Raj Mehta
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raj-mehta.bsky.social
Raj Mehta
@raj-mehta.bsky.social
410 followers 1.8K following 5 posts
#FamilyMedicine, Clinical Informaticist, EBM & Bioethics enthusiast | Faculty AdventHealth Family Medicine Residency | UFMEDICINE alum
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Reposted by Raj Mehta
rnflex.bsky.social
It's finally here! SURPASS CVOT trial results! This is an interesting blend of benefits. The quick summary is tirzepatide is better for renal outcomes, A1c, weight and all cause mortality. For cardiovascular outcomes it's essentially equivalent/slightly better to a monoagonist GLP1. Let's dive in 🧵
September 18, 2025 at 3:28 PM
Reposted by Raj Mehta
hswapnil.medsky.social
The new ⌚️ will have hypertensive notifications

This doesn’t seem like a cuffless BP - but more like a notification ‘you may have hypertension, go check your BP’ ?

From www.apple.com/newsroom/202...

@jordybc.bsky.social @drwanpen.bsky.social @spjuraschek.bsky.social @daichishimbo.bsky.social?
Hypertension Notifications Building on its suite of advanced health features, Apple Watch Series 11 introduces groundbreaking hypertension notifications, which can alert users if signs of chronic high blood pressure — or hypertension — are detected.5 Hypertension is the leading modifiable risk factor for heart attack, stroke, and kidney disease, and impacts approximately 1.3 billion adults globally. It is frequently undiagnosed because it often has no symptoms, many people do not see a doctor regularly, and even during a clinical visit, it can be easily missed with a single measurement. Hypertension notifications on Apple Watch use data from the optical heart sensor to analyze how a user’s blood vessels respond to the beats of the heart. The algorithm works passively in the background reviewing data over 30-day periods, and will notify users if it detects consistent signs of hypertension. These notifications provide users with valuable insights into their health as it relates to this widespread condition simply by wearing their Apple Watch, so they can begin making potentially lifesaving behavioral changes, or start treatment to reduce their risk of serious, long-term health events. Replay video: Apple Watch Series 11 Hypertension Notifications Hypertension notifications use data from the optical heart sensor on Apple Watch to analyze how a user’s blood vessels respond to the beats of the heart. Like all of Apple’s health features, hypertension notifications are grounded in rigorous scientific validation. The feature was developed with advanced machine learning and training data from multiple studies totaling over 100,000 participants. Its performance was then validated in a clinical study of over 2,000 participants. While hypertension notifications will not detect all instances of hypertension, with the reach of Apple Watch, the feature is expected to notify over 1 million people with undiagnosed hypertension within the first year. Hypertension notifications use data from the optical heart sensor on Apple Watch to analyze how a user’s blood vessels respond to the beats of the heart. Like all of Apple’s health features, hypertension notifications are grounded in rigorous scientific validation. The feature was developed with advanced machine learning and training data from multiple studies totaling over 100,000 participants. Its performance was then validated in a clinical study of over 2,000 participants. While hypertension notifications will not detect all instances of hypertension, with the reach of Apple Watch, the feature is expected to notify over 1 million people with undiagnosed hypertension within the first year. “Hypertension is the leading preventable cause of heart attack and stroke, yet millions remain undiagnosed,” said Harlan Krumholz, MD, SM, cardiologist and scientist at Yale University and Yale New Haven Hospital. “Making accurate detection easy and part of daily life can help people get care earlier and prevent avoidable harm.” A user’s iPhone and Apple Watch Series 11 show “Possible Hypertension” and offer more details. Hypertension notifications were developed with advanced machine learning and training data from multiple studies totaling over 100,000 participants. If users receive a hypertension notification, it is recommended that they log their blood pressure for seven days using a third-party blood pressure cuff and share the results with their provider at their next visit, which is consistent with the latest American Heart Association guidelines for the diagnosis and management of hypertension. Clearance for hypertension notifications from the FDA and other regulators is expected soon, and the feature will be available in more than 150 countries and regions — including the U.S. and the EU — this month. Hypertension notifications will be available on Apple Watch Series 9 and later, and Apple Watch Ultra 2 and later, with watchOS 26. Hypertension Notifications Hypertension notifications use data from the optical heart sensor on Apple Watch to analyze how a user’s blood vessels respond to the beats of the heart. Like all of Apple’s health features, hypertension notifications are grounded in rigorous scientific validation. The feature was developed with advanced machine learning and training data from multiple studies totaling over 100,000 participants. Its performance was then validated in a clinical study of over 2,000 participants. While hypertension notifications will not detect all instances of hypertension, with the reach of Apple Watch, the feature is expected to notify over 1 million people with undiagnosed hypertension within the first year. “Hypertension is the leading preventable cause of heart attack and stroke, yet millions remain undiagnosed,” said Harlan Krumholz, MD, SM, cardiologist and scientist at Yale University and Yale New Haven Hospital. “Making accurate detection easy and part of daily life can help people get care earlier and prevent avoidable harm.” A user’s iPhone and Apple Watch Series 11 show “Possible Hypertension” and offer more details. Hypertension notifications were developed with advanced machine learning and training data from multiple studies totaling over 100,000 participants. If users receive a hypertension notification, it is recommended that they log their blood pressure for seven days using a third-party blood pressure cuff and share the results with their provider at their next visit, which is consistent with the latest American Heart Association guidelines for the diagnosis and management of hypertension. Clearance for hypertension notifications from the FDA and other regulators is expected soon, and the feature will be available in more than 150 countries and regions — including the U.S. and the EU — this month. Hypertension notifications will be available on Apple Watch Series 9 and later, and Apple Watch Ultra 2 and later, with watchOS 26.
September 9, 2025 at 8:35 PM
Reposted by Raj Mehta
jordybc.bsky.social
Some key changes that stood out to me (got the opportunity to help w writing these!):

1) Stronger recs for single pill combos
2) Broader recs for screening for primary aldo (now consider in anyone with stage 2 HTN — i.e., BP >=140/90)
3) Just. Say. No… to cuffless BP devices… and to EtOH

2/
No.to
August 14, 2025 at 6:10 PM
Reposted by Raj Mehta
hswapnil.medsky.social
should we screen for CKD in the general population?

Finally, flozins, finerenone and GLP1s allow a good cost-effectiveness case

www.nephjc.com/news/2025/7/... for #NephJC shorts

Time to stop just being dialysis-ologists and flozinate, glipinate!

#NephSky
NephJC Shorts: Should we Screen for Kidney Disease? — NephJC
Should we screen for CKD?
www.nephjc.com
July 31, 2025 at 5:45 PM
Reposted by Raj Mehta
leorahorwitzmd.bsky.social
Heard from #AHRQ that the entire grants staff has been let go! They are unable to issue funds for grants already funded, let alone fund new grants. This is outrageous and will make Americans poorer and sicker. Why? A brief thread about just some recent AHRQ-funded research: #MedSky #HealthPolicy
July 23, 2025 at 10:59 PM
Reposted by Raj Mehta
middeldorps.bsky.social
This is what we were waiting for. A direct comparison between apixaban and rivaroxaban for the treatment of acute VTE. Apixaban reduces bleeding risk in the first 3 months by >50%!

Practice changing investigator-initiated RCT.

#ISTH2025
June 22, 2025 at 1:49 PM
Reposted by Raj Mehta
erictopol.bsky.social
Is generative #AI capable of clinical reasoning?
Our new piece @thelancet.bsky.social open-access
@adamrodmanmd.bsky.social
www.thelancet.com/journals/lan...
Is generative artificial intelligence capable of clinical reasoning?
What does it mean for a computer to think like a doctor? This question has vexed physicians working on clinical reasoning artificial intelligence (AI) for more than 70 years. The first generation of p...
www.thelancet.com
February 27, 2025 at 11:38 PM
Reposted by Raj Mehta
agawande.bsky.social
Rubio terminated 5800 USAID contracts – more than 90% of its foreign aid programs – in defiance of the courts.

Here’s a list of just some of the lifesaving awards that were terminated. Nearly all were Congressionally mandated. They’ve saved millions of lives. 🧵
February 27, 2025 at 8:59 PM
Reposted by Raj Mehta
erictopol.bsky.social
A randomized trial of tailored A.I.-guided ablation of atrial fibrillation vs standard-of-care, anatomical ablation demonstrated superiority of AI guidance
www.nature.com/articles/s41...
February 14, 2025 at 2:44 PM
Reposted by Raj Mehta
erictopol.bsky.social
I wrote a book The Creative Destruction of Medicine (2013, title adopted after Schumpeter).

This title of the book for what we are now seeing in the U.S. is just The Destruction of Medicine.
February 14, 2025 at 11:15 PM
Reposted by Raj Mehta
gorskon.bsky.social
Indirects support infrastructure for translational research and clinical trials. Look for clinical trials to be paused or halted because universities will no longer have funds to keep them open. This will be devastating for cancer patients at NCI-designated comprehensive cancer centers, for example.
donmoyn.bsky.social Don Moynihan @donmoyn.bsky.social · Feb 8
Medical and health research will be especially badly hit, since medical schools rely more heavily on grant funding from NIH relative to other parts of the university.
February 8, 2025 at 2:35 PM
Reposted by Raj Mehta
jamesheathers.bsky.social
I have a piece half-done on the entire world of indirect costs. It's too big an endeavor to finish now, in the middle of the night, when this problem *that was always a live grenade with a half-pulled pin* is suddenly a topic du jour. Shit of a thing.

Here are some highlights.
February 8, 2025 at 5:59 AM
Reposted by Raj Mehta
erictopol.bsky.social
A randomized trial of GPT-4 vs 92 physicians with or without this #AI LLM for performance on patient care tasks.
AI improved physician performance, on par with AI alone (based on 5 clinical vignettes) nature.com/articles/s41...
GPT-4 assistance for improvement of physician performance on patient care tasks: a randomized controlled trial - Nature Medicine
In a prospective study involving 92 physicians from multiple institutions, access to large language model assistance on top of conventional resources increased a score expressing the quality of their ...
nature.com
February 5, 2025 at 3:51 PM
Reposted by Raj Mehta
jama.com
From JAMA Cardiology:

South African regulations limiting sodium in processed foods were associated with reductions in sodium consumption and blood pressure among rural adults aged 40 years or older.

ja.ma/4hMWyUW

#CardioSky
Figure 2. Sodium Content on Packaging in a Basket of Food Products in the Agincourt-Bushbuckridge by Wave and Legislative Target
February 5, 2025 at 7:29 PM
Reposted by Raj Mehta
hswapnil.medsky.social
In @ajkd.bsky.social

www.ajkd.org/article/S027...

Revisiting protein restriction: did they get it wrong?

Yes they did it wrong.

But they don’t admit that in this commentary, sadly 😕
Editorial commentary title in AJKD by Bill Mitch and colleagues ‘Revisiting Protein Restrictions in Early CKD: Did we get it wrong’?
January 30, 2025 at 10:03 PM
Reposted by Raj Mehta
hswapnil.medsky.social
Finally!

Antibiotics are not non-inferior to appendectomy despite a generous 20% non-inferiority margin

They are actually inferior: www.thelancet.com/journals/lan... in the @thelancet.bsky.social

#MedSky
At 12-month follow-up, primary outcome data were available for 846 (90%) patients. Treatment failure occurred in 153 (34%) of 452 patients in the antibiotic group, compared with 28 (7%) of 394 in the appendicectomy group (difference 26·7%, 90% CI 22·4–30·9).
January 17, 2025 at 3:06 AM
Reposted by Raj Mehta
erictopol.bsky.social
The potential importance of reactivation of herpes simplex virus type 1 (HSV-1) as a contributing factor to developing Alzheimer's disease
www.science.org/doi/10.1126/...
January 7, 2025 at 7:39 PM
Reposted by Raj Mehta
mikejohansenmd.medsky.social
Published an opinion piece in @bmj.com with @raj-mehta.bsky.social. I bet no one has opinions about the topic.

www.bmj.com/content/388/...
AI in medicine: preparing for the future while preserving what matters
2025 is here and medicine has continued to move away from the utopian vision of our admission essays for medical school. We are spending countless hours on electronic health records scrolling through ...
www.bmj.com
January 7, 2025 at 8:09 PM
Reposted by Raj Mehta
medicine.stitches.today
A protein intake of 1.5 g/kg/day enhances net protein balance in older adults on a two-meal eating pattern.

by Church DD, Hirsch KR (...) Ferrando AA et 5 al. in J Nutr #MedSky

📖 read the article:
Effect of Three Different Daily Protein Intakes in a Two-Meal Eating Pattern on Protein Turnover in Middle Age and Older Adults: A Randomized Controlled Trial
Reduced meal frequency patterns have become popular for weight loss, maintenance, and improving cardiometabolic health. The extended fasting windows w…
www.sciencedirect.com
January 6, 2025 at 6:36 PM
Reposted by Raj Mehta
ericweinhandl.bsky.social
We need some of these phrases for nephrology!

Kidney failure = Filter futility

Peritoneal dialysis = Abdominal cleaning

Hyponatremia = Salt shortage
December 20, 2024 at 1:09 PM
Reposted by Raj Mehta
altmetric.com
THREAD

This Is The Story Of The The Pernicious Rise of AI-Generated Papers and their Online Impact

An Incomplete History Told In The Voice of Documentarian Adam Curtis
1/31
Adam Curtis Title Card: We Too Are Trapped In A System. Text over a background of a large office building
December 19, 2024 at 9:10 PM
Reposted by Raj Mehta
yarakyrychenko.bsky.social
🚨New in Nature Computational Science! 🚨

Do large language models (LLMs) exhibit social identity biases like humans?

(co-lead by @tiancheng.bsky.social, together with @steverathje.bsky.social, Nigel Collier, @profsanderlinden.bsky.social, and Jon Roozenbeek)
1/
www.nature.com/articles/s43...
Generative language models exhibit social identity biases - Nature Computational Science
Researchers show that large language models exhibit social identity biases similar to humans, having favoritism toward ingroups and hostility toward outgroups. These biases persist across models, trai...
www.nature.com
December 12, 2024 at 12:33 PM
Reposted by Raj Mehta
ryanmarino.bsky.social
The data speaks for itself
A magic carpet with bullet holes
December 6, 2024 at 5:55 PM
Reposted by Raj Mehta
nephjc.bsky.social
#MedSky #NephSky

🛣️ BPROAD takes the known path of ACCORD trial, minus glycemic control

🎯Question to address: should we aim for a BP of 120 or 140 in patients with diabetes?

#NephJC summary by @shahsonride.bsky.social and @madihaaziz.bsky.social

www.nephjc.com/news/bproad
BPROAD: Sprinting down the BP Road in DIabetes — NephJC
This week, we will discuss hopefully the final story of intensive BP lowering. BPROAD is a larger version of ACCORD without the glycemic control arm. Dive in.
www.nephjc.com
December 3, 2024 at 2:49 AM
raj-mehta.bsky.social
An incredible review by @richard-lehman.bsky.social

bjgplife.com/the-art-of-u...
The Art of Uncertainty: How to Navigate Chance, Ignorance, Risk and Luck
bjgplife.com
December 1, 2024 at 12:13 PM