Discover and read the best of Twitter Threads about #epitwitter

Most recents (24)

let’s talk about covid stress.

even if you and your loved ones are healthy and you still have your job and your home, your stress, pain, sadness, frustration, etc. are legitimate! 1/
#epitwitter #BodnarTwitterTakeover
this is not the Olympics of suffering, where only people with the worst situation get to be the ones who are in pain. we are ALL struggling (even if people seem like they have it together)! 2/
we are collectively grieving. Grief requires a lot of energy. Therefore, our mental reserves are low, meaning that “small” stressors that you could handle without so much emotion pre-covid now feel overwhelming. why? 3/
Read 16 tweets
#epitwitter #BodnarTwitterTakeover i've had a few requests to tweet on 'How to Say No." lots of people have published smart pieces on this. doing a google or a twitter search on 'saying no in academia' will help! but i'm happy to share a few things and take any questions! 1/
first, i've gotten undeserved credit for the idea of establishing a No Committee. it was originally written about by Professor Vilna Bashi Treitler at Baruch College and CUNY. i started my own No Committee after someone pointed me to her blog years ago 2/
we all have had the experience of saying yes to what seem at the time like great opportunities and then realizing that we have WAY too much on our plates and becoming super overwhelmed. 3/
Read 20 tweets
let's talk about boundaries! (saying no)

@Doc_Courtney asked this great question to @ProfMattFox and me after this week's @ShinyEpiPeople episode on kindness.

to me, questions about balancing kindness and your own work are about setting boundaries. 1/
Anne Katherine has a couple of great books on setting boundaries. the quotes here are from her book Where to Draw the Line:
'A boundary is a limit. By the limits you set, you protect the integrity of your day, your energy and spirit, the health of your relationships,...' cont. 2/
'...Each day is shaped by your choices. When you violate your own boundaries or let another violate them, stuffing spills out of your life.'
(ok and who wants to lose their stuffing and become one of those stuffed animals with the droopy head b/c you have no neck stuffing??) 3/
Read 21 tweets
hi #epitwitter! i have the pleasure of taking over SER's account today! i am a nutritional, perinatal, and goofball epidemiologist. my work centers on maternal weight & diet patterns in relation to adverse pregnancy outcomes. i'm a professor @PittPubHealth. #BodnarTwitterTakeover
SER is my intellectual home. i have been attending the meeting since 2002 (gulp!). i host the podcast @ShinyEpiPeople. i am a single mom of 3 kids ages 9, 12, 15. they are wonderful and exhausting. i like to dance and i don't like mean people or eggplant.
i am going to tweet about work-life balance, saying no, priorities, covid mental health, and *whatever* you'd like to talk about. please tweet at me! i don't want to feel all alone over here! #epitwitter #BodnarTwitterTakeover
Read 3 tweets
Gastroenteritis #Seasonality

Smear infections. No droplets, no aerosols.
Noro autumn/early winter, Rota sping/early summer.

Can we explain this by "being indoor" or the weather? Or is our body following a seasonal pattern of immunological activity?

Remeber any Rota-lockdowns? Image
Let me add Campylobacter (bacterial) Gastroenteritis. Peaks in late summer each year. So steady, you could use it as a calendar.

Most human infections occur in distinct cycles. Image
And, dear epidemiologists - can you please explain how these patterns are explained by your beloved SIR models? Why are you still using these, knowing that they *never ever* made a correct prediction?

#epitwitter #teamdrosten @nataliexdean @BallouxFrancois
Read 3 tweets
Excited for Priya Bahri’s plenary session on #scicomm at #ICPE20 #RxEpi starting at 11:15am ET today

#pharmacoepidemiology @ISPE_Exchange
Here we go! #icpe2020
"Is silence better than getting it wrong?" when it comes to emerging medication safety issues for patients - Priya Bahri asks of #drugsafety at #ICPE20
Read 9 tweets
1/ Had an absolute blast guest lecturing in one of @EpiEllie's classes today about my experience as a clinician, researcher, and contact tracer during #COVID19!

#CovidTesting #epitwitter #medtwitter #nursetwitter

Curious about what I had to say? Check it out! 👇🧵 #nerdout Image
2/ Started out with some basics of contact tracing.

Why we do it --> control spread of disease

And the differences between isolation/quarantine & case/contact

Did you know it is possible to be quarantined MULTIPLE times?! 😱 #COVID19 #6feet #maskup… ImageImageImage
3/ I continue to highly recommend this thorough, informative, and FREE course for educating the #COVID19 contact tracing workforce by
@JohnsHopkinsSPH's Dr. Emily Gurley! (I don't work for them, I just think they are awesome lol) @deniswirtz… Image
Read 16 tweets
If you follow #medtwitter, #epitwitter or #covid twitter even cursorily, you've probably noticed a serious freakout over political interference in an obscure journal you've likely never heard of before: MMWR - Morbidity and Mortality Weekly Report. Who cares? Why so much? 1/
MMWR is...not the world's most exciting journal. Imagine if your mom produced a medical journal. It would be a lot like MMWR. Reports about consumption rates of sugary drinks in high schoolers, etc. But it has a very special role in the medical ecosystem. 2/
For instance, on June 4, 1981, MMWR published the report, Pneumocystis Pneumonia -- Los Angeles. Yes, that's really its title. About as exciting as pencil shavings, right? 3/…
Read 6 tweets
1/ Did the Sturgis bike rally cause 266,796 new cases of COVID-19? Probably not. Lesson- Beware viral studies that confirm your pre-existing beliefs so satisfyingly. (Long) thread:… @FutureTenseNow @EricTopol @slate @govkristinoem @DearPandemic #Sturgis
2/ Like most people working on COVID-19, I am of the strong belief that mass gatherings during a pandemic are a bad idea. When this paper came out, the huge figures immediately hit the "I Told you So!" button in my & many people’s brains.…
3/ The first red flag is the huge number itself-it doesn't pass the sniff test.
Read 27 tweets
Pleased to finally present this work! Large (n=1130), global (67 countries) case-control study of exposures associated with HCP illness with COVID-19. Granular look at workplace exposures with respirator vs. medical mask data.

Three main findings: a 🧵 Image
Considered “risky” by most: AGPs on COVID patients. AGPs not associated with infection in this work (OR 0.9)
Considered “risky” by many: work on wards enriched with COVID patients (COVID units) or sicker COVID patients (ICUs, COVID ICUs). These areas associated with lower likelihood of HCP infection than work on regular hospital ward (ORs 0.5-0.7 vs. OR 1.4).
Read 14 tweets
A lot of people have asked me today how much of a big deal this is, and the honest answer is ‘we don’t know yet’—the trial was stopped in order to figure out the answer to this question.

But let’s talk a bit about causality.
There are many ways to define what we mean when we ask the question “did the vaccine cause this adverse event?” because there are many ways to define the idea of a “cause”.
One possible way to make this question more clear is to ask “if everything else had been the same, but this person had not been vaccinated, would they still have experienced this event at that time & in this way?”
Read 9 tweets
Counterfactual Values and Exchangeability #tweetorial
Now with typos fixed, and a bonus slide on pedagogy. #thread #epitwitter
Say you are an investigator in a world with people who are either stressed or unstressed, and either smokers or non-smokers.
You have access to a great dataset that represents this population. You are interested in the causal effect of stress on smoking.
Read 23 tweets
One modeler’s thoughts on the UIUC thing. Because while there are some valid criticisms to be had here, I think there’s also some unfair aspects running around #epitwitter .

So here we go - a long thread.
First, yes, it's fun to drag physicists for modeling epi problems. And there is a tendency for some fields to show up and assume your problem is an easy subset of their problems. And to want to mock them

I'll admit to having done so in the past too. @NoahHaber will confirm ;)
But there is, on occasion, just as much armchair modeling from non-modeler epis as there is armchair epi from non-epi modelers.

Y'all make some silly assertions too.

At the risk of subtweeting, some of those silly assertions are published.
Read 21 tweets
The main research project from my postdoc just got published in Human Reproduction: cost-effectiveness of medically assisted reproduction for unexplained subfertility. (open access)
Time for a tweetorial on cost-effectiveness!
#epitwitter #statstwitter
Thinking of our health care in terms of finances can come across as cold and calculating. Unfortunately we do not have infinite amounts of medical staff and hospital beds. The harsh truth is that we DO have to make choices, for instance more effective or less expensive treatments
In practice, we often encounter the situation that a (new) treatment seems more effective but also more expensive than usual care or control. This constitutes a decision problem: is it ‘worth’ to set the more expensive treatment as the new standard of care?
Read 15 tweets
I've been thinking about this, and I wonder how much of this type of poll reflects reverse causality

I.e. here the idea is that Republicans believe in QAnon, but perhaps it's more that QAnon people become Republicans #epitwitter
Alternatively, could be that people who reject QAnon leave the aside their Republican identification and/or become Democrats
Anyway, this is being used to say that Republicans are crazy and these beliefs are widespread, but that really depends entirely on how many people in the total sample defined themselves as "Republican"

33% of 5%, for example, would not be a big number!
Read 4 tweets

Ever wanted to harness repeatedly-measured predictors within a clinical prediction model but found the existing literature overwhelming?

Look no further, our recent methodological review can help! 👇👇👇

#epitwitter #statstwitter #phdchat #epidemiology https://diagnprognres.biome...
💡 To make this field more accessible for applied researchers, the extracted modelling techniques were grouped based on similarity, and how they used repeated observations to enhance prediction. 💡
The three main motivations to incorporate repeatedly-measured predictors were:

1⃣ To improve model specification and applicability over time
2⃣ To infer an error-free predictor value at a pre-specified time
3⃣ To account for the effects of predictor change over time
Read 9 tweets
1/ Q: So the CDC just released data that said 94% of U.S. COVID-19 deaths had underlying medical conditions?


We’ve heard this interpretation is making the rounds, but it’s just not correct.

So what did the @CDCgov data actually say?
2/ The CDC report summarized all deaths in the U.S. from Feb until August 22nd with COVID-19 on the death certificate (161,392 total deaths).

The CDC reports that for 6% of these deaths COVID-19 was the *only* cause mentioned.…
3/ For all other COVID-19 deaths there were on avg. 2.6 additional conditions/causes. Surprising? No. US death certificates have spaces for immediate causes & several lines for underlying conditions. For *any* cause of death, it would be unusual for only one cause to be listed.
Read 13 tweets
The debate around face-to-face teaching in UK #HigherEd escalated yesterday when @ucu warned it 'could spark a #Covid avalanche' and UK universities could be the 'care homes of a second wave'.

#EpiTwitter #COVID19 #SarsCoV2
We know (younger) students are at a MUCH lower risk of death from #COVID19. And we know masks can be remarkably effective at reducing disease spread. So, on the face of it, the idea of universities being the next care homes seems alarmist.
Meanwhile, university managers claim they've been working hard to make campuses safe, adding ventilation and developing testing protocols. They naturally want to provide the best possible experience to their fee-paying students.
Read 15 tweets
Ok, am I going crazy or is this table nonsensical #epitwitter

Leftmost column is the RELATIVE RISK increase associated with a 100mg increase in caffeine consumption

Rightmost column appears to make absolutely no sense whatsoever Image
If I'm reading correctly, the author multiplied the RR by the TOTAL NUMBER OF EVENTS to get the number of events attributable to caffeine consumption

i.e. drinking 200mg caffeine per day is 28% increased risk, 1,000,000 miscarriages, therefore 280k caused by caffeine
There's actually a formula to do this properly, the population attributable fraction, but what the author has done here is...assume that 100% of the population who have had miscarriages drink 200mg of coffee/day????

That seems, uh, unlikely (it's 2-3 espressos)
Read 4 tweets
Just to be clear, @FDA commissioner (leading an organisation which is incharge of approving and bringing life saving treatments to patients) DOES NOT KNOW the difference between relative risk and absolute risk reduction?
This is the data he cited.
Reduction in 7-day mortality (from 11.9-8.7%)- a 35% reduction in mortality in no way means that if 100 people get #covid19 and are treated with convalescent plasma, then 35 lives will be saved. These were his words to #American people yesterday. No grasp of Stats 101?
Unpublished data shows that compared to patients getting plasma on day 4, day 3 plasma patients have a 35% lower mortality risk. Comparison of intervention on Day 4 Vs Day 3. Not comparing people who receive plasma Vs those who don't.
#FDA commissioner!
#coronavirus #epitwitter
Read 3 tweets
1/ Maybe it’s my #epitwitter bias, but I get frustrated by the outsized attention these hospital-based viral load comparison studies (kids vs adults) get. And interpreted as children as a group highly infectious...
2/ the epidemiologic evidence of actual transmission in real-life settings (household studies, popn-representative seroprevalence studies, overall experiences of daycares and elementary schools globally) has indicated than young children lower risk than adults re: spread...
3/ the viral load studies seem much less relevant evidence...
* viral load is not live virus nor infectiousnes. For instance, viral load often stays high for a while in #COVID19 patients who are no longer infectious. Viral load is necessary but not sufficient for infectiousness
Read 14 tweets
Alright, let's do this once last time. Predictions vs probabilities. What should we give doctors when we use #AI / #ML models for decision making or decision support?


First, we need to ask: is there a difference?

This is a weird question, right? Of course there is! One is a categorical class prediction, the other is a continuous variable. Stats 101, amirite?

Well, no.

Let's set out the two ways that probabilities are supposed to be different than class predictions.

1) they are continuous, not categorical
2) they are probabilities, meaning the numbers reflects some truth about a patient group and are not arbitrary


Read 23 tweets
This preprint is interesting (PSA hornets nest, meet stick) on #masks

which we should use as recommended
for which I and many have been awsiting data in community use
(see my pinned tweet, oldish but stands). /1…

#epitwitter #COVID19 #idtwitter Image
...They use big picture real data not modelling assumptions (COVID case and death rates, dates of NPI start) from mostly European countries with highly varied start dates and orders of these 8 NPI (unable to untangle school by age of students sadly because same date mostly) /2
NPI effects are modeled as percentage reduction in R:

Mean reduction across 41 countries for eight NPIs

mandating mask-wearing in public spaces (2%; 95% CI: -14%-16%),

limiting gatherings to 1000 people or less (2%; -20%-22%),

to 100 people or less (21%; 1%-39%)
Read 8 tweets
Safety analyses in clinical trials - room for improvement

In clinical trials, probability of an AE is typically estimated using the incidence proportion, i.e. dividing the number of patients with a given AE by the total number of patients.
The Survival analysis for AdVerse events with VarYing follow-up times (SAVVY) project aims to improve the analyses of adverse event data in clinical trials through the use of survival techniques appropriately dealing with

1) varying follow-up times and
2) competing events.
To this end, 10 sponsors (industry and academia) have contributed summary data of 17 RCTs to estimate the bias of various estimators in estimating AE probabilities of 186 types of AEs and comparing them between two arms.

Compared to the gold standard (Aalen-Johansen estimator):
Read 9 tweets

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