<?xml version="1.0" encoding="utf-8" standalone="yes"?><rss version="2.0" xmlns:atom="http://www.w3.org/2005/Atom"><channel><title>Medicine on Jin Saeki Ko</title><link>https://jinsko.com/categories/medicine/</link><description>Recent content in Medicine on Jin Saeki Ko</description><generator>Hugo</generator><language>en-us</language><lastBuildDate>Mon, 29 Jun 2026 00:00:00 +0000</lastBuildDate><atom:link href="https://jinsko.com/categories/medicine/index.xml" rel="self" type="application/rss+xml"/><item><title>Surrogate endpoints in clinical trials</title><link>https://jinsko.com/blog/surrogate/</link><pubDate>Mon, 29 Jun 2026 00:00:00 +0000</pubDate><guid>https://jinsko.com/blog/surrogate/</guid><description>&lt;p&gt;Surrogate endpoints are endpoints that are not directly related to the clinical outcome of interest but are used as a substitute for it. They are often used in clinical trials to assess the efficacy of a treatment when the actual clinical outcome may take a long time to observe or may be difficult to measure. For instance, in a trial for a new drug to treat high blood pressure, the surrogate endpoint may be the reduction in blood pressure rather than the actual clinical outcome of interest: reduction in the risk of heart attack, stroke, or death.&lt;/p&gt;</description></item><item><title>JAMA on how to read clinical trials</title><link>https://jinsko.com/blog/jamaseries/</link><pubDate>Wed, 27 May 2026 00:00:00 +0000</pubDate><guid>https://jinsko.com/blog/jamaseries/</guid><description>&lt;p&gt;There&amp;rsquo;s a series from JAMA that goes over how to read clinical trials. The series is written by individuals who are widely recognized in the field of evidence-based medicine. The entire series is a valuable resource for navigating literature in general, but there&amp;rsquo;s a total of six relevant parts to the series, specifically on how to read clinical trials:&lt;/p&gt;
&lt;p&gt;I: &lt;a
 href="https://jamanetwork.com/journals/jama/article-abstract/409068"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;how to get started&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt; &lt;sup id="fnref:1"&gt;&lt;a href="#fn:1" class="footnote-ref" role="doc-noteref"&gt;1&lt;/a&gt;&lt;/sup&gt;
II-A: &lt;a
 href="https://jamanetwork.com/journals/jama/article-abstract/409494"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;validity of therapy/prevention studies&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt; &lt;sup id="fnref:2"&gt;&lt;a href="#fn:2" class="footnote-ref" role="doc-noteref"&gt;2&lt;/a&gt;&lt;/sup&gt;
II-B: &lt;a
 href="https://jamanetwork.com/journals/jama/fullarticle/361625"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;results and whether they help your patients&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt; &lt;sup id="fnref:3"&gt;&lt;a href="#fn:3" class="footnote-ref" role="doc-noteref"&gt;3&lt;/a&gt;&lt;/sup&gt;
XIX-A: &lt;a
 href="https://jamanetwork.com/journals/jama/fullarticle/191311"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;surrogate endpoints&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt;
XIX-B: &lt;a
 href="https://jamanetwork.com/journals/jama/fullarticle/191982"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;drug class effect&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt;\&lt;/p&gt;</description></item><item><title>Ethical Considerations: Sham Surgeries</title><link>https://jinsko.com/blog/sham/</link><pubDate>Mon, 02 Mar 2026 00:00:00 +0000</pubDate><guid>https://jinsko.com/blog/sham/</guid><description>&lt;p&gt;Sham surgeries are procedures that mimic real surgeries but do not include the critical therapeutic component. They are often used in clinical trials to serve as one of the controls, allowing researchers to assess efficacy of surgical interventions. These surgeries imply that patients undergo anesthesia and incisions, but the actual surgical procedure is not performed. This obviously raises very interesting questions about the ethical implications of such practices.&lt;/p&gt;
&lt;h1 id="utilitarian-arguments-in-favor-of-sham-surgeries-my-objections-to-abbasi-and-cifus-paper"&gt;Utilitarian Arguments in Favor of Sham Surgeries: My Objections to Abbasi and Cifu’s Paper&lt;a href="#utilitarian-arguments-in-favor-of-sham-surgeries-my-objections-to-abbasi-and-cifus-paper" class="heading-anchor" aria-label="Link to this section"&gt;&lt;svg class="h-4 w-4" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;g fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2"&gt;&lt;path d="M10 13a5 5 0 0 0 7.54.54l3-3a5 5 0 0 0-7.07-7.07l-1.72 1.71"/&gt;&lt;path d="M14 11a5 5 0 0 0-7.54-.54l-3 3a5 5 0 0 0 7.07 7.07l1.71-1.71"/&gt;&lt;/g&gt;&lt;/svg&gt;&lt;/a&gt;&lt;/h1&gt;&lt;p&gt;Most of the arguments in favor of sham surgeries employ utilitarian reasoning, which is the idea that the best action is the one that maximizes overall happiness or well-being of a population in question. In this case, the argument is that sham surgeries provide more of a benefit to society than they do harm to the individual patients who undergo them. This is what&lt;sup id="fnref:1"&gt;&lt;a href="#fn:1" class="footnote-ref" role="doc-noteref"&gt;1&lt;/a&gt;&lt;/sup&gt; argues. As a evidence-based thinker, I like most of the things Dr. Cifu says, but this is an interesting paper to say the least…&lt;/p&gt;</description></item><item><title>RSS Feeds</title><link>https://jinsko.com/blog/rss/</link><pubDate>Mon, 23 Feb 2026 00:00:00 +0000</pubDate><guid>https://jinsko.com/blog/rss/</guid><description>&lt;p&gt;So far I&amp;rsquo;ve subscribed to a couple journals and some blogs. Here&amp;rsquo;s a partial list:&lt;/p&gt;
&lt;ul&gt;
&lt;li&gt;&lt;a
 href="https://www.cdc.gov/mmwr/index.html"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;CDC MMWR&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt;&lt;/li&gt;
&lt;li&gt;Phase 3 and 4 clinical trials from:
&lt;ul&gt;
&lt;li&gt;BMJ&lt;/li&gt;
&lt;li&gt;NEJM&lt;/li&gt;
&lt;li&gt;The Lancet&lt;/li&gt;
&lt;/ul&gt;
&lt;/li&gt;
&lt;li&gt;Blogs from:
&lt;ul&gt;
&lt;li&gt;&lt;a
 href="https://www.sensible-med.com/"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;Sensible Medicine&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt;&lt;/li&gt;
&lt;li&gt;&lt;a
 href="https://vajenda.substack.com/"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;The Vajenda&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt;&lt;/li&gt;
&lt;li&gt;&lt;a
 href="https://theanesthesiaconsultant.com/"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;The Anesthesia Consultant&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt;&lt;/li&gt;
&lt;li&gt;&lt;a
 href="https://pbfluids.com/"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;Precious Bodily Fluids&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt;&lt;/li&gt;
&lt;li&gt;&lt;a
 href="https://johnmandrola.substack.com/"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;Stop and Think&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt;&lt;/li&gt;
&lt;li&gt;&lt;a
 href="https://www.drvinayprasad.com/"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;Vinay Prasad&amp;rsquo;s Observations and Thoughts&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt;&lt;/li&gt;
&lt;li&gt;&lt;a
 href="https://theskepticalcardiologist.substack.com/"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;The Skeptical Cardiologist&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;The NIH walks you through how to set up filtered RSS feeds for pubmed: &lt;a
 href="https://www.nlm.nih.gov/pubs/techbull/ja20/ja20_pubmed_updated.html"target="_blank"
 class="inline-flex items-center gap-1"
 &gt;NIH RSS Feeds&lt;svg class="h-3 w-3 flex-shrink-0" id="external-link" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;path fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M15 3h6v6m-11 5L21 3m-3 10v6a2 2 0 0 1-2 2H5a2 2 0 0 1-2-2V8a2 2 0 0 1 2-2h6"/&gt;&lt;/svg&gt;
 &lt;/a&gt;. This is how I obtained the feeds for phase 3 and above.&lt;/p&gt;</description></item><item><title>SPICES Model of Medical Education</title><link>https://jinsko.com/blog/spices/</link><pubDate>Sun, 21 Dec 2025 00:00:00 +0000</pubDate><guid>https://jinsko.com/blog/spices/</guid><description>&lt;p&gt;What follows is an argument for the more liberal forms of the SPICES model of medical education&lt;sup id="fnref:1"&gt;&lt;a href="#fn:1" class="footnote-ref" role="doc-noteref"&gt;1&lt;/a&gt;&lt;/sup&gt;. The paper itself is relatively old, but many medical schools, especially in the States, have still not seriously re-evaluated their curriculum. Even though newer schools tend to be more liberal in their approach, the inertia of older programs makes the framework oddly current, and therefore still relevant.&lt;/p&gt;
&lt;p&gt;The SPICES model is a way of describing a curriculum by placing it on six continua. The acronym stands for student-centered versus teacher-centered learning, problem-based versus information-gathering learning, integrated versus discipline-based teaching, community-based versus hospital-based education, electives versus a standard programme, and systematic versus apprenticeship or opportunistic training. The point is not that every school must live at one extreme, but that schools should be honest about where they sit and whether that position makes sense.&lt;/p&gt;</description></item><item><title>Diabetic Ketoacidosis and Non-Ketotic Coma</title><link>https://jinsko.com/blog/diabetic-ketoacidosis/</link><pubDate>Wed, 24 Sep 2025 00:00:00 +0000</pubDate><guid>https://jinsko.com/blog/diabetic-ketoacidosis/</guid><description>&lt;p&gt;Robbins pathology&lt;sup id="fnref:1"&gt;&lt;a href="#fn:1" class="footnote-ref" role="doc-noteref"&gt;1&lt;/a&gt;&lt;/sup&gt; and GH medical physiology&lt;sup id="fnref:2"&gt;&lt;a href="#fn:2" class="footnote-ref" role="doc-noteref"&gt;2&lt;/a&gt;&lt;/sup&gt;&lt;/p&gt;
&lt;h1 id="introduction"&gt;Introduction&lt;a href="#introduction" class="heading-anchor" aria-label="Link to this section"&gt;&lt;svg class="h-4 w-4" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"&gt;&lt;g fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="2"&gt;&lt;path d="M10 13a5 5 0 0 0 7.54.54l3-3a5 5 0 0 0-7.07-7.07l-1.72 1.71"/&gt;&lt;path d="M14 11a5 5 0 0 0-7.54-.54l-3 3a5 5 0 0 0 7.07 7.07l1.71-1.71"/&gt;&lt;/g&gt;&lt;/svg&gt;&lt;/a&gt;&lt;/h1&gt;&lt;p&gt;Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by the destruction of beta cells, leaving patients lacking insulin. Immune effector cells react to self-antigens present on the surface of beta cells. There are a variety of reasons why the effector cells target endogenous antigens (T-cell selection, HLA alleles, etc.), but that discussion would digress from the topic.&lt;/p&gt;</description></item></channel></rss>