Robert W. Yeh @rwyeh Twitter profile

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Robert W. Yeh

1 year

It can be difficult to discern high quality observational studies from the rest. But it is critical that we try. Sharing some of the things I've learned here: Bringing the Credibility Revolution to Observational Research in Cardiology | Circulation

Bringing the Credibility Revolution to Observational Research in Cardiology | Circulation

www.ahajournals.org

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Robert W. Yeh

@rwyeh

6 years

BREAKING NEWS!!! In the first ever randomized clinical trial, we demonstrated that parachutes did NOT prevent death or major injury compared to control in individuals jumping from aircraft. Published today in @bmj_latest : #PARACHUTETrial #XmasBMJ

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Robert W. Yeh

@rwyeh

5 years

Job security for cardiologists.

CNN

@CNN

5 years

KFC has announced that it will be testing a new combination of fried chicken and glazed doughnuts. The new items will be sold for a limited time, and aren't nationally available just yet: only in Pittsburgh and two Virginia cities — Norfolk and Richmond.

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Robert W. Yeh

@rwyeh

3 years

It was only a matter of time…

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Robert W. Yeh

@rwyeh

4 years

Sorrry for the unkind take but if you are dabbling in clinical research by publishing flawed observational studies, you are doing no favors for people devoting their careers to doing observational studies the right way. It hurts the credibility of the whole field.

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Robert W. Yeh

@rwyeh

6 months

Astonishing results from the DanGer Shock Trial presented at #ACC24 and out in @NEJM today. In patients with ST-elevation MI with cardiogenic shock, Impella reduced all-cause mortality (45.8% Impella vs. 58.5% control) at 180 days. Some thoughts on this ground breaking trial:

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Robert W. Yeh

@rwyeh

2 years

It’s not unlikely that you won’t not understand what is being said here.

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Robert W. Yeh

@rwyeh

2 years

"Hi Mom, looks like I got my first R01." Congrats @rkwadhera ! We couldn't be more proud of you. @SmithBIDMC

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Robert W. Yeh

@rwyeh

5 years

1/Lot's of angst about #ISCHEMIA and what it will mean for cardiology practice. For me, a positive trial is likely to mean more for changing my practice than a negative one. I'll try to explain (Thread). #AHA19

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Robert W. Yeh

@rwyeh

5 years

I am seriously amazed by the number of different sizes and styles of envelopes that the AMA uses to try to coerce me to pay membership dues. Their stationary budget must be astronomical.

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Robert W. Yeh

@rwyeh

5 years

To anyone out there who was ever made fun of for being a germophobe.... We’re sorry. You were right. Signed, The rest of us

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Robert W. Yeh

@rwyeh

4 years

Mr. Miyagi’s got nothing on Ignacio.

Ignacio Cruz Gonzalez

@icruzgonzalez

4 years

@manuelbarreirop No more! @JeanNunezG @RodrigoEstvez1 @StructuralBCN

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Robert W. Yeh

@rwyeh

5 years

More stunning results published in NEJM. ISAR REACT 5. Prasugrel vs ticagrelor for ACS: Prasugrel reduces death/MI/stroke at 1 year. No difference in bleeding. Wow. #ESCcongress2019

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Robert W. Yeh

@rwyeh

5 years

Strange mix of emotions: - Helplessness/guilt watching NYC (and friends) struggle - Grateful to feel safe with family at the moment - Frustrated by the mundane but real challenges of pseudo-homeschooling kids - Terrified/energized, as the prospect of getting redeployed looms.

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Robert W. Yeh

@rwyeh

11 months

PCI is effective at reducing angina when the target coronary lesion is responsible for angina. Sounds obvious, but bears repeating because of the implications: This is a DIAGNOSTIC problem, not a therapeutic one. We don't have a perfect test linking symptoms to disease.

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Robert W. Yeh

@rwyeh

11 months

Congratulations @rkwadhera for your promotion to Associate Professor of Medicine at Harvard Medical School!!! You've made incredible contributions to the fields of health policy evaluation and health equity research, to the mentorship of so many trainees, and to @SmithBIDMC .

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Robert W. Yeh

@rwyeh

5 years

We are all accommodating to this new world of virtual education during the pandemic. Here’s our dad, preparing to teach an engineering class he’s been teaching for >50 years(!) at @UCLA , but doing it remotely on a tablet for the first time! @michaelyehmd

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Robert W. Yeh

@rwyeh

6 years

One small jump for woman, one giant leap for evidence-based medicine....

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Robert W. Yeh

@rwyeh

5 years

Bill Gates needs a quick tweetorial on conditional probability.

Bill Gates

@BillGates

5 years

Why I would rather encounter a shark in the wild than a mosquito: #MosquitoWeek

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Robert W. Yeh

@rwyeh

3 years

Interventional cardiology version: 1) “Groin might be faster” 2) “Gonna confirm with a distal injection” 3) “JR4. I’ll just pull a guideliner if I need it.” 4) “Nah, we’re done. Stent looks good enuf on angio.” 5) “We can just post-dil super high if it doesn’t expand.” …

🌼 SEX,LIES and SENSIBILITY out Now

@NikkiPayneBooks

3 years

Apart from "life is short" what other lines do you use before making bad decisions?

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Robert W. Yeh

@rwyeh

6 years

First thoughts on #COAPT - a blow out. MitraClip won across the board. It wasn’t close - very meticulously conducted, including very carefully selected population - effectiveness in real world will hinge on how closely docs can replicate enrolled pt group #TCT2018

Robert W. Yeh

@rwyeh

6 years

Key figures from #COAPT . #TCT2018

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Robert W. Yeh

@rwyeh

4 years

Going to embarrass @EricSecemskyMD here, but this is too good not to share. His NHLBI K23 was officially awarded today. Quickly becoming THE PAD triple threat. @SmithBIDMC @BidmcCvi

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Robert W. Yeh

@rwyeh

5 years

Tiger moms aren’t easily impressed.

The Nobel Prize

@NobelPrize

5 years

"As a child, I promised my mother I would win the Nobel Prize in Physics. 50 years later, I said to my mother, 'See, I have kept my promise. I won the Nobel Prize.' 'No,' said my mother, 'You promised it would be in physics!'" - Kenzaburo Oe, awarded the 1994 Literature Prize

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Robert W. Yeh

@rwyeh

4 years

1/ #COVID19 took the life of a great man today. Former Stanford President, and former FDA Commissioner Donald Kennedy. This thread is a personal one though, as Don was profoundly influential in my career. via @Stanford

Home Page

news.stanford.edu

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Robert W. Yeh

@rwyeh

5 years

Everything I believed yesterday, I believe even more strongly today. #ISCHEMIA #AHA19

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Robert W. Yeh

@rwyeh

5 years

Can’t wait for the day we can get back to quibbling about periprocedural MI definitions and c-statistics for polygenic risk scores....

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Robert W. Yeh

@rwyeh

5 years

Maybe this is how we ought to greet one another at #ACC20 next month?

Steven Ray Lammers

@StevenRayAround

5 years

My favorite non-pharmaceutical intervention of the week. #COVID2019

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Robert W. Yeh

@rwyeh

4 years

This is pretty cool. #FauciGrandRounds

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Robert W. Yeh

@rwyeh

5 years

Lots of question from friends & family that start with: “Is it too paranoid to....” “Am I overreacting if I...” Cancel the party, don’t go to the movie, skip that flight, don’t let my kid go to the sleepover. Feels like the right answer universally has been, “No.” #Covid_19

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Robert W. Yeh

@rwyeh

5 years

I’m stunned by how positive the #COMPLETE trial is. Complete revasc wins definitively over culprit only revasc on the difficult to game death/MI endpoint. Want to dig into the MI definition a bit, but looks like a practice changer. #ESCcongress2019

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Robert W. Yeh

@rwyeh

5 years

New beginnings for @rkwadhera . - Newly-minted faculty member at @SmithBIDMC . - New recipient of an NIH-sponsored K23 award. On fire!

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Robert W. Yeh

@rwyeh

3 years

#MASTERDAPT is out in @NEJM , short vs standard DAPT in high bleeding risk patients. Will be the most important DAPT Study we see this year. Much respect for the authors. Here’s are some quick thoughts (thread): - high risk patients (1/3 NSTEMI, 11% STEMI, complex long lesions)

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Robert W. Yeh

@rwyeh

4 years

It’s less dramatic but a needle works too. 🤷‍♂️

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Robert W. Yeh

@rwyeh

4 years

I’m not sure I can tell the difference between preprints and peer reviewed publications at the moment.

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Robert W. Yeh

@rwyeh

5 years

It's notable that the rapid erosion of equipoise in experimental treatments for #COVID19 is driven principally by doctors doing what they think is best in desperate circumstances, to a lesser degree by biological plausibility, and not at all by financial conflict of interest.

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Robert W. Yeh

@rwyeh

3 years

Could hear a loud lecture coming from ⁦ @EricSecemskyMD ⁩ ‘s office. Wanted to check out what it was. Grand rounds talk? FDA meeting? Vascular conference presentation? Nope. Teaching his 1st grader’s class about Hanukkah. (Sound on) ⁦ @SmithBIDMC ⁩

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Robert W. Yeh

@rwyeh

4 years

Note to trainees: This is how to hurt your attending’s feelings.

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Robert W. Yeh

@rwyeh

6 years

Not a joke - I was asked by a reviewer to separately present the results of a study limited to Caucasian subjects. The entire study population was 91% Caucasian. Because what’s really missing in the clinical trial literature are white people subgroup analyses.

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Robert W. Yeh

@rwyeh

3 years

That sound you heard from #ESCCongress was the collective sigh of relief from all interventionalists who take call and their spouses. Immediate Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation did not show benefit.

Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation | NEJM

Myocardial infarction is a frequent cause of out-of-hospital cardiac arrest. However, the benefits of early coronary angiography and revascularization in resuscitated patients without electrocardio...

www.nejm.org

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Robert W. Yeh

@rwyeh

5 years

“The clues in their name”? Cmon... I’m saddened by how acceptable it has become to disparage an entire profession. ICs are your med student classmates, your co-fellows, your colleagues you consult every day. We, like you, are doing the best we can for our shared patients.

Dr Akhlaque Uddin

@UddinAkhlaque

5 years

BMJ jumping the gun? Shall we wait for the paper? Should have been "60secsON ischaemia" OMTfirst

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Robert W. Yeh

@rwyeh

7 years

Good example of “immortal time bias”. Complete revasc within 60 days of STEMI means you must have lived long enough to receive it. STEMI pts who eat a bag of Cheetos within 60 days also have lower mortality than those who don’t, it turns out.

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Robert W. Yeh

@rwyeh

5 years

Genuine thanks to all of my Twitter friends for the kind congratulatory messages. Truly appreciative of mentors and friends. Now get back to the scientific quibbling that makes this such a fun platform!

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Robert W. Yeh

@rwyeh

7 months

In the first US trial evaluating a drug-coated balloon for coronary in-stent restenosis, we found that the Agent paclitaxel balloon reduced target lesion failure by > 40% compared with conventional angioplasty. Now FDA approved. Published in JAMA now:

Paclitaxel-Coated Balloon vs Uncoated Balloon for Coronary In-Stent Restenosis

This clinical trial compares a paclitaxel-coated balloon vs an uncoated balloon in patients with in-stent restenosis undergoing percutaneous coronary intervention.

jamanetwork.com

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Robert W. Yeh

@rwyeh

7 months

Just out today: First drug-coated balloon for the coronary circulation now approved in the US, for in-stent restenosis.

Boston Scientific Receives FDA Approval for the AGENT™ Drug-Coated Balloon

/PRNewswire/ -- Boston Scientific Corporation (NYSE: BSX) today announced it has received U.S. Food and Drug Administration (FDA) approval for the AGENT™...

www.prnewswire.com

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Robert W. Yeh

@rwyeh

5 years

Maybe an unpopular take: Academics docs like to create classification systems for diseases and syndromes. Unless they clearly distinguish distinct biological processes with different treatments, their main use is to create material for trainees to memorize and be tested on.

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Robert W. Yeh

@rwyeh

5 years

This is mesmerizing.

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Robert W. Yeh

@rwyeh

7 years

1/ This is going to be a long take on ORBITA - the first sham-controlled PCI trial ever, published in the Lancet.

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Robert W. Yeh

@rwyeh

4 years

Don’t fret, #epitwitter . POTUS tweetorial gets into immortal time bias and confounding by indication later in the thread.

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Robert W. Yeh

@rwyeh

7 years

Just finishing the usual morning ritual. “Kind Sir...” - Delete “Esteemed Colleague...” - Delete “Dear Dr. Robert W. Yeh...” - Delete “Greeting from Journal of...” - Delete On to the rest of my day.

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Robert W. Yeh

@rwyeh

5 years

All the focus on whether revascularization “works” misses the mark. If someone creates a test that can better attribute symptoms to lesions, we’ll do a lot better. Our primary challenge in stable CAD is a DIAGNOSTIC problem, not a therapeutic one. #AHA19 #ISCHEMIA

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Robert W. Yeh

@rwyeh

5 years

10/So if you're an evidence-based patient-centered interventional cardiologist, I personally think you can rest comfortably whatever the results of the trial show. I'm trying to go in with an open mind and no agenda. It's the spin cycle that I'm more worried about.... end.

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Robert W. Yeh

@rwyeh

3 years

If vaccines were anti platelet meds, J&J = clopidogrel Pfizer = ticagrelor Moderna = prasugrel Regeneron= PCI for stent thrombosis

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Robert W. Yeh

@rwyeh

6 years

Still so funny, at its 15 anniversary.... @bmj_latest

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Robert W. Yeh

@rwyeh

7 months

Big congrats to my good friend ⁦ @EricSecemskyMD ⁩ for his promotion to Associate Professor of Medicine at Harvard Medical School!! The promotions committee was particularly impressed by this keynote lecture delivered to a panel of luminaries! (Sound on) ⁦ @SmithBIDMC ⁩

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Robert W. Yeh

@rwyeh

7 years

If I ever say "I found" or "My paper" to describe a study for which I am not the sole author, please free free to punch me, especially if you are a co-author.

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Robert W. Yeh

@rwyeh

4 years

If you ever thought you might share a paper you were asked to review before it was public and thought, “what could go wrong?” Today’s @NEJM hydroxychloroquine debacle is the answer.

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Robert W. Yeh

@rwyeh

3 years

Thank you Reviewer 10!

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Robert W. Yeh

@rwyeh

6 years

Our editorial, behind the scenes of the trial, linked below. N.B. to the public - please continue to use parachutes for skydiving.

We jumped from planes without parachutes (and lived to tell the tale) - The BMJ

“Would you be willing to jump out of this plane without a parachute?” For the last year we’ve posed this question, mid-flight, to dozens of unsuspecting travellers seated on [...]More...

blogs.bmj.com

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Robert W. Yeh

@rwyeh

4 years

NEJM Surgisphere article retracted also. Not sure how this can be signed by Sapan Desai....

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Robert W. Yeh

@rwyeh

6 years

Find me a device or treatment that docs selectively use in sick patients, and I'll find you an observational study showing that its use is associated with worse outcomes.

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Robert W. Yeh

@rwyeh

4 years

The natural experiment begins....

NBC News

@NBCNews

4 years

More than 20 states across the country have begun lifting lockdowns. See the plans for your state

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Robert W. Yeh

@rwyeh

3 years

@EpiEllie Here was our attempt with cheetos, in response to a pretty egregious recurring example in the cardiology literature.

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Robert W. Yeh

@rwyeh

5 years

If you like thinking about confidence intervals and uncertainty, this visualization is really incredible. Interpreting Confidence intervals from @krstoffr . H/t ⁦ @statsepi ⁩

Interpreting Confidence Intervals

Interactive visualization of confidence intervals

rpsychologist.com

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Robert W. Yeh

@rwyeh

6 years

Submitted manuscript vs. Revised manuscript responsive to all 3 reviewers. #peerreview

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Robert W. Yeh

@rwyeh

5 years

Big congrats to @EricSecemskyMD for his promotion to Assistant Professor of Medicine at Harvard Medical School, just 9 months into his first year on faculty! The triple threat of vascular intervention. Cc: @SmithBIDMC @kardiologykazi

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Robert W. Yeh

@rwyeh

5 years

How hard is it to get busy high quality reviewers to donate their time to help journals evaluate papers? This hard. 👇

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Robert W. Yeh

@rwyeh

5 years

It is amazing how little it takes to erode perceived equipoise. If we can’t randomize treatment for a disease that was unknown 4 months ago and for which the only treatments available are designed and approved for other diseases, RCTs don’t have much hope at all.

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Robert W. Yeh

@rwyeh

4 years

It’s a shame that the takeaway is often “I can’t trust any observational study.” Painting every study with the same brush isn’t right either. But with so many deeply confounded study coming out week after week, who can blame people for having that response?

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Robert W. Yeh

@rwyeh

7 years

The belittling, bullying and name calling of @LisaRosenbaum17 by those she somehow offended by her most recent article is incredibly disappointing to see. Is this really how you talk to people you disagree with??? Or does the digital medium erode your decency? #whentheygolow

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Robert W. Yeh

@rwyeh

2 years

My favorite ladies of cardiology ❤️ @Drroxmehran and @ddefariayeh

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Robert W. Yeh

@rwyeh

5 years

I am in waaay over my head. @ADAlthousePhD @SVRaoMD #TCT2019

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Robert W. Yeh

@rwyeh

4 years

Our big news: Andre D’Avila joins @BidmcCvi to lead electrophysiology. Amazing innovator, clinician and educator. Welcome Andre!

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Robert W. Yeh

@rwyeh

4 years

Great news for present and future @BIDMCVFellows ! @AM_AnagnosMD was appointed the Director of Recruitment and Advancement of Women Fellows in Cardiology Training. And @rkwadhera named the Associate Program Director for the fellowship. Great things to come!!

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Robert W. Yeh

@rwyeh

4 years

#COVID19 COVID is plateauing. Meanwhile, observational research is hitting rock bottom. I'd have more to say, except homeschool is crushing my soul.

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Robert W. Yeh

@rwyeh

5 years

Trying to get a computer charger plugged into the socket below my airplane seat is seriously harder than anything I do in the cath lab.

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Robert W. Yeh

@rwyeh

5 years

I’m no germophobe, but the last thing I want to do on my way out of a public restroom is to put my hands on a touch screen that thousands of people who’ve just done their business have touched right before me.

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Robert W. Yeh

@rwyeh

3 years

Swallowing my pride.

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Robert W. Yeh

@rwyeh

5 years

Imagine this pandemic without the internet...

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Robert W. Yeh

@rwyeh

5 years

Here are the results of #ISCHEMIA for all you at home.

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Robert W. Yeh

@rwyeh

7 years

Privilege to receive letters like these from grateful patients who feel better after failing to get symptom-free on meds. #reallife #nosham #noshame

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Robert W. Yeh

@rwyeh

11 months

If we reframe angina as a diagnostic issue rather than a therapeutic one, we'd stop saying things like "PCI is modestly effective." It's really effective, in the right patient. We'd instead say, "we are modestly good at knowing the etiology of your angina."

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Robert W. Yeh

@rwyeh

7 years

In my experience, when you lead a sentence with "in my experience" you end up sounding condescending, foolish or both.

Sunil V. Rao

@SVRaoMD

7 years

@willsuh76 @CardiacConsult @mcsassymd @JReinerMD @drdevireddy @HeartOTXHeartMD @rwyeh @mmamas1973 @rajivxgulati @MGKatz036 @Tesslagra “Never say ‘in my experience’ until you’ve had 10 years of experience”

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Robert W. Yeh

@rwyeh

10 months

Just an amazing @BIDMCVFellows class of not so long ago featuring @djc795 @hmkyale @CMichaelGibson @drmalissawood ,JDC, Joe Carozza, Cliff Berger In division led by WG. Can you pick everyone out? Incredible legacy that is still being written.

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Robert W. Yeh

@rwyeh

5 years

It’s official. #ACC20 cancelled. Good decision.

American College of Cardiology

@ACCinTouch

5 years

Due to @CDC , @WHO #COVID19 reports, and in the best interest of our attendees and the #CVD patients whom they serve around the globe, #ACC20 / #WCCardio is canceled. Virtual meeting options in the works. More here:

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Robert W. Yeh

@rwyeh

5 years

Wonderful evening honoring Dr. Igor Palacios @MGHHeartHealth . Enormous outpouring of love and respect for one of the fathers of interventional and structural heart intervention. So great to see so many of his former trainees - an incredible legacy.

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Robert W. Yeh

@rwyeh

7 years

Daily conversation in our house: Wife: How was your day? Me: Great! Wife: Let me guess. The artery was closed and now it's open? Me: YES!

C. Michael Gibson MD

@CMichaelGibson

7 years

Well said Ted You too have no choice but to be an interventional cardiologist You are compelled to do so

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Robert W. Yeh

@rwyeh

5 years

Very true. When I disagree with 90% of what you are saying, it’s very hard to publicly endorse the 10% I agree with. But mutual recognition of the common ground is the first step toward progress.

chadi nabhan MD, MBA, FACP

@chadinabhan

5 years

Sums a lot of twitter exchanges...

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Robert W. Yeh

@rwyeh

4 years

Great study by David Manly, @SVRaoMD and team on transradial cath and PCI in patients with prior CABG in @JACCJournals CV Interventions. For radial: - a bit more time/fluoro on the diagnostic - highly feasible for PCI - better outcomes

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Robert W. Yeh

@rwyeh

5 years

I’ve been pronouncing dabigatran wrong the whole time, and I’ll but you’ve been too. Amazingly funny article on how we name generic drugs. H/t ⁦⁦ @hswapnil ⁩

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Robert W. Yeh

@rwyeh

3 years

In addition to all the great advice being given to new cardiology fellows on Twitter, I’ll add this pearl. “If in doubt, counter clock.”

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Robert W. Yeh

@rwyeh

4 years

I think this definitely proves that I am a child of the 80s and also have terrible taste but #CobraKai is the most compelling TV I’ve watched since Ben H’s season of the Bachelor.

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Robert W. Yeh

@rwyeh

7 months

Tremendously excited for this announcement. @LisaRosenbaum17 is one of the most important voices in our profession today. She'll lead a new effort at @SmithBIDMC to advance writing and critical thinking in medicine. Welcome Lisa!

BIDMC Smith Center

@SmithBIDMC

7 months

We are pleased to announce that @LisaRosenbaum17 will join @SmithBIDMC as the inaugural Writer-In-Residence, beginning July 2024. Please join us in welcoming Dr. Rosenbaum!

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@rwyeh

5 years

PSA: If your patient has been in the MICU for any reason, there are few good reasons to send them for coronary angiography during the same hospitalization. There are many good reasons not to.

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Robert W. Yeh

@rwyeh

4 years

Here’s an idea for a catchy title: “Why Most Preprinted Research Findings Are False?”

Coronavirus Tests Science’s Need for Speed Limits (Published 2020)

Preprint servers and peer-reviewed journals are seeing surging audiences, with many new readers not well versed in the limitations of the latest research findings.

www.nytimes.com

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Robert W. Yeh

@rwyeh

6 years

Some meandering thoughts about #CardioTwitter in @CircOutcomes : - Is it inherently democratic? - Are there risks to community building? - What’s industry’s role in all this? - Who will be the arbiter’s of truth? As always, interested in your thoughts.

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Robert W. Yeh

@rwyeh

3 years

Exciting to work with the @US_FDA to provide a safety evaluation of endovascular grafts for abdominal aortic aneurysms for the FDA Advisory Panel meeting today. Complete team effort for the @SmithBIDMC team, quarterbacked by @EricSecemskyMD . I'll take credit for the camera work.

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Robert W. Yeh

@rwyeh

5 years

This is important. Our individual risk is not the primary reason for social distancing, hand washing etc. The sum total of our Individual decisions have implications for everyone. If you’re primarily thinking about your personal risk, you’re thinking about this the wrong way.

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Robert W. Yeh

@rwyeh

2 years

Go time. #TCT22 ⁦ @mbmcentegart ⁩ ⁦ @hectortamezmd ⁩

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Robert W. Yeh

@rwyeh

5 years

Just the usual collection of experts for this complex PCI panel at #CHIPSeattle . @ArasiMaran @mbmcentegart @KateKearney4 #JenniferTremel Cc: @ajaykirtane @Drroxmehran

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