It’s not often that an ophthalmology study makes it into the New England journal of medicine. This is pretty neat technology, but subretinal surgery is a skill mostly forgotten by retina surgeons. It will be interesting to see who will end up offering this kind of surgery.
They didn’t really demonstrate that patients without the implant had worse vision. You could argue that with the magnifying glasses themselves that patients could improve their vision without surgery. So it will be up to a future study to determine this.
As someone at an academic institution, this drives me insane. I mean, have some sort of pride in your work. Copy forward but make the necessary changes!!
As someone who’s worked on EHRs, I can tell you that doctors rely on “carry forward” and templated notes and other entry types.
They are fixated on fast and smooth workflow, both because they want the computer out of their face, they want software to help them jump through the ever growing number of mandatory hoops, and they are under serious pressure to keep their numbers high.
Doctors that I know don't necessarily mind carry forward notes if it is in a standard template, and it's been reviewed for accuracy. The doctors I know rightly hate when trainees (or occasionally but rarely other attendings) do either of these:
1. Carry forward non-templated notes that reuses another physician's prose with zero or near-zero updates as it invites mis-interpretation from colleagues.
2. Carry forward templated or non-templated information that clearly hasn't been reviewed, best indicated by signatures/names of physicians that had nothing to do with the note as in this article or dates that are clearly wrong.
And it's doubly-bad when it's non-templated notes with incorrect physician names and/or dates.
It's complicated. Physicians can own imaging equipment, for example, but they can't require you to use it for the radiology tests that they order. There are weird carve-outs for in-office ancillary services (e.g. you're an orthopedic surgeon who uses x-rays in your office, which is common and arguably necessary).
There's also rules regarding things like percentage ownership of physician owned facilities and the percentage of referrals to that equipment that come from the physician owners.
Urine drug screens in an in-office "lab" are another big source of revenue for certain specialties that involve referring patients to your own tests, or doing your own pathology on biopsies as a dermatologist or whatever. My understanding is that most of those things, and many like them, are not Stark law violations.
Most people don't get blocks nowadays for cataract surgery. I will do so for patients with wandering eye movements or for more difficult cases, or for more invasive surgery besides cataract surgery. I just did a cataract surgery on a young patient today using topical numbing drops. But I have them monitored by an anesthetist with mild sedation during the entire case.
Eye surgeon here:
FLACS isn't really that amazing. I would actually argue that a man made incision using steel or diamond (yes, diamond) is better than the incision made using the femto laser for long term safety/sealing. Number of studies have borne this out.
95% success rate seems low. you need to define success in this scenario. Are we aiming for 20/20 vision outcomes? Just getting the cataract out in full?
Eye doctor here:
some hot takes in this thread about the diagnostic abilities of the specialists involved in this patient's care. It's easy to be an armchair clinician.
The timeline for delayed immune reaction to a leptospirosis infection makes diagnosis incredibly difficult. There was no mention of an acute febrile illness preceding this during the patient's trip to the tropics, which I assume a uveitis specialist would ask.
While empiric treatment with doxycycline wouldn't be a bad idea, you have to decide what to empirically treat with, and for how long, and what the ramifications of increasing resistance to antibiotics are for society. Do I commit a patient to the hospital for two weeks of IV penicillin because I "suspect" syphilis? of course not.
Better diagnostics for these occult diseases should be applauded. But we shouldn't be vilifying the clinicians that are by all accounts doing their best.
This is something that really bothered me - I had an app that was small and worked fine on the latest Android OS, yet they took the app and account down because we hadn’t uploaded a new version in a year. Appeals didn’t help
Their reasoning is probably security. They're working under the assumption your app takes untrusted input in some way, maybe over the network. Which isn't a bad assumption, I mean almost all apps do. Very few apps are true self-contained applications, like a calculator.
So then if there happens to be some vulnerabilities in an older Android SDK then your app is susceptible. They could patch back security but that's expensive after a while. Easier to force app makers to update their apps.
3P app developers are also complicit. Often they deliberately cut off support for old OS's and old devices, because it's "too hard" to support them or whatever. Everyone seems to be working together to keep us on the hamster wheel.
Granted, it is hard. It's a whole extra version to QA on. If it works fine, fine, but if there are consistent negative user reviews on a version with < 5% market share, it's not worth it.
We don't support old iOS versions at all. We can't source new devices on old iOS versions so we can't reliably develop or test on them.
Exactly how I feel about every new React framework. It’s strictly worse than using any other framework and every recruiter continues to ask for it.
Don’t want to speak too negative in regards to the orgs which use it but definitely wouldn’t be the best choice from an engineering perspective for a new project.
Sorry I am not a front end developer. I am a general software engineer please don’t effectively sabotage my career because Silicon Valley wants to make the entire discipline a group of hamsters learning tools which aren’t used by the largest organizations.
> "It’s strictly worse than using any other framework"
If you actually believe that, consider yourself very lucky.
React, like any FE framework, can be implemented well or implemented badly.
React benefits from a very strong (imo the strongest) ecosystem, so if you set up your tooling and patterns correctly its fantastic.
Here's my personal preference: NextJS as the backbone, RTKQ as the central data retrieval/API calls/caching management, RHF for form handling, ag-grid for data grids, and MUI as the component library (can optionally switch this to any equivalent).
If components are designed sufficiently generic and customizable, RTKQ is used to keep data fetching on component instances, and central state storage is avoided as much as possible, it's a great system. Unless you just really hate JSX syntax or something.
There may not have been any. Individual app-store reviewers can block you any time they feel like it, the guy checking your appeal is the same, and none of them have any real pressure to behave unless you have money and corporate power behind you.
Advantage is relevant. Medicare advantage is a specific type of plan that isn’t quite Medicare that insurance companies offer. And it’s at the center of that case.
The question isn't what is relevant, the question is comparative relevance. "Medicare plan" might be another option, though my suggestion to add the year already comes up hard against HN's 80-char limit.
Wordsmithing titles is in fact both hard and a matter of compromises.
HN's guidance is to use the original title, except where that's misleading or clickbait, and as an alternative to shorten that, or to substitute alternate text from either a subhead / alternate headline, or the article itself:
If you care to suggest something that is accurate, covers the relevant elements, and fits inside 80 characters, you're welcome to do so. It makes the mods' decision and action far easier, and is why I'd made a specific recommendation myself. I'm not wedded to that, but it is my good faith best-effort attempt. I'm happy to consider better. I've scoured the article a few times with limited success myself.
Though "DoJ alleges United Healthcare cheated Medicare out of more than $2 billion" (from "Justice Department alleges the giant health insurer cheated Medicare out of more than $2 billion") might also work, and makes the titled action current. 74 characters.
(I've submitted that as an alternate to HN's overworked mods as well.)
It's a newspaper article. It's very likely there was one week he was paid for the previous 5 years of messing around with a script all at once. Or it was actually a week and he holed up with some director for a week to save a show off the rails. Is this how the final season of game of thrones happened?
They didn’t really demonstrate that patients without the implant had worse vision. You could argue that with the magnifying glasses themselves that patients could improve their vision without surgery. So it will be up to a future study to determine this.