Category Archives: Monthly Transcripts

June #urojc Transcript

Healthcare Social Media Transcript

From: Sun Jun 02 13:00:00 PDT 2013
To: Tue Jun 04 15:00:00 PDT 2013

What is #urojc? Who were the influencers during this time period? #urojc analytics

Healthcare Conference  – Healthcare Tweet Chats  –  Healthcare Analytics

StorkBrian
@DrRunz_Urology Cris, were are talking about stones this month @iurojc #urojc Love to have you join in the conversation

iurojc
Welcome to the June #urojc discussion. Starts now & runs for 48 hours. Paper is available on line as free download http://t.co/QcwJRn0zto

LoebStacy
New research showing 26% decreased risk of #kidney stones w/ 1 or more servings #coffee per day! Off to @Starbucks #thankgod #addict #urojc

iurojc
June #urojc article is open access http://t.co/QcwJRn0zto thanks to #CJASN Lead author @FerraroManuel will be joining us for the discussion

iurojc
Don’t forget to include the hashtag with every discussion tweet in order for everybody to see. #urojc

iurojc
It’s @AustProstate. MT “@StorkBrian@DrHWoo Anyone know the Twitter Handle for Aust Prostate Ca Research? #urojc” Ping @declangmurphy

iurojc
Q1. Are these results applicable to your patient population? What about for your existing stone formers? #urojc

iurojc
Q2. How can we account for influence of overall fluid consumption? Is this an important consideration? #urojc

Tdave
Soda, cola: bad. Coffee, beer & wine: good. I like this paper! #urojc

DrHWoo
@DrAdamMurphy @LoebStacy Could it be the diuretic action. Cups of coffee in the US are huge+. Real coffee when you come to Melbourne. #urojc

Tdave
But what exactly is “punch” and why so bad? Who is drinking this exactly? #urojc

iurojc
@DrAdamMurphy Do join us for current discussion on stones. Follow the hashtag #urojc

CBayneMD
@iurojc fluid consumption extremely important to consider in stone papers as it is only variable in RCT to sig impact stone formation #urojc

LoebStacy
New study shows 1 or more sugar-sweetened cola/day increases #kidney #stone risk by 23% #urojc Attn @MikeBloomberg @jwgale #nyc #sodaban

JZanetti11
RT @LoebStacy: New study shows 1 or more sugar-sweetened cola/day increases #kidney #stone risk by 23% #urojc Attn @MikeBloomberg @jwgale #…

DrHWoo
@Tdave I always thought of fruit punch being a home made concoction & usually laced with plenty of ETOH. Is it a defined drink? #urojc

Tdave
@DrHWoo Maybe Kool-Aid type drink? Unknown, but clearly evil! #urojc

DrHWoo
@LoebStacy @MikeBloomberg @jwgale Authors postulate it’s the fructose that is the issue with kidney stone http://t.co/LAL6KsDIXC #urojc

MattBultitude
@DrHWoo @Tdave – Quite important to know the definition of punch – should have been in the paper. Can authors please clarify for us ? #urojc

linton_kate
@iurojc looks like we need to relocate stone clinic to the dental hospital as patients likely need dental and urology input #urojc

daviesbj
Just wanted to say hi. Nothing to add #urojc I love fruit punch btw (with gin) #deepdaviesthoughts

MattBultitude
I tell patients diet 7-up/ sprite/ sunkist are best fizzy drinks. This supports that but still shows increase risk. Better than colas #urojc

iurojc
Up for grabs is a chance to join King @daviesbj in Hall of Fame for best discussion tweet – best tweet prize thanks to @EUplatinum #urojc

iurojc
Lets not forget the #urojc hashtag MT“@DrAdamMurphy@DrHWoo @LoebStacy ……..It has been postulated to be the diuretic action”

LoebStacy
#urojc Sound byte: Not all liquids are equal w/respect to #kidneystones. Avoid sugar soda/punch. Wine/coffee/tea good. @sosa_ernie comment?

MattBultitude
What do we think of methodology? Large cohort studies. Enrolled 1976, ’86, ’89. All male HCP’s or female nurses. Prone to dehydration?#urojc

DrHWoo
Mostly Caucasian as well! MT“@MattBultitude: ……Enrolled 1976, ’86, ’89. All male HCP’s or female nurses. Prone to dehydration?#urojc

_TheUrologist_
.@Tdave drinking “punch” means you live in 1870s London and are going to pus out of Petit’s triangle #urojc

_TheUrologist_
@MattBultitude wondered about overlap of high sugary drink consumption and sedentary/Ca++ mobilizing lifestyle. Less likely in HCPs #urojc

DrAdamMurphy
@LoebStacy @sosa_ernie The relationship may not be linear. At least modest coffee intake is ok. High levels could be bad #urojc.

DrHWoo
Tweeps, we are discussing a fascinating paper on what drinks ⬆or⬇ your risk of kidney stones on the hashtag #urojc http://t.co/XIWWGUSY3G

DrHWoo
@DrAdamMurphy @LoebStacy No worries Adam, we totally for that! Please do join in on #urojc http://t.co/XIWWGUSY3G

iurojc
Currently discussion on what drinks ⬆or⬇kidney stones. http://t.co/QcwJRn0zto #hcsm #hcsmanz #meded #urojc #foamed #coffee #kidneystones

UroOncologist
Scotch needs to be tested. @daviesbj @matthayn @Tdave: Soda, cola: bad. Coffee, beer & wine: good. I like this paper! #urojc

StorkBrian
RT @iurojc: Currently discussion on what drinks ⬆or⬇kidney stones. http://t.co/QcwJRn0zto #hcsm #hcsmanz #meded #urojc #foamed #coffee #ki

StorkBrian
@iurojc Muskegon, MI is also known as “The Beer Tent Capitol of the World” *We See A Lot of Obese Patients* http://t.co/Iea4U09IAh #urojc

captfun99
@iurojc #urojc Dietary sodium consumption and Controlling for caffeine levels in diet or sugar sodas omitted. Confounders?

Tdave
@UroOncologist @daviesbj @matthayn #Bourbon medicinal properties will clearly be protective #urojc

iurojc
Look forward to input from primary author @FerraroManuel when he wakes up – currently 0200 in Rome! #urojc Please make him welcome!

iurojc
#urojc RT“@hardy_bm@DrHWoo also, thanks for that link to the Harvard study. I can’t even comprehend the logistics of 100k participants!”

iurojc
Insightful #urojc RT“@hardy_bm@DrHWoo does the diuretic effect of the caffeine in energy drinks make up for the stone-forming potential?”

hardy_bm
RT @DrHWoo: Tweeps, we are discussing a fascinating paper on what drinks ⬆or⬇ your risk of kidney stones on the hashtag #urojc http://t.co/…

StorkBrian
@aweizer1 @montrose52 @hollenbeck1971 @UMichUrology Discussing Kidney Stones this Month at #urojc Welcome your input! @DrHWoo @iurojc

nickbrookMD
@iurojc gr8 paper and potential practice changer…could dispel the any-fluid-is-good-fluid dogma #urojc

nickbrookMD
@MattBultitude good point, but we do base advice not to restrict Ca on evidence from same cohort, so NHS-II already changed practice #urojc

nickbrookMD
@denbysteele this month’s #urojc may be of interest to you…currently being discussed RE https://t.co/76lWnpNRZK

medsexual
RT @iurojc: Insightful #urojc RT“@hardy_bm@DrHWoo does the diuretic effect of the caffeine in energy drinks make up for the stone-forming…

JYLeeUroSMH
#urojc #kidneystones Intrsting paper. R findings applicable to most stone pts today? Cohort of health prof’s(⇑ SES), ⇓ meanBMI, ++white

nickbrookMD
RT @JYLeeUroSMH#urojc #kidneystones Intrsting paper. R findings applicable to most stone pts today? Cohort of health prof’s(⇑ SES), ⇓ meanBMI, ++white

JYLeeUroSMH
#urojc #kidneystones Incidence of stone events v. low? 582/51k (HPFS), 194/121k (NHS I) 858/116k (NHS II)

JYLeeUroSMH
#urojc #kidneystones Lastly, all known stone pts exclded. Do reslts apply to them? Does this change advice we give our recurrent stone pts?

JYLeeUroSMH
#urojc self-admittedly, we need better research/methodology in endourol (eg cf uro-onc) This subspclty issue discussd at AUA podium session

Tdave
@JYLeeUroSMH @UroOncologist @daviesbj @matthayn must include small batch arm #urojc

FlavorFaze
@iurojc where does Coke Zero fall into this equation? That’s my poison of choice. No renal colic episodes yet! #urojc

medskep
MT @LoebStacy#urojc Sound byte: Not all liquids are equal w/respect to #kidneystones. Avoid sugar soda/punch. Wine/coffee/tea good.

DrHWoo
T2 – twitter has been great for global journal club interaction such as #urojc. Succinct, targeted & great for time poor clinicians #hcsm

JYLeeUroSMH
MT @DrHWoo: twitter great for global journal club interaction (eg #urojc) Succinct, targeted, great for time poor clinicians #hcsm #hcsmca

DrRKSingal
Time to check in to #urojc. Sugary drinks and risk of #kidneystones #cdnhealth #onhealth http://t.co/Iij8P3fMk8

roccorossiTO
RT @DrRKSingal: Time to check in to #urojc. Sugary drinks and risk of #kidneystones #cdnhealth #onhealth http://t.co/Iij8P3fMk8

DrRKSingal
#urojc Not sure the cohort is very useful. Older population.Sedentary. Health care workers. Problem with not including recurrent formers.

DrRKSingal
And here’s a question for 2013. What about sugary coffees? a la @TimHortons @Starbucks etc #frappacinno #urojc

CBayneMD
#urojc enjoyed the paper and the ideas. Appreciate the effort the authors made to control for variables, track diet, and separate beverages

CBayneMD
#urojc unfort, paper highlights the inherent difficulty in assessing urolithiasis risk: dietary habits virtually impossible to truly control

CBayneMD
#urojc unless you can administer diet and control metabolic differences w/ 24hr urine, hard to draw anything by very soft correlations

Tdave
@CBayneMD You hit nail I’m the head! Association is NOT causality #urojc

CBayneMD
#urojc most interesting to me was signif p correlation with sugar-sweetened sodas but no signif in BMI, DM, and high BP

DrRKSingal
I am unclear re definition of stone incident. All Colic? Not sure of routine use of US in 1970s/80s.How 2account 4 asymptomatic stone #urojc

DrRKSingal
Well said MT @CBayneMD#urojc unless you can administer diet & control metabolic differences w/ 24hr urine, can only very soft correlations

FlavorFaze
@Tdave @CBayneMD isn’t this a disease of associations? Think it still helps direct pts on how to make real life intake decisions #urojc

CBayneMD
#urojc still about body’s default: the health(ier) diet (except spinach!) with lots of H2O is likely to lean toward less stone formation

DrRKSingal
& mind the salt MT @CBayneMD#urojc still about body’s default: healthier diet (except spinach!) with lots of H2O likely less stone formed

hardy_bm
#urojc @CBayneMD or even just the prevailing bias. Many super-powerful studies suffer from this. Ioannidis’ essay: http://t.co/tgNykrc05n

nickbrookMD
@DrRKSingal good point. we have this filth in Aus..branded ice coffee 58g sugar/600ml in packets http://t.co/nJQKjumNn1 #urojc

UroOncologist
So are the stone docs going to tell patients to drink tea? Was a longstanding tenant to avoid #urojc #questionvalidity @Tdave

DrRKSingal
I think the tea link is weak #urojc #oxalate @UroOncologist @Tdave

DrRKSingal
Us stone docs are firing up the Holmium Laser RT @UroOncologist: So are the stone docs going to tell patients to drink tea? #urojc @Tdave

DrRKSingal
@specialkdmd check in on #urojc over the next 48 hours. It is going on now #meded

Tdave
@UroOncologist perhaps…no. Moderation is key. But we’ve been basing on oxalate not caffeine, volume or whatever else T drinkers do #urojc

ClairWhelan
#urojc water, tea and coffee not magic, just cheap. And my grandpa always recommended adding scotch to negate the fish-poo

iurojc
RT @ClairWhelan#urojc water, tea and coffee not magic, just cheap. And my grandpa always recommended adding scotch to negate the fish-poo

doctorfullerton
RT @DrRKSingal: Time to check in to #urojc. Sugary drinks and risk of #kidneystones #cdnhealth #onhealth http://t.co/Iij8P3fMk8

LoebStacy
@CBayneMD #Diet studies hard in humans. Same in #prostatecancer -weak evidence for lycopene, #soy,green tea,etc but many confounders #urojc

FlavorFaze
@iurojc who over 12 yo drinks punch? Second, has anyone heard of “Big Red”. Popular in southern USA apparently. #cokezeroFTW #urojc

FerraroManuel
#urojc Greetings everybody, I’m the first author of the cJASN paper you are discussing. Happy you find it interesting

iurojc
RT @FerraroManuel#urojc Greetings everybody, I’m the first author of the cJASN paper you are discussing. Happy you find it interesting

FerraroManuel
#urojc @MattBultitude The study doesn’t show that non-colas are “better” than colas since the referent category for colas wasn’t non-colas

iThangasamy
@DrRKSingal @_TheUrologist_ @MattBultitude Can vouch that junior docs dehydrated often! QLD health talking about mandatory mealtime.. #urojc

iThangasamy
RT @JYLeeUroSMH#urojc #kidneystones Lastly, all known stone pts exclded. Do reslts apply to them? Does this change advice we give our rec…

iThangasamy
@DrRKSingal Agreed it is a very select group. Not sure if can apply to average Joe Blogs that walks on the door (John Doe if in US!) #urojc

iThangasamy
RT @DrRKSingal: Well said MT @CBayneMD#urojc unless you can administer diet & control metabolic differences w/ 24hr urine, can only very …

iThangasamy
RT @FerraroManuel#urojc Greetings everybody, I’m the first author of the cJASN paper you are discussing. Happy you find it interesting

iurojc
@FerraroManuel Welcome Dr. If you track back, there are a number of questions for which we’d value your thoughts. #urojc

linton_kate
@iThangasamy I suspect surgeons get v dehydrated on theatre days #urojc #needteabetweencases

FerraroManuel
#urojc @CBayneMD Agreed. Anyway, unless you don’t follow those participants to collect data on incident stones, you would only have data…

FerraroManuel
#urojc @CBayneMD …on urine composition, which doesn’t necessarily translate into kidney stones.

UrologyMatch
RT @iurojc@FerraroManuel Welcome Dr. If you track back, there are a number of questions for which we’d value your thoughts. #urojc

UrologyMatch
RT @FerraroManuel#urojc @MattBultitude The study doesn’t show that non-colas are “better” than colas since the referent category for colas wasn’t non-colas

UrologyMatch
RT @LoebStacy#urojc Sound byte: Not all liquids are equal w/respect to #kidneystones. Avoid sugar soda/punch. Wine/coffee/tea good. @sosa

UrologyMatch
RT @Tdave: Soda, cola: bad. Coffee, beer & wine: good. I like this paper! #urojc

iurojc
#urojc MT“@FerraroManuel: Ext validity is interesting issue. As others pointed out, we analyzed selected popltn; however, the distrib of…”

iurojc
#urojc MT“@FerraroManuel: risk factors was not diff from gen pop. Furthermore, other assoc found in these cohorts have been replicated…”

iurojc
#urojc RT“@FerraroManuel@iurojc …in other populations.”

iurojc
Check out great feedback from lead author @FerraroManuel http://t.co/QcwJRn0zto #urojc

FerraroManuel
#urojc @CBayneMD Sorry, I don’t follow you on this. The p-values reported for BMI/DM/HBP refer to effect modification not to association.

luisreyva
RT @UrologyMatch: RT @Tdave: Soda, cola: bad. Coffee, beer & wine: good. I like this paper! #urojc

Tdave
@LoebStacy @CBayneMD #Onlyamatteroftime Somebody would relate to prostate cancer #urojc

drerickgrullon
RT @LoebStacy: New study shows 1 or more sugar-sweetened cola/day increases #kidney #stone risk by 23% #urojc Attn @MikeBloomberg @jwgale #…

nickbrookMD
@FerraroManuel nice work. These stone popn studies have potential to change managmt..NHSII already changed approach to Ca advice #urojc

DrHLN
@FerraroManuel May I ask what defines punch? I agree with @DrHWoo that generally thought of in Oz as alcoholic #urojc #urojc

DrHLN
@FerraroManuel May I ask what defines punch? I agree with @DrHWoo that generally thought of in Oz as alcoholic #urojc

FerraroManuel
#urojc @DrHLN In the QTN we asked about punch intake defining it as fruit drink w/ sugar excluding fruit juices, e.g. Hawaiian Punch.

MattBultitude
@FerraroManuel @DrHLN Usually punch is very alcoholic in the UK ! Must be a lot of Hawaiian punch drinkers in the US ! #urojc

DrRKSingal
Not to mention the existence of the phrase ‘punch drunk’ @DrHLN @FerraroManuel @DrHWoo #urojc

DrRKSingal
Dr Ferraro, TY for coming. Nice paper. What about my earlier ? about sugary coffees? @FerraroManuel @DrHLN #urojc #frappacino

FerraroManuel
#urojc @DrRKSingal You’re welcome. Based on the info from the QTN, we couldn’t separate the “effects” of components of coffee or of…

FerraroManuel
#urojc @DrRKSingal …different types of coffee on the risk of stones. The “effect” of caffeine might offset that of oxalate/sugar…

FerraroManuel
#urojc @DrRKSingal …in the beverage.

FerraroManuel
#urojc @DrRKSingal I’m referring to “effect” in quotes since we just observe associations, not causal effects.

iThangasamy
MT #urojc @FerraroManuel@iurojc This is certainly impt. We adjusted analysis for total fluid consumption, hence assoc b/w each type of…”

iThangasamy
RT #urojc “@FerraroManuel@iurojc …beverage and stones should be considered as for subjects who drink the same amount of fluids.”

Tdave
So where are all the uro-onc tweeps? Scared of some stone paper? Can’t handle it? #gauntletthrown #urojc

MattBultitude
@Tdave – strangely silent – like they don’t understand it – let’s call it stone cancer – would that help ? #ButICantUseMyRobotForThis #urojc

matthayn
@MattBultitude You can still use robo for stones, right @Tdave#urojc

DrRKSingal
Be careful guys the pure oncologists usual laugh at our wonky trial designs in #endourology #urojc @MattBultitude @Tdave

KeithKow
@DrRKSingal @MattBultitude @Tdave I lasered TWO stones today! One is even getting a metabolic work up! The other a partial nx….. #urojc

DrRKSingal
Maybe but some new coffee concoctions have ridiculous amount of sugar. MT @FerraroManuel#urojc . caffeine may offset calories/oxalate

JYLeeUroSMH
#urojc @nickbrookMD @FerraroManuel Agree, nice work. Huge cohorts w/ undoubtedly +data to sift through. Also thx for joining convo. +valuble

JYLeeUroSMH
#urojc @FerraroManuel Wonder signif of caffeine on “relative dehydrtn” MDs “dehydrtd” all day in OR, drink after work. Total intake N but…

MattBultitude
All this talk of stones and the King seems becalmed and far less angry #urojc @daviesbj #GoodForHisBloodPressure

Tdave
@matthayn @MattBultitude absolutely! [see CJU editorial coming next month] #shamelessplug #urojc

daviesbj
@MattBultitude #urojc I don’t mind stones at all. Just nothing high volume. My ADD isn’t good for URS

peepeeDoctor
@MattBultitude@Tdave – #ButICantUseMyRobotForThis #urojc” but yes folks you can use the robot for complex stones. highly recommend

DrRKSingal
The plenary at #aua13 showed lap anatrophic for complete stag. waste of time @peepeeDoctor @MattBultitude @Tdave #urojc

DrRKSingal
for difficult ureteral stones can consider but very rare in my experi & pure lap okay & cheaper #urojc @peepeeDoctor @MattBultitude @Tdave

peepeeDoctor
@DrRKSingal: lap anatrophic for stag. waste of time” @MattBultitude @Tdave #urojc completely agree. Not so if robotic + cold ischemia.

Tdave
@DrRKSingal @MattBultitude Wonky? 194,095 pts ain’t too shabby #urojc

DrRKSingal
Agreed. Not this paper. #s are impressive. In general I meant and compared with large onc trials @Tdave @MattBultitude #urojc

sueurology
Can someone please tell me the makeup of “punch”. Surely each batch varies unless this is a product available OTC in the us.#urojc

DrRKSingal
Forget #urojc. Time for #bruinspens13 @KeithKow @daviesbj @matthayn @Tdave

Tdave
On hold RT @DrRKSingal: Forget #urojc. Time for #bruinspens13 @KeithKow @daviesbj @matthayn @Tdave

DrHWoo
See previous response by @ferraromanuel MT @sueurology Can someone pls tell me makeup of “punch”. #urojc

JYLeeUroSMH
@DrRKSingal @tdave @mattbultitude #urojc Agree impressive dataset. But generalizabilty limtd by focusd cohort. Also agree abt endo research

CBayneMD
@FerraroManuel I was surprised no significance was found with BMI or DM status. I think it lends support to significance of sugarcola #urojc

iThangasamy
RT @Tdave: So where are all the uro-onc tweeps? Scared of some stone paper? Can’t handle it? #gauntletthrown #urojc

sueurology
Sounds like I’ll have punch with a shot of caffeine. Preferably artificially sweetened. And a large shot of gin #urojc

DrHWoo
With regard to ‘sugar’ the paper suggests that we should perhaps differentiate between fructose and glucose. Thoughts @ferraromanuel#urojc

cooperberg_ucsf
Bet #urojc members knew this already: drink coffee, wine, beer! Skip (Diet) Coke. Didn’t need 2.6M person-years f/u… #BacktoCancer @iurojc

cooperberg_ucsf
In the meantime, HPFS has been _heavily_ analyzed; multiple comparisons problem applies. Also, control for comorbidity was inadequate #urojc

JustUro
@FerraroManuel @DrRKSingal Presume components=caffine+milk(if present)+water+sugar(if present). Decaf+tea similarly variable then? #urojc

JustUro
Using tab1’s data, overall median fluid intake for all grps <1.3L/d! Time for more coffee and wine… #urojc

UrologyMatch
RT @cooperberg_ucsf: Bet #urojc members knew this already: drink coffee, wine, beer! Skip (Diet) Coke. Didn’t need 2.6M person-years f/u… #BacktoCancer@iurojc

iurojc
Still another 10 hours to run for the June #urojc Still time to get your comments in.

iurojc
RT @JustUro: Using tab1’s data, overall median fluid intake for all grps <1.3L/d! Time for more coffee and wine… #urojc

Tdave
RT @iurojc: Still another 10 hours to run for the June #urojc Still time to get your comments in.

DrHLN
How sugary is your coffee?! Fructose in 1 tspn sucrose approx 2g vs 22g in cola, total sugar 4 vs 39g @DrRKSingal @FerraroManuel #urojc

DrHLN
Fructose the bad guy? No control for common foods high in fructose eg honey, fruits, processed foods/sauces/cereals #urojc

DrRKSingal
@DrHLN @FerraroManuel No sugar in mine but talking about stuff like this #urojc http://t.co/hx3rZqh5Om

Tdave
@DrRKSingal @DrHLN @FerraroManuel You all are making me hungry! #JustSayNoToFructose #urojc

DrHLN
Cola & apple juice both high sources fructose yet increased cola = stones despite caffeine diuresis vs no sig diff with increased AJ #urojc

DrRKSingal
Probably MT @JustUro@FerraroManuel Presume components=caffine+milk(if present)+H2O+sugar(if present). Decaf+tea similarly variable? #urojc

DrRKSingal
Or just more fluids. RT @JustUro: Using tab1’s data, overall median fluid intake for all grps <1.3L/d! Time for more coffee and wine. #urojc

DrHLN
Ok wow…and made with fructose syrup so high vs glucose! NOT making me hungry! @DrRKSingal @FerraroManuel @Tdave #urojc

DrAdamMurphy
RT @iurojc: Lets not forget the #urojc MT“@DrAdamMurphy@DrHWoo @LoebStacy ……..It has been postulated to be the diuretic action”

sosa_ernie
@LoebStacy I council patients to drink water avoiding sugar. For one there is a calciuric effect to sugar. #urojc who needs more cals?

DrRKSingal
Nice MT @sosa_ernie@LoebStacy I council: drink water avoiding sugar. For one there’s calciuric effect to sugar #urojc who needs more cals?

MattBultitude
2 hours left for #urojc this month. What top tips do people have as dietary advice for stone patients? Who uses lemons? Baking soda? Etc

LoebStacy
@MattBultitude #urojc good #kidneystone recs: more water, low added salt & animal #protein. Don’t restrict #calcium based on Borghi RCT.

PoppyPocket
RT @DrRKSingal: Nice MT @sosa_ernie@LoebStacy I council: drink water avoiding sugar. For one there’s calciuric effect to sugar #urojc who needs more cals?

DrRKSingal
That’s what I say + stay active. MT @LoebStacy@MattBultitude #urojc for #kidneystones more H20, <salt, animal #protein#calcium ok

declangmurphy
@MattBultitude Everything in moderation. And check your PSA. Or your husband’s PSA. This has been a LONG 48h #urojc#cancerplease

iurojc
June #urojc wraps up in about an hour? Great effort for our first ever non-oncology paper. Love to hear from our many observers/watchers

MattBultitude
@declangmurphy – oh come on Mr Murphy. I know you have loved stone cancer ever since you sucked a stent out with an elick evacuator! #urojc

iurojc
Big thks again author @FerraroManuel. Thanks also CJASN 4 allowing open access of article. Thanks @EUplatinum 4 Best Tweet prize #urojc

linton_kate
@iurojc what is next month? Female/recon? #urojc

iurojc
@linton_kate We are open to suggestions. Hot off press articles esp favored. We may have to do cancer in July to quell restlessness #urojc

iurojc
RT @sosa_ernie@LoebStacy I council patients to drink water avoiding sugar. For one there is a calciuric effect to sugar. #urojc who needs…

JYLeeUroSMH
@MattBultitude #urojc Depends on stone type but on balance, ⇑fluids (2L/d), ⇓salt, ⇑citrate (lemon or OJ). Ca & oxalate-rich ok in moderatn.

cooperberg_ucsf
@JYLeeUroSMH @MattBultitude Yep. Agree. Now, what @declangmurphy said! #urojc @iurojc

 

December #urojc Discussion

Dear all
The next paper for discussion for the Twitter International Urology Journal Club is the final report from the EORTC study on dose and duration of maintenance BCG treatment for NMIBC . It is hot off the press and published on line ahead of print. Be at the cutting edge of high level evidence outcomes for BCG treatment.
The first and corresponding author Dr Jorg Oddens will be making himself available during the paper discussion so it is a great opportunity to question or challenge the lead author.
European Urology have been kind enough to unlock the article for free download for a limited time using the link below.
This month’s prize for best tweet has been donated by Nature Reviews in Urology. This is now the second highest impact factor journal in Urology and not generally all that easy to access – they are offering a one year free on line access which is worth a good few hundred dollars.
Discussion starts on Monday 3 December at 0700 AEDT as an asynchronous discussion held over 48 hours. Not to be missed.
Last month’s club discussion had approximately 40 urologists participating (excluding observers) with about 240 tweets and from amplification over 50,000 impressions. Asst Professor Ben Davies from UPMC won the prize for best tweet. This #urojc will be bigger now that the word is getting out there.
Please join us!
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Transcript of November Journal Club Discussion

#urojc transcript

Healthcare Social Media Transcript

From: Sun Nov 04 0:00:00 PDT 2012
To: Wed Nov 07 0:00:00 PST 2012
 

New ! Explore analytics for this time period: #urojc analytics

Explore the world of healthcare social mediaHealthcare Conferences  –  Healthcare Analytics

Learn more about #urojc at The Healthcare Hashtag Project

iurojc
Reminder to use hashtag #urojc with tweets. Some questions soon but feel free to make comments in meantime -eg. will urologists take notice?

iurojc
Monday morn 5 November 2012 AEDT. The 1st #urojc journal club discussion may now begin. Pls DM or message/follow if need full txt article

daviesbj
#urojc question: who decides on the best tweet??

iurojc
An introduction & welcome to @jdsammon & @qdtrinh as first & senior authors of our inaugural #urojcpaper. http://t.co/4hHufEwT

iurojc
@daviesbj At the moment it is @iurojc but will consult with @UrologyMatch Will teak this as we move forward. #urojc

_TheUrologist_
I’m trying to use the truly hopeless @JUrology iPad app to get the PDF for #urojc #tearsofrage#atleasttheadsload

StorkBrian
#urojc Rather academic & community urologists work together to improve overall surgical quality rather than promote regionalizing care

IsaacThangasamy
@iurojc @_TheUrologist_ May I get a copy too please? #urojc

daviesbj
#urojc regionalization of procedures is the death knell of modern day urology. We need to change training if the trends prevail (they will)

daviesbj
#urojc are we creating a medico legal issue with these articles #wondering

StorkBrian
@daviesbj #urojc Wondering about that myself… Suspect differences among surgeons even at high volume centers.

DrMarniqueB
#urojc Should we be aiming for national standardised accredited robotic training centres? Who would give accreditation? (?college surgeons)

_TheUrologist_
#urojc taken to logical (farcical?) extreme: why waste 10 years of life and med training to spit out RARPists? 3yr apprenticeship out of HS?

DrMarniqueB
#urojc I’d feel it unjust if it were my dad, the recipient of a ‘Low-volume centre’ or ‘learning curve’ complication #notjustanumber

StorkBrian
@DrMarniqueB #urojc Understand your concern… Have heard it stated by prominent robotic surgeons that learning curve never ends.

DrHenryWoo
@daviesbj Don’t think so. These days, journals email manuscripts out to the press. Urologist interpretation better than journalists? #urojc

_TheUrologist_
.@DrMarniqueB complications are tricky from pt perspective: I imagine same comp accepted more readily if from high-vol center 1/2 #urojc

DrHenryWoo
@_TheUrologist_ Interesting point. We already have growing numbers of urologists doing just RARP and nothing else. #justatechnician #urojc

DrMarniqueB
@StorkBrian #urojc Ageed and not an issue limited to robotics of course

_TheUrologist_
.@DrMarniqueB if incont/ED & high-vol surg: “went with the best, these things happen”, if low-vol surg: “hack screwed me up” 2/2 #urojc

DrHenryWoo
#urojc Regionalisation already occurred in the UK – I understand that was govt directive rather than urologist driven. UK urologists?

iurojc
‘Nonetheless, low volume institutions experienced inferior outcomes relative to the highest volume centers irrespective of approach’ #urojc

MattBultitude
@DrHenryWoo Yes. In UK, Min 50 pelvic cancer surgical cases per year per centre. At the time caused upset but doesn’t seem many now? #urojc

DrMarniqueB
@DrHenryWoo @_theurologist_ Ultimate for the patient…. Robotic assisted radical prostatectomists. A few around already I’d think #urojc

MattBultitude
Of course volume matters in most areas – better surgeons/ support/ nursing/ ITU etc. Hence super specialisation in many countries #urojc

outbacktourer
RT @DrHenryWoo#urojc Regionalisation already occurred in the UK – I understand that was govt directive rather than urologist driven. UK urologists?

MattBultitude
Not acceptable that some low volume units do only 26 RARP / 5 ORP per year. Should be centralising. Now more evidence to support this #urojc

DrHenryWoo
@MattBultitude Am I correct that the regionalization of pelvic surgery was govt mandated rather than via BAUS? #urojc

MattBultitude
@DrHenryWoo Correct – 2002 NICE guidelines on ‘Improving Outcomes In Urological Cancers’http://t.co/TnSzpjGp #urojc

iurojc
A reminder that #urojc is not live tweet discussion so jump in when your time zone allows. Current discussion on paper by @jdsammon et al

Tdave
Not saying anything we didn’t know about volume. Regionalization based on who could afford robot first.#urojc

Tdave
RT @iurojc: An introduction & welcome to @jdsammon & @qdtrinh as first & senior authors of our inaugural #urojc paper. http://t.co/4hHufEwT

Tdave
In US, quality will eventually determine payment. Low volume centers may be out of luck. #urojc

DrDavidMalouf
@mattbultitude #urojc hard to argue against central/n re outcomes. Australia’s size is a challenge as many in rural locations want local Rx

DrDavidMalouf
@mattbultitude #urojc Not an excuse, but patient education and support for temp relocation to major centre for Rx needs to be factored.

StorkBrian
@hjluks Tonight we are using #hcsm for our first International Urology Journal Club via Twitter #urojc@iurojc

jdsammon
@iurojc #urojc 1/4 of ORP patients getting operated on at centers averaging 5.2 per year. That can’t be good for pts or urology @daviesbj

urodocbg
RT @iurojc: An introduction & welcome to @jdsammon & @qdtrinh as first & senior authors of our inaugural #urojc paper. http://t.co/4hHufEwT

DrHenryWoo
@jdsammon @daviesbj This data when linked to outcomes is going to bc increasingly diff for urologists, hospitals & funders to ignore #urojc

daviesbj
Shit. My amazing tweets were going to #iurojc not #urojc #wtf

daviesbj
@DrDavidMalouf @tdave @drhenrywoo @jdsammon #urojc look peeps. Last I checked defending scope of practice was as American as apple pie.

DrDavidMalouf
@daviesbj @drhenrywoo @jdsammon Shorter hospital stay fewer readmissions fewer secondary procedures to Rx complications #nobrainer #urojc

DrHenryWoo
@daviesbj Easily fixed. Can be retweeted into the chat. That will ensure that you don’t miss out in the running for best tweet! #urojc

iurojc
RT “@daviesbj@DrHenryWoo @jdsammon #urojc also don’t underestimate the AUA disdain against limiting a doctors scope of practice @Tdave

DrDavidMalouf
@Tdave @daviesbj @drhenrywoo @jdsammon I believe parts of Europe have for some time reimbursed according to volume #urojc #whywouldntthey?

daviesbj
#urojc the best idea is creating “medical” urologist and a “surgical” urologist. That means a fundamental change in urologic education

3NT
RT @Tdave: In US, quality will eventually determine payment. Low volume centers may be out of luck.#urojc

3NT
RT @DrMarniqueB#urojc I’d feel it unjust if it were my dad, the recipient of a ‘Low-volume centre’ or ‘learning curve’ complication #notjustanumber

daviesbj
#urojc of course that model has issues. GU docs already underserve poor populations and by restricting practice you will deepen the problem

3NT
RT @jdsammon@iurojc #urojc 1/4 of ORP patients getting operated on at centers averaging 5.2 per year. That can’t be good for pts or urology @daviesbj

StorkBrian
@drhenrywoo @jdsammon #urojc How was complication data gathered on patients who had surgery at high volume centers but F/U w community docs?

jdsammon
@3NT @DrMarniqueB one interesting caveat is that low-vol cntrs aren’t necessarily on any learning curve. Just operating wen they can #urojc

3NT
Follow #urojc for leading urologists from all over the world discussing clinical practice in an online journal club

_TheUrologist_
Scope of practice limitations in effect in Canada – thoracic & HPB so far. Uro is coming http://t.co/Iqqlwhdchttp://t.co/eqs8z8nS #urojc

3NT
RT @daviesbj#urojc the best idea is creating “medical” urologist and a “surgical” urologist. That means a fundamental change in urologic education

_TheUrologist_
@StorkBrian @DrHenryWoo @jdsammon excellent point, how does NIS handle data like this? #urojc

DrHenryWoo
RT @3NT: Follow #urojc for leading urologists from all over the world discussing clinical practice in an online journal club

StorkBrian
@jdsammon #urojc Does HFH discharge patients directly home or to a step down facility p surgery? If latter does this effect D/C data?

matthayn
@_TheUrologist_ @StorkBrian @DrHenryWoo @jdsammon Pretty sure that NIS only covers the initial admit, no data on readmit/late comps #urojc

_TheUrologist_
Different angle on quality: @CancerCare_ON has some good resources on defining quality in#prostatecancer tx #urojc https://t.co/SY3rQCYJ

daviesbj
#urojc I’m more interested in getting urologists to operate on the right patients than demonizing low volume practitioners #besttweet

_TheUrologist_
.@daviesbj been thinking that w appropriate care = our results will _seem_ to get worse (skew to high risk -> more PSM, ED, incont) #urojc

DrDavidMalouf
@daviesbj @USANZUrology #urojc Men will accept #activesurveillance as a Rx if urologists take the time to explain it http://t.co/4hYqxFrI

marcoalvarez
RT @daviesbj#urojc I’m more interested in getting urologists to operate on the right patients than demonizing low volume practitioners #besttweet

IsaacThangasamy
RT @3NT: Follow #urojc for leading urologists from all over the world discussing clinical practice in an online journal club

sivanrij
#urojc trainees perspective, with centralisation if not going to be uro-onc when do they stop learning RP,cost of training vs all round Surg

jodelancey
RT @daviesbj#urojc I’m more interested in getting urologists to operate on the right patients than demonizing low volume practitioners #besttweet

DrDavidMalouf
@_TheUrologist_ @daviesbj We can only hope the days of quoting 0% positive surgical margin rates are behind us #activesurveillance #urojc

IsaacThangasamy
RT @jdsammon@iurojc #urojc 1/4 of ORP patients getting operated on at centers averaging 5.2 per year. That can’t be good for pts or urology @daviesbj

IVLINE
RT @3NT: Follow #urojc for leading urologists from all over the world discussing clinical practice in an online journal club

IsaacThangasamy
Market will change dramatically when centre’s numbers are made public. No one wants low-vol surgeon op on them “only the best for me” #urojc

USANZUrology
RT @DrDavidMalouf@daviesbj @USANZUrology #urojc Men will accept #activesurveillance as a Rx if urologists take the time to explain it http://t.co/4hYqxFrI

UrologyMatch
RT @iurojc: An introduction & welcome to @jdsammon & @qdtrinh as first & senior authors of our inaugural #urojc paper. http://t.co/4hHufEwT

IsaacThangasamy
RT @3NT: Follow #urojc for leading urologists from all over the world discussing clinical practice in an online journal club #urojc

IsaacThangasamy
RT @DrDavidMalouf@daviesbj @USANZUrology #urojc Men will accept #activesurveillance as a Rx if urologists take the time to explain it http://t.co/4hYqxFrI

IsaacThangasamy
Staying up to date with world-first, international journal club, #urojc via TweetChat. Follow for a unique insight into current Uro issues

chrisfilson
RT @DrDavidMalouf@daviesbj @USANZUrology #urojc Men will accept #activesurveillance as a Rx if urologists take the time to explain it http://t.co/4hYqxFrI

iurojc
RT @IsaacThangasamy: Staying up to date with world-first, international journal club, #urojc via TweetChat. Follow for a unique insight into current Uro issues

iurojc
RT @daviesbj#urojc the best idea is creating “medical” urologist and a “surgical” urologist. That means a fundamental change in urologic education

iurojc
@daviesbj Interesting to have UK perspective on medical/surgical urologists since they’ve looked at this option. Also German input? #urojc

iurojc
RT @jdsammon@iurojc #urojc 1/4 of ORP patients getting operated on at centers averaging 5.2 per year. That can’t be good for pts or urology @daviesbj

uretericbud
@iurojc @jdsammon @qdtrinh #urojc volumes higher bc of good results or results better bc of high volumes? #chickenortheegg

UrologyMatch
@3NT: Follow #urojc for leading urologists from all over the world discussing clinical practice in an online journal club”

IsaacThangasamy
RT @uretericbud@iurojc @jdsammon @qdtrinh #urojc volumes higher bc of good results or results better bc of high volumes? #chickenortheegg

iurojc
RT @uretericbud@iurojc @jdsammon @qdtrinh #urojc volumes higher bc of good results or results better bc of high volumes? #chickenortheegg

DrHenryWoo
RT @uretericbud@iurojc @jdsammon @qdtrinh #urojc volumes higher bc of good results or results better bc of high volumes? #chickenortheegg

DrMarniqueB
RT @UrologyMatch: “@3NT: Follow #urojc for leading urologists from all over the world discussing clinical practice in an online journal club”

DrMarniqueB
So excited to be training in such a forward thinking, dynamic specialty #Urology – Loving @iurojc 1st internatn’l JC, follow #urojc

drjonrees
Pressure for high numbers at least subliminal incentive for Urologist to operate on low risk ptnts. How to avoid? #urojc

iurojc
Thanks to all so for the wonderful start to #urojc – let’s continue the discussion – hoping to hear from@cooperberg_ucsf @declangmurphy

iurojc
#urojc Also hoping to hear views from @JimCatto @marclanido @benchallacombe @LoebStacy@UroOncMD @urorao @prokarurol @dbh44 @JamesDuthie1

JamesDuthie1
#urojc Subspecialisation seems inevitable, less variety for surgeon but better for pt? Rural Pts may just have to travel more.

iurojc
@drjonrees Incentive may not always be financial – bid to achieve minimal annual numbers cases? Hasten overcoming learning curve? #urojc

iurojc
@roboturoloog if you are able, we would love to have some European input to our current discussion on#urojc

DrHelenF
Stoked to be now following #urojc @iurojc. Was elbow deep in bowel, now rescued and can follow this brilliant initiative. #gourology

qdtrinh
@uretericbud @iurojc @jdsammon surely a little bit of both. #singersongorboth @cooperberg_ucsf #urojc

qdtrinh
@DrMarniqueB maybe this could work in smaller countries, but for places such as Australia or USA: traveling distances factor in. #urojc

qdtrinh
@_TheUrologist_ #urojc you could argue that you can apply this reasoning for all technical aspects of surgery

qdtrinh
@DrHenryWoo @_TheUrologist_ #urojc plus won’t make much sense if #prostatecancer becomes a non-surgically managed condition #welfare

qdtrinh
@MattBultitude @DrHenryWoo #urojc i’m all for enforcing ‘minimal’ ‘non-restrictive’ thresholds.

qdtrinh
@MattBultitude #urojc a lot of places in the U.S. acquire robot to put ‘in display’ but almost don’t use it. a means to attract patients.

qdtrinh
background reading for #urojc robot-induced regionalization by @dannymak76 http://t.co/3ImdwzoO

StorkBrian
@DrRunz_Urology International Urology Journal Club up and going. #urojc @iurojc

qdtrinh
@DrHenryWoo @daviesbj i think such papers won’t create a legal issue as of yet, but insurers are following with great interest (hint) #urojc

StorkBrian
@qdtrinh @drmarniqueb #urojc Most patients want to be taken care of in their own communities. So, if a gap exists, how do we narrow it?

qdtrinh
so true, any comment from @AmerUrological ? “@daviesbj#urojc don’t underestimate AUA disdain against limiting doctor’s scope of practice”

qdtrinh
@daviesbj #urojc how about 3 years of medical urology, with an option for surgical urology afterwards?

qdtrinh
didn’t know that, cool stuff “@_TheUrologist_: Scope of practice limitations in effect in Canada. Uro is coming #urojc

qdtrinh
@daviesbj #urojc not a lot to be honest, as a Canadian. are there precedents out there specifically on RARP?

DrMarniqueB
@qdtrinh National governing body accredits multiple hospitals per state if meet min volume output & training capacity requirements? #urojc

qdtrinh
@matthayn @_TheUrologist_ a readmission would be categorized as a completely different ‘discharge’, so there’s no clear way to link. #urojc

iurojc
#urojc lays claim as the first truly international journal club in any area of healthcare. Urologists can be proud to be leading the way.

StorkBrian
RT @iurojc#urojc lays claim as the first truly international journal club in any area of healthcare. Urologists can be proud to be leading the way.

qdtrinh
RT “@iurojc: Introduction & welcome to @jdsammon & @qdtrinh as first & senior authors of our inaugural#urojc paper. http://t.co/YTCyjqtR”

qdtrinh
@iurojc @daviesbj @MattBultitude @marclaniado @benchallacombe #urojc hope they’re awake, it’s 10AM over there

daviesbj
@qdtrinh #urojc I’ve heard arguments in court about why ORP was chosen. Was there informed consent about getting a RARP instead.

DrMarniqueB
@StorkBrian @qdtrinh I suspect only time for baby RARPists to filter through & more peripheral robots when $$ decr. with an oligopoly #urojc

qdtrinh
RT @daviesbj@qdtrinh #urojc I’ve heard arguments in court about why ORP was chosen. Was there informed consent about getting a RARP instead.

qdtrinh
RT @iurojc#urojc lays claim as the first truly international journal club in any area of healthcare. Urologists can be proud to be leading the way.

HavishSrinath
RT @IsaacThangasamy: Staying up to date with world-first, international journal club, #urojc via TweetChat. Follow for a unique insight into current Uro issues

StorkBrian
@audvin Is #urojc registered with @symplur? If not, can we get it registered? @DrHenryWoo @iurojc@AmerUrological

daviesbj
#urojc Deep thought #1 regionalization is everywhere. Walmart. Lowes. Macy’s. Still – do we shun the local tailor, grocer, hardware store?

qdtrinh
@daviesbj #urojc don’t forget the cheesecake factory http://t.co/VrB4fYjJ @Atul_Gawande

DrMarniqueB
RT @iurojc#urojc lays claim as the first truly international journal club in any area of healthcare. Urologists can be proud to be leading the way.

StorkBrian
@daviesbj #urojc Absolutely not! Not sure colleagues in academics recognize care we provide w/o res., fellows & dedicated surgery teams

qdtrinh
RT @StorkBrian@daviesbj #urojc Absolutely not! Not sure colleagues in academics recognize care we provide w/o res., fellows & dedicated surgery teams

daviesbj
#urojc deep thought #2. Mandating the regionalization of RARP will not happen in the US. Maybe for rplnd, ivc thrombus, neobladder

qdtrinh
Less than 24h into the first Twitter Journal Club, and more than 100 tweets already #urojc @iurojc@BJUIjournal @EUplatinum @AmerUrological

qdtrinh
@daviesbj #urojc right now too common of a procedure… but with decreasing screening and more AS, … who knows.

qdtrinh
@iurojc @BJUIjournal @EUplatinum @AmerUrological hope the journals take notice of the initiative #urojc

StorkBrian
#urojc Community and Academic urologists have partnered in Michigan Uro Surg Imp. Coll. (MUSIC) to gather data & optimize surgical outcomes

ornellaspvkyj8
RT @IsaacThangasamy: Staying up to date with world-first, international journal club, #urojc via TweetChat. Follow for a unique insight into current Uro issues

EUplatinum
RT @qdtrinh: Less than 24h into the first Twitter Journal Club, and more than 100 tweets already #urojc@iurojc @BJUIjournal @EUplatinum @AmerUrological

iurojc
#urojc Reminder that best tweet author for the Nov paper will receive a bottle of #makers46 which has kindly been donated by @UrologyMatch

iurojc
RT @qdtrinh@iurojc @BJUIjournal @EUplatinum @AmerUrological hope the journals take notice of the initiative #urojc

iurojc
RT @qdtrinh: Less than 24h into the first Twitter Journal Club, and more than 100 tweets already #urojc@iurojc @BJUIjournal @EUplatinum @AmerUrological

iurojc
@qdtrinh @bjuijournal @euplatinum @amerurological We’ll be publishing tweet analytics on our website following formal disc closure. #urojc

iurojc
@StorkBrian @audvin @symplur @amerurological Happy to investigate. Let me get back to you on this Brian & thanks for suggestion. #urojc

iurojc
Welcome @mahirBozgen – please join in the discussion. We are discussing http://t.co/4hHufEwTRemember to use the hashtag #urojc

iurojc
Welcome @MorganRoupret We’re eager for EU view on regionalization of surgery – we’re discussinghttp://t.co/4hHufEwT Please use #urojc

UrologyMatch
@iurojc#urojc lays claim as the first truly international journal club in any area of healthcare. Uro can be proud leading the way.”

UrologyMatch
RT @iurojc#urojc Reminder that best tweet author for the Nov paper will receive a bottle of #makers46which has kindly been donated by @UrologyMatch

iurojc
Welcome @cjab69 Pls join in the discussion on regionalization of surgery – we’re discussinghttp://t.co/4hHufEwT Please use #urojc hashtag

StorkBrian
#urojc Surgical collaboratives between high & low volume centers, such as MUSIC, promote understanding, trust, & improved Pt care/outcomes

MorganRoupret
#urojc it is obvious that there is a need to concentrate several robots in few hospitals rather than the opposite

drawmdapp
RT @iurojc#urojc lays claim as the first truly international journal club in any area of healthcare. Urologists can be proud to be leading the way.

3NT
RT @StorkBrian#urojc Community and Academic urologists have partnered in Michigan Uro Surg Imp. Coll. (MUSIC) to gather data & optimize surgical outcomes

qdtrinh
RT @UrologyMatch: “@iurojc#urojc lays claim as the first truly international journal club in any area of healthcare. Uro can be proud leading the way.”

qdtrinh
RT @StorkBrian#urojc Surgical collaboratives between high & low volume centers, such as MUSIC, promote understanding, trust, & improved Pt care/outcomes

daviesbj
#urojc Deep thought #3 Complication rates for RARP are very low. Do we care? Maybe losing some blood means your nerve dissection was better?

daviesbj
#urojc Deep thought #4 I will gladly take a pint of blood for a working stiffy #besttweet #bourbonismine

IsaacThangasamy
RT @daviesbj#urojc Deep thought #4 I will gladly take a pint of blood for a working stiffy #besttweet#bourbonismine

DrMarniqueB
#urojc Not so sure deep thought #4 cuts the Colman’s for best tweet! @daviesbj

daviesbj
@drmarniqueb #urojc Please. I’m on fire. I will donate the bourbon to the victims of #sandy they could use a break

MattBultitude
@qdtrinh – Of course we are awake – some of us have work to do!! UK already centralised with cancer centres – better for patients! #urojc

MattBultitude
@qdtrinh @daviesbj – all sounds like a debate going round the UK since 2004. Attempted to introduce reduced training which failed. #urojc

qdtrinh
Haha of course. Starting my OR now. “@MattBultitude@qdtrinh – Of course we are awake – some of us have work to do!! #urojc

DrSWeinstein
#urojc@DrSWeinstein are there more experienced surgeons at higher volume centers? R the cancer outcomes also different in lv vs hv centers

_TheUrologist_
Locked into OR all day today. Do the operation you’re best at. If growing your learning curve, let the pt know (most will stay) #urojc

marclaniado
#urojc problem is if u actively monitor pts & do template bxs, the surgical numbers drop, so even fewer centres and surgeons will be left

iurojc
#urojc RT“@DrSWeinstein: are there more exp/senior surgeons at higher vol centers? R the cancer outcomes also different in lv vs hv centers”

iurojc
RT @marclaniado#urojc problem is if u actively monitor pts & do template bxs, the surgical numbers drop, so even fewer centres and surgeons will be left

iurojc
@prostatediaries From a urologist & consumer perspective, what are your thoughts on discussion ofhttp://t.co/4hHufEwT Please use #urojc

iurojc
Thanks @KidneyHospital for your DM. Can’t respond by DM bc you’re not following us. We would love input from India on #urojc – pls join us

iurojc
For those who have just begun following #urojc – we are discussing http://t.co/4hHufEwT – pls join the discussion. Don’t forget hashtag

daviesbj
#urojc new study? effect of twitter on my continence rates? marriage?

dmsomford
@iurojc #urojc Not surprising volume does matter for RP, limitation: different criteria for high volume for ORP (>32) and RARP (>144).

dmsomford
@iurojc #urojc next step would be to survey oncological results for low- and high-volume radical prostatectomy centers http://t.co/hTd5RDbs

dmsomford
@iurojc #urojc In The Netherlands critical volume has been set at >20 radical prostatectomies per center, good enough?

jdsammon
RT @iurojc#urojc lays claim as the first truly international journal club in any area of healthcare. Urologists can be proud to be leading the way.

jdsammon
RT @StorkBrian#urojc Community and Academic urologists have partnered in Michigan Uro Surg Imp. Coll. (MUSIC) to gather data & optimize surgical outcomes

jdsammon
@dmsomford @iurojc #urojc caveat/limitation. There simply aren’t ORP centers doing >300-400/yr captured in NIS. Several RARP centers are.

jdsammon
RT @qdtrinh@iurojc @BJUIjournal @EUplatinum @AmerUrological hope the journals take notice of the initiative #urojc

qdtrinh
RT @daviesbj#urojc new study? effect of twitter on my continence rates? marriage?

jdsammon
@dmsomford #urojc Central Question: is robot the driver of improved outcomes just because it’s incidentally driving centralization @qdtrinh

Tdave
RT @iurojc#urojc lays claim as the first truly international journal club in any area of healthcare. Urologists can be proud to be lea …

healthhashtags
New Health Hashtag: #urojc http://t.co/cx6UghYi Thank you @IsaacThangasamy #hcsm

audvin
@iurojc @StorkBrian @symplur @amerurological We just published the hashtag #urojchttp://t.co/AwdPmrXZ

Ben_L_Jackson
@SURG_UK Members, go to #urojc for interesting discussion about ORP vs RARP and impact of centralisation/volume on outcomes.

StorkBrian
@audvin Thanks Audun Thanks @healthhashtags @symplur #urojc @iurojc @amerurological

DrHenryWoo
@jdsammon @dmsomford @qdtrinh Yes, I think robot is playing role on centralization – access to technology. #urojc

DrHenryWoo
@jdsammon @dmsomford @qdtrinh Yes, I think robot is playing role on centralization & improved outcomes- technology. #urojc

DrHenryWoo
@jdsammon @dmsomford @qdtrinh Yes, I think robot is playing role on centralization & therefore improved outcomes. Yr data suggests #urojc

_TheUrologist_
.@Tdave @qdtrinh @daviesbj I sensed a disturbance in the Force when you wrote that. The Kraken of the Case Series stirs in the deep #urojc

daviesbj
#urojc the robot has been marketed to community urologist as a leveling of the playing field. Yet – we are seeing regionalization. #wtf

DrHenryWoo
@jdsammon @qdtrinh R U able to determine prop of hospitals with residency programs for each quartile? Could teaching drive quality? #urojc

DrHenryWoo
RT @daviesbj#urojc the robot has been marketed to community urologist as a leveling of the playing field. Yet – we are seeing regional …

daviesbj
#urojc Davies Deep Thought #5 actual # of RRP going up. So maybe there is both regionalization and a leveling of the playing field

iurojc
#urojc RT “@Tdave@qdtrinh @daviesbj But if we are honest with our results then should we not be self police #DevilsAdvocate #iurojc

iurojc
@daviesbj Interesting to see that the # of DDT and RRP are both going up #urojc

iurojc
Welcome @captfun99 @SLa_Touche @Ben_L_Jackson Thanks for following. Please join our disc onhttp://t.co/4hHufEwT Don’t forget #urojc

StorkBrian
@DrHenryWoo @iurojc #urojc Twitter Medical Journal Clubs via @healthhashtags http://t.co/fmHURjWr@Berci

iurojc
General house keeping msg to remind all to use #urojc in all tweets. Best way is via http://t.co/bebykVjRwhich auto loads hashtag selected

DrHenryWoo
#urojc MT“@dmsomford@jdsammon RARP facilitated/speeded centralization of RP. Patients will benefit from both robotics & centralization!”

StorkBrian
@DrHenryWoo @dmsomford @jdsammon #urojc We could consider ways low & high volume centers could improve outcomes by working together

_TheUrologist_
@Tdave @qdtrinh @daviesbj I agree (was being sarcastic re: the outcomes bar set by Big Name case series). Have to be honest with self #urojc

outbacktourer
RT @DrHenryWoo#urojc MT“@dmsomford@jdsammon RARP facilitated/speeded centralization of RP. Patients will benefit from both robotics …

iurojc
Welcome @FerPerazaGodoy from Spain. Pls join our discussion on #urojc – we are eager to have EU input. Current disc on http://t.co/4hHufEwT

Tdave
@DrMarniqueB @daviesbj Ohhh, now I get it! #ImALittleDense #urojc

Tdave
Corollary: high volume tweeting = best tweets? #NoEvidence #urojc

IsaacThangasamy
@iurojc I went ahead and got #urojc registered. Will be helpful for analytics in the long run.

DrRunz_Urology
#urojc when I was in learning curve, every patient knew what # they were. Transparency, communication and team building with Pts

DrRunz_Urology
#urojc no matter your volume, every case is a learning experience. I still watch my case videos and pick up tips.

DrMarniqueB
@DrRunz_Urology #urojc Thats brilliant to be able to have such a frank conversation. Did any patients object once they knew their #?

StorkBrian
@DrMarniqueB GR8 Moustache on Twitter Profile! Appreciate UR #Movember support & participation in#urojc @iurojc http://t.co/R6mpLmNp

UrologyMatch
@iurojc who is in the running for the bourbon? #postjournalclubeyeopener #urojc

DrMarniqueB
Top Influencers of #urojc@iurojc @daviesbj @jdsammon @qdtrinh @drhenrywoo @storkbrian@drmarniqueb http://t.co/5Vh7mTGD via @symplur

qdtrinh
RT @DrMarniqueB: Top Influencers of #urojc@iurojc @daviesbj @jdsammon @qdtrinh @drhenrywoo@storkbrian @drmarniqueb http://t.co/5Vh7mT …

Tdave
@DrMarniqueB @iurojc @daviesbj @jdsammon @qdtrinh @DrHenryWoo @StorkBrian @symplur So again, numbers matter! #urojc

daviesbj
Bow bitches MT @DrMarniqueB: Top Influencers of #urojc : @iurojc @daviesbj @jdsammon @qdtrinh@drhenrywoo @storkbrian

3NT
RT @iurojc#urojc lays claim as the first truly international journal club in any area of healthcare. Urologists can be proud to be lea …

_TheUrologist_
@DrMarniqueB @iurojc @daviesbj @jdsammon @qdtrinh @DrHenryWoo @StorkBrian @symplur I demand a recount! My ballot had a hanging RT 😉 #urojc

StorkBrian
@UrologyMatch @DrHenryWoo Suggest the bourbon go 2 #urojc @iurojc organizers in recognition of efforts & job well done

iurojc
The winner of the inaugural best Tweet prize will be announced soon. Thanks you all for what was a spectacular start to this project #urojc

iurojc
RT @DrMarniqueB: Top Influencers of #urojc@iurojc @daviesbj @jdsammon @qdtrinh @drhenrywoo@storkbrian @drmarniqueb http://t.co/5Vh7mT …

DrHenryWoo
RT @daviesbj: Bow bitches MT @DrMarniqueB: Top Influencers of #urojc : @iurojc @daviesbj@jdsammon @qdtrinh @drhenrywoo @storkbrian

iurojc
#urojc RT“@captfun99@jdsammon @iurojc @daviesbj remember the zero mortality paradox . . . .http://t.co/HztB7Eeq”

IsaacThangasamy
RT @iurojc#urojc RT“@captfun99@jdsammon @iurojc @daviesbj remember the zero mortality paradox . . . . http://t.co/HztB7Eeq”

DrMarniqueB
@iurojc @DrHenryWoo @IsaacThangasamy @StorkBrian @_TheUrologist_ Goes to show 48hr discussion window necessary #urojc http://t.co/GUVuNdCV

jdsammon
@captfun99 @iurojc @daviesbj #urojc valid and interesting point about the zero mortality paradox in surgery http://t.co/1q3gLRBa

daviesbj
Do not forget #urojc MT @jdsammon@captfun99 @daviesbj no peri operative mortality from ORP or RARP at very-hi vol centers in 2009 NIS