Evidence Rounds @evidencerounds.bsky.social · 27/08/2026Study links here #EvidenceRounds #HospitalMedicine #InfectiousDisease Todd C Lee MD MPH www.nejm.org/doi/ful... 100
Evidence Rounds @evidencerounds.bsky.social · 27/08/2026Two 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 · 18/05/2026Study link here #EvidenceRounds #Diagnosisscience.orgPerformance of a large language model on the reasoning tasks of a physician | ScienceMore 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 · 18/05/2026In 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 · 14/05/2026Proof of concept trial here. Larger ones are underway #EvidenceRounds #Addiction #GLP1 www.thelancet.com/jo... 000
Evidence Rounds @evidencerounds.bsky.social · 14/05/2026In 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 · 24/04/2026Study link #EvidenceRounds #HospitalMedicine #Endocrinology jamanetwork.com/jour... 000
Evidence Rounds @evidencerounds.bsky.social · 24/04/2026Do 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 · 22/04/2026Prior small proof of concept trial of larger fluid intake pubmed.ncbi.nlm.nih.... 000
Evidence Rounds @evidencerounds.bsky.social · 22/04/2026PUSH trial here #EvidenceRounds #HospitalMedicine #Endocrinology #Urology www.thelancet.com/jo... 100
Evidence Rounds @evidencerounds.bsky.social · 22/04/2026Does 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 · 11/04/2026Study link here #EvidenceRounds #Neurology www.thelancet.com/jo... 000
Evidence Rounds @evidencerounds.bsky.social · 11/04/2026Minocycline 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 · 26/03/2026COBRA trial link #EvidenceRounds #HospitalMedicine #Cardiology #Hematologynejm.orgBleeding Risk with Apixaban vs. Rivaroxaban in Acute Venous Thromboembolism | New England Journal of MedicineApixaban 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 · 26/03/2026In 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 · 24/03/2026SOHO trial link #EvidenceRounds #HospitalMedicine #PulmCrit www.nejm.org/doi/ful... 000
Evidence Rounds @evidencerounds.bsky.social · 24/03/2026Even 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 · 24/03/2026The 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 · 19/03/2026TAPER-V trial link here #EvidenceRounds #HospitalMedicine #InfectiousDisease jamanetwork.com/jour... 000
Evidence Rounds @evidencerounds.bsky.social · 19/03/2026Should 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 · 17/03/2026Trial link here #EvidenceRounds #HospitalMedicine #Nephrology evidence.nejm.org/do... 000
Evidence Rounds @evidencerounds.bsky.social · 17/03/2026However, 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 · 17/03/2026Does 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 · 09/03/2026Addiction Consult pragmatic trial jamanetwork.com/jour... 000
Evidence Rounds @evidencerounds.bsky.social · 09/03/2026ED peer navigator trial #EvidenceRounds #HospitalMedicine #Addiction jamanetwork.com/jour... 100
Evidence Rounds @evidencerounds.bsky.social · 09/03/2026Treating 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 · 05/03/2026The DIALIZE-Outcomes trial #EvidenceRounds #HospitalMedicine #Nephrology www.kidney-internati... 000
Evidence Rounds @evidencerounds.bsky.social · 05/03/2026Mild 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 · 23/02/2026Study link here #EvidenceRounds #HospitalMedicine #Orthopedics #Radiology #Diagnosis jamanetwork.com/jour... 000
Evidence Rounds @evidencerounds.bsky.social · 23/02/2026In 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 · 20/02/2026Small economic analysis from Ward 86, a historic safety net HIV clinic at SFGH pubmed.ncbi.nlm.nih.... 000
Evidence Rounds @evidencerounds.bsky.social · 20/02/2026LATITUDE trial here #EvidenceRounds #HospitalMedicine #InfectiousDisease www.nejm.org/doi/ful... 100
Evidence Rounds @evidencerounds.bsky.social · 20/02/2026Long-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 · 10/02/2026Link here #EvidenceRounds #HospitalMedicine jamanetwork.com/jour... 000
Evidence Rounds @evidencerounds.bsky.social · 10/02/2026Up 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 · 06/02/2026Trial link here #EvidenceRounds #HospitalMedicine #InfectiousDisease www.thelancet.com/jo... 000
Evidence Rounds @evidencerounds.bsky.social · 06/02/2026In 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 · 30/01/2026Original Ambition trial www.nejm.org/doi/ful... 000
Evidence Rounds @evidencerounds.bsky.social · 30/01/2026Study link here #EvidenceRounds #HospitalMedicine ##InfectiousDisease jamanetwork.com/jour... 100
Evidence Rounds @evidencerounds.bsky.social · 30/01/2026Consider 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 · 29/01/2026Study link here #EvidenceRounds #HospitalMedicine #Surgery #InfectiousDisease jamanetwork.com/jour... 000
Evidence Rounds @evidencerounds.bsky.social · 29/01/2026Antibiotics 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 · 24/01/2026Link here #EvidenceRounds ##HospitalMedicine #Diagnosis #MedEd onlinelibrary.wiley.... 000
Evidence Rounds @evidencerounds.bsky.social · 24/01/2026A 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 · 23/01/2026Study here #EvidenceRounds #HospitalMedicine #Cardiology www.acpjournals.org/... 000
Evidence Rounds @evidencerounds.bsky.social · 23/01/2026For 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 · 15/01/2026Thread here as well x.com/i/status/20068... 000
Evidence Rounds @evidencerounds.bsky.social · 15/01/2026@Sensible__Med @adamcifu @drjohnm #Evidence Rounds #HospitalMedicinesensible-med.comThe Best Studies of 2025 for Hospital MedicineWhat changed practice, what confirmed it, and what absolutely should not 100
Evidence Rounds @evidencerounds.bsky.social · 15/01/2026Best of Hospital Medicine in 2025 In article format... 100