3min chapter

Freely Filtered 052: Acetazolamide for Acute Decompensated Heart Failure (ADVOR)

Freely Filtered, a NephJC Podcast

CHAPTER

Inpatient Acute Decompensated Heart Failure Intervention - Does It Improve Mortality?

The primary endpoint was consistent across subgroups as well, but all favored acetazolamide for secondary outcomes. They called out in their discussion that the patients on the higher dose of diuretics had less benefit from acetazolamia. So these things weren't pre-specified or powered so they don't have peace for interaction,. But that does seem to be something you can observe that if you're on higher doses of diuretic, it seems to probably not as beneficial. These are all exploratory ideas.

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Speaker 3

That's kind of funny because I think of gambling as this perfect toy problem to think about risk and uncertainty in the world. And to the extent that it's also kind of a greasy business, I'm purely entertained by it. For instance, I love the contrast between guys who understand math well enough to know when slot machines go positive. And yet they spend their time in smoky casinos, elbowing out tourists to get the juicy plays. But not everyone is going to appreciate that grease aesthetic.

Speaker 2

Although I have to admit, you know, the dean at the time, it took a little convincing to put the craps table in there. And then, and he didn't like the idea of me teaching everybody craps, you know, and then I wanted to keep it there forever. And that was a no-go.

Speaker 3

I've seen a short video of Robert's dice rolling machine. And the best way I can describe it is sort of like a crossbow. The dice go in a slot, then there's a spring, and it shoots the dice out. I'll post a link in the show notes because there are pictures of the machine in one of Robert's papers. Also because it has ways to customize the toss, you could tweak the settings until it does something non-random.

Speaker 4

For initially, we

Speaker 2

tinkered with the machine, then we had the high speed camera come down and that's when we optimized it and said, okay, here's how dice throwers are throwing. Here's the height, here's the speed, here's the spin rate and everything. And we dialed the machine into those specifications. And then we left it at those specifications for every roll, for a ton of rolls. And so we rolled a whole bunch on those sort of ideal settings. And we didn't see any randomness. Then we started, then like you said, probably, you know, in some ways where we should have started was we sort

Speaker 4

of said, can we produce

Speaker 2

non-random events? And so that's when we really started messing with the angle and the speed and the spin rate and all those other factors. And so we tracked, you know, we would do, let's say, two or three hundred rolls on a particular setting and then we'd make an adjustment to the setting and do more rolls. And then we'd consistently address that. So we had exactly what the settings and the adjustments and the distance and everything were and we couldn't repeat

Speaker 3

it.