iiinova — where your digital self keeps evolving

Shiela Appavoo MD @shielaappavoo.bsky.social · 17/11/2025

You might like one of my favourite quotes, which is from Middlemarch, by George Eliot (Mary Ann Evans). “People talk about evidence as if it could really be weighed in scales by a blind Justice. No man can judge what is good evidence on any particular subject, unless he knows that subject well.”

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Shiela Appavoo MD @shielaappavoo.bsky.social · 12/11/2025

Actually, this isn’t X! Just seemed like it for a moment!

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Reposted by Shiela Appavoo MD

Mark Ungrin @mark-ungrin.bsky.social · 02/06/2025

Makary's claim of "no data" illustrates the classic EBM failure mode. Too many don't understand science outside their "gold standard" kiddie pool, everything inside it is slow and retrospective, and without mechanistic understanding they can't generalize - everything is just memorized special cases.

canadahealthwatch.ca

Trump’s cronies aren’t what broke public health

The structural blind spots that undermine medical progress and how to fix them.

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Reposted by Shiela Appavoo MD

Mark Ungrin @mark-ungrin.bsky.social · 28/04/2025

There is a recurring pattern of institutional research integrity offices shielding influential clinical studies and the researchers responsible for them from accountability, and ignoring harm to the public. This is far from an isolated incident.

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Reposted by Shiela Appavoo MD

David Fisman. @dfisman.bsky.social · 25/04/2025

For what it’s worth, here’s the editorial I sent the Globe and Mail April 5. The Globe took a pass. Balancing Individual Rights and Community Health Requires Knowledge of History

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Reposted by Shiela Appavoo MD

David Fisman. @dfisman.bsky.social · 24/04/2025

A thread on quality, evidence and EBM: Clinical research often labels evidence as "high quality" or "low quality," but how reliable are these categories? How meaningful is this "quality" construct?

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Reposted by Shiela Appavoo MD

André Picard @picardonhealth @picardonhealth.bsky.social · 18/04/2025

Trump’s cronies aren’t what broke public health. The structural blind spots that undermine medical progress and how to fix them, by Mark Ungrin canadahealthwatch.ca/2025/04/18/t... via @canadahealthwatch.bsky.social @nicktsergas.ca

canadahealthwatch.ca

Trump’s cronies aren’t what broke public health

The structural blind spots that undermine medical progress and how to fix them.

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Shiela Appavoo MD @shielaappavoo.bsky.social · 28/03/2025

I’m not crying, you’re crying! 😭

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Shiela Appavoo MD @shielaappavoo.bsky.social · 16/03/2025

Anyone who actively wants to be a Canuck has, by definition, the right attitude to be a Canuck.

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Shiela Appavoo MD @shielaappavoo.bsky.social · 16/03/2025

Poutine rapée for extra points and a little Acadian flair!

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Shiela Appavoo MD @shielaappavoo.bsky.social · 12/03/2025

Again, I believe you have missed the point. Have a good day.

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Shiela Appavoo MD @shielaappavoo.bsky.social · 12/03/2025

Perhaps you have missed the point.

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Shiela Appavoo MD @shielaappavoo.bsky.social · 12/03/2025

So you feel a complete lack of mention of an external review when discussing being put on pause is “full disclosure”? Would you use that logic with a patient consent?

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Shiela Appavoo MD @shielaappavoo.bsky.social · 12/03/2025

Did you read the minister’s statement? It is clear the meeting with the chair of the EER was part of the decision. And I ask you to answer my question if you will. Do you feel there is full disclosure in the petition? Enough to ask for a signature?

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Shiela Appavoo MD @shielaappavoo.bsky.social · 11/03/2025

I do not know the final EER report and that is not the point. If you read my article, it is about the lack of transparency that is exhibited by the task force. Again, would you consider it to be full disclosure without the mention of an external review? Enough to get a signature?

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Shiela Appavoo MD @shielaappavoo.bsky.social · 11/03/2025

Read minister Holland’s statement. The point is not about the content of the EER. The point is that while Holland stated that it was a cause for the pause, it was completely ignored in the petition. Would you consider this full disclosure to a patient before asking them sign a consent?

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Shiela Appavoo MD @shielaappavoo.bsky.social · 11/03/2025

It’s a good query. We are a grassroots group of leaders in various specialties, family medicine, epidemiology and even patients. It is completely voluntary and there is no financial support. Let me know if you have any questions.

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Reposted by Shiela Appavoo MD

Mark Ungrin @mark-ungrin.bsky.social · 11/03/2025

One of the strongest arguments against allowing secretive bodies like the Canadian Task Force on Preventative Health Care to make guidance in back rooms, without transparency or scientific oversight, is the behaviour they exhibit when forced out into the open. canadahealthwatch.ca/2025/03/11/h...

canadahealthwatch.ca

Health guidelines should be transparent. The Task Force’s aren’t

The Task Force oversimplifies the criticisms of its detractors.

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Shiela Appavoo MD @shielaappavoo.bsky.social · 11/03/2025

My opinion on a few of the many problems with the Canadian Task Force on Preventive Health Care and what they failed to disclose in their recent petition.

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Shiela Appavoo MD @shielaappavoo.bsky.social · 11/03/2025

Terrific op ed about modernizing our screening guidelines development body. #cancer

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Shiela Appavoo MD @shielaappavoo.bsky.social · 09/03/2025

I’ve also never seen a formal equation weighing recalls against avoidable late stage cancers (and the attendant heavier treatments and higher mortality). It’s ultimately just a judgment call by the person writing the guideline, no matter how much the analysis is framed as “rigorous”.

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Reposted by Shiela Appavoo MD

Cheryl White @ladyscorcher.bsky.social · 08/03/2025

So apparently the government asked a group of experts in EBM to review the work of the task force and based on that review the government has asked the task force to pause their work for a month.

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Shiela Appavoo MD @shielaappavoo.bsky.social · 08/03/2025

The pause on the Task Force was the result of an External Experts Review (EER) by a panel of many well qualified individuals, including family docs and population specialists. www.canada.ca/en/public-he... Ask yourself why the critical context of that EER is not mentioned in the letter… 🤔

canada.ca

External Expert Review of the Canadian Task Force on Preventive Health Care: About - Canada.ca

About the External Expert Review for the Canadian Task Force on Preventative Health Care, member biographies, meeting minutes.

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Reposted by Shiela Appavoo MD

David Fisman. @dfisman.bsky.social · 24/05/2024

Has the impact of Cochrane reviews and GRADE on health outcomes ever been evaluated in a randomized controlled trial? 😬

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Shiela Appavoo MD @shielaappavoo.bsky.social · 04/08/2023

ascopubs.org/doi/pdf/10.1200/JCO.23… Important new publication supporting the experts’ recommendation to screen 40-49 yo women for breast cancer. #40not50

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Shiela Appavoo MD @shielaappavoo.bsky.social · 09/07/2023

It said “translate post” at the bottom of this, so I clicked it… 🤔

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Shiela Appavoo MD @shielaappavoo.bsky.social · 03/07/2023

Thank you, DSP! Happy to meet everyone over here under the new ‘sky!

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Reposted by Shiela Appavoo MD

Andrea Kaston Tange @aktange.bsky.social · 03/07/2023

This was one of the most beautiful portraits of a friendship I have ever read. Also superb sports writing. Do yourself a favor, and sit down with it today.

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