Angry Cardiologist Profile picture
Oct 2, 2020 10 tweets 2 min read Read on X
One thing I love about ET is that he identifies the best COVID studies.
These studies are looking at in-hospital cardiac arrest (IHCA) in COVID.

If you want to understand unique aspects of IHCA in COVID, who should you compare COVID arresters to?
In the British study (bmj.com/content/371/bm…) who were COVID arresters compared to? (Poll in next tweet.)
Who were British COVID arresters compared to?
There was also an American study, thank goodness! (jamanetwork.com/journals/jamai…).
This study was done at a single hospital. And these guys were smarter than those Brits, because they compared COVID arresters to non-COVID arresters, albeit historically.

In all fairness, it is hard to find too many contemporaneous non-COVID arresters during the pandemic.
So, what was the comparison group to the single-hospital COVID arrester cohort?
Wow, this is hard work!

How does @ProfDFrancis have time to cath?

It’s getting late early here, so I’ll add some concluding remarks after folks have had a chance to vote.
Yes—not only did I accidentally fork this thread, but I gave away the answer to the British paper.
For God’s sake, I’m not even asking math questions!

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More from @AngryCardio

Feb 19, 2022
Here is a recent RCT of ivermectin in COVID, published in @JAMAInternalMed: jamanetwork.com/journals/jamai…
I have screenshotted why I think are key elements: ImageImage
Abstract ImageImageImageImage
Read 8 tweets
Sep 12, 2021
Working as a scientist in industry, it took me a long time to understand the differences between the research I do now & the research I did as an academic.

A good framework is the differences between pharma & academic research is “Finite & Infinite Games” en.m.wikipedia.org/wiki/Finite_an…
What do I mean?

Briefly, pharma research is directed at answering specific questions to move a drug development program forward—or kill it.

Academic research is directed at answering questions—sure. But the productive questions are those that lead to more interesting questions.
In this sense, pharma research is a “finite game”, with winners & losers.

Academic research is an “infinite game”, where the goal is to keep playing.

This is relevant to the discussion around COVID mRNA vaccine-associated myocarditis.
Read 8 tweets
Sep 12, 2021
Now it’s time for me to weigh in on the “COVID vaccine-associated myocarditis” preprint.
I have tweeted on many occasions that VAERS ought not to be used for analysis, but rather for signal detection.

My view on that remains the same.
I think what is useful from this preprint is as follows:

1) myocarditis/pericarditis seems to be an AE being observed with enough frequency to merit further, systematic attention.

2) Young men & boys are likely at substantially higher risk than older men & women/girls.
Read 10 tweets
Aug 21, 2021
Too many of my colleagues, facing the reality of vaccine-associated myocarditis, are either burying their heads in the sand or throwing up their hands.

In an effort to promote vaccination, they are making what I believe are misguided actions.
I believe vaccination for COVID is our best way back to a normal life. And we need to be honest with people about what we know.

We also need to acknowledge that there is a great deal we can do to minimize the harms of our interventions.
Regarding what we know—we need to be honest about who is affected, and how frequently. We shouldn’t try to make marginally valid comparisons to COVID. The folks you want to persuade won’t believe you anyway. Most people think differently about an active interventions & disease.
Read 5 tweets
Mar 14, 2021
Let’s be clear: 2 months of safety data for a new drug or vaccine is at best marginally better than 1 month for identifying acute AEs. And it has almost no power in identifying chronic/long term AEs.
A 2-month cutoff is not a routine cutoff for evaluating AEs in drug or vaccine development.

Of course, all cutoffs are arbitrary to some degree, but there are typical timeframes that are routinely used: eg 1 month, 1 year.
In the setting of a pandemic, we have to weigh potential risks with benefits. Every day we wait to accumulate more data is a day we are not immunizing.
Read 9 tweets
Oct 8, 2020
Time for another takedown.

Today, it’s the editors of @NEJM for today’s editorial.
nejm.org/doi/full/10.10…
I will start with the references: 2 database queries, and 2 newspaper articles.

Definitely typical for an editorial in arguably the world’s top medical journal.
Regarding the arguments forwarded by the editors, we should first compare COVID rates of cherry-picked countries.

Should Canadians complain that their death rate is ~1000x that of Vietnam?
Read 11 tweets

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