It’s the Medicaid Expansion, Stupid

I came across this nice post:

My initial reactions: hmm, some of this looks like lack of Medicaid expansion, some might be from a combination of too-high premiums/insufficient subsidies/ignorance of subsidies etc on the exchanges.
But wait, "childless adults"? That sounds familiar!

"Childless adults, most uninsured under traditional Medicaid." For those who have studied health policy, it's a stimulus-response, like "chloramphenicol, grey baby" and "dental plan, Lisa needs braces."

I followed the link and noticed the normal, understated citation at the bottom of the post:
Source: Kaiser Family Foundation: Who is Impacted by the Coverage Gap in States that Have Not Adopted the Medicaid Expansion?
The title on KFF's page is, not surprisingly:

Who is Impacted by the Coverage Gap in States that Have Not Adopted the Medicaid Expansion?

This reminds me of the famous desaturation curve which appears in every airway lecture, as mandated by CMS due to Obamacare:

Note the title of the source of this familiar graph: Critical Hemoglobin Desaturation Will Occur before Return to an Unparalyzed State following 1 mg/kg Intravenous Succinylcholine.

(Benumof, Dagg, Benumof. Anesthesiology. 1997 Oct;87(4):979-82.)

How often are these graphs shared without noting their expressed purpose? 

PE in Syncope: An External Validation of the Wells Score

I'm not going to reinvent the wheel -- see some of the fantastic analyses of PESIT (in no particular order) at:

St. Emlyns - Simon Carley
EM Lit of Note - Ryan Radecki
EMNerd at EMCrit - Rory Spiegel

One common thread is that the patients who had PEs seemed to be patients who we would think had PEs, rather than some occult finding we need to hunt for in all of our syncope patients.

Just look at Table 2, emphasis mine, which looks a lot like their Table 1, which is (gasp!) the Wells Score:


Sure, prolonged immobility and recent trauma/surgery don't reach frequentist significance, but they're close, and there just aren't a lot of people in either of those groups.

Literally the only non-Wells factors they find are tachypnea and hypotension.

You cannot make this up: