Sign in

Evidence Rounds

@evidencerounds.bsky.social
11 followers 1 following 119 posts

News you can use in hospital medicine Medical literature is doubling rapidly, but knowledge isn't. Too many studies fail to answer the questions that matter most. We find and appraise the rare practice-changing evidence and cutting edge ideas.

PostsRepliesMedia
Evidence Rounds @evidencerounds.bsky.social · 27/08/2026
www.thelancet.com/jo...
000
Evidence Rounds @evidencerounds.bsky.social · 27/08/2026
Study links here #EvidenceRounds #HospitalMedicine #InfectiousDisease Todd C Lee MD MPH www.nejm.org/doi/ful...
100
Evidence Rounds @evidencerounds.bsky.social · 27/08/2026
Two recent trials challenged the historical preference for anti-staphylococcal penicillin. For MSSA bacteremia, cefazolin should be first-line, and when the isolate is penicillin susceptible, benzylpenicillin is the preferred narrow-spectrum option
100
Evidence Rounds @evidencerounds.bsky.social · 18/05/2026
Study link here #EvidenceRounds #Diagnosis
science.org
Performance of a large language model on the reasoning tasks of a physician | Science
More than 65 years ago, complex clinical diagnostic reasoning cases were introduced as the gold standard for the evaluation of expert medical computing systems, a standard that has held ever since....
000
Evidence Rounds @evidencerounds.bsky.social · 18/05/2026
In a proof-of-concept AI second opinion study of 76 ED visits, an LLM exceeded 2 independent MD reviewers on diagnostic performance at 3 touchpoints (ER triage, ER physician & admit) Whether it outperforms physicians in real-world practice is yet to be determined
100
Evidence Rounds @evidencerounds.bsky.social · 14/05/2026
Proof of concept trial here. Larger ones are underway #EvidenceRounds #Addiction #GLP1 www.thelancet.com/jo...
000
Evidence Rounds @evidencerounds.bsky.social · 14/05/2026
In a double-blind RCT of 108 obese AUD pts motivated for sobriety, semaglutide reduced heavy drinking days by 13% (absolute) vs placebo Reduction in drinking strongly correlated w/ weight los Suggests shared mechanism or functional unblinding, which might exaggerate benefits
100
Evidence Rounds @evidencerounds.bsky.social · 24/04/2026
Study link #EvidenceRounds #HospitalMedicine #Endocrinology jamanetwork.com/jour...
000
Evidence Rounds @evidencerounds.bsky.social · 24/04/2026
Do patients on a low dose of levothyroxine truly have hypothyroidism? In a multicenter longitudinal descriptive study, 64% on a levothyroxine dose of 50 µg/d or lower were able to successfully discontinue treatment, suggesting that very low doses more often reflect overtreatment
100
Evidence Rounds @evidencerounds.bsky.social · 22/04/2026
Prior small proof of concept trial of larger fluid intake pubmed.ncbi.nlm.nih....
000
Evidence Rounds @evidencerounds.bsky.social · 22/04/2026
PUSH trial here #EvidenceRounds #HospitalMedicine #Endocrinology #Urology www.thelancet.com/jo...
100
Evidence Rounds @evidencerounds.bsky.social · 22/04/2026
Does hydration reduce kidney stones? A behavioral intervention ↑ fluid intake ~300 mL (w/ slight ↑ urinary symptoms) but did NOT ↓ recurrence or improve outcomes Intake difference may have been too small, as a prior small trial showed benefit w larger separation (~2.5 vs 1L)
100
Evidence Rounds @evidencerounds.bsky.social · 11/04/2026
Study link here #EvidenceRounds #Neurology www.thelancet.com/jo...
000
Evidence Rounds @evidencerounds.bsky.social · 11/04/2026
Minocycline for acute ischemic stroke? In a multicenter RCT, oral minocycline within 72h of an ischemic stroke (NIHSS 4–25) improved functioning at 90 days (mRS 0–1: 52.6% vs 47.4%; ~5% absolute; RR 1.11), supporting a modest neuroprotective benefit
100
Evidence Rounds @evidencerounds.bsky.social · 26/03/2026
COBRA trial link #EvidenceRounds #HospitalMedicine #Cardiology #Hematology
nejm.org
Bleeding Risk with Apixaban vs. Rivaroxaban in Acute Venous Thromboembolism | New England Journal of Medicine
Apixaban and rivaroxaban are the oral anticoagulants most frequently used to treat acute venous thromboembolism. However, uncertainty remains about the difference in bleeding risk between the two m...
000
Evidence Rounds @evidencerounds.bsky.social · 26/03/2026
In a head-to-head trial for VTE treatment, apixaban was safer than rivaroxaban with similar effecacy at 90 days, with ~4% less clinically relevant bleeding (RR 0.5) Since the safety advantage was confined to the loading-dose phase, its not relevant for atrial fibrillation
100
Evidence Rounds @evidencerounds.bsky.social · 24/03/2026
SOHO trial link #EvidenceRounds #HospitalMedicine #PulmCrit www.nejm.org/doi/ful...
000
Evidence Rounds @evidencerounds.bsky.social · 24/03/2026
Even if the primary outcome of mortality didn't improve, avoiding intubation and improving breathlessness are meaningful benefits x.com/i/status/20341...
100
Evidence Rounds @evidencerounds.bsky.social · 24/03/2026
The SOHO trial confirms the use of high-flow nasal cannula for acute hypoxic respiratory failure with less intubation (NNT ~17; benefit by day 1, plateaus by day 4) and less dyspnea (NNT ~7; ~5-point improvement on a 100-point scale)
100
Evidence Rounds @evidencerounds.bsky.social · 19/03/2026
TAPER-V trial link here #EvidenceRounds #HospitalMedicine #InfectiousDisease jamanetwork.com/jour...
000
Evidence Rounds @evidencerounds.bsky.social · 19/03/2026
Should longer vanc courses be prescribed for first episodes of C diff? In a Bayesian RCT, a 4-week pulse+taper reduced recurrence vs standard 2-week course at 1 month (RRR 43%, 99% probability of superiority) and at 2 mos (RRR 16%, 74% prob) But 3-month recurrence was similar
110
Evidence Rounds @evidencerounds.bsky.social · 17/03/2026
Trial link here #EvidenceRounds #HospitalMedicine #Nephrology evidence.nejm.org/do...
000
Evidence Rounds @evidencerounds.bsky.social · 17/03/2026
However, findings may be biased toward the null because the intervention only increased eunatremia by 14% (60% vs 46%), 30-day hyponatremia rates were similar, and the algorithm relied heavily on investigator phenotyping (chronicity/etiology/volume status)
100
Evidence Rounds @evidencerounds.bsky.social · 17/03/2026
Does correcting chronic hyponatremia improve outcomes? In an RCT of hospitalized adults with Na <130, a targeted correction algorithm did not improve 30-day death/rehospitalization (20.5% vs 21.8%) or neurocognitive outcomes...
100
Evidence Rounds @evidencerounds.bsky.social · 09/03/2026
Addiction Consult pragmatic trial jamanetwork.com/jour...
000
Evidence Rounds @evidencerounds.bsky.social · 09/03/2026
ED peer navigator trial #EvidenceRounds #HospitalMedicine #Addiction jamanetwork.com/jour...
100
Evidence Rounds @evidencerounds.bsky.social · 09/03/2026
Treating addiction is hard In a pragmatic RCT of patients with nonfatal opioid overdose, ED peer navigators did not reduce 1-year outcomes This builds on a prior step-wedge cluster RCT: addiction consult increased med use, but 6-month retention was low & similar (2.4% vs 3.2%)
100
Evidence Rounds @evidencerounds.bsky.social · 05/03/2026
The DIALIZE-Outcomes trial #EvidenceRounds #HospitalMedicine #Nephrology www.kidney-internati...
000
Evidence Rounds @evidencerounds.bsky.social · 05/03/2026
Mild predialysis hyperkalemia may not warrant treatment Among ESRD patients with a pre-dialysis K≥5.5, Lokelma improved long-term potassium control but did NOT reduce arrhythmia-related cardiovascular events (8.8% vs 8.9%) The trial was stopped early for low event rates
100
Evidence Rounds @evidencerounds.bsky.social · 23/02/2026
Study link here #EvidenceRounds #HospitalMedicine #Orthopedics #Radiology #Diagnosis jamanetwork.com/jour...
000
Evidence Rounds @evidencerounds.bsky.social · 23/02/2026
In a nationally representative sample of adults 41–76, almost all had abnormal shoulder MRI findings, including ~51% of asymptomatic individuals with partial-thickness rotator cuff tears Like spine, knee, & hip imaging, this high prevalence suggests these are normal age-related
100
Evidence Rounds @evidencerounds.bsky.social · 20/02/2026
Small economic analysis from Ward 86, a historic safety net HIV clinic at SFGH pubmed.ncbi.nlm.nih....
000
Evidence Rounds @evidencerounds.bsky.social · 20/02/2026
LATITUDE trial here #EvidenceRounds #HospitalMedicine #InfectiousDisease www.nejm.org/doi/ful...
100
Evidence Rounds @evidencerounds.bsky.social · 20/02/2026
Long-acting monthly injectable cabotegravir/rilpivirine was superior to oral ART in the LATITUDE trial among people with nonadherence, with an 18% absolute reduction in regimen failure A prior small economic analysis from a safety-net clinic suggests it is cost-effective
100
Evidence Rounds @evidencerounds.bsky.social · 10/02/2026
Link here #EvidenceRounds #HospitalMedicine jamanetwork.com/jour...
000
Evidence Rounds @evidencerounds.bsky.social · 10/02/2026
Up to 40% of hospitalized adults discharge to post-acute care at home or in a facility This review demystifies post-acute care with a practical framework to match the right setting to a patient’s needs and plan for a smoother transition
100
Evidence Rounds @evidencerounds.bsky.social · 06/02/2026
Trial link here #EvidenceRounds #HospitalMedicine #InfectiousDisease www.thelancet.com/jo...
000
Evidence Rounds @evidencerounds.bsky.social · 06/02/2026
In an open-label RCT of HIV-related sepsis in endemic TB regions, immediate anti-TB therapy reduced 28-day mortality in the subgroup with later microbiologically confirmed tuberculosis This suggests, as with sepsis, that time to initiate anti-TB therapy might also matter
100
Evidence Rounds @evidencerounds.bsky.social · 30/01/2026
Original Ambition trial www.nejm.org/doi/ful...
000
Evidence Rounds @evidencerounds.bsky.social · 30/01/2026
Study link here #EvidenceRounds #HospitalMedicine ##InfectiousDisease jamanetwork.com/jour...
100
Evidence Rounds @evidencerounds.bsky.social · 30/01/2026
Consider single-dose amphotericin for cryptococcal meningitis In a US safety-net hospital, the AMBITION regimen established in LMICs (single-dose liposomal ampho+flucy/fluc) achieved same outcomes with fewer severe adverse events in a pre-post analysis vs standard 14-day course
100
Evidence Rounds @evidencerounds.bsky.social · 29/01/2026
Study link here #EvidenceRounds #HospitalMedicine #Surgery #InfectiousDisease jamanetwork.com/jour...
000
Evidence Rounds @evidencerounds.bsky.social · 29/01/2026
Antibiotics hold up for more than half of patients with uncomplicated appendicitis, but decision to avoid upfront surgery is in the eye of the beholder At 10-year follow-up, 44% eventually underwent an appendectomy Greatest risk was in the first 12-18 months
100
Evidence Rounds @evidencerounds.bsky.social · 24/01/2026
Link here #EvidenceRounds ##HospitalMedicine #Diagnosis #MedEd onlinelibrary.wiley....
000
Evidence Rounds @evidencerounds.bsky.social · 24/01/2026
A 2023 narrative review challenges the centrality of dual-process models, arguing that diagnostic expertise matters more Improving clinical reasoning may depend less on debiasing & more on richer problem representations, illness scripts & better access to the right knowledge
100
Evidence Rounds @evidencerounds.bsky.social · 23/01/2026
Study here #EvidenceRounds #HospitalMedicine #Cardiology www.acpjournals.org/...
000
Evidence Rounds @evidencerounds.bsky.social · 23/01/2026
For older adults w/ newly diagnosed afib during hospitalization the 1-yr stroke risk w/o anticoag was low: 0.7% for CHA2DS2VASc 1-4 & 1.8% for 5-8 Given consensus of ≥2%/year, anticoag may be less compelling in hospital-detected AF but should still be individualized by risk
100
Evidence Rounds @evidencerounds.bsky.social · 15/01/2026
Thread here as well x.com/i/status/20068...
000
Evidence Rounds @evidencerounds.bsky.social · 15/01/2026
@Sensible__Med @adamcifu @drjohnm #Evidence Rounds #HospitalMedicine
sensible-med.com
The Best Studies of 2025 for Hospital Medicine
What changed practice, what confirmed it, and what absolutely should not
100
Evidence Rounds @evidencerounds.bsky.social · 15/01/2026
Best of Hospital Medicine in 2025 In article format...
100