Adam Wilk

Three major and interrelated mental hurdles every student in a research-oriented graduate degree program has to contend with and, at some point, hopefully, make peace with: 1. #ImpostorSyndrome. You are smart. You know things. You belong here. apa.org/gradpsych/2013…

💯%. Sensible reform from @UREssien @JayBLusk @DusetzinaS. Moral hazard is not a myth, but the idea affects health policy in too many ways. Cost-Sharing Reform for Improved Health Care Equity and Value in Chronic Disease Treatments ja.ma/3vthQ3C via @JAMAHealthForum

“There’s no place like home,” says Paul Hall, 64. He's one of ~780K Americans with ESRD, requiring either dialysis, or a transplant, to live. Now, Mr. Hall dialyzes at home at any hour he pleases, thanks to #TabloDialysis. Read more in today's @NYTimes: nytimes.com/2022/11/10/bus…

JOB ALERT: @EmoryHSR is looking for a dynamic biostatistician to join our team! Full details: tinyurl.com/yr8nn2wt To apply, send 1) a cover letter with a brief description of your interest in the position, 2) a current CV, & 3) three references to Tracy at: tsitler@emory.edu

Join our team! @EmoryHSR is looking for a Senior Scientist! Full description here: staff-emory.icims.com/jobs/102174/jo… To apply, send 1) a cover letter with a brief description of your interest in the position, 2) a current CV, & 3) three references to Tracy at: tsitler@emory.edu

Join our team! @EmoryHSR is looking for an Epidemiologist! Full description here: staff-emory.icims.com/jobs/101495/jo… To apply, send 1) a cover letter with a brief description of your interest in the position, 2) a current CV, & 3) three references to Tracy at: tsitler@emory.edu

Really excited to share this paper! I’ll do a tweet thread later because I’m recovering from #KidneyWk and starting clinical service Also, we did an interview on the podcast, which summarizes the paper edhub.ama-assn.org/jn-learning/au…

Interesting evidence potentially pointing to reason for plateauing PD growth in the U.S. A Comparison of US Medicare Expenditures for Hemodialysis and Peritoneal Dialysis jasn.asnjournals.org/content/33/11/…

Relevant thinking for those who would like to engage with these ideas more: hbr.org/2021/02/stop-t… universityworldnews.com/post.php?story… forbes.com/sites/forbesbu…

I claim as a part of my own identity very few marginalized identities. Identifying with the experiences of those who have experienced what others call "impostor syndrome" -- when it is in fact marginalization -- is something I am continually working on in myself.

Three major and interrelated mental hurdles every student in a research-oriented graduate degree program has to contend with and, at some point, hopefully, make peace with: 1. #ImpostorSyndrome. You are smart. You know things. You belong here. apa.org/gradpsych/2013…

We are 72 hours after online publication of the linked analysis of ETC, and I have some thoughts. 🧵 Financial Incentives to Facilities and Clinicians Treating End-stage Kidney Disease and Use of Home Dialysis ja.ma/3Vj6RFK via @JAMAHealthForum part of @JAMANetwork

🚨New Paper Alert🚨 @liraneinav, @nealemahoney, Amy Finkelstein and I study the first year of the ESRD Treatment Choice model, a nationwide RCT that provides financial incentives to dialysis facilities and clinicians to increase home dialysis use.

@lindsbullinger @danieldench1 @Gen_Pov @sppgatech @GATechEcon @GTliberalarts @_JanetCummings

ANNOUNCEMENT! @DanielDench1 & I are thrilled to host the inaugural Atlanta Workshop on Public Policy & Child Well-being (PPCW)! March 10-11. @Gen_Pov will keynote. Limited funds for PhD students. Website in comments. Generously sponsored by @SPPGaTech @GaTechEcon @GTliberalarts

@eugelin06 @eric_weinhandl @nupur_nephron @SBdoc33 @GrahamAbra @hswapnil @mikejohansenmd @JAMAHealthForum @AJKDonline I rechecked some of that sample size math this afternoon because, I agree, it seemed wild that the ultimate sample was only 18k pts. Incident only + age >66 + only 9 months = dwindling sample!

@AdamSWilk @eric_weinhandl @nupur_nephron @SBdoc33 @GrahamAbra @hswapnil @mikejohansenmd @JAMAHealthForum @AJKDonline Plus incident. It’s interesting how they only have 18000 patients in the sample after making all these restrictions.

RCT shows incentives don’t increase home therapies rate in ESRD (yeah @mikejohansenmd who could have predicted that😏🤔🙄) Authors conclusion: we need more and higher incentives 😳 jamanetwork.com/journals/jama-… @JAMAHealthForum

@eugelin06 @eric_weinhandl @nupur_nephron @SBdoc33 @GrahamAbra @hswapnil @mikejohansenmd @JAMAHealthForum @AJKDonline My partial understanding is that this is rough, maybe unacceptably imprecise because dates of service (start/through) on SNF claims don't need to be super accurate or complete (hence Eric's concern). Still it may be what they did. (We punted on SNF in our related paper.)

@eric_weinhandl @nupur_nephron @SBdoc33 @GrahamAbra @hswapnil @mikejohansenmd @JAMAHealthForum @AJKDonline Not sure if this is correct, but i would personally just look for simultaneous SNF claims? Not sure if that’s correct, or if that’s how they did it

@eric_weinhandl @eugelin06 @nupur_nephron @SBdoc33 @GrahamAbra @hswapnil @mikejohansenmd @JAMAHealthForum @AJKDonline I do think you can get to 20% home dialysis in this study (relative to USRDS stats) when you account for exclusions of: - low-volume facilities (<11 pts) - SNF care and dementia - individuals without Medicare Part B coverage - privately insured individuals (w/o Medicare)

@eugelin06 @nupur_nephron @SBdoc33 @GrahamAbra @hswapnil @mikejohansenmd @JAMAHealthForum @AJKDonline If you trust the authors (full disclosure: I never do), we still need to explain why 20% of incident patients over age 65 are on home dialysis. That is *double* what USRDS reports.

It's only 9 months of post-experience, and it's limited to older Medicare beneficiary pts (age 66+), where there may be lesser potential to increase home dialysis % in ETC-assigned facilities. But it's one early data point that ETC didn't really shake things up that much. 🤔

Observed: No difference in home dialysis % of incident patients (treatment measured at 90 days) between ETC-assigned and control HRRs, controlling for lagged outcomes and lots of other factors. Did not look at transplant-related outcomes.

Medicare ETC Model evaluation paper from Ji et al. Financial Incentives to Facilities and Clinicians Treating End-stage Kidney Disease and Use of Home Dialysis ja.ma/3ClxcKJ in @JAMAHealthForum

A young man is in a mental health crisis. He attacked his grandmother. Instead of police, a mobile crisis unit arrives. No sirens or flashing lights — and no guns. The counselors only talk. He agrees to get a psych eval. Alternative response in action. inquirer.com/health/mental-…