Brad D Constant MD @BradDConstantMD
Pediatric Gastroenterologist at Children's Hospital of Colorado. Comparative Effectiveness Research and Advocacy. Crohn’s Disease patient since ‘97. Joined May 2021-
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Following145
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cnn.com/2023/03/10/hea… Great article by @laurenmsausser showing all the ways prior authorizations take medical decision making out of doctors’ and patients’ hands, disrupt care, and lead to real patient harm. This system need to change.
Great preliminary work by @BradDConstantMD and colleagues, who are collaborating to better understand the safety and efficacy of antiTNFs in internally penetrating pediatric Crohn’s disease #CCCongress23
In this retrospective review, @BradDConstantMD et al studied the use of tofacitinib as salvage therapy in children with steroid and biologic-refractory #ulcerativecolitis with >50% remaining colectomy-free after 90 days. bit.ly/3VPi4NX bit.ly/3VPi4NX
NEW PAPER I was challenged by @morleycp to write a 1000-word paper about a tweet. It was fun to do, and hopefully useful to some of you Open acces 👉 journals.stfm.org/primer/2022/va…
New patient education project: Blast this on repeat from the top of your hospital, in every patient room, outside of every pharmacy, and put the link in every AVS. PBMs controlling medical care to siphon funds from patients to insurance/pharmacy execs doesn’t have to be the way
New patient education project: Blast this on repeat from the top of your hospital, in every patient room, outside of every pharmacy, and put the link in every AVS. PBMs controlling medical care to siphon funds from patients to insurance/pharmacy execs doesn’t have to be the way
Step therapy policies limit medication access, contribute to patient harm, and are converse to medical evidence. At this point, the only reason not to eliminate step therapy is that its awfulness is the only thing left uniting Democrats and Republicans.
Step therapy policies limit medication access, contribute to patient harm, and are converse to medical evidence. At this point, the only reason not to eliminate step therapy is that its awfulness is the only thing left uniting Democrats and Republicans.
When the figure is so good you don’t even need to read the paper (but still read it).
Thinking about the cost-effectiveness of virtual vs in-person meetings and scientific collaborations @Nature nature.com/articles/d4158…
Happy Doctor’s Day!
Thank you @aap_pediatrics for these thoughtful pieces demonstrating how #PriorAuthorizations impact patients across all of #Pediatrics! @lewis_first publications.aap.org/journal-blogs/… @CaraColeman73 bit.ly/3LXd6KG
Authors of this study hypothesized that prior authorizations are associated with prolonged biologic initiation time and increased inflammatory bowel disease (IBD)-related healthcare utilization among children with IBD: bit.ly/3sTSQkm #Pediatrics
Per @FrankIScottMD, #PriorAuthorizations lead to delays in starting disease modifying therapies --> which adversely impact patient outcomes in #IBD. Wow... @walidgellad may have something to say about this - suspect not isolated to #IBD...
CannaLab @canna_lab
1K Followers 1K Following Auto- & Hyper-inflammation | MAS HLH | IL-18 | Down wit OPD | we❤️puns (see logo) | 🚲 evangelist | opinions my ownVoiceForIBD @VoiceForIBD
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268 Followers 696 Following Silicon Valley medical technology executive.Anna Silverman, MD @silverman_anna
624 Followers 2K Following GI fellow @MayoClinicGIHep, former IM resident @UCSDIM and clinical researcher passionate about #IBD and using #AI to extract insights from real-world data.sea color @cherish_own
2K Followers 2K Following Cherish life, God bless you alive, there must be his arrangements #Yoga🧘🏼♀️#Travel✈️#shopping🛍#swim🏊🏻♀️ski⛷parachute🪂Laura Tuccio @LauraTuccioo1
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24 Followers 349 Following I like to listen to a piece of music in my spare time, or touch the fine paper with the tip of my pen and leave my memories on itGoldy @WiscoIllini
147 Followers 2K Following Interests: sales, psychology, leadership, economics, nutrition, medicine, biotechnology, sports, bass fishing. Sales Manager, lIllini and Geis MBA alumFionna @fionna_kopp
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262 Followers 825 Following Grateful to everyone treating or researching Crohn's, especially perianal Crohn's. Find that cure 🤞扬州思思 @fyballday
546 Followers 2K Following 本人工作实习 偶尔兼职随缘接.可提前预约.可空降.陪聊.可出私人情趣衣物. 也可以直接私信我留下你联系方式我看到会加你 . 本人爱好舞蹈 瑜伽.每天下午六点才有空 不闲聊.拒绝口嗨 不喜欢就删. 私人纸飞机联系 电报TG:https://t.co/jAYFydUafPNoa Krugliak Clevelan.. @KrugCleveland
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975 Followers 498 Following Follow for monthly peds GI chats Thurs 7p ET. Opinions≠med advice. Hosts @RossMaltz @KevinWatsonJrMD @RSanchez490MD @temarahajjat @PLLU. Sponsored by @naspghan.Whitney @TwittyWhitty22
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119 Followers 891 Following Gastroenterologist at University of Florida.Wendy @xiaoxiaoting5
37 Followers 315 Following I like an active lifestyle. Sometimes I just sit on the sofa and watch movies at night. I respect people's opinions and hate lies.Parul Tandon @ptandonGI
1K Followers 2K Following "IBDologist", Clin Associate @UHN, @UofTGastroHep alumni, @SinaiHealth IBD fellow alumni, PhD candidate @ihpmeuoft; lucky husband and father!Tom Wallach, MD @md_wallach
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2K Followers 3K Following Instructor and postdoc @Stanford_GI, MSTP @umnmedschool | Gut microbiome, mucosal immunology, and IBD | Mommy | Classical singing, running, weightliftingTrukkeTrukkePlease @WeShouldStudyIt
53 Followers 484 Following Human, 🇬🇭 diaspora, lover of Arsenal, Philadelphia and more..Lauren Sausser @laurenmsausser
3K Followers 1K Following Covering health care in the South for @KFFHealthNews, previously @postandcourier. *She had a weakness for fresh new notebooks and finely sharpened pencils.*Michael Kappelman, MD.. @MichaelKappel12
414 Followers 128 Following Professor of Pediatrics, Inflammatory Bowel Disease Specialist, University of North Carolina at Chapel HillEdward Barnes MD MPH @EdBarnesMD
3K Followers 685 Following Associate Professor, Associate Program Director, GI & Hepatology Fellowship @UNCGastro | Research & Clinical interest in #IBD, #pouchitis, outcomes after #IPAAChristopher Ma MD MPH @ChrisMa_YYC
519 Followers 188 Following Gastroenterologist, University of CalgaryLori Plung @LoriPlung
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82 Followers 102 Following Pediatric Gastro Doctor IBD Specialist Patient focused care enthusiast Follow me on insta @AfterstoolspecialDr. Carlie Myers @Queeniemd22
961 Followers 716 Following #PedsICU Attending @CincyChildrens Pediatrician Minimizing health disparities in the #PICU Food lover Earth wanderer Black Lives Matter✊🏽✊🏾✊🏿 Tweets=my ownJay Hochman, MD @gutsandgrowth
1K Followers 35 Following Jay Hochman, Pediatric Gastroenterologist, Uses twitter to publicize his blogDigestive Disease Wee.. @DDWMeeting
27K Followers 6K Following DDW is the world’s largest gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy and GI surgery. #DDW2024Cara Coleman @CaraColeman73
110 Followers 76 Following Momma of 4, Wifey, Love Thee ND☘️, Attorney, Advocate, Assoc. Editor Pediatrics, Narrative Medicine, Guided by My Sweet Bluebird (Justice Hope)AAP Pediatrics @aap_peds
4K Followers 74 Following Pediatrics is an official peer-reviewed journal of the @ameracadpeds, continuously publishing ground-breaking research since January 1948.Tom Wallach, MD @md_wallach
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16 Followers 66 FollowingPooja Mehta MD MSCS @EoEDoc
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12 Followers 12 FollowingRogério Parra @rogeriosparra
810 Followers 873 Following M.D., PhD., Colorectal surgeon and IBD Specialist! School of Medicine, Ribeirão Preto, University of São Paulo. GEDIIB Vice-president (2023/24)Kevin Haynes @khaynes001
375 Followers 498 Following Pharmacoepidemiologist with a passion for data and drug safety.Miranda van Tilburg @DrvanTilburg
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674 Followers 505 Following Pediatric gastroenterologist with focus on IBD, intestinal ultrasound and precision medicine @ChildrensLA. Daughter, wife, 🇭🇹 descent. Tweets are my own.CU Department of Medi.. @CUDeptMedicine
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1K Followers 2K Following "IBDologist", Clin Associate @UHN, @UofTGastroHep alumni, @SinaiHealth IBD fellow alumni, PhD candidate @ihpmeuoft; lucky husband and father!Price Edwards @pricetedwards
1K Followers 1K Following Husband and father interested in pediatric GI, health equity, neurogastro, the microbiome, and the @memgrizz. @TFAMemphis alum. Matter is the minimum. He/him.@drvolts These figures are useful to show whether emissions reductions were caused by recessions and not much else
Question for EU climate/energy nerds: Does a drop in EU-ETS carbon prices ironically correlate with greater climate policy ambition because it becomes more likely the stability mechanism will be triggered to remove allowances?
Imagine a hospital lost all of its interns/residents and wanted to hire a PA/NP to replace each one. What does that job listing look like? 10-12+ patients a day, 12 hours from sign in to sign out, 6 days a week, with the occasional night float or 24 hour shift thrown in.
While there are hospitals that cover residencies out of pocket, it still remains a big savings. To replace a resident you need a Hospitalist, or an NP or PA. These folks make about 2-3x as much as the resident does. Even factoring in educational costs it’s a great deal
Great preliminary work by @BradDConstantMD and colleagues, who are collaborating to better understand the safety and efficacy of antiTNFs in internally penetrating pediatric Crohn’s disease #CCCongress23
Great (short) thread about NOR-DRUM-B from @laura_targownik - If it was not blinded, was it truly a trial at all? - Why RWE (real world evidence) should not be used for drug approval.
Is proactive TDM effective in preventing relapse in IBD? What can we learn from the NOR-DRUM-B trial recently published in @JAMA_current?
@ibddoctor @IBDimmunology @laura_targownik Trials are still critically important. But in small populations, like in pediatrics, and those with rare diseases, trials many not be feasible. Need to rely on observational studies and real world data when that’s all that there is.
The good people at @propublica are putting together a project about health insurance denials. They are collecting stories. They came to the right corner of twitter for stories. You can tell yours at the link below. propublica.org/getinvolved/in…
@petolb_huvr I always go home for dinner with my family. May work later in the evening. Try to schedule conferences with family trips. And I also say no to most unrelated academic/admin things (critical @DrAshM2). In the long run - your family is most important! time flies.
NEW PAPER I was challenged by @morleycp to write a 1000-word paper about a tweet. It was fun to do, and hopefully useful to some of you Open acces 👉 journals.stfm.org/primer/2022/va…
Great method for colons. 👇
@ElGastroDoc @ASGEendoscopy @AmerGastroAssn @stevenbollipo @AraSahakianMD @drkeithsiau The "C-loop" method - advocated by @JTA_Endo; @CanGastroAssn SEE pgm; @CatharineMWalsh in the @ASGEendoscopy ergonomics curriculum among others 1. Create a "C" in the colonoscope perpendicular to the bed 2. Use the LEFT hand (dial hand) to torque the entire scope 90 deg CW/CCW
Pleased to announce that my Machine Learning textbook is now a free download -- enjoy! tinyurl.com/mtzuckhy
I believe all high school students should take a dedicated class in statistics before they learn, say, calculus. Nothing wrong with calc, but I believe everyone can benefit from stats. There would be far reaching benefits if every child learned statistical thinking early in life.
@dziring @UHC @ibdtweets They are literally just making this stuff up.
Wait, what? @UHC denies risankizumab for my 18 year old with Crohn's who lost response to infliximab because it hasn't been approved by the FDA for more than a year??? What kind of craziness is this??? #respectmyprescription @ibdtweets
Update- after 3 hours of deliberation xeljanz approved!
Tweet was deleted- thank you @MedImpact for denying my patient medication which will now lead to colectomy and requiring multiple hoops delaying care and worsen outcomes. @ImproveCareNow
Pharmacy Benefit Managers
I think health insurance companies come up with all these names to obscure the fact that they own US healthcare. Optum is owned by United, CVS is Aetna, express scripts is Cigna. They are all vertically integrating & gouging patients/independent pharmacies for insane profits.
IFX levels <7 highest risk factor (aHR 2.32) for relapse in Pediatric Crohn’s. #pedigitwitter @RossMaltz @JonathanMoses77 @DrRosenIBD journals.lww.com/ajg/Abstract/2…
United Healthcare earned 5.4 billion in profit last quarter. This is false equivalency at its finest and the exact narrative insurance companies like to push. “But what about doctor salaries??” Please, we actually serve an important function that has real value in society.
@nurse_jaqwellen Agreed - but don't think for a minute it's JUST the payers harvesting huge profits from our system. Everyone's complicit. ... and docs blaming payers hides their complicity. .