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7 Apr, 4 tweets, 1 min read
Bit of a misleading headline there. As someone who suffers from chronic pain, I find this topic really interesting. The guideline change is based on the fact that RCTs have failed to find a long-term benefit for painkillers for this type of chronic pain
Or, if there are benefits, they are modest compared to the risks of treatment (especially long-term)
I also don't think these guidelines (at least from my reading) say anything about emergency relief for flare-ups, just for long-term management of chronic pain
The headline isn't very good tho, I'd recommend reading the actual article which goes into the nuance of why painkillers are being dropped as a first-line option

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More from @GidMK

Health Nerd Profile picture
6 Apr
One of the weird things about the pandemic is watching people talk about uncertainty but refuse to admit that it usually runs in both directions
"All of the COVID-19 cases might be false positives!"

Well, unlikely, but perhaps. It was just as reasonable to say that NONE of the cases were false positives, or that there were many more cases than we could observe
"There are fewer COVID-19 deaths than we've recorded"

Again, possible. Unlikely, but possible. But people who say this rarely acknowledge that it is just as - if not more - likely that there have been MORE deaths than recorded
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28 Mar
Recently, Professor John Ioannidis, most famous for his meta-science and more recently COVID-19 work, published this article in the European Journal of Clinical Investigation

It included, among other things, a lengthy personal attack on me

Some thoughts 1/n
2/n The article itself is here, and honestly it’s a bit of an odd piece. If I were to commission a review on the small number of SR/MAs on the COVID-19 IFR, I’d probably want it to be written by someone who hadn’t authored one of the 6 onlinelibrary.wiley.com/doi/10.1111/ec…
3/n Moreover, I personally find the entire focus of the piece strange. I do not think it is reasonably possible to accurately estimate the GLOBAL IFR (infection fatality rate/ratio) of COVID-19
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Health Nerd Profile picture
26 Mar
I've been thinking a bit about why I'm so unimpressed by the arguments about how terrible "academic silencing" is, and I've got some thoughts 1/n
2/n You know the arguments I mean. They usually go something like "[x famous academic] is being horribly silenced/faced the modern inquisition!"

And they usually come off as, well, nonsense
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Health Nerd Profile picture
23 Mar
People often make the claim that, during the COVID-19 pandemic, we have "failed to protect the elderly"

While initially this was definitely true (April/March 2020), I'm not sure the claim is accurate past that 1/n
2/n I'm basing my opinion here on seroprevalence data. This is basically data looking at who has antibodies to COVID-19, and therefore who was previously infected

We reviewed 100s of studies for our IFR paper. What did they show? link.springer.com/article/10.100…
3/n Well, not all of them looked at the age-stratified rates of infection

But of those that DID, an interesting pattern emerges
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Health Nerd Profile picture
22 Mar
The somewhat depressing fact is that making COVID-19 predictions is essentially cost-free

No one will hold you accountable for predicting wrong, if they even remember in a few months time
The reality is that most people who have predicted the future of COVID with any certainty have made a lot of mistakes, but no one ever checks back to audit those in any meaningful way
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Health Nerd Profile picture
21 Mar
It's not like this is something most infectious diseases epidemiologists have been saying since March last year

Oh wait
Herd immunity through natural infection was always an absurd idea that made no sense whatsoever

Herd immunity through population vaccination is more complex
This is something covered in the John Snow Memorandum quite well, actually. There's no guarantee that immunity (even vaccine-induced) will last sufficiently long to ensure herd immunity
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