Second, this thread especially grabbed my attention coming on the heels of yesterday’s @NIH_ORWH virtual conference on gaps in research about the health needs most particular to women orwh.od.nih.gov/research/2021-…
showing how much conditions that primarily affect women are grossly underfunded for research by the #NIH
Note: The y-axis is on log-scale. It’s probably worse than it looks
🧵5/ Symptoms of conditions as varied as ovarian cancer, Crohn’s, colon cancer, #fibroids, #endometriosis, etc. can be similar
When these symptoms happen to women, US culture is quick to shove them into the box of menstrual-symptoms-you-just-need-to-deal-with-on-your-own
🧵6/ Even a highly trained MD initially thought of the sudden changes she observed as likely due to menstrual & lifestyle symptoms that could be self-managed
🧵7/ A lot of this ambiguity is bc we haven’t invested the research resources in even characterizing the range of what healthy menstruation looks like versus more serious conditions
We can do better and produce more actionable info for providers and everyday people
🧵8/ And I haven’t touched on the healthcare access issues in @ShawnteJamesMD’s story
Another big issue
🧵9/ We also wrote a paper about the specific work that needs to be done to advance the epidemiology of gynecologic health. We need to know more, and we can know more. #gynhealth jech.bmj.com/content/75/4/3…
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In 2019, I was on a planning committee for a scientific conference. One of our duties was a “hot topics” session — a hard task when you’re planning a year in advance
We were trying to predict, What will be relevant & topical in epidemiology in 2020?
🧵1/ When we don’t get #SARSCoV2 transmission low, the most vulnerable - the old, the immunocompromised, the just plain unlucky whose bodies can’t mount a robust immune response to vaccines - they pay a high price
🧵2/ I know many people in US see #COVID19 primarily in personal terms. Their risk to others is not a main priority…
Others argue that the unlucky vulnerable should just “shield” themselves indefinitely, as if being old or sick means that you are no longer a social being
🧵3/ And others argue that the shortening of life for the old in particular is not that great a tragedy bc they would have died soon anyway*
🧵 1/ I really like the idea of “test to stay” in US K12 schools
There are actually several different policies called this, but a big one is testing to reduce K12 quarantines when a person/group is a close contact of positive case. I think that’s a great use of “test to stay”
2/ One confusion I see in comments on Dr. Mina’s post is people thinking of very sensitive PCR testing, which can pick up infections in days when people are no longer contagious
“Test-to-stay” typically uses Rapid Antigen Testing: RAT finds those who are actively contagious
3/ One drawback is there will be occasional false positives with widespread use of rapid antigen tests. So a fast, easy protocol for additional testing to confirm (or refute) positives needs to be in place
2/ Re: p-hacking: I was really lucky to learn about dangers of p-hacking/selective reporting/publication bias early when I took Charlie Poole’s meta-analysis class in my MSPH at @UNCSPHResearch
Seeing the funnel plot assymetry in study estimates was powerful!
3/ We even published this study 👇🏾 years later.
If I’d known how much work it was going to be, I may not have done it! But I was young & energetic & totally in love with Epi Methods 😍…
🧵2/n To my knowledge, my kids haven’t been infected with #SARSCoV2 - but I’ve accepted that they probably will at some point because of where we live (US)
🧵3/n So then my decision is whether I’d like that first infection to be in a naive immune system or in one already primed by vaccination for a quicker immune response
1/ This article does a good job presenting several foundational public health tenets that I’ve felt frustration at not communicating earlier and better:
A disease that hurts a small % of a huge population can hurt a LOT of people
Small increases in risk for a person can seem relatively inconsequential but still have big, longterm effects on a large group of people
3/ It’s a mind-bending way of thinking that I see people grappling w in real time re: COVID
That self-learning is cool to watch from a teaching & learning perspective but scary when critical decision-making depends on understanding the implications of this seeming contradiction