My Authors
Read all threads
Interesting thread on need 4 data in medicine, few thoughts:

1. No one will ask 4 RCTs 4 parachute effects.
If you made a pill that 100% cured advanced Alzheimers, and you gave it to 10 severely demented people and they all were restored, we would use it immediately
[thread]
2. Trouble is almost nothing in medicine has an effect size this large; Nearly nothing is like a parachute. But maybe a few things once were, like insulin in Type1DM

Much of this low hanging fruit may be picked
3. So you are left with interventions that at best have modest to marginal effect sizes,

And you are left in a world where there are 10^8 or 9 hypotheses per year, and most don't actually work;

So pretest prob = low
and at best your Rx is not a parachute
4. You know what is the best way to sort out the modest and marginal effects from the null effects...

Randomized trials

Which is why people keep asking for them for whatever malarial drug, vitamin, or arthritis medication has the most exciting in vitro activity of the day.
5. And if you want to say, but there is no RCT of smoking

Well, we don't even have a cohort study to show you shouldn't put your hand in the garbage disposal and hit the on switch.

RCTs for interventions of putative benefit, with at best modest effect sizes aka most biomed
Missing some Tweet in this thread? You can try to force a refresh.

Enjoying this thread?

Keep Current with Vinay Prasad

Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

Twitter may remove this content at anytime, convert it as a PDF, save and print for later use!

Try unrolling a thread yourself!

how to unroll video

1) Follow Thread Reader App on Twitter so you can easily mention us!

2) Go to a Twitter thread (series of Tweets by the same owner) and mention us with a keyword "unroll" @threadreaderapp unroll

You can practice here first or read more on our help page!

Follow Us on Twitter!

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just three indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!