Kristen Panthagani, MD, PhD Profile picture
Jul 20, 2021 10 tweets 3 min read Read on X
People are looking at the percent of vaccinated hospitalizations and getting alarmed. But by itself, this number can't tell you much about how the vaccines are working, as it's highly dependent on the rate of vaccination in a community. Here's some maths to show what I mean👇🏽
As more people are vaccinated (and all else being equal), total hospitalizations will decrease but the *percent* of vaccinated hospitalizations will increase, not because the vaccines aren't working, but because there are more vaccinated people and fewer hospitalizations overall.
To make this point really obvious, look at the scenario where 100% of the population is vaccinated -- there will be way fewer hospitalizations, but 100% of those few hospitalizations will be vaccinated people. So you can't only look at the percentage.
Also, lest anyone get confused, the above data is a hypothetical model of 100,000 people exposed to COVID where the hospitalization rates for the vaccinated and unvaccinated are fixed, and the only variable changing is the % vaccinated.
Some are getting upset that this model isn't taking into account other variables that affect hospitalization rate. It is certainly correct other variables are at play in real world data, but was not the point of this graph. The point was to illustrate that by itself,
% vaccinated hospitalizations is a really bad metric to decide how the vaccines are working, because it is influenced by so many variables, not just the vaccine efficacy (which in this example, is constant).
Of course when it comes to real world data, more variables should be considered. That is the point.
Here is the visualization in Spanish. Thank you to @rusosnith for providing the translation (and the suggestion!)
And here in French. Thank you to @T_Fiolet for providing the French translation and suggestion!
for those wanting a more in-depth explanation, check out this post:

youcanknowthings.com/2021/07/21/som…

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More from @kmpanthagani

Jun 27, 2023
It’s slow right now in the ICU, so here it is… the thread you’ve never seen before….

Tips for new interns.
First, we must get this out of the way. Saying “it’s slow” does not actually impact the number of sick patients about to come your way. You don’t have that much power.

Nevertheless, everyone will be mad at you if you say this out loud, so probs don’t say this out loud.
2. In residency you will constantly be asked things you don’t know, and get to play the very fun game of “was I taught this in med school and forgot” or “have I never heard of this before this very moment?”
Read 15 tweets
Jun 11, 2023
What are vitamin K shots, and why do we give them to fresh lil' newborns?

A thread on why we give vitamin K to the little ones. Image
This is vitamin K. It is a vitamin. Basically everyone agrees that vitamins (in the right doses) are good for people. Our bodies need them. Image
Our bodies use vitamin K for a variety of things, but one of the most critical is clotting factors.

The clotting cascade strikes fear in the heart of medical students for how complex it is.... ImageImage
Read 14 tweets
Apr 9, 2023
You may recall Florida's vaccine analysis which claimed that mRNA vaccines are associated with increased risk of cardiac death in young men.

This week, @TB_Times published earlier, unpublished drafts of that analysis.

Those earlier drafts tell a dramatically different story... Image
The @TB_Times obtained 5 previous drafts of the analysis from an anonymous source. These drafts show very different results and/or conclusions compared to the final version of the report released last October.

tampabay.com/news/health/20…
(For a quick run down of the original report, see this thread):
Read 32 tweets
Feb 25, 2023
I have a lot of thoughts about the Cochrane mask analysis, and will try to summarize them soon. But right now I'm only going to talk about one of them:

the Denmark study.
As you have probably heard by now, the Cochrane review looks at randomized-controlled trials (RCTs) of mask use for respiratory infections. The majority of studies were conducted before the pandemic, and only two during the pandemic: one in Denmark, and one in Bangladesh.
The Denmark study was conducted in spring of 2020 and published in March 2021. When it was published, it caused a lot of controversy and many people pointed out flaws...

acpjournals.org/doi/10.7326/m2…
Read 23 tweets
Dec 19, 2022
You may have heard the shocking headline that 250,000 people die every year in the US due to misdiagnosis in the ER.

You may be even more shocked to know that this statistic is extrapolated from the death of...

just one man.

in a Canadian ER.

over a decade ago.
These shocking numbers are the results of a report published by the Agency for Health Care Research and Quality (AHRQ), reported in the NY Times this week:

nytimes.com/2022/12/15/hea…
But as it turns out, the methods used to arrive at these estimates are very, very bad.

Let's go through them and see why...
Read 42 tweets
Oct 29, 2022
Great thread here by @ENirenberg dissecting why the serious adverse events reported in the moderna vaccine study on kids is not as alarming as the FL state surgeon general is suggesting.

I would add two other quick points:
First, the vaccine group (N = 1761) was 3 times larger than the placebo group (N = 589). If you are comparing raw numbers of adverse events, you would expect there to be fewer in the placebo group simply because there are fewer kids overall in that group.
Second, as Ed already pointed out, the majority of these severe adverse events have a clear cause that is not the vaccine. When assessing vaccine safety, you don't just add up the number of severe adverse events and draw conclusions on that information alone.
Read 8 tweets

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