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#TWICPodcast update

You may have seen one of >3000k journal articles describing #obesity paradox: high BMI is protective in, say, AF or Heart failure

That is so weird, b/c exactly zero docs tell normal-weight pts with AF or HF to eat Cheetos or donuts

How can this be?
🧵
Well, here's the deal: there is NO paradox

It's all due to systemic bias

Like studying the r-ship of IQ and sports ability but only in students at an elite college. Here, you'd find an inverse r-ship

The problem is a form of selection bias called collider bias
2/
It is a huge problem and it comes from the choice of which patients to select from

@StevenStovitz showed how it happens in this elegant paper > Please read and save.

Here obesity looks protective for childhood diabetes!

Not!

pubmed.ncbi.nlm.nih.gov/29374028/
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