Discover and read the best of Twitter Threads about #rct

Most recents (7)

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Recently in our #MICU, I took pics of the oxygen sats of patients on oxygen supplementation.

What is the optimal oxygen supplementation strategy for a clinically stable patient in the ICU?

Follow me down this #tweetorial rabbit hole. #medtwitter #pulmcc #AIMW19
1/
Given that population health improvements often come from small benefits in large populations, and the fact that #oxygen is one of the most commonly prescribed interventions in the #ICU, there is potential for benefit if we can correctly titrate our oxygen titration.
2/
I’m going to refer to hypoxia and hyperoxia in this #medthread, and I’d like to (somewhat arbitrarily) define these terms. I’ll call hypoxia anything below 90% and hyperoxia anything above 96%. This is based upon some of the literature I will discuss.
3/
Read 23 tweets
Proud to have led this #clusterRCT, presented @ESCCardio's #LBCT session & published today in @JAMA_current. Among 2495 adults (50% women) hospitalized for #HF, a transitional care model implemented in our publiclyfunded system did not ⬇️time to comp readmission/ED visit/death.
There was a significant improvement in the patient-reported outcomes of #discharge-preparedness, #qualityofcaretransition, and #QOL. However, there was no improvement in #QALY. The #PROs were not adjusted for multiplicity, but we will do post-hoc exploratory analysis.
Read 8 tweets
Today’s #tweetorial—positivity for #causalinference: what it is and why it matters.

First, what it’s not: the type of positivity Im going to talk about is not a positive mental attitude!
The technical definition of positivity is that the probability of having a particular level of exposure, conditional on your covariates, is greater than 0 and less than 1, for all strata and exposure levels of interest:

0<P(A=a|L)<1 for all a in A and L
But what does that actually mean?

If you want to compare two types of treatment, then you have to have people in your data who are able to & sometimes will receive all relevant treatment options!
Read 20 tweets
Tweetorial 1 / Eficacia de la vacuna #HPV de @RecheckHealth

¿Te importaría empezar el año nuevo con un TWEETORIAL? Nuestro humilde homenaje a-@VPrasadMDMPH te guiará a través de la evidencia sobre las vacunas #HPV y lo que @Cochranecollab hizo de ella.
2/n Primero acordemos una cosa: los ensayos controlados aleatorios (ECA) son superiores a los estudios observacionales @JuanGrvas @RedeSciELO
3/n En las vacunas contra el VPH, muchos estudios observacionales publicados y los ensayos controlados aleatorios promocionados de #Gardasil #Cervarix no pudieron demostrar la eficacia esperada sin embargo. Es triste, verdadero y poco discutido. Echemos un vistazo más de cerca
Read 26 tweets
Care to kick off the New Year with a TWEETORIAL? Our humble homage to @VPrasadMDMPH will walk you through the evidence on #HPV vaccines and what @Cochranecollab made of it. Let’s first agree on one thing: RCTs are superior to observational studies
On HPV vaccines many observational studies published and hyped Randomized Controlled Trials on #Gardasil #Cervarix failed to demonstrate the expected efficacy though. It is sad, true and rarely discussed. Let’s have a closer look. @garyschwitzer @HealthNewsRevu @senseaboutsci
In 2006 @US_FDA VRBPAC Committee required @Merck to provide data and analyses on Gardasil RCTs FUTURE I and II.
Which outcome would you consider as the most relevant to assess Gardasil efficacy?
Read 22 tweets
Have you heard of #PARACHUTETrial?

@rwyeh & his team convinced 23 adventurous people to jump out of a plane wearing either a parachute or an empty backpack!

This trial is a great chance to talk about target validity: what are we asking & for why? bmj.com/content/363/bm…
First let me say I’m not an expert on target validity, because it’s a new concept. But I think this trial is a nice case study for it.

Check out the great paper introducing the concept, here: doi.org/10.1093/aje/kw…
So, what is target validity? When we do an #RCT, we want to know about the effect of a treatment *in a target population*.

Target validity tells us about how well we have learned about that from our trial (or observational study).
Read 21 tweets
I love fries; you love fries; but should we only eat 6 per serving? Less is more is good advice but why 6 & not 5, or 7?

Unfortunately, there’s prob no way to know if 5 or 6 is better!

Why? Here’s a #tweetorial on estimating causal effects for nutrition. Grab a 🥗 & get comfy!
Imagine you want to reduce your intake of French fries with the specific goal of reducing your chance of a heart attack.

You need to make 2 decisions: how often should I eat any fries; and how many fries should I eat in a serving?
To help you live your best life (ie eating max safe # of fries), researchers need to ask a pair of causal questions:

•what is the best frequency of French fry consumption to prevent heart attacks?
•what is the best serving size of French fries to prevent heart attacks?
Read 27 tweets

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