What’s the need for external validation?
There’s no external validity without internal validity. 2 of N
Internal validity is absence or minimization of influence of any types/sources of systematic error.
3 of N
Sources of Systematic Error
1. Confounding
2. Selection Bias
3. Measurement error

Other dangerous errors
1: sparse data bias
n. Stupidity

4 of N
The basics of #Epidemiology will not only help in understanding science, but also will help to improve overall understanding of life.

It is #bias, which is the enemy of understanding and awareness. N of N

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More from @epigiri

19 Dec
It changes everything about what we understand, this virus is bit too much for mankind. Challenges aplenty but #Science will take us through !
Read 9 tweets
14 Dec
At this stage, Universal vaccination is a double edged strategy, promoted for protecting against #SARS_CoV_2 infection under EUA.

Many reasons

1. Fewer approved vaccines in stockpile, universal coverage is a myth in short term. It will induce & worsen inequities

1 of N
2. The countries will have to reserve significant $$$$ to buy vaccines for universal coverage, often more than their annual health budget.

Resources will have to be spent justifiably: it doesn’t make sense not paying salaries of health care workers but buy vaccines. 2 of N
3. (A)Safety , (B)efficacy are prerequisites. (C) Feasibility and (D) effectiveness are next steps. Having worked for polio eradication, I love vaccines. They do wonders when they pass the critical septs (A to D). For Covid19, we do not have many options with vaccines, yet 3 of N
Read 5 tweets
12 Dec
#NFHS5 report released by @MoHFW_INDIA . Here are some snippets
-% women having a mobile phone that they themselves use has increased from 47 to 62 in #Karnataka compared to previous survey.
-Women who are overweight or obese (BMI ≥25) has increased from 23.3 to 30.1

1 of N
Ever-married women age 18-49 years who have ever experienced spousal violence has increased from 20.6 to 44.4 %. It either means that reporting has improved or we are becoming more regressing societies. 2 of N
Breastfeeding practices are not improving and have dropped in initiation with one hour of birth. #NFHS5

@srinidhikoya et al reported from @_MAASTHI regarding the determinants and consequences of ineffective breastfeeding practices in India. 3 of N
Read 7 tweets
27 Sep
How India became global leader in #polioeradication efforts?

This was enabled by world class surveillance system for detecting Acute Flaccid Surveillance in India. Districts which were detecting less than expected minimum of AFP rate per unit population were strengthened. 1 of N
In response against #COVID19 in #India, we seem not to use our own successful model. Instead, I see districts and states with poor reporting of cases (and therefore missing many deaths) are celebrated as success models. By now, if your are not reporting, there is a problem. 2of N
There should be a revised strategy. Define number of cases/million (CPM) as a standard unit. Compare metros, urban areas & districts based on a minimum CPM. If districts are not detecting cases, review & strengthen. A huge #inequity issue for now; vulnerable suffer more. 3 of N
Read 6 tweets
12 Sep
The opening up effect: Cases per million per day galloping in the United Kingdom and India. Via @FT
1 of N Image
#UK: young are the most infected in last two weeks. Although overall mortality is low it’s higher disproportionately in ethnic minorities, health & care home workers. Low seroprevalence indicates high degree of susceptibility; the young might spread to vulnerable people. 2 of N ImageImageImageImage
Cases and Deaths per million are matching for most countries. The better a country tests, higher the case load and higher the mortality detected. Exception to the rule: China covid19.who.int/table
Interesting table on the Situation by Country, Territory & Area by @WHO
3 of N ImageImageImage
Read 4 tweets
1 Sep
Virus doesn't behave differently across states, reporting does.

You find fewer suspect cases, test fewer and will have fewer cases. This is not the ideal way to contain #covid19. It is unethical as well.
It’s not testing numbers alone , whom do you test and how did you test through the entire period starting from early days is important. A wrong trend is to simply inflate testing numbers using RAT.
This is shared by the press release of the Government. My above statements and comments in the story in Indian express should be read against this in background.

Absence of Evidence does not mean absence of circulation. Image
Read 4 tweets

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