Dr David Robert Grimes Profile picture
Sep 21, 2020 6 tweets 3 min read Read on X
Hi @JuliaHB1 - your claim here is highly misleading, and misunderstands #CovidTesting. I'll try explain why: firstly, the sensitivity of PCR #COVID19 test is ~98%, specificity 98.9%. Now, false positives & negative rates depend on prevalence of COVID in test population... (1/n)
...we can simulate this as prevalence changes, like I just did here, showing test PPV (chances a positive is a true positive) and NPV (chances a negative result is true negative) as prevalence increases. At your 5% prevalence, a positive test is 82% likely to be correct (2/n)
..but the impressive part is the NPV: this is close to 100%, and tells us that a negative result is, in general, highly reliable (with some caveats). That is really important to know, as it means we can have confidence in negative results. That's extremely important! (3/n)
If prevalence is low, than a positive test is of course less reliable, as you can see on the graph. But if you have a + test and symptoms, your a priori probability of having COVID is high. If you've a false +, you'll remain asymptomatic, & re-test will likely show no COVID (4/n)
To conclude, NPV extremely useful by itself to rule out COVID, & asymptomatic positives are easily re-tested & corrected. This, by the way, is a difficulty in ALL medical screening, but it doesn't detract from utility of testing. Hope this helps. (5/5, n = 5)
Post-script: @CillianDeGascun had an excellent thread on PCR testing for those curious, and @Kit_Yates_Maths / @GidMK great on this kinda stuff too.

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More from @drg1985

Jan 30
Social media plagued by health grifters, scaremongering, & snake-oil peddlers, many with huge followings. I'm often asked to weigh in on claims and confirm whether someone is a pushing misinformation or not. Here's a useful heuristic for spotting health charlatans.. a🧵.. Image
..First question: Does claimant have relevant experience? Have they related qualifications, publications, or specific expertise to assess and make the claim they do? If not, that is a red flag. Also, important to dig beyond appearance: any grifter can pose in lab coat or scrubs Image
..Second question: Are they extrapolating from limited evidence, or dubious sources? Murine studies and petri dish prelims should never be the basis for human health advice. Also be extremely wary of someone who takes a small study, or a weak association, and makes a big claim Image
Read 8 tweets
Jan 26
Whenever I see a guideline insisting we're all Vitamin D deficient, I get a sinking feeling I'm reading the legacy of bad science. Meta-scientists often complain how Vitamin D research is, as a field, so methodologically shabby as to be meaningless. How bad? Well let's dig in...
Firstly, what *is* vitamin D deficiency? Methodologists say not to dichotomise a continuous variables for good reason, & medical scientists completely ignore this because they want pretty results. I looked at last 5 years of Vit-D obs. trials: Here's what it looked like.. Image
..you read that correctly. Of trials that set an arbitrary threshold (the majority), authors used at least 9 different thresholds, ranging from 0.2 ng / mL to 200,000 ng / mL. Generously assuming they're howling typos, 20 ng / mL was most common, then 10 ng/ mL, then 30 ng / mL
Read 15 tweets
Jan 1
Misinformation, disinformation and malinformation are rampant on social media, and their influence and prevalence will only get worse in 2024. I'm often asked what we can do to limit their harms. Here are some simple suggestions. A short thread 🧵 Image
..first, we need distinguish between them. Misinformation is the inadvertent sharing of falsehoods, disinformation is the deliberate propagation of the same, and the lesser-known cousin malinformation is the weaponisation of information out of context to mislead. All are harmful Image
So what can we do to protect ourselves? First and foremost, we can check our sources. When we come across a claim, we need to determine whence it originates and its inherent veracity. Is it fact-checked, or from a reliable news source? Or does it come from a dubious corner? Image
Read 11 tweets
Jun 18, 2023
So @joerogan insisting @PeterHotez "debate" notorious antivaccine spoofer RFK Jr shows Rogan fails to grasp debate is only useful if conducted in good faith. If one party lies, youre just giving them a vehicle to spread that lie to detriment of understanding. A short thread.. 🧵
So debate is not an arbiter of truth. If one perspective amply supported by evidence, & another completely unsupported, giving them equal consideration merely because theyre opppsed has effect of allowing the unevidenced view leech an illusion of legitimacy, misleading people
...this is the false balance problem, and it has utterly damaged public understanding on everything from climate change to vaccination. Cranks adore it, because it allows them to push their misinformation, as I wrote for guardian in 2016

theguardian.com/science/blog/2…
Read 9 tweets
Mar 29, 2023
Good grief - utter nonsense shared yesterday by @ABridgen and his ideological cohort claims COVID vaccines are dangerous has gotten huge traction, but its founded on an utter abuse of data. Let's look at precisely why its junk - Strap in, it's a thread... 🧵 Image
..firstly the source is Expose News, which solicits donations & pumps out conspiracy junk. They've taken publicly available ONS data, and presented it as shocking: for example, this is their figure (mislabelled as it is) of unvaccinated versus vaccinated deaths April-Dec 2021... Image
..4034 deaths in unvaccinated versus 13,116 (~76.5%) deaths in vaccinated cohort, scary right? Well.. no: in the same period of time, 93.6% of UK were vaccinated; so a tiny fraction of unvaccinated (6.4%) accounted for 23.5% of deaths, 3.7x greater hazard being unvaccinated! Image
Read 9 tweets
Mar 3, 2023
US Department of Energy (DoE) report on COVID origins & FBI director on Fox news has set cat among pidgeons again -so is a #lableak now more likely now?

No - and demands to investigate lab-leak narratives neglect basic principles of scientific inquiry; a thread 🧵 Image
So first thing to note is the DoE report is classified, but concludes with "low confidence" - what does that mean in practice? That its unreliable, and not a basis for an analytical conclusion. Note that the report didn't change any other intelligence outfits minds either.. Image
This togethers implies that any ostensible evidence DoE marshal is somewhat underwhelming; not surprising when steady evidence has accumulated since 2020 all pointing to the conclusion that the virus emerged from animal spill-over, with not a shred of solid evidence otherwise..
Read 15 tweets

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