinmd.com/blog/2012/02/physicians-care-amanda-trujillo.html
http://futuredocsblog.com/2010/02/14/making-a-match-list-checking-it-twice%e2%80%a6/
http://www.brit-thoracic.org.uk/bts-learning-hub/short-courses/practical-update-on-the-management-of-pe.aspx
http://www.acgme-nas.org/assets/pdf/NEJMfinal.pdf
http://throughlifeanddeath.com/nurses

(If you would like to use the tool to analyse the tweets in your community or simply to archive your tweet chats like this then please get in touch. Beta-testers wanted!)

Observer bias in RCTs

Non-blinded observers in clinical trials are biased. This paper in the BMJ explores the effect for certain outcome assessments where a binary classification of patients was required. What does this say for ongoing workplace evaluations where clinicians are not routinely 'blinded'? It highlights the importance of trying to remove bias when classifying a patient outcome.
Observer bias in randomised clinical trials with binary outcomes: systematic review of trials with both blinded and non-blinded outcome assessors | BMJ

Royal College of Physicians #RCPegm

Extraordinary General Meeting at Royal College of Physicians today. Some brave Fellows were tweeting during the debate on the #nhsbill relaying it to others who couldn't get to the meeting because ... eh ... they were working for the NHS. This is an archive of those tweets.

Involved ...
@GabrielScally @COPDdoc @musicmp @DrGrumble @hipp0campus @butlerceri @brixtonbarb @onegpprotest @mwardle @NHShulk @dean_jenkins @amcunningham @rob_aldridge @djnicholl @GilulaArc @christoclifford @northern_doctor @ObsGynSpR @elinlowri @drquesh @GeraintLewis @drobeirne @Croachcatcher @marcuschown @leannefluke @MrsBofVigo @profhelenward @milesmack @drmarielouise @paulstpancras @AngusCarruthers @Dr_Aust_PhD @Eadgifu @virginiamoffatt @successcvs @TheNiceLadyDoc @badderssjb @DouglasNobleMD @mulberrybush @DaveyBoyBish @socialindepth @Davewwest @BTSchief @drjamiegreen @christinasosseh @brynwat @HPIAndyCowper @e1ucidate @Innerwisdom1 @PeteDeveson
 
Top resources ...
http://abetternhs.wordpress.com/2012/02/27/rcp/
http://dean-jenkins.blogspot.com/2012/02/royal-college-of-physicians-rcpegm.html
http://www.facebook.com/pages/The-Nice-Lady-Doctor/111879805505889
http://yfrog.com/eswskygj
http://www.guardian.co.uk/commentisfree/2012/feb/27/royal-college-of-physicians-nhs-bill
http://video.google.com/videoplay?docid=-6295413612196553191

@BGSMDS	@djnicholl @rcplondon @trishgreenhalgh How will the #nhsbill affect people with #Parkinson 's disease? Time to speak up #RCPEGM 27 Feb (Tue, 21 Feb 2012 17:53:26 +0000)
@COPDdoc	On my way to the #RCPegm (Mon, 27 Feb 2012 12:30:23 +0000)
@drjamiegreen	@COPDdoc We hope to hear lots of tweets about what happens at the #RCPegm (Mon, 27 Feb 2012 12:34:29 +0000)
@christinasosseh	RT @COPDdoc : On my way to the #RCPegm (Mon, 27 Feb 2012 12:36:12 +0000)
@COPDdoc	@drjamiegreen there's a big and distinguished turnout for the #RCPegm (Mon, 27 Feb 2012 13:11:50 +0000)
@COPDdoc	Good turn out of chest physicians at the #RCPegm @BTSchief (Mon, 27 Feb 2012 13:39:12 +0000)
@COPDdoc	@djnicholl @trishgreenhalgh I'm 43. #RCPegm (Mon, 27 Feb 2012 13:53:28 +0000)
@GabrielScally	In good company with @martinmckee and @richardhorton1 at the #RCPegm Theatre will be full! (Mon, 27 Feb 2012 13:56:55 +0000)
@brynwat	Looks like @richardhorton1 could be a useful source of information this afternoon on how the #RCPegm is progressing. (Mon, 27 Feb 2012 14:01:20 +0000)
@GabrielScally	#RCPegm starts with instruction for anyone not a Fellow leaves immediately. (Mon, 27 Feb 2012 14:01:25 +0000)
@musicmp	@brynwat Try hashtag #RCPegm (Mon, 27 Feb 2012 14:02:40 +0000)
@BTSchief	RT @COPDdoc : Good turn out of chest physicians at the #RCPegm @BTSchief (Mon, 27 Feb 2012 14:03:23 +0000)
@musicmp	I'm following the RCP meeting re #nhs bill at #RCPegm (Mon, 27 Feb 2012 14:03:25 +0000)
@GabrielScally	#RCPegm Registrar says by-laws about calling an EGM will be subject to review! (Mon, 27 Feb 2012 14:04:20 +0000)
@GabrielScally	#RCPegm Registrar makes beautifully crafted remarks about the use of Twitter in the meeting. (Mon, 27 Feb 2012 14:05:22 +0000)
@drquesh	Thanks to those at #RCPegm today. Magnitude of decision makes it an afternoon of now bearing future of nation's healthcare on your shoulders (Mon, 27 Feb 2012 14:06:38 +0000)
@GabrielScally	@djnicholl opening the debate by proposing the motion at the #RCPegm (Mon, 27 Feb 2012 14:09:40 +0000)
@GeraintLewis	RT @GabrielScally : #RCPegm Registrar says by-laws about calling an EGM will be subject to review! (Mon, 27 Feb 2012 14:13:25 +0000)
@GeraintLewis	RT @GabrielScally : #RCPegm Registrar makes beautifully crafted remarks about the use of Twitter in the meeting. (Mon, 27 Feb 2012 14:13:33 +0000)
@rob_aldridge	It's all gone quiet at the #RCPegm . Have they banned twitter? (Mon, 27 Feb 2012 14:16:12 +0000)
@musicmp	@trishgreenhalgh Would you mind using hashtag #RCPegm for those of us who are there in spirit? (Mon, 27 Feb 2012 14:16:54 +0000)
@COPDdoc	@GabrielScally @djnicholl Ilora Finlay FRCP and cross bench peer outlines some modest Lords achievements in modifying bill #RCPegm (Mon, 27 Feb 2012 14:17:03 +0000)
@musicmp	@djnicholl Thanks for everything you are doing. Would you mind using hashtag #RCPegm for those following please? (Mon, 27 Feb 2012 14:18:25 +0000)
@GabrielScally	Baroness Finlay talks about the voting balance in the Lords. Does not see a vote coming that will defeat the Bill. #RCPegm (Mon, 27 Feb 2012 14:22:17 +0000)
@COPDdoc	@rob_aldridge @trishgreenhalgh @richardhorton1 Ilora Finlay ""If bill passed profession must remain solidly behind NHS provision"" #RCPegm (Mon, 27 Feb 2012 14:28:27 +0000)
@GabrielScally	Registrar putting the case that the RCP has done a good job in consulting members and fellows. #RCPegm Does not support call for withdrawal. (Mon, 27 Feb 2012 14:34:53 +0000)
@butlerceri	RT @GabrielScally : Registrar putting the case that the RCP has done a good job in consulting members and fellows. #RCPegm Does not support call for withdrawal. (Mon, 27 Feb 2012 14:37:12 +0000)
@COPDdoc	@GabrielScally A good job of consultation apart from actually consulting members. #RCPegm (Mon, 27 Feb 2012 14:37:52 +0000)
@musicmp	Let's hope the Fellows don't get bamboozled by the leadership, and that they do the right thing. #RCPegm (Mon, 27 Feb 2012 14:38:55 +0000)
@GabrielScally	2 former Presidents speak. Carol Black does not favour withdrawal; George Alberti supports poll of Fellows & Members #RCPegm (Mon, 27 Feb 2012 14:39:10 +0000)
@COPDdoc	George Alberti ""should have opposed the bill vigorously when it first appeared"" ""let's ballot fellows"" #RCPegm (Mon, 27 Feb 2012 14:39:30 +0000)
@GabrielScally	Registrar tells us off for Tweeing! #RCPegm (Mon, 27 Feb 2012 14:40:37 +0000)
@Davewwest	from @GabrielScally at RCP meeting: Carol Black does not favour withdrawal; George Alberti supports poll of Fellows & Members #RCPegm (Mon, 27 Feb 2012 14:41:07 +0000)
@butlerceri	#RCPegm this is not the time to take the 'safe' option. All or nothing. (Mon, 27 Feb 2012 14:41:56 +0000)
@mulberrybush	RT @COPDdoc : George Alberti ""should have opposed the bill vigorously when it first appeared"" ""let's ballot fellows"" #RCPegm (Mon, 27 Feb 2012 14:42:45 +0000)
@drquesh	#RCPegm 'blackout' highlights @FPH good conduct of their EGM. Willingness to try online video/social media was risky, but we felt involved. (Mon, 27 Feb 2012 14:45:57 +0000)
@musicmp	RT @drquesh : #RCPegm 'blackout' highlights @FPH good conduct of their EGM. Willingness to try online video/social media was risky, but we felt involved. (Mon, 27 Feb 2012 14:47:05 +0000)
@GabrielScally	@RCPLondon getting upset at the use of social media #RCPegm (Mon, 27 Feb 2012 14:47:39 +0000)
@GabrielScally	Thomas Bewley quotes CS Parnell at #RCPegm (Mon, 27 Feb 2012 14:52:51 +0000)
@GabrielScally	@RCPLondon Which bylaw states that the #RCPegm is a 'secret' meeting, as is claimed by your Officers? (Mon, 27 Feb 2012 14:55:33 +0000)
@musicmp	@rob_aldridge @DrQuesh Looks like it really is a blackout. Hope it isn't also a whitewash. #RCPegm (Mon, 27 Feb 2012 14:56:07 +0000)
@musicmp	@richardhorton1 What did I say about changing the rules #RCPegm Twitter blackout (Mon, 27 Feb 2012 14:58:46 +0000)
@mwardle	Not clear why twitter use disallowed? #RCPegm (Mon, 27 Feb 2012 15:00:13 +0000)
@GabrielScally	Former RDPH and Medical Director of NHS Exec Graham Winyard makes plea, as a Lib Dem, for professional organisations to oppose Bill #RCPegm (Mon, 27 Feb 2012 15:00:16 +0000)
@GabrielScally	@martinmckee rises to speak #RCPegm ""Mr Lansley is an honourable man"". ""This Bill is a disaster!"" (Mon, 27 Feb 2012 15:07:48 +0000)
@COPDdoc	RT @GabrielScally : @martinmckee rises to speak #RCPegm ""Mr Lansley is an honourable man"". ""This Bill is a disaster!"" (Mon, 27 Feb 2012 15:08:17 +0000)
@rob_aldridge	RT @GabrielScally : @martinmckee rises to speak #RCPegm ""Mr Lansley is an honourable man"". ""This Bill is a disaster!"" (Mon, 27 Feb 2012 15:09:12 +0000)
@butlerceri	RT @GabrielScally : @martinmckee rises to speak #RCPegm ""Mr Lansley is an honourable man"". ""This Bill is a disaster!"" (Mon, 27 Feb 2012 15:10:44 +0000)
@GabrielScally	@butlerceri @rcplondon In House of Commons only MPs can participate. It doesn't mean that it is secret. #RCPegm (Mon, 27 Feb 2012 15:11:02 +0000)
@butlerceri	@GabrielScally @rcplondon I totally agree. #RCPegm is not and should not be secret. I was citing what little they had on website! (Mon, 27 Feb 2012 15:12:17 +0000)
@GabrielScally	At last, a couple of speakers against withdrawing the Bill. First hisses heard rather, than warm applause for @martinmckee et al. #RCPegm (Mon, 27 Feb 2012 15:15:37 +0000)
@GabrielScally	Warm praise for @clarercgp from a speaker ,applause results! #RCPegm (Mon, 27 Feb 2012 15:17:18 +0000)
@GabrielScally	Plenty of people watching Twitter but clearly put off by schoolmaster-ish approach at #RCPegm (Mon, 27 Feb 2012 15:20:04 +0000)
@GabrielScally	Walter Holland former Pres of FPH says it seems to crazy for College to support something that does no good. Calls for rejection. #RCPegm (Mon, 27 Feb 2012 15:22:34 +0000)
@amcunningham	@GabrielScally yes- enjoying the #rcpegm tweets:) (Mon, 27 Feb 2012 15:24:45 +0000)
@amcunningham	@GabrielScally yes- enjoying the #rcpegm tweets:) (Mon, 27 Feb 2012 15:24:45 +0000)
@GabrielScally	New Consultant Cmttee of College support RCP position and would not wish it to change that position #RCPegm (Mon, 27 Feb 2012 15:25:15 +0000)
@butlerceri	@GabrielScally thank you for keeping us all in the loop of events taking place at #RCPegm (Mon, 27 Feb 2012 15:26:56 +0000)
@rob_aldridge	Well done to @GabrielScally who is providing some form of transparency to the #RCPegm by live tweeting. What is RCP afraid of? (Mon, 27 Feb 2012 15:33:10 +0000)
@musicmp	RT @rob_aldridge : Well done to @GabrielScally who is providing some form of transparency to the #RCPegm by live tweeting. What is RCP afraid of? (Mon, 27 Feb 2012 15:34:39 +0000)
@NHShulk	GRRR RT @GabrielScally Plenty of people watching Twitter but clearly put off by schoolmaster-ish approach at #RCPegm (Mon, 27 Feb 2012 15:35:40 +0000)
@hipp0campus	thanks to @GabrielScally we have window into #RCPegm - not impressed by @RCPLondon 's veil of secrecy #nhsbill (Mon, 27 Feb 2012 15:36:38 +0000)
@mwardle	RT @rob_aldridge : Well done to @GabrielScally who is providing some form of transparency to the #RCPegm by live tweeting. What is RCP afraid of? (Mon, 27 Feb 2012 15:36:43 +0000)
@GabrielScally	Now I have been rebuked by President for my Tweeting and identified by my rugby affiliation. #RCPegm (Mon, 27 Feb 2012 15:41:24 +0000)
@elinlowri	RT @GabrielScally : Now I have been rebuked by President for my Tweeting and identified by my rugby affiliation. #RCPegm (Mon, 27 Feb 2012 15:42:54 +0000)
@GabrielScally	I spoke in defence of openness in #RCPegm That is until silenced by President! (Mon, 27 Feb 2012 15:43:26 +0000)
@onegpprotest	RT @GabrielScally : I spoke in defence of openness in #RCPegm That is until silenced by President! (Mon, 27 Feb 2012 15:44:06 +0000)
@NHShulk	GRRRRR VOTE NOW!!!! RT @GabrielScally Now I have been rebuked by President ... identified by my rugby affiliation. #RCPegm (Mon, 27 Feb 2012 15:44:09 +0000)
@amcunningham	RT @GabrielScally : I spoke in defence of openness in #RCPegm That is until silenced by President! (Mon, 27 Feb 2012 15:45:12 +0000)
@musicmp	RT @GabrielScally : Now I have been rebuked by President for my Tweeting and identified by my rugby affiliation. #RCPegm (Mon, 27 Feb 2012 15:46:16 +0000)
@musicmp	RT @GabrielScally : I spoke in defence of openness in #RCPegm That is until silenced by President! (Mon, 27 Feb 2012 15:46:25 +0000)
@GabrielScally	@jobbingdoctor No, attempted silencing. I don't think the 'secrecy' approach will survive. #RCPegm (Mon, 27 Feb 2012 15:47:34 +0000)
@NHShulk	#LansleyFacts ARE AS RIPPED AS MY SHIRT. #DROPTHEBILL #NHSBILL #RCPEGM (Mon, 27 Feb 2012 15:49:42 +0000)
@butlerceri	RT @GabrielScally : I spoke in defence of openness in #RCPegm That is until silenced by President! (Mon, 27 Feb 2012 15:52:22 +0000)
@COPDdoc	#RCPegm Voting now. Royal College of Physicians - Meeting strongly opposed to bill. (Mon, 27 Feb 2012 15:56:19 +0000)
@COPDdoc	#RCPegm Voting now. Royal College of Physicians - Meeting strongly opposed to bill - still some hope for the NHS (Mon, 27 Feb 2012 15:58:15 +0000)
@hipp0campus	@COPDdoc thanks for update! Good to hear - following some of the earlier tweets was fearing a different outcome. #RCPegm (Mon, 27 Feb 2012 16:00:01 +0000)
@butlerceri	79% must surely signal college opposition to #NHSbill #RCPegm (Mon, 27 Feb 2012 16:05:28 +0000)
@hipp0campus	RT @butlerceri : 79% must surely signal college opposition to #NHSbill #RCPegm (Mon, 27 Feb 2012 16:06:35 +0000)
@musicmp	@GabrielScally Thanks for tweeting about #RCPegm today. Greatly appreciated. (Mon, 27 Feb 2012 16:16:32 +0000)
@COPDdoc	@chrisshipitv not a straw poll - done with electronic voting pads #RCPegm strong opposition to bill. Desire to save #NHS from privatisation (Mon, 27 Feb 2012 16:22:40 +0000)
@onegpprotest	RT @COPDdoc : #RCPegm Voting now. Royal College of Physicians - Meeting strongly opposed to bill - still some hope for the NHS (Mon, 27 Feb 2012 16:22:49 +0000)
@DaveyBoyBish	RT @COPDdoc : #RCPegm Voting now. Royal College of Physicians - Meeting strongly opposed to bill - still some hope for the NHS (Mon, 27 Feb 2012 16:23:08 +0000)
@socialindepth	RT @COPDdoc : #RCPegm Voting now. Royal College of Physicians - Meeting strongly opposed to bill - still some hope for the NHS (Mon, 27 Feb 2012 16:23:46 +0000)
@hipp0campus	“ @richardhorton1 : 80% of Fellows call on the RCP to ballot Fellows and Members on the Health and Social Care Bill.” #RCPegm #nhsbill (Mon, 27 Feb 2012 16:34:08 +0000)
@GabrielScally	Voting decisive at #RCPegm Comprehensive describes it. (Mon, 27 Feb 2012 16:34:25 +0000)
@HPIAndyCowper	RT @GabrielScally : Voting decisive at #RCPegm Comprehensive describes it. (Mon, 27 Feb 2012 16:35:36 +0000)
@northern_doctor	RT @GabrielScally : Voting decisive at #RCPegm Comprehensive describes it. (Mon, 27 Feb 2012 16:36:41 +0000)
@DrGrumble	The president's concern about Twitter users at the #RCPEGM has made me realise what an important medium it is. (Mon, 27 Feb 2012 16:37:19 +0000)
@northern_doctor	RT @DrGrumble : The president's concern about Twitter users at the #RCPEGM has made me realise what an important medium it is. (Mon, 27 Feb 2012 16:38:07 +0000)
@elinlowri	RT @DrGrumble : The president's concern about Twitter users at the #RCPEGM has made me realise what an important medium it is. (Mon, 27 Feb 2012 16:43:35 +0000)
@GilulaArc	RT @DrGrumble : The president's concern about Twitter users at the #RCPEGM has made me realise what an important medium it is. (Mon, 27 Feb 2012 16:43:49 +0000)
@e1ucidate	RT @DrGrumble : The president's concern about Twitter users at the #RCPEGM has made me realise what an important medium it is. (Mon, 27 Feb 2012 16:44:24 +0000)
@DouglasNobleMD	RT @GabrielScally : Voting decisive at #RCPegm Comprehensive describes it. (Mon, 27 Feb 2012 16:44:46 +0000)
@welsh_gas_doc	RT @DrGrumble : The president's concern about Twitter users at the #RCPEGM has made me realise what an important medium it is. (Mon, 27 Feb 2012 16:49:17 +0000)
@hipp0campus	RT @DrGrumble : The president's concern about Twitter users at the #RCPEGM has made me realise what an important medium it is. (Mon, 27 Feb 2012 16:51:49 +0000)
@brixtonbarb	"" @trishgreenhalgh : 89 pc of FRCPs at EGM felt Bill wd damage pt care"" #RCPegm (Mon, 27 Feb 2012 16:52:09 +0000)
@brixtonbarb	"" @trishgreenhalgh : RCP tied up in own red tape over how + when to survey but overwhelming message from FRCPs DROP THIS BILL"" #RCPegm (Mon, 27 Feb 2012 16:52:59 +0000)
@brixtonbarb	"" @trishgreenhalgh : Getting hot in here http://t.co/97CsomVm "" #RCPegm (Mon, 27 Feb 2012 16:53:15 +0000)
@brixtonbarb	"" @trishgreenhalgh : Roger Williams: ""haven't seen as many people here since my Harveian Lecture"""" #RCPegm Bless! (Mon, 27 Feb 2012 16:54:23 +0000)
@brixtonbarb	"" @richardhorton1 : RCP breaking news: 89% Fellows say Health Bill will damage the health of the public in England."" #RCPegm (Mon, 27 Feb 2012 16:55:32 +0000)
@brixtonbarb	"" @richardhorton1 : 81% of RCP Fellows call on the College to unite with other Colleges to call for withdrawal of the Health Bill."" #RCPegm (Mon, 27 Feb 2012 16:56:46 +0000)
@brixtonbarb	"" @richardhorton1 : 69% of RCP Fellows call on College to hold press conf with other medical bodies to seek withdrawal of #Healthbill "" #RCPegm (Mon, 27 Feb 2012 16:57:50 +0000)
@Dr_LJ	RT @DrGrumble : The president's concern about Twitter users at the #RCPEGM has made me realise what an important medium it is. (Mon, 27 Feb 2012 16:58:50 +0000)
@mattleys	RT @DrGrumble : The president's concern about Twitter users at the #RCPEGM has made me realise what an important medium it is. (Mon, 27 Feb 2012 17:00:19 +0000)
@mwardle	RT @brixtonbarb : "" @richardhorton1 : RCP breaking news: 89% Fellows say Health Bill will damage the health of the public in England."" #RCPegm (Mon, 27 Feb 2012 17:04:02 +0000)
@ObsGynSpR	#RCOGEGM RT @DrGrumble : The president's concern about Twitter users at the #RCPEGM has made me realise what an important medium it is. (Mon, 27 Feb 2012 17:10:13 +0000)
@DrGrumble	Can you believe it? The College has electronic voting! The first time they have used it though. #RCPEGM (Mon, 27 Feb 2012 17:23:44 +0000)
@DrGrumble	RT @rob_aldridge : RT @GabrielScally : @martinmckee rises to speak #RCPegm ""Mr Lansley is an honourable man"". ""This Bill is a disaster!"" (Mon, 27 Feb 2012 17:26:43 +0000)
@DrGrumble	RT @COPDdoc : @GabrielScally A good job of consultation apart from actually consulting members. #RCPegm (Mon, 27 Feb 2012 17:27:04 +0000)
@COPDdoc	An early #FF for #RCPegm stars @martinmckee @GabrielScally @djnicholl @trishgreenhalgh @richardhorton1 (Mon, 27 Feb 2012 17:34:07 +0000)
@DrGrumble	College speakers at the #RCPEGM cut no ice. The mood of the fellows was clear. Lots of passionate speeches. A historic occasion - no video. (Mon, 27 Feb 2012 17:34:54 +0000)
@Innerwisdom1	RT @rob_aldridge : RT @GabrielScally : @martinmckee rises to speak #RCPegm ""Mr Lansley is an honourable man"". ""This Bill is a disaster!"" (Mon, 27 Feb 2012 17:36:37 +0000)
@GabrielScally	Lessons aplenty today at #RCPegm for @RCS_SurgeryNews and Roy Coll of O&G on how to develop open discussion and debate at their EGMs. (Mon, 27 Feb 2012 17:47:35 +0000)
@PeteDeveson	RT @GabrielScally : Lessons aplenty today at #RCPegm for @RCS_SurgeryNews and Roy Coll of O&G on how to develop open discussion and debate at their EGMs. (Mon, 27 Feb 2012 17:48:26 +0000)
@djnicholl	Quite the most remarkable day in my career. Real passion & anger in the room to defeat the Bill...and I was one the youngsters at 47 #RCPEGM (Mon, 27 Feb 2012 17:49:52 +0000)
@tobyhillman	Email summary of #RCPegm sent out already - do I detect a new zest in @RCPLondon following EGM (Mon, 27 Feb 2012 17:54:10 +0000)
@ObsGynSpR	#RCPEGM our colleagues in the Royal College of Physicians are against the Bill-how about you? (Mon, 27 Feb 2012 17:54:49 +0000)
@DrGrumble	@clarercgp You were praised at the #RCPEGM . (Mon, 27 Feb 2012 17:55:08 +0000)
@hipp0campus	RT @COPDdoc : An early #FF for #RCPegm stars @martinmckee @GabrielScally @djnicholl @trishgreenhalgh @richardhorton1 (Mon, 27 Feb 2012 17:55:33 +0000)
@djnicholl	Hanging around in Millbank to do BBC Midlands Today (4th item) and the catch the train. We done good today #rcpegm @rcplondon (Mon, 27 Feb 2012 18:00:59 +0000)
@PennyWalker26	RT @ObsGynSpR : #RCPEGM our colleagues in the Royal College of Physicians are against the Bill-how about you? (Mon, 27 Feb 2012 18:06:34 +0000)
@christoclifford	RT @DrGrumble : @clarercgp You were praised at the #RCPEGM . (Mon, 27 Feb 2012 18:20:07 +0000)
@GilulaArc	RT @GabrielScally : Lessons aplenty today at #RCPegm for @RCS_SurgeryNews and Roy Coll of O&G on how to develop open discussion and debate at their EGMs. (Mon, 27 Feb 2012 18:22:18 +0000)
@MrsBofVigo	RT @COPDdoc : An early #FF for #RCPegm stars @martinmckee @GabrielScally @djnicholl @trishgreenhalgh @richardhorton1 (Mon, 27 Feb 2012 18:22:38 +0000)
@DrGrumble	The outcome of the #RCPEGM should be that we now go all out in concert with others to #dropthebill . But I fear more College shenanigans. (Mon, 27 Feb 2012 18:30:06 +0000)
@profhelenward	@trishgreenhalgh Press release is just that - doesn't reflect the overwhelming feeling of the meeting but pats itself on the back! #rcpegm (Mon, 27 Feb 2012 18:31:47 +0000)
@christoclifford	RT @DrGrumble : The outcome of the #RCPEGM should be that we now go all out in concert with others to #dropthebill . But I fear more College shenanigans. (Mon, 27 Feb 2012 18:35:45 +0000)
@djnicholl	""every consultant in this meeting should be calling on their MP for a meeting on a Friday to discuss #NHSBill "" #RCPegm Let's do this NOW!RT (Mon, 27 Feb 2012 18:38:27 +0000)
@DrGrumble	RT @djnicholl : ""every consultant in this meeting should be calling on their MP for a meeting on a Friday to discuss #NHSBill "" #RCPegm Let's do this NOW!RT (Mon, 27 Feb 2012 18:40:45 +0000)
@leannefluke	RT @ObsGynSpR : #RCPEGM our colleagues in the Royal College of Physicians are against the Bill-how about you? (Mon, 27 Feb 2012 18:49:54 +0000)
@DrGrumble	@jobbingdoctor I hate to say this but it was pointed out at the #RCPEGM that they stand to gain financially from increased private care. (Mon, 27 Feb 2012 19:11:47 +0000)
@DrGrumble	A very nice man called Harold Lambert was at the #RCPEGM . He taught me as a student so I thanked him. http://t.co/ANehQ0qX (Mon, 27 Feb 2012 19:23:31 +0000)
@Croachcatcher	@DrGrumble @jobbingdoctor #RCPEGM that they stand to gain financially from increased private care. so can't be wanting more money >>object (Mon, 27 Feb 2012 19:28:18 +0000)
@marcuschown	RT @djnicholl : ""every consultant in this meeting should be calling on their MP for a meeting on a Friday to discuss #NHSBill "" #RCPegm Let's do this NOW!RT (Mon, 27 Feb 2012 19:41:58 +0000)
@badderssjb	RT @djnicholl : ""every consultant in this meeting should be calling on their MP for a meeting on a Friday to discuss #NHSBill "" #RCPegm Let's do this NOW!RT (Mon, 27 Feb 2012 19:42:51 +0000)
@onegpprotest	'Please, Mr Cameron, even now, at five minutes to midnight for the NHS, think again' http://t.co/Ygrjr8RG #dropthebill #RCPegm (Mon, 27 Feb 2012 19:55:39 +0000)
@DrGrumble	Today’s #RCPEGM saw heavy criticism of the foundering Health and Social Care Bill: http://t.co/XlGW995R (Mon, 27 Feb 2012 19:57:23 +0000)
@paulstpancras	RT @DrGrumble : Today’s #RCPEGM saw heavy criticism of the foundering Health and Social Care Bill: http://t.co/XlGW995R (Mon, 27 Feb 2012 19:59:46 +0000)
@TheNiceLadyDoc	""I think that leaves Cameron, Lansley, & the knife-wielders pretty much alone now. Finish the job, Surgeons!"" #RCPEGM http://t.co/V5mD7OEC (Mon, 27 Feb 2012 20:06:30 +0000)
@COPDdoc	RT @DrGrumble : Today’s #RCPEGM saw heavy criticism of the foundering Health and Social Care Bill: http://t.co/XlGW995R (Mon, 27 Feb 2012 20:10:07 +0000)
@Eadgifu	RT @DrGrumble : Today’s #RCPEGM saw heavy criticism of the foundering Health and Social Care Bill: http://t.co/XlGW995R (Mon, 27 Feb 2012 20:11:45 +0000)
@AngusCarruthers	RT @DrGrumble : Today’s #RCPEGM saw heavy criticism of the foundering Health and Social Care Bill: http://t.co/XlGW995R (Mon, 27 Feb 2012 20:21:43 +0000)
@dean_jenkins	Royal College of Physicians #RCPegm : Extraordinary General Meeting at Royal College of Physicians today. Some br... http://t.co/wOQdZ92h (Mon, 27 Feb 2012 20:54:45 +0000)
@dean_jenkins	RT @DrGrumble : The president's concern about Twitter users at the #RCPEGM has made me realise what an important medium it is. (Mon, 27 Feb 2012 21:00:01 +0000)
@dean_jenkins	. @DrGrumble just curated the tweets on the EGM (circulating the twitter minutes if you like) ... http://t.co/QFrevsH0 #nhsbill #RCPegm (Mon, 27 Feb 2012 21:01:15 +0000)
@DrGrumble	RT @GabrielScally : Warm praise for @clarercgp from a speaker ,applause results! #RCPegm (Mon, 27 Feb 2012 21:02:44 +0000)
@hipp0campus	RT @dean_jenkins : Royal College of Physicians #RCPegm : Extraordinary General Meeting at Royal College of Physicians today. Some br... http://t.co/wOQdZ92h (Mon, 27 Feb 2012 21:04:53 +0000)
@hipp0campus	RT @djnicholl : ""every consultant in this meeting should be calling on their MP for a meeting on a Friday to discuss #NHSBill "" #RCPegm Let's do this NOW!RT (Mon, 27 Feb 2012 21:05:47 +0000)
@successcvs	RT @djnicholl : ""every consultant in this meeting should be calling on their MP for a meeting on a Friday to discuss #NHSBill "" #RCPegm Let's do this NOW!RT (Mon, 27 Feb 2012 21:05:57 +0000)
@Dr_Aust_PhD	RT @DrGrumble : Today’s #RCPEGM saw heavy criticism of the foundering Health and Social Care Bill: http://t.co/XlGW995R (Mon, 27 Feb 2012 21:10:11 +0000)
@virginiamoffatt	RT @djnicholl : ""every consultant in this meeting should be calling on their MP for a meeting on a Friday to discuss #NHSBill "" #RCPegm Let's do this NOW!RT (Mon, 27 Feb 2012 21:11:15 +0000)
@milesmack	RT @DrGrumble : Today’s #RCPEGM saw heavy criticism of the foundering Health and Social Care Bill: http://t.co/XlGW995R (Mon, 27 Feb 2012 21:13:25 +0000)
@drobeirne	RT @dean_jenkins : Royal College of Physicians #RCPegm : Extraordinary General Meeting at Royal College of Physicians today. Some br...... (Mon, 27 Feb 2012 21:26:58 +0000)
@drmarielouise	RT @djnicholl : ""every consultant in this meeting should be calling on their MP for a meeting on a Friday to discuss #NHSBill "" #RCPegm Let's do this NOW!RT (Mon, 27 Feb 2012 21:27:03 +0000)

#twitjc Feb 26th 2012

Transcript of this evening's Twitter Journal Club (using an experimental Twitter chat curation tool).

Involved ...
@northern_doctor @twitjournalclub @silv24 @PaedsSHO @payamtorabi @GasCast @dsdarbyshire @elinlowri @andrew_dawes @amcunningham @Albajuly @bmdavies89 @Lush_London @tobyhillman @dannymcg @Puffles2010 @dean_jenkins @amitns @benedictwarner @mdthemd @sturob79 @tomayates @dermotor @mgcmitchell @pabakz @JoMacIver @justanotherSHO @wrexhamrob @Chipara @RikThomas @LizzyFerret @JDMoffatt @michealb @pipkelly @discthrower @SavvasN @cheekynurse11 @GPLEDeducation @gasclass @whole_patients @docshannon @MrEpid @rmtyner @Aghoury_ @PAT_Libraries @DrPlumEU @PHTwitJC @CatherinBrunton @EdanStarforth @taggiemonster

Top resources ...
http://www.twitjc.com/2012/02/week-16-low-molecular-weight-heparin-mortality-in-acutely-ill-medical-patients/
http://www.twitjc.com/2012/02/week-16-discussion-points-lmwh-mortality-in-medical-patients/
http://blogs.nejm.org/now/index.php/low-molecular-weight-heparin-in-medical-patients/2011/12/30/
http://www.twitjc.com/2012/02/week-16-low-molecular-weight-heparin-and-mortality-in-acutely-ill-medical-patients/
http://www.nejm.org/doi/full/10.1056/NEJMoa1111288

@twitjournalclub	The paper for this Sunday's #twitjc will be announced tomorrow...watch this space for further details (Mon, 20 Feb 2012 18:11:37 +0000)
@PAT_Libraries	RT @twitjournalclub : The paper for this Sunday's #twitjc will be announced tomorrow...watch this space for further details (Tue, 21 Feb 2012 09:35:14 +0000)
@GasCast	@silv24 @fidouglas @twitjournalclub - love the idea of #twitjc so much we've featured it on our latest podcast - http://t.co/28bQxNeR (Wed, 22 Feb 2012 13:56:59 +0000)
@twitjournalclub	Paper for this week& #39 ;s #twitjc will be Low-Molecular-Weight Heparin & Mortality in Acutely Ill Medical Patients http://t.co/JOdL2WyZ (Wed, 22 Feb 2012 17:42:52 +0000)
@twitjournalclub	New post: Week 16 http://t.co/7jcd9kzM #TwitJC (Wed, 22 Feb 2012 17:49:29 +0000)
@silv24	RT @twitjournalclub : Paper for this week& #39 ;s #twitjc will be Low-Molecular-Weight Heparin & Mortality in Acutely Ill Medical Patients http://t.co/JOdL2WyZ (Wed, 22 Feb 2012 17:51:58 +0000)
@silv24	RT @twitjournalclub : New post: Week 16 http://t.co/7jcd9kzM #TwitJC (Wed, 22 Feb 2012 17:52:05 +0000)
@DrPlumEU	RT @twitjournalclub : New post: Week 16 http://t.co/7jcd9kzM #TwitJC (Wed, 22 Feb 2012 17:55:57 +0000)
@PHTwitJC	RT @twitjournalclub : Paper for this week& #39 ;s #twitjc will be Low-Molecular-Weight Heparin & Mortality in Acutely Ill Medical Patients http://t.co/JOdL2WyZ (Wed, 22 Feb 2012 18:04:49 +0000)
@PaedsSHO	RT @twitjournalclub : New post: Week 16 http://t.co/7jcd9kzM #TwitJC (Wed, 22 Feb 2012 22:53:42 +0000)
@PaedsSHO	RT @twitjournalclub : Paper for this week& #39 ;s #twitjc will be Low-Molecular-Weight Heparin & Mortality in Acutely Ill Medical Patients http://t.co/JOdL2WyZ (Wed, 22 Feb 2012 22:53:48 +0000)
@Aghoury_	RT @twitjournalclub : Paper for this week& #39 ;s #twitjc will be Low-Molecular-Weight Heparin & Mortality in Acutely Ill Medical Patients http://t.co/JOdL2WyZ (Thu, 23 Feb 2012 23:12:15 +0000)
@rmtyner	@twitjournalclub Paper for this week& #39 ;s #twitjc will be LMWH & Mortality in Acutely Ill Medical Patients http://t.co/QT3hMegB #meded (Fri, 24 Feb 2012 02:28:27 +0000)
@silv24	The paper for this Sunday's #twitjc - summary of the paper to be posted shortly (delayed slightly by this virus) http://t.co/pZ2wwEtR (Fri, 24 Feb 2012 16:06:25 +0000)
@twitjournalclub	RT @silv24 : The paper for this Sunday's #twitjc - summary of the paper to be posted shortly (delayed slightly by this virus) http://t.co/pZ2wwEtR (Fri, 24 Feb 2012 16:06:48 +0000)
@gasclass	RT @silv24 : The paper for this Sunday's #twitjc - summary of the paper to be posted shortly (delayed slightly by this virus) http://t.co/pZ2wwEtR (Fri, 24 Feb 2012 16:35:59 +0000)
@silv24	@SuzetteWoodward This Sunday's #twitjc might interest you, LMWH and mortality in medical patients http://t.co/pZ2wwEtR (Fri, 24 Feb 2012 17:15:13 +0000)
@twitjournalclub	New post: Week 16 http://t.co/3pqzUzT5 #TwitJC (Fri, 24 Feb 2012 22:10:34 +0000)
@whole_patients	RT @silv24 : The paper for this Sunday's #twitjc - summary of the paper to be posted shortly (delayed slightly by this virus) http://t.co/pZ2wwEtR (Fri, 24 Feb 2012 22:58:39 +0000)
@PaedsSHO	Week 16 – Low Molecular Weight Heparin & Mortality in Acutely Ill Medical Patients http://t.co/JVBRkAjv #twitjc (Sat, 25 Feb 2012 00:38:09 +0000)
@docshannon	RT @PaedsSHO : Week 16 – Low Molecular Weight Heparin & Mortality in Acutely Ill Medical Patients http://t.co/JVBRkAjv #twitjc (Sat, 25 Feb 2012 09:24:11 +0000)
@silv24	Ahead of tomorrow's #twitjc - my summary of LMWH and mortality in acutely unwell medical patients http://t.co/IFQVHWX3 (Sat, 25 Feb 2012 14:43:47 +0000)
@twitjournalclub	RT @silv24 : Ahead of tomorrow's #twitjc - my summary of LMWH and mortality in acutely unwell medical patients http://t.co/IFQVHWX3 (Sat, 25 Feb 2012 14:44:17 +0000)
@PaedsSHO	RT @silv24 : Ahead of tomorrow's #twitjc - my summary of LMWH and mortality in acutely unwell medical patients http://t.co/IFQVHWX3 (Sat, 25 Feb 2012 14:45:03 +0000)
@silv24	Tomorrow's #twitjc should be interesting - does low molecular weight heparin as thromboprophlaxis affect mortality? http://t.co/IFQVHWX3 (Sat, 25 Feb 2012 14:45:54 +0000)
@Puffles2010	RT @silv24 : Ahead of tomorrow's #twitjc - my summary of LMWH and mortality in acutely unwell medical patients http://t.co/IFQVHWX3 (Sat, 25 Feb 2012 14:46:29 +0000)
@silv24	This is a great paper for medical student to join in & critique & an important patient safety issue - hoping for a lively discussion #twitjc (Sat, 25 Feb 2012 14:47:12 +0000)
@twitjournalclub	RT @silv24 : Tomorrow's #twitjc should be interesting - does low molecular weight heparin as thromboprophlaxis affect mortality? http://t.co/IFQVHWX3 (Sat, 25 Feb 2012 14:47:21 +0000)
@MrEpid	RT @silv24 : Tomorrow's #twitjc should be interesting - does low molecular weight heparin as thromboprophlaxis affect mortality? http://t.co/IFQVHWX3 (Sat, 25 Feb 2012 14:48:36 +0000)
@Chipara	RT @silv24 : Ahead of tomorrow's #twitjc - my summary of LMWH and mortality in acutely unwell medical patients http://t.co/IFQVHWX3 (Sat, 25 Feb 2012 14:53:33 +0000)
@amcunningham	@silv24 another pay walled journal article? :( #twitjc but interesting topic ++ (Sat, 25 Feb 2012 15:04:01 +0000)
@CatherinBrunton	RT @silv24 : Ahead of tomorrow's #twitjc - my summary of LMWH and mortality in acutely unwell medical patients http://t.co/IFQVHWX3 (Sat, 25 Feb 2012 15:51:11 +0000)
@silv24	@k2_UK tomorrow's journal club may interest, does prophylaxis with LMWH affect mortality in medical patients? #twitjc http://t.co/IFQVHWX3 (Sat, 25 Feb 2012 17:15:09 +0000)
@twitjournalclub	If anyone is having trouble accessing the full paper for tomorrow's #twitjc a link can be found at - http://t.co/Cn2gQL4L (Sat, 25 Feb 2012 17:49:22 +0000)
@silv24	RT @twitjournalclub : If anyone is having trouble accessing the full paper for tomorrow's #twitjc a link can be found at - http://t.co/Cn2gQL4L (Sat, 25 Feb 2012 17:52:19 +0000)
@EdanStarforth	RT @twitjournalclub : If anyone is having trouble accessing the full paper for tomorrow's #twitjc a link can be found at - http://t.co/Cn2gQL4L (Sat, 25 Feb 2012 17:56:26 +0000)
@PaedsSHO	RT @twitjournalclub : If anyone is having trouble accessing the full paper for tomorrow's #twitjc a link can be found at - http://t.co/Cn2gQL4L (Sat, 25 Feb 2012 19:01:54 +0000)
@pabakz	http://t.co/PVlPOGAe Not the easiest paper to access #twitjc (Sat, 25 Feb 2012 23:59:53 +0000)
@wrexhamrob	RT @twitjournalclub : If anyone is having trouble accessing the full paper for tomorrow's #twitjc a link can be found at - http://t.co/Cn2gQL4L (Sun, 26 Feb 2012 12:22:06 +0000)
@twitjournalclub	Don't miss #twitjc tonight - low-molecular weight heparin and mortality in medical patients - discussion starts at 8pm http://t.co/aCkr4vNq (Sun, 26 Feb 2012 12:47:38 +0000)
@silv24	RT @twitjournalclub : Don't miss #twitjc tonight - low-molecular weight heparin and mortality in medical patients - discussion starts at 8pm http://t.co/aCkr4vNq (Sun, 26 Feb 2012 12:48:19 +0000)
@silv24	If anyone is having trouble accessing the full paper for tonight's #twitjc a link can be found at - http://t.co/TNcmhUEr (Sun, 26 Feb 2012 12:49:22 +0000)
@twitjournalclub	RT @silv24 : If anyone is having trouble accessing the full paper for tonight's #twitjc a link can be found at - http://t.co/TNcmhUEr (Sun, 26 Feb 2012 12:50:04 +0000)
@jonthehen	RT @silv24 : If anyone is having trouble accessing the full paper for tonight's #twitjc a link can be found at - http://t.co/TNcmhUEr (Sun, 26 Feb 2012 12:51:30 +0000)
@parkerflash	RT @twitjournalclub : Don't miss #twitjc tonight - low-molecular weight heparin and mortality in medical patients - discussion starts at 8pm http://t.co/aCkr4vNq (Sun, 26 Feb 2012 12:53:08 +0000)
@Puffles2010	RT @silv24 : If anyone is having trouble accessing the full paper for tonight's #twitjc a link can be found at - http://t.co/TNcmhUEr (Sun, 26 Feb 2012 12:54:52 +0000)
@EpiSagar	RT @twitjournalclub : Don't miss #twitjc tonight - low-molecular weight heparin and mortality in medical patients - discussion starts at 8pm http://t.co/aCkr4vNq (Sun, 26 Feb 2012 12:54:57 +0000)
@living_as_if	RT @silv24 : If anyone is having trouble accessing the full paper for tonight's #twitjc a link can be found at - http://t.co/TNcmhUEr (Sun, 26 Feb 2012 12:55:59 +0000)
@twitjournalclub	New post: Week 16 - Discussion Point http://t.co/xkOse1dk #TwitJC (Sun, 26 Feb 2012 16:32:54 +0000)
@silv24	“ @twitjournalclub : New post: Week 16 - Discussion Point http://t.co/21UttdfJ #TwitJC ” - discussion starts at 8pm tonight - please join in (Sun, 26 Feb 2012 16:34:53 +0000)
@Puffles2010	Puffles says if you know any medics, please (*point*) them to @twitjournalclub & http://t.co/u8byW1qK #TwitJC (Sun, 26 Feb 2012 16:36:14 +0000)
@twitjournalclub	RT @silv24 : “ @twitjournalclub : New post: Week 16 - Discussion Point http://t.co/21UttdfJ #TwitJC ” - discussion starts at 8pm tonight - please join in (Sun, 26 Feb 2012 16:36:15 +0000)
@PaedsSHO	RT @twitjournalclub : New post: Week 16 - Discussion Point http://t.co/xkOse1dk #TwitJC (Sun, 26 Feb 2012 16:37:23 +0000)
@immigrant007	RT @Puffles2010 : Puffles says if you know any medics, please (*point*) them to @twitjournalclub & http://t.co/u8byW1qK #TwitJC (Sun, 26 Feb 2012 16:38:13 +0000)
@taggiemonster	RT @silv24 : “ @twitjournalclub : New post: Week 16 - Discussion Point http://t.co/21UttdfJ #TwitJC ” - discussion starts at 8pm tonight - please join in (Sun, 26 Feb 2012 16:45:28 +0000)
@dannymcg	RT @silv24 : “ @twitjournalclub : New post: Week 16 - Discussion Point http://t.co/21UttdfJ #TwitJC ” - discussion starts at 8pm tonight - please join in (Sun, 26 Feb 2012 16:47:36 +0000)
@silv24	“ @PaedsSHO : The paper can be found here: http://t.co/YMqXhKLV” #twitjc (Sun, 26 Feb 2012 18:08:52 +0000)
@silv24	Two hours until #twitjc - please say some of you are going to join in! It is a great paper up for discussion http://t.co/inB34OtI (Sun, 26 Feb 2012 18:10:32 +0000)
@DrDLittle	RT @silv24 : “ @twitjournalclub : New post: Week 16 - Discussion Point http://t.co/21UttdfJ #TwitJC ” - discussion starts at 8pm tonight - please join in (Sun, 26 Feb 2012 18:10:52 +0000)
@GPLEDeducation	RT @Puffles2010 : Puffles says if you know any medics, please (*point*) them to @twitjournalclub & http://t.co/u8byW1qK #TwitJC (Sun, 26 Feb 2012 18:12:57 +0000)
@pabakz	“ @silv24 @PaedsSHO : The paper can be found here: http://t.co/jq2uVkjg #twitjc >> only the abstract, unless I'm doing something wrong (Sun, 26 Feb 2012 18:20:41 +0000)
@tobyhillman	RT @silv24 : “ @twitjournalclub : New post: Week 16 - Discussion Point http://t.co/21UttdfJ #TwitJC ” - discussion starts at 8pm tonight - please join in (Sun, 26 Feb 2012 18:25:29 +0000)
@jenrow	RT @silv24 : Two hours until #twitjc - please say some of you are going to join in! It is a great paper up for discussion http://t.co/inB34OtI (Sun, 26 Feb 2012 18:28:40 +0000)
@silv24	Half an hour until tonight's #twitjc - low molecular weight heparin and mortality in acutely unwell medical patients - http://t.co/inB34OtI (Sun, 26 Feb 2012 19:30:20 +0000)
@twitjournalclub	RT @silv24 : Half an hour until tonight's #twitjc - low molecular weight heparin and mortality in acutely unwell medical patients - http://t.co/inB34OtI (Sun, 26 Feb 2012 19:30:38 +0000)
@Chipara	RT @silv24 : Half an hour until tonight's #twitjc - low molecular weight heparin and mortality in acutely unwell medical patients - http://t.co/inB34OtI (Sun, 26 Feb 2012 19:39:57 +0000)
@silv24	Hope everyone is ready for #twitjc .... (Sun, 26 Feb 2012 19:50:55 +0000)
@bmdavies89	@silv24 ready I think. But a #twitjc virgin (Sun, 26 Feb 2012 19:58:14 +0000)
@PaedsSHO	@bmdavies89 We'll be gentle with you ;-) #twitjc (Sun, 26 Feb 2012 19:59:51 +0000)
@GasCast	@silv24 ready and looking forward to my first #twitjc (Sun, 26 Feb 2012 19:59:54 +0000)
@twitjournalclub	@bmdavies89 welcome!! always great to have new people join in! #twitjc (Sun, 26 Feb 2012 20:00:16 +0000)
@twitjournalclub	Good evening and welcome to the 16th week of the journal club which will be run by @silv24 #twitjc (Sun, 26 Feb 2012 20:00:41 +0000)
@twitjournalclub	Tonight's paper is a very interesting one - Low molecular weight heparin and mortality in acutely unwell medical patients #twitjc (Sun, 26 Feb 2012 20:01:14 +0000)
@twitjournalclub	A summary of the paper http://t.co/3pqzUzT5 #twitjc (Sun, 26 Feb 2012 20:01:52 +0000)
@benedictwarner	Not had a chance to properly read the paper, but looking forward to quietly following my first #twitjc over dinner... #twitjc (Sun, 26 Feb 2012 20:02:17 +0000)
@payamtorabi	#twitjc Hello! (Sun, 26 Feb 2012 20:02:19 +0000)
@twitjournalclub	To start with - introductions.... #twitjc (Sun, 26 Feb 2012 20:03:01 +0000)
@silv24	Hi, Natalie currently a F2 in ITU and soon to be ACCS anaesthetics trainee. Will be running the journal club again tonight #twitjc (Sun, 26 Feb 2012 20:04:00 +0000)
@dsdarbyshire	#twitjc Hi! Dan, anatomy demonstrator, sometime A&E SHO. (Sun, 26 Feb 2012 20:04:42 +0000)
@PaedsSHO	David, current NICU doc but soon to be adult intensivist. #twitjc (Sun, 26 Feb 2012 20:04:46 +0000)
@payamtorabi	#twitjc I'm Payam an F2 currently on Cardiology at Newham. Only my second #twitjc (Sun, 26 Feb 2012 20:05:17 +0000)
@sturob79	Hi Stuart Gen Surg SpR #twitjc (Sun, 26 Feb 2012 20:05:32 +0000)
@northern_doctor	I'm Mark - medical registrar specialising in elderly care and stroke #twitjc (Sun, 26 Feb 2012 20:05:33 +0000)
@Microblog_me_uk	Ok, lets begin #twitjc (Sun, 26 Feb 2012 20:05:46 +0000)
@bmdavies89	Ben. Med Student in Manchester #twitjc (Sun, 26 Feb 2012 20:06:41 +0000)
@twitjournalclub	Thank you all and great to see some new faces. And so on with the discussion with the first discussion point... #twitjc (Sun, 26 Feb 2012 20:07:02 +0000)
@GasCast	Hi - I'm Rik. Anaesthetics ST5. #twitjc (Sun, 26 Feb 2012 20:07:02 +0000)
@andrew_dawes	OK gonna try to join in #twitjc . Another newie be kind silvey!! (Sun, 26 Feb 2012 20:07:10 +0000)
@elinlowri	Elin - respiratory and acute medicine consultant #twitjc but have poorly child so may dip in and out! (Sun, 26 Feb 2012 20:07:46 +0000)
@amitns	Hi, Amit, GP #twitjc (Sun, 26 Feb 2012 20:07:47 +0000)
@mgcmitchell	Mark - Med student and Pharmacist #twitjc (Sun, 26 Feb 2012 20:07:56 +0000)
@twitjournalclub	Is the methodology of the study robust enough to support the conclusion that the use of LMWH doesn't alter mortality in medical pts? #twitjc (Sun, 26 Feb 2012 20:08:22 +0000)
@andrew_dawes	FY2 Doctor A&E #twitjc (Sun, 26 Feb 2012 20:08:49 +0000)
@discthrower	@PaedsSHO what's #twitjc ? (Sun, 26 Feb 2012 20:09:20 +0000)
@silv24	@andrew_dawes I am always kind Dawes!! #twitjc (Sun, 26 Feb 2012 20:09:37 +0000)
@PaedsSHO	So, methodology; double-blind, placebo-controlled, randomised, international, multi-centre... good start! #twitjc (Sun, 26 Feb 2012 20:09:38 +0000)
@northern_doctor	Methodology of study was robust, but caution with extrapolation of results given demographics of study population (ie. not western) #twitjc (Sun, 26 Feb 2012 20:10:07 +0000)
@RikThomas	Only within the limits of the study i.e. geography (narrow) and patient selection (low numbers with Hx of VTE) #twitjc (Sun, 26 Feb 2012 20:10:14 +0000)
@northern_doctor	So for population studied, yes, conclusions seem to be based on sound methods #twitjc (Sun, 26 Feb 2012 20:10:38 +0000)
@payamtorabi	#twitjc yeah. I struggled to find much to complain about methodologically! (Sun, 26 Feb 2012 20:10:47 +0000)
@PaedsSHO	That said, none of the centres used are very close to the UK in terms of demographics. #twitjc (Sun, 26 Feb 2012 20:11:01 +0000)
@bmdavies89	Didn't see their exclusion appendix but does seem population bereft of major RFs for an adverse outcome #twitjc (Sun, 26 Feb 2012 20:11:08 +0000)
@andrew_dawes	Attempt at trying to calculate power of study needed according to effect expected - also good #twitjc (Sun, 26 Feb 2012 20:11:11 +0000)
@silv24	Good points - multicentre, randomised, double blind and international, clear inclusion and exclusion criteria #twitjc (Sun, 26 Feb 2012 20:11:22 +0000)
@dsdarbyshire	#twitjc No. The populations are incredibly diverse and a difference in one may be masked by the lack in others. (Sun, 26 Feb 2012 20:12:00 +0000)
@payamtorabi	#twitjc True, but no similar study (mortality as end-point) done on western caucasian population as far as I could find... (Sun, 26 Feb 2012 20:12:26 +0000)
@andrew_dawes	Thought the demographc young compared to UK MAU intake. #twitjc (Sun, 26 Feb 2012 20:12:30 +0000)
@twitjournalclub	Are there any obvious flaws in the study design? #twitjc (Sun, 26 Feb 2012 20:12:33 +0000)
@SavvasN	RT @silv24 : Good points - multicentre, randomised, double blind and international, clear inclusion and exclusion criteria #twitjc (Sun, 26 Feb 2012 20:12:51 +0000)
@bmdavies89	Side point but Could someone clarify the study power, when they mention 77% power to ..... #twitjc (Sun, 26 Feb 2012 20:13:26 +0000)
@northern_doctor	@andrew_dawes Maybe, but a quarter of study population were >75, so that's not too exclusive #twitjc (Sun, 26 Feb 2012 20:13:46 +0000)
@benedictwarner	Interesting-wld we be asking same question of a study ONLY carried out in western/caucasian pop? (eg does this apply to my 'x' pts?) #twitjc (Sun, 26 Feb 2012 20:14:22 +0000)
@twitjournalclub	RT @bmdavies89 : Side point but Could someone clarify the study power, when they mention 77% power to ..... #twitjc (Sun, 26 Feb 2012 20:14:37 +0000)
@benedictwarner	(where x=any non-caucasian group) #twitjc (Sun, 26 Feb 2012 20:14:48 +0000)
@payamtorabi	#twitjc my personal bias is that I feel for a purely preventative treatment we need exceptionally robust evidence before we start using it (Sun, 26 Feb 2012 20:15:07 +0000)
@northern_doctor	Wouldn't call it a *flaw* but I think it's important to point out that the max length of treatment was 14 days #twitjc (Sun, 26 Feb 2012 20:15:40 +0000)
@GasCast	The study was underpowered because the overall mortality rate was lower than predicted. However, only .1% difference between groups. #twitjc (Sun, 26 Feb 2012 20:15:55 +0000)
@dsdarbyshire	@benedictwarner #twitjc we would if we work outside the western world. (Sun, 26 Feb 2012 20:16:05 +0000)
@PaedsSHO	@benedictwarner I think that if the trial was done purely in the UK, docs in China would rightly ask about applicability to them! #twitjc (Sun, 26 Feb 2012 20:16:14 +0000)
@cheekynurse11	RT @northern_doctor : I'm Mark - medical registrar specialising in elderly care and stroke #twitjc (Sun, 26 Feb 2012 20:16:15 +0000)
@northern_doctor	Suspect they did this to make it comparable with previous trials that have studied prophylactic LMWH and shown reduction in VTE #twitjc (Sun, 26 Feb 2012 20:16:31 +0000)
@payamtorabi	@northern_doctor that's fairly typical length of stay for UK adult inpatients though? #twitjc (Sun, 26 Feb 2012 20:17:01 +0000)
@silv24	Reading throughly the study design it seems very well thought out and clearly set out - I can't see any obvious flaws #twitjc (Sun, 26 Feb 2012 20:17:05 +0000)
@sturob79	the problem is the patient groups most mortality will be from primary disease not VTE therefore grossly underpowered #twitjc (Sun, 26 Feb 2012 20:17:09 +0000)
@northern_doctor	I would be interested to know the mean length of treatment in a real hospital population - suspect many pts given it for much longer #twitjc (Sun, 26 Feb 2012 20:17:26 +0000)
@dsdarbyshire	#twitjc they continue treatment at home. Not standard practice as far as I know. (Sun, 26 Feb 2012 20:17:39 +0000)
@mdthemd	@silv24 power calc difficult given lack of previous and usually a huge number when calculated Hence lower power as compromise #twitjc (Sun, 26 Feb 2012 20:17:48 +0000)
@RikThomas	@benedictwarner see ref 29 - rarity of PE in Asians #twitjc (Sun, 26 Feb 2012 20:18:11 +0000)
@northern_doctor	@payamtorabi Yes, but I'm also interested in the pt population who have long stays and are on LMWH for the duration #twitjc (Sun, 26 Feb 2012 20:18:20 +0000)
@twitjournalclub	Leading on to point 2 - Was all-cause mortality the right primary end point for this study? #twitjc (Sun, 26 Feb 2012 20:18:56 +0000)
@payamtorabi	@northern_doctor Ah, I see! #twitjc (Sun, 26 Feb 2012 20:19:17 +0000)
@amcunningham	@kerryhood very strangely your tweets not showing up when I search #twitjc so others might not be seeing! (Sun, 26 Feb 2012 20:19:40 +0000)
@northern_doctor	Good question...! RT @twitjournalclub : Leading on to point 2 - Was all-cause mortality the right primary end point for this study? #twitjc (Sun, 26 Feb 2012 20:19:44 +0000)
@GasCast	@twitjournalclub I think so but I was surprised at how rare PE was as a cause of mortality. #twitjc (Sun, 26 Feb 2012 20:19:50 +0000)
@amcunningham	“ @kerryhood : I did have one Q (sorry not a clinician) - is bruising likely to unblind? #twitjc ” (Sun, 26 Feb 2012 20:20:22 +0000)
@Albajuly	@twitjournalclub Sorry, sneaking in the back late! Med Cons. Whilst the study is sound, I think the end-point is of little value. #twitjc (Sun, 26 Feb 2012 20:20:26 +0000)
@northern_doctor	All-cause mortality was an interesting thing to look at. After all, that's what we're hoping to improve by giving the rx #twitjc (Sun, 26 Feb 2012 20:20:31 +0000)
@amcunningham	“ @kerryhood : @bmdavies89 post hoc power calc given low death rate (my pet hate!) #twitjc ” (Sun, 26 Feb 2012 20:20:35 +0000)
@payamtorabi	RT @amcunningham : @kerryhood very strangely your tweets not showing up when I search #twitjc so others might not be seeing! (Sun, 26 Feb 2012 20:20:54 +0000)
@northern_doctor	Prev studies have shown a reduction in VTE with LMWH, but what does that actually mean for the patient? #twitjc (Sun, 26 Feb 2012 20:21:02 +0000)
@Albajuly	@twitjournalclub I have no expectations of enoxaparin reducing mortality from sepsis or cancer. #twitjc (Sun, 26 Feb 2012 20:21:06 +0000)
@dsdarbyshire	#twitjc all cause mortality is the ultimate question. Doesn't answer it so a more precise measure would have greater utility. (Sun, 26 Feb 2012 20:21:10 +0000)
@twitjournalclub	@Albajuly oh, why do you say that? #twitjc (Sun, 26 Feb 2012 20:21:11 +0000)
@PaedsSHO	I thought the primary outcome was a very interesting choice, and probably the right one. #twitjc (Sun, 26 Feb 2012 20:21:29 +0000)
@northern_doctor	Controversial? MT @Albajuly : Whilst the study is sound, I think the end-point is of little value. #twitjc (Sun, 26 Feb 2012 20:22:00 +0000)
@GasCast	@Albajuly I always thought the PE was a big source of mortality in cancer? #twitjc (Sun, 26 Feb 2012 20:22:27 +0000)
@payamtorabi	RT @PaedsSHO : I thought the primary outcome was a very interesting choice, and probably the right one. #twitjc (Sun, 26 Feb 2012 20:22:28 +0000)
@PaedsSHO	@Albajuly why not? Both sepsis and malignancy are risk factors for VTE. #twitjc (Sun, 26 Feb 2012 20:22:37 +0000)
@twitjournalclub	@Albajuly you answered my question with your second point about reducing mortality #twitjc (Sun, 26 Feb 2012 20:22:38 +0000)
@northern_doctor	Remember prev studies in support of VTE prophylaxis went looking for VTE that would not have necessarily been clinical suspected! #twitjc (Sun, 26 Feb 2012 20:22:48 +0000)
@amcunningham	“ @kerryhood : does a more precise measure matter if it doesn't have an effect on all cause mortality? #twitjc ” (Sun, 26 Feb 2012 20:22:51 +0000)
@andrew_dawes	@northern_doctor - agree brave - but would have been safer to show reduction in VTE? #twitjc (Sun, 26 Feb 2012 20:23:16 +0000)
@Albajuly	@twitjournalclub The inclusion of the term 'active cancer' I may be missing something but could this mean terminally ill? #twitjc (Sun, 26 Feb 2012 20:23:47 +0000)
@bmdavies89	It should be considered. Does the similarity between placebo and LMWH evidence safety of LMWH prophylaxis? #twitjc (Sun, 26 Feb 2012 20:24:01 +0000)
@twitjournalclub	If not all cause mortality, what other measures could have been used? #twitjc (Sun, 26 Feb 2012 20:24:07 +0000)
@payamtorabi	@amcunningham @kerryhood Well, exactly #twitjc (Sun, 26 Feb 2012 20:24:17 +0000)
@northern_doctor	This has already been done, hence a different study question! RT @andrew_dawes : would have been safer to show reduction in VTE? #twitjc (Sun, 26 Feb 2012 20:24:20 +0000)
@elinlowri	@silv24 @andrew_dawes @northern_doctor But a lot of VTE is not diagnosed, which is why mortality is the best endpoint #twitjc (Sun, 26 Feb 2012 20:24:34 +0000)
@dermotor	@northern_doctor @payamtorabi Do think that there are patients on LMWH for too long. Assessed as @ risk & prescribed for whole stay #twitjc (Sun, 26 Feb 2012 20:24:34 +0000)
@northern_doctor	Trials have already shown that we can prevent VTE with LMWH, but does it make a difference in overall outcomes if we do this? #twitjc (Sun, 26 Feb 2012 20:25:05 +0000)
@northern_doctor	Yes! RT @dermotor : Do think that there are patients on LMWH for too long. Assessed as @ risk & prescribed for whole stay #twitjc (Sun, 26 Feb 2012 20:25:21 +0000)
@Albajuly	@payamtorabi @northern_doctor Aren't we using enoxaparin to reduce death from VTE? #twitjc (Sun, 26 Feb 2012 20:25:24 +0000)
@mdthemd	All cause mortality is easy and reliable to record Hence Also previously reported in the literature and used 4 power calc #twitjc (Sun, 26 Feb 2012 20:25:26 +0000)
@JoMacIver	Love it when studies measure the thing we're interested in. Doesn't matter if it stops a few VTEs if it causes more mortality! #twitjc (Sun, 26 Feb 2012 20:25:31 +0000)
@northern_doctor	Agree! RT @elinlowri : But a lot of VTE is not diagnosed, which is why mortality is the best endpoint #twitjc (Sun, 26 Feb 2012 20:25:37 +0000)
@andrew_dawes	@northern_doctor Thank you!! #twitjc (Sun, 26 Feb 2012 20:25:41 +0000)
@Lush_London	@twitjournalclub #twitjc mortality related to VTE? PE etc? (Sun, 26 Feb 2012 20:25:47 +0000)
@sturob79	@northern_doctor it depends on your background mortality rate related to primary disease #twitjc (Sun, 26 Feb 2012 20:26:02 +0000)
@elinlowri	@northern_doctor Exactly. No point faffing about with heparin if people die anyway, despite it seeming the right thing to do #twitjc (Sun, 26 Feb 2012 20:26:25 +0000)
@GasCast	@Albajuly but despite common sense, there doesn't seem to be a huge link between VTE and death. #twitjc (Sun, 26 Feb 2012 20:26:44 +0000)
@Albajuly	@northern_doctor Personally I see LMWH as an attempt to reduce mortality from VTE whilst we attempt to treat their other illness #twitjc (Sun, 26 Feb 2012 20:26:54 +0000)
@GasCast	Only 1 patient in each group had PE as cause of death #twitjc (Sun, 26 Feb 2012 20:27:05 +0000)
@PaedsSHO	I thought it was interesting that patients were ineligible if predicted hospitalisation was less than 6 days. #twitjc (Sun, 26 Feb 2012 20:27:37 +0000)
@payamtorabi	@Albajuly @northern_doctor but it could increase risk of death from other causes? #twitjc (Sun, 26 Feb 2012 20:28:07 +0000)
@andrew_dawes	@payamtorabi @northern_doctor I meant safer for the drug Co as that is is easier to prove beneficial effect #twitjc (Sun, 26 Feb 2012 20:28:23 +0000)
@twitjournalclub	RT @PaedsSHO : I thought it was interesting that patients were ineligible if predicted hospitalisation was less than 6 days. #twitjc (Sun, 26 Feb 2012 20:28:36 +0000)
@Lush_London	@PaedsSHO #twitjc exactly - so how comparable to UK? (Sun, 26 Feb 2012 20:28:37 +0000)
@pipkelly	#twitjc mortality seems exactly what's important (Sun, 26 Feb 2012 20:28:41 +0000)
@northern_doctor	Would you treat this population in real life? RT @PaedsSHO : Patients were ineligible if predicted hospitalisation was <6 days. #twitjc (Sun, 26 Feb 2012 20:29:01 +0000)
@dsdarbyshire	#twitjc to adequately measure all cause mortality you need a big sample in a homogenous population. This study doesn't do that. (Sun, 26 Feb 2012 20:29:13 +0000)
@Albajuly	@payamtorabi @northern_doctor And that's where the incidence of haemorrhage recorded is useful. #twitjc (Sun, 26 Feb 2012 20:29:39 +0000)
@justanotherSHO	I brought this paper up with our 'VTE specialist nurse'. He said 'well, its what NICE recommends...' #sigh #twitjc (Sun, 26 Feb 2012 20:30:01 +0000)
@PaedsSHO	@northern_doctor If they had plenty of risk factors, probably. You may be asking the wrong specialist though ;-) #twitjc (Sun, 26 Feb 2012 20:30:05 +0000)
@elinlowri	I suspect mortality may have been lower than 'normal' in both groups because underlying conditions better treated #twitjc (Sun, 26 Feb 2012 20:30:27 +0000)
@northern_doctor	@Albajuly Me too? But is it effective and safe? Especially for longer admissions? Don't think we really know. #twitjc (Sun, 26 Feb 2012 20:30:28 +0000)
@silv24	@northern_doctor @paedssho according to our risk assessment tool yes if they had any risk factors for VTE #twitjc (Sun, 26 Feb 2012 20:30:40 +0000)
@bmdavies89	@dsdarbyshire #twitjc how big is big? (Sun, 26 Feb 2012 20:30:59 +0000)
@Albajuly	@twitjournalclub I think the problem is using such a wide range of conditions vaguely defined. Impossible to match the groups #twitjc (Sun, 26 Feb 2012 20:31:01 +0000)
@twitjournalclub	Moving onto the third point - Are the results of this study applicable to a Western population? #twitjc (Sun, 26 Feb 2012 20:31:12 +0000)
@GasCast	I thought it was interesting that the MEDENOX trial that did show a difference in mortality had 10 times higher Hx of VTE. #twitjc (Sun, 26 Feb 2012 20:31:15 +0000)
@northern_doctor	@justanotherSHO And hence why he has a job! NICE has improved the screening and prophylactic treatment, but is there more to it? #twitjc (Sun, 26 Feb 2012 20:31:45 +0000)
@Albajuly	@twitjournalclub I think the end point would have been fine if the condition range had been more specific. #twitjc (Sun, 26 Feb 2012 20:31:46 +0000)
@amcunningham	“ @kerryhood : @GasCast @Albajuly but with ongoing malignancy you would want to continue treating not stop at 14 days #twitjc ” (Sun, 26 Feb 2012 20:31:51 +0000)
@amcunningham	“ @kerryhood : @northern_doctor @sturob79 no randomisation doesn't - need a more targetted population #twitjc ” (Sun, 26 Feb 2012 20:32:08 +0000)
@northern_doctor	Maybe but no way of knowing for sure! RT @twitjournalclub : Are the results of this study applicable to a Western population? #twitjc (Sun, 26 Feb 2012 20:32:28 +0000)
@Puffles2010	Puffles (*invites*) healthcare professionals to follow & join in the debate at #twitjc (Sun, 26 Feb 2012 20:32:47 +0000)
@GasCast	@andrew_dawes I agree. I thought that was weird. #twitjc (Sun, 26 Feb 2012 20:32:53 +0000)
@elinlowri	@amcunningham @kerryhood @GasCast @Albajuly True - trials in lung cancer suggest it improves outcome #twitjc (Sun, 26 Feb 2012 20:33:18 +0000)
@Lush_London	@twitjournalclub as @PaedsSHO said, only its with stay of 6+ days anticipated, so not that applicable to UK for surgical patients? #twitjc (Sun, 26 Feb 2012 20:33:30 +0000)
@PaedsSHO	@GasCast @andrew_dawes No autopsies performed in either group. #twitjc (Sun, 26 Feb 2012 20:33:53 +0000)
@twitjournalclub	And could such a study be carried out in a hospital in the UK given the emphasis on prescription of LMWH in NICE guidelines? #twitjc (Sun, 26 Feb 2012 20:33:57 +0000)
@dsdarbyshire	#twitjc all cause and specific conditions not compatible in same study. Need specific studies for specific diseases in specific situations. (Sun, 26 Feb 2012 20:34:04 +0000)
@elinlowri	Are the results of this study applicable to a Western population? #twitjc Errr, probably. (Sun, 26 Feb 2012 20:34:29 +0000)
@andrew_dawes	@GasCast But did they actively investigate for PE? Cause of death was resp failure in this study - not allowed in UK #twitjc (Sun, 26 Feb 2012 20:34:41 +0000)
@dsdarbyshire	#twitjc this study cannot be applied to any population as it encompasses too many different ones. (Sun, 26 Feb 2012 20:35:11 +0000)
@GasCast	@Lush_London Surgical patients already have proven reduction in mortality, although two papers referenced are from 1975 & 1988! #twitjc (Sun, 26 Feb 2012 20:35:16 +0000)
@northern_doctor	No! Unethical! MT @twitjournalclub : Could study be carried out in UK given emphasis on prescription of LMWH in NICE guidelines? #twitjc (Sun, 26 Feb 2012 20:35:24 +0000)
@PaedsSHO	@Lush_London @twitjournalclub Exclusion criteria (appendix 2) removed all surgical patients. #twitjc (Sun, 26 Feb 2012 20:35:33 +0000)
@elinlowri	@twitjournalclub I think this would be like trying to trial steroids in lung fibrosis - the horse has bolted. #twitjc (Sun, 26 Feb 2012 20:35:35 +0000)
@Lush_London	#twitjc cannot see they analysed by medical or surgical pts, and different rates of VTE in those 2 groups (Sun, 26 Feb 2012 20:35:56 +0000)
@silv24	There are a couple of studies referenced that show little difference in frequency DVTs in Asian and Western populations #twitjc (Sun, 26 Feb 2012 20:36:08 +0000)
@bmdavies89	I think such a trial in the UK would face serious ethical dilemmas over safety of placebo. Would struggle with red tape? #twitjc (Sun, 26 Feb 2012 20:36:19 +0000)
@Albajuly	@twitjournalclub It would be near impossible to gain ethical approval in the UK, esp. since you would be consenting an acute pt #twitjc (Sun, 26 Feb 2012 20:36:24 +0000)
@GasCast	@twitjournalclub Yes - because NICE guidelines are evidence based and this is the latest evidence #twitjc (Sun, 26 Feb 2012 20:36:29 +0000)
@twitjournalclub	@northern_doctor why unethical if as far as we know there is no difference in mortality? #twitjc (Sun, 26 Feb 2012 20:37:11 +0000)
@dannymcg	@twitjournalclub Doubt it, ethics committee would have a little fit #twitjc (Sun, 26 Feb 2012 20:37:24 +0000)
@northern_doctor	But areas that still lack evidence base include longer duration of stay, and use in CRF or AKI #twitjc (Sun, 26 Feb 2012 20:37:30 +0000)
@payamtorabi	@dsdarbyshire bt at present we dn't have this yet DO prescribe LMWH. Srely til we have evidence of efficacy for specific situations.. #twitjc (Sun, 26 Feb 2012 20:37:34 +0000)
@twitjournalclub	If there is clinical uncertainty would be be unethical to carry out such a trial in a UK hospital? #twitjc (Sun, 26 Feb 2012 20:37:49 +0000)
@mdthemd	@twitjournalclub a protocol like this would not gain ethical approval in UK Also VTE now enshrined in new outcomes for MONITOR #twitjc (Sun, 26 Feb 2012 20:37:57 +0000)
@dsdarbyshire	#twitjc perhaps retrospective using those patients who ""fail"" to receive VTE prophylaxis. (Sun, 26 Feb 2012 20:38:01 +0000)
@northern_doctor	Other studies have shown increased bleeding risk with eGFR <30 (reduced dose of LMWH doesn't improve this, only lessens efficacy) #twitjc (Sun, 26 Feb 2012 20:38:08 +0000)
@PaedsSHO	To be done in UK, any consent form would have to be VERY carefully worded! #twitjc (Sun, 26 Feb 2012 20:38:19 +0000)
@northern_doctor	@twitjournalclub Because it's already enshrined within NICE guidelines as 'best practice' #twitjc (Sun, 26 Feb 2012 20:38:45 +0000)
@bmdavies89	RT @dsdarbyshire : #twitjc perhaps retrospective using those patients who ""fail"" to receive VTE prophylaxis. (Sun, 26 Feb 2012 20:38:50 +0000)
@Lush_London	@PaedsSHO #twitjc apologies didn't see appendix, so none of medical pts admitted for surgery (Sun, 26 Feb 2012 20:38:53 +0000)
@elinlowri	But I d love to see the use of heparin rationalised - it is part of CQUIN and takes up a whole page of admission proforma! #twitjc (Sun, 26 Feb 2012 20:38:54 +0000)
@Albajuly	@twitjournalclub Not unethical on it's face, given there is a potential complication (haemorrhage). But practically? #twitjc (Sun, 26 Feb 2012 20:39:33 +0000)
@amcunningham	“ @kerryhood are the patients likely to have received different treatments to Western ones that affect the risk profile? #twitjc ” (Sun, 26 Feb 2012 20:39:39 +0000)
@GasCast	@Albajuly why does consenting an acute patient create an ethical problem? #twitjc (Sun, 26 Feb 2012 20:39:43 +0000)
@twitjournalclub	@northern_doctor but does best practice with little evidence trump genuine clinical uncertainty when it comes to trial ethics? #twitjc (Sun, 26 Feb 2012 20:39:44 +0000)
@JoMacIver	@silv24 #twitjc Surely more interested in effect of LMWH in the different pops than the freq of events? (Sun, 26 Feb 2012 20:39:57 +0000)
@northern_doctor	In my trust they're so focused on VTE screening, no tests can be ordered or prescriptions written until it's been done. #crazy #twitjc (Sun, 26 Feb 2012 20:40:17 +0000)
@dsdarbyshire	@payamtorabi #twitjc That is the difference between research design and clinical practice. Agree it's important to consider. (Sun, 26 Feb 2012 20:40:24 +0000)
@northern_doctor	RT @twitjournalclub : Does best practice with little evidence trump genuine clinical uncertainty when it comes to trial ethics? #twitjc (Sun, 26 Feb 2012 20:40:33 +0000)
@PaedsSHO	@northern_doctor I used to have a consultant who wouldn't allow you to present a post-take patient without a VTE assessment! #twitjc (Sun, 26 Feb 2012 20:41:21 +0000)
@twitjournalclub	RT @dannymcg : @twitjournalclub Doubt it, ethics committee would have a little fit #twitjc (Sun, 26 Feb 2012 20:41:46 +0000)
@GasCast	@northern_doctor it certainly shouldn't #twitjc (Sun, 26 Feb 2012 20:41:47 +0000)
@twitjournalclub	RT @Albajuly : @twitjournalclub Not unethical on it's face, given there is a potential complication (haemorrhage). But practically? #twitjc (Sun, 26 Feb 2012 20:41:53 +0000)
@mdthemd	@twitjournalclub actually trusts would not give governance approval so ethics committee would not have to discuss and thats b4 MHRA #twitjc (Sun, 26 Feb 2012 20:41:56 +0000)
@northern_doctor	@twitjournalclub That's a whole different debate! Agree in theory, but practically couldn't do it. Would never get ethical approval. #twitjc (Sun, 26 Feb 2012 20:42:02 +0000)
@elinlowri	Would need to be a massive study to be properly powered, pragmatic to be do-able, funding might be MRC/NIHR - big ask #twitjc (Sun, 26 Feb 2012 20:42:08 +0000)
@amcunningham	“ @kerryhood : @twitjournalclub @northern_doctor it shouldn't and probably is surmountable, but would need to be very convincing! #twitjc ” (Sun, 26 Feb 2012 20:42:18 +0000)
@payamtorabi	@dsdarbyshire yes. but at present clinical practice has lept ahead of the available evidence... #twitjc (Sun, 26 Feb 2012 20:42:23 +0000)
@northern_doctor	@PaedsSHO Post-take a bit different as you've had time to do initial management. Not so good when urgent treatments or tests needed #twitjc (Sun, 26 Feb 2012 20:42:47 +0000)
@twitjournalclub	RT @elinlowri : Would need to be a massive study to be properly powered, pragmatic to be do-able, funding might be MRC/NIHR -big ask #twitjc (Sun, 26 Feb 2012 20:42:48 +0000)
@justanotherSHO	#anecdotalevidence The only deaths from PE I have seen in inpatients have all had disseminated cancer already #twitjc . (Sun, 26 Feb 2012 20:43:12 +0000)
@GasCast	With this study in mind, I would like to see a comparison of LMWH vs. TEDS #twitjc (Sun, 26 Feb 2012 20:43:33 +0000)
@dannymcg	@northern_doctor now that is utterly mad. No, please stop CPR until someone fills in the form. #WorldGoneMad #twitjc (Sun, 26 Feb 2012 20:43:53 +0000)
@northern_doctor	I'll rephrase - I personally don't consider it unethical (because of arguements re evidence) but an ethics committee would #twitjc (Sun, 26 Feb 2012 20:44:03 +0000)
@elinlowri	We used to think every acute patient should be on PPI's but now the pharmacists go round crossing them off - things change! #twitjc (Sun, 26 Feb 2012 20:44:50 +0000)
@northern_doctor	Agree! RT @payamtorabi : At present clinical practice has lept ahead of the available evidence... #twitjc (Sun, 26 Feb 2012 20:45:10 +0000)
@twitjournalclub	And this brings us perfectly to the last point - Are compression stockings alone enough as thromboprophylaxis in medical patients? #twitjc (Sun, 26 Feb 2012 20:45:12 +0000)
@GasCast	@northern_doctor I disagree and it was a French ethics committee that approved this #twitjc (Sun, 26 Feb 2012 20:45:15 +0000)
@bmdavies89	@northern_doctor #twitjc absolutely- too scared of being sued. (Sun, 26 Feb 2012 20:45:22 +0000)
@dsdarbyshire	#twitjc are we underestimating the benefit of TEDS? (Sun, 26 Feb 2012 20:45:56 +0000)
@amcunningham	“ @kerryhood : @elinlowri agree, but I'm not sure that they would want to fund after this study - maybe NICE will rethink guidance #twitjc ” (Sun, 26 Feb 2012 20:46:01 +0000)
@payamtorabi	@twitjournalclub Probs need another study for that? #twitjc (Sun, 26 Feb 2012 20:46:28 +0000)
@dannymcg	@PaedsSHO @northern_doctor I had Consultant who said proformas were killing clinical acumen. I couldn't agree more. #twitjc (Sun, 26 Feb 2012 20:46:36 +0000)
@amcunningham	RT @northern_doctor : Agree! RT @payamtorabi : At present clinical practice has lept ahead of the available evidence... #twitjc (Sun, 26 Feb 2012 20:46:40 +0000)
@GasCast	Bearing in mind estimated mortality was 7% and measured was 4.7% - TEDS are awesome! #TEDS #twitjc (Sun, 26 Feb 2012 20:46:53 +0000)
@northern_doctor	Sorry, mistake on last tweet - we *don't* use TEDS for stroke patients any more. No benefit, but risk of complications! #twitjc (Sun, 26 Feb 2012 20:46:59 +0000)
@elinlowri	'Are compression stockings alone enough thromboprophylaxis in medical patients?' - well, maybe! Wouldn't that be great/cheap/safe #twitjc (Sun, 26 Feb 2012 20:47:23 +0000)
@twitjournalclub	RT @northern_doctor : mistake on last tweet - we *dont* use TEDS for stroke patients any more. No benefit, but risk of complications! #twitjc (Sun, 26 Feb 2012 20:47:52 +0000)
@Lush_London	@twitjournalclub in the population they studied then probably, but no agreement whether applicable in UK #twitjc (Sun, 26 Feb 2012 20:47:54 +0000)
@payamtorabi	@elinlowri as long as we make sure our patients don't have PVD before we prescribe! #twitjc (Sun, 26 Feb 2012 20:48:29 +0000)
@PaedsSHO	@northern_doctor Use of TEDS ineffective in preventing DVT in stroke patients; CLOTS trial #twitjc (Sun, 26 Feb 2012 20:48:36 +0000)
@twitjournalclub	MT @elinlowri : Are compression stockings alone enough thromboprophylaxis in medical pts? - maybe! Wouldnt that be great/cheap/safe #twitjc (Sun, 26 Feb 2012 20:48:58 +0000)
@northern_doctor	Evidence shows LMWH reduces VTE, but no evidence of mortality reduction. Is VTE reduction alone enough to justify rx? NICE says yes #twitjc (Sun, 26 Feb 2012 20:49:27 +0000)
@northern_doctor	@PaedsSHO Yes, I knew that. Mistyped original tweet. *hangs head in shame* #twitjc (Sun, 26 Feb 2012 20:50:02 +0000)
@dsdarbyshire	#twitjc getting out of bed every couple of hours, for those that can, might help. (Sun, 26 Feb 2012 20:50:13 +0000)
@PaedsSHO	@northern_doctor Does NICE say that because anticoagulating them long-term is expensive? #twitjc (Sun, 26 Feb 2012 20:50:18 +0000)
@andrew_dawes	@GasCast @dsdarbyshire - and they used non full length stockings which arent meant to be as good! #twitjc (Sun, 26 Feb 2012 20:50:28 +0000)
@Lush_London	@Lush_London #twitjc could repeat study and this time actually screen for asymptomatic VTE especially as no pm carried out to exclude PE etc (Sun, 26 Feb 2012 20:50:36 +0000)
@northern_doctor	@PaedsSHO There's actually a 3rd CLOTS trial ongoing looking at pneumatic compression stockings. Fancy! #twitjc (Sun, 26 Feb 2012 20:50:44 +0000)
@northern_doctor	@PaedsSHO Suspect because VTE generally regarded as a bad thing #twitjc (Sun, 26 Feb 2012 20:51:15 +0000)
@elinlowri	@northern_doctor But despite this, if someone dies from PE and not on LMWH we get twitched about being sued. EBM can be tricksy! #twitjc (Sun, 26 Feb 2012 20:51:19 +0000)
@andrew_dawes	Does VTE prophylaxis reduce hospital stay?? That would be the nly other reason for NICE recomending Rx. #twitjc (Sun, 26 Feb 2012 20:51:49 +0000)
@northern_doctor	It was assumed that insignificant mortality difference in older trials may be because VTE was discovered and treated. Maybe not! #twitjc (Sun, 26 Feb 2012 20:52:03 +0000)
@northern_doctor	Very true! RT @elinlowri : If someone dies from PE and not on LMWH we get twitched about being sued. EBM can be tricksy! #twitjc (Sun, 26 Feb 2012 20:52:28 +0000)
@PaedsSHO	@northern_doctor Plus there are obviously non-fatal complications from VTE, post-thrombotic syndrome etc #twitjc (Sun, 26 Feb 2012 20:52:54 +0000)
@tobyhillman	@dsdarbyshire and fantastic for patients for many other reasons too... #twitjc (Sun, 26 Feb 2012 20:53:52 +0000)
@northern_doctor	Valid point! RT @PaedsSHO : Plus there are obviously non-fatal complications from VTE, post-thrombotic syndrome etc #twitjc (Sun, 26 Feb 2012 20:53:54 +0000)
@GasCast	@northern_doctor MEDENOX found 9 - 21% PE on autopsy but only 3 deaths attributed to PE?high numbers of clinically insignificant VTE #twitjc (Sun, 26 Feb 2012 20:53:58 +0000)
@payamtorabi	#twitjc but also non-fatal complications from LMWH... (Sun, 26 Feb 2012 20:54:07 +0000)
@twitjournalclub	Overall - should this paper lead to a review of the NICE guidance and further studies into VTE prophylaxis? #twitjc (Sun, 26 Feb 2012 20:54:21 +0000)
@PaedsSHO	@twitjournalclub Yes. #twitjc (Sun, 26 Feb 2012 20:55:15 +0000)
@tobyhillman	@GasCast finding more and more PEs with better CT scanners nowadays - what to do with them can be a conundrum ( no sx etc) #twitjc (Sun, 26 Feb 2012 20:55:45 +0000)
@northern_doctor	This is what I suspect too RT @GasCast : ?high numbers of clinically insignificant VTE #twitjc (Sun, 26 Feb 2012 20:55:59 +0000)
@northern_doctor	RT @GasCast : MEDENOX found 9 - 21% PE on autopsy but only 3 deaths attributed to PE?high numbers of clinically insignificant VTE #twitjc (Sun, 26 Feb 2012 20:56:07 +0000)
@LizzyFerret	Something always conspires against me making #twitjc on a Sunday night :( #RageDotCom (Sun, 26 Feb 2012 20:56:23 +0000)
@GasCast	@twitjournalclub definitely. Work on LMWH in surgery done in 1975/88 when bedrest was an important treatment. #twitjc (Sun, 26 Feb 2012 20:56:37 +0000)
@elinlowri	#twitjc I would love this study to be true as it would justify my apathy towards our VTE proforma (Sun, 26 Feb 2012 20:56:44 +0000)
@payamtorabi	@twitjournalclub yes #twitjc (Sun, 26 Feb 2012 20:56:45 +0000)
@Albajuly	@twitjournalclub I think if study was broken down into comparison of similar conditions eg sepsis only, it may change the impact #twitjc (Sun, 26 Feb 2012 20:56:57 +0000)
@northern_doctor	I think so! RT @twitjournalclub : Should this paper lead to a review of NICE guidance and further studies into VTE prophylaxis? #twitjc (Sun, 26 Feb 2012 20:57:06 +0000)
@payamtorabi	RT @elinlowri : #twitjc I would love this study to be true as it would justify my apathy towards our VTE proforma (Sun, 26 Feb 2012 20:57:16 +0000)
@dsdarbyshire	#twitjc asymptomatic PE. Medicines incidentaloma. (Sun, 26 Feb 2012 20:57:19 +0000)
@northern_doctor	Ditto RT @tobyhillman : Finding more and more PEs with better CT scanners - what to do with them can be a conundrum ( no sx etc) #twitjc (Sun, 26 Feb 2012 20:57:38 +0000)
@northern_doctor	@tobyhillman Always feel obliged to treat if found, but never totally sure if that's the right thing #twitjc (Sun, 26 Feb 2012 20:58:13 +0000)
@northern_doctor	RT @dsdarbyshire : #twitjc asymptomatic PE. Medicines incidentaloma. #twitjc (Sun, 26 Feb 2012 20:58:24 +0000)
@GasCast	Would be nice to do a study that quantified the contribution of TEDS alone in high risk patients. #twitjc (Sun, 26 Feb 2012 20:58:28 +0000)
@dsdarbyshire	#twitjc the review will happen but as this study wouldn't change practice in the UK it alone shouldn't expedite it. (Sun, 26 Feb 2012 20:58:40 +0000)
@andrew_dawes	article doest do enough to disprove its cont use. But does deserve further evaluation. as said prev other complications #twitjc (Sun, 26 Feb 2012 20:58:44 +0000)
@elinlowri	@dsdarbyshire #twitjc 'asymptomatic PE. Medicines incidentaloma' - get phoned about these a lot. Little known about their natural history (Sun, 26 Feb 2012 20:59:11 +0000)
@tobyhillman	@northern_doctor One starts to wonder if that is something the lungs are nicely placed to do - filter clots... #offtopic #twitjc (Sun, 26 Feb 2012 20:59:27 +0000)
@twitjournalclub	Thank you all for such an interesting and lively discussion, I have really enjoyed it #twitjc (Sun, 26 Feb 2012 20:59:36 +0000)
@dannymcg	Anyone else notice the somewhat extensive list of pharmaceuticals at the bottom. Cause for concern? #twitjc (Sun, 26 Feb 2012 20:59:47 +0000)
@Lush_London	@twitjournalclub more UK based studies in medical patients needed for review of NICE #twitjc (Sun, 26 Feb 2012 21:00:15 +0000)
@tomayates	#TwitJC real questions to be answered about the process by which lmwh initially recommended and the role of industry funded pressure groups (Sun, 26 Feb 2012 21:00:28 +0000)
@northern_doctor	Interesting! RT @tobyhillman : One starts to wonder if that is something the lungs are nicely placed to do - filter clots... #twitjc (Sun, 26 Feb 2012 21:00:33 +0000)
@twitjournalclub	Please continue the discussion using the hashtag or alternatively leave a comment on the website - http://t.co/Luo5ewL4 #twitjc (Sun, 26 Feb 2012 21:00:44 +0000)
@payamtorabi	@twitjournalclub Thanks for arranging :) #twitjc (Sun, 26 Feb 2012 21:00:51 +0000)
@northern_doctor	@dannymcg If anything dodgy was going on, you would have expected a positive result from the study though... #twitjc (Sun, 26 Feb 2012 21:01:18 +0000)
@payamtorabi	@andrew_dawes has the evidence really ever been strong enough for continued use? #twitjc (Sun, 26 Feb 2012 21:01:25 +0000)
@PaedsSHO	Good debate, probably a reflection of the fact that we still don't definitely know the right answer. #twitjc (Sun, 26 Feb 2012 21:01:40 +0000)
@tobyhillman	@twitjournalclub Thanks very much - sorry to join late #twitjc (Sun, 26 Feb 2012 21:01:41 +0000)
@GasCast	@twitjournalclub Thanks very much. Interesting paper and discussion. #twitjc (Sun, 26 Feb 2012 21:01:41 +0000)
@twitjournalclub	Once again thank you all and I look forward to another interesting discussion in two weeks time - goodbye from @silv24 #twitjc (Sun, 26 Feb 2012 21:01:56 +0000)
@payamtorabi	@tomayates exactly! Posters for ""stop the clot"" have been going up this week with Sanofi Aventis logo emblazoned on them #twitjc (Sun, 26 Feb 2012 21:02:12 +0000)
@dsdarbyshire	@tobyhillman @northern_doctor #twitjc and given emboli don't always infarct... (Sun, 26 Feb 2012 21:02:14 +0000)
@payamtorabi	@tomayates someone making a lot of money from all the clexane we're prescribing #twitjc (Sun, 26 Feb 2012 21:02:36 +0000)
@andrew_dawes	Thanks for organising. Must remember to include hashtags!! Doh #twitjc (Sun, 26 Feb 2012 21:02:53 +0000)
@northern_doctor	Thank you & goodnight! RT @twitjournalclub : Once again thank you all I look forward to another interesting discussion in 2 wks time #twitjc (Sun, 26 Feb 2012 21:03:17 +0000)
@tobyhillman	@dsdarbyshire @northern_doctor and as resolutions get better on scanners - we will only find more. #twitjc (Sun, 26 Feb 2012 21:03:47 +0000)
@PaedsSHO	As ever, massive thanks to @silv24 ; I know just how much she puts into each and every week. Well done. #twitjc (Sun, 26 Feb 2012 21:04:04 +0000)
@andrew_dawes	@payamtorabi Evdience for prevention of VTE is better as discussed earlier. #twitjc (Sun, 26 Feb 2012 21:04:10 +0000)
@benedictwarner	@twitjournalclub Thanks! Really enjoyed following along - and impressed at how much was covered in exactly 1hr! Learnt a lot. #twitjc (Sun, 26 Feb 2012 21:04:23 +0000)
@silv24	Thank you all so much for joining in #twitjc this week, fantastic discussion!!! (Sun, 26 Feb 2012 21:04:39 +0000)
@elinlowri	RT @PaedsSHO : As ever, massive thanks to @silv24 ; I know just how much she puts into each and every week. Well done. #twitjc (Sun, 26 Feb 2012 21:04:47 +0000)
@payamtorabi	RT @PaedsSHO : As ever, massive thanks to @silv24 ; I know just how much she puts into each and every week. Well done. #twitjc (Sun, 26 Feb 2012 21:05:56 +0000)
@dermotor	@twitjournalclub So after all this, as medical director, should I seek to change our guidance for medical patients VTE prevention? #twitjc (Sun, 26 Feb 2012 21:06:00 +0000)
@PaedsSHO	Thanks to everyone who took part in #twitjc . If you enjoyed it, maybe come back next time? Maybe bring a friend? (Sun, 26 Feb 2012 21:06:21 +0000)
@mgcmitchell	@twitjournalclub @silv24 Thank you for stimulating discussion. Wasn't able to join in but followed.Interesting points for reflection #twitjc (Sun, 26 Feb 2012 21:06:25 +0000)
@silv24	RT @PaedsSHO : Thanks to everyone who took part in #twitjc . If you enjoyed it, maybe come back next time? Maybe bring a friend? (Sun, 26 Feb 2012 21:06:41 +0000)
@northern_doctor	@dermotor I don't think you can yet. Current practice adheres to NICE guidelines. #twitjc (Sun, 26 Feb 2012 21:07:15 +0000)
@tobyhillman	MT @elinlowri :RT @PaedsSHO : As ever, massive thanks to @silv24 ; I know just how much she puts into each and every week.> Hear Hear! #twitjc (Sun, 26 Feb 2012 21:07:59 +0000)
@wrexhamrob	@twitjournalclub @silv24 #twitjc thanks for good discussion #uncertainty . Rd=Prescribing advisor pharmacist NWales (Sun, 26 Feb 2012 21:08:04 +0000)
@northern_doctor	RT @tobyhillman : @dsdarbyshire @northern_doctor and as resolutions get better on scanners - we will only find more. #twitjc (Sun, 26 Feb 2012 21:08:20 +0000)
@silv24	@mgcmitchell glad you enjoyed!! Keen to get as many people involved from lots of different backgrounds #twitjc (Sun, 26 Feb 2012 21:08:41 +0000)
@dermotor	@northern_doctor Be interesting if the NHS & NICE guidance leads to measurable fall VTE mortality #twitjc #patientsafety (Sun, 26 Feb 2012 21:09:31 +0000)
@michealb	#twitjc When CTPA first became gold standard, tiny PEs in subsegmental branches were not seen/rxed w/o any inc mortal in the CTPA-ve group (Sun, 26 Feb 2012 21:12:40 +0000)
@amcunningham	RT @northern_doctor : @tobyhillman Always feel obliged to treat if found, but never totally sure if that's the right thing #twitjc (Sun, 26 Feb 2012 21:15:03 +0000)
@amcunningham	@PaedsSHO yes, well done @silv24 :) #twitjc (Sun, 26 Feb 2012 21:17:22 +0000)
@northern_doctor	RT @dermotor : @northern_doctor Be interesting if the NHS & NICE guidance leads to measurable fall VTE mortality #twitjc #patientsafety (Sun, 26 Feb 2012 21:20:27 +0000)
@silv24	Very tired tonight - culmination of four days of tonsillitis and a very engaging #twitjc (Sun, 26 Feb 2012 21:25:58 +0000)
@amitns	Sorry missed the fab discussion. This highlights serious flaw in deciding 'best practices' based on flimsy evidences. Egs abound. #twitjc (Sun, 26 Feb 2012 21:26:17 +0000)
@JDMoffatt	@silv24 A v interesting #twitjc indeed. (Sun, 26 Feb 2012 21:30:42 +0000)
@dean_jenkins	#twitjc Feb 26th 2012: Transcript of this evening's Twitter Journal Club using an experimental Twitter chat cura... http://t.co/qWNbKlNk (Sun, 26 Feb 2012 22:10:49 +0000)
@dsdarbyshire	RT @dean_jenkins : #twitjc Feb 26th 2012: Transcript of this evening's Twitter Journal Club using an experimental Twitter chat cura... http://t.co/qWNbKlNk (Sun, 26 Feb 2012 22:30:42 +0000)
@tomayates	@payamtorabi did you see this in the BMJ - http://t.co/2tjmkf1d? #twitjc (Sun, 26 Feb 2012 22:35:44 +0000)
@dean_jenkins	@amcunningham @dsdarbyshire OK I've modified my curation widgety thingy on the beta site. Shall I redo the blog example for #twitjc ? (Sun, 26 Feb 2012 22:47:25 +0000)
@dean_jenkins	@dsdarbyshire @amcunningham @twitjournalclub @silv24 @fidouglas pleasure to help curate ... been working on a tool to automate it. #twitjc (Sun, 26 Feb 2012 23:00:09 +0000)
@dean_jenkins	Added a list of those involved in #twitjc with the most prolific first. http://t.co/HMy2gJJb Will add this to Twitter curation tool. (Mon, 27 Feb 2012 00:34:24 +0000)
@northern_doctor	Following on from #twitjc , this is well worth a read! RT @DrGrumble http://t.co/Kcm9bnz6 » v useful and good rules of thumb at end #meded (Mon, 27 Feb 2012 07:02:54 +0000)
@northern_doctor	Most prolific! Good or bad? RT @dean_jenkins : Added a list of those involved in #twitjc with the most prolific first. http://t.co/NigEwv6k (Mon, 27 Feb 2012 07:12:30 +0000)
@amitns	RT @northern_doctor : Following on from #twitjc , this is well worth a read! RT @DrGrumble http://t.co/Kcm9bnz6 » v useful and good rules of thumb at end #meded (Mon, 27 Feb 2012 07:17:36 +0000)
@andrew_dawes	RT @northern_doctor : Following on from #twitjc , this is well worth a read! RT @DrGrumble http://t.co/Kcm9bnz6 » v useful and good rules of thumb at end #meded (Mon, 27 Feb 2012 07:47:15 +0000)
@tomayates	@parks_tom @drcjar check out yesterday's #twitjc on nejm lmwh paper (Mon, 27 Feb 2012 08:00:41 +0000)
@silv24	RT @dean_jenkins : Added a list of those involved in #twitjc with the most prolific first. http://t.co/HMy2gJJb Will add this to Twitter curation tool. (Mon, 27 Feb 2012 08:49:08 +0000)
@amitns	@silv24 @DrGrumble @northern_doctor The Sixth Sense as a metaphor for Medicine's Heart of Darkness http://t.co/8bsfAQbB last #twitjc (Mon, 27 Feb 2012 09:47:10 +0000)