Appreciate authors of the 🇧🇩 RCT finally releasing raw data.

Dismayed at their topline conclusion on mask effectiveness that generated so much buzz

Out of ~340,000 ppl in mask and control arm.. the difference in symptomatic cases was 20 over 8 weeks.

benjamin-recht.github.io/2021/11/23/mas…
Brief summary for those interested. Bangladesh mask was a cluster RCT, (cluster because unit of randomization was a village) Treatment group had public policy intervention to increase use of masks, Control group was basically a poorly enforced govt. mask mandate)
Per pre-print 342,126 individuals in study. Endpoint was COVID 19 +ve symptoms AND positive antibodies.
Key Table shows of ~150k pts in each arm, blood samples could only be collect from ~5k patients in each arm.

poverty-action.org/sites/default/…
Unfortunately, nowhere in the paper is it noted how many of those tested were +ve for SarsCov2 Antibody. Weird. Since that is the primary endpoint.

This graph that made the rounds when the preprint came out? The #s used are coefficients from a model. They aren't 'real'
The raw data was finally released. @beenwrekt 'crunched' the data to find the elusive raw # of symptomatic positives in treatment and control arm.

So of the ~10k blood samples available . 1086 were +ve in the treatment arm, 1106 +ve in the control arm

gitlab.com/emily-crawford…
It would appear that the primary endpoint differs by 20 cases from the data provided. (Is poxXsymp the right column heading @Jabaluck ?).

One of the problems of the study is that despite the vast size of the study, the primary endpoint depends on ~5000 blood samples collected.
So we are left to extrapolate from a 20 case difference tested in ~10,000 patients to a 300,000 patient study.. which gets us to a discussion made for headlines --> A policy intervention that increased mask wearing 29%, reduces symptomatic Sars COV2 by 9%!
But how robust can this possibly be? It seems a bit much to go from these small differences to the police tracking down and fining people who don't mask in public.. (this from the author of the Bangladesh RCT)
I wish I could say most health policy was based on stronger sauce than this.. What's a billion here or there when the taxpayer foots the bill?
By the way, most of these incidents that the US Attorney General, and almost Supreme Court Judge Merrick Garland wants to make a federal crime involve face covering incidents.
I find it pretty disconcerting as well that disagreeing with the conclusions of the Bangladesh RCT is disqualifying in some way when arguing in court!

The judge should have asked for the raw data!

Statistical significance matters little when the outcomes isn't clinically significant. Especially relevant in very large trials when even small differences in 2 groups give highly statistically significant differences which may be clinically irrelevant.

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Anish Koka

Anish Koka Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @anish_koka

25 Nov
Again kudos to @beenwrekt for taking the trouble to find out what the raw numbers actually were in the Bangladesh mask RCT that’s been used in court to support school mask mandates.

The difference between the raw data and what was presented in the Preprint is striking 1/
Here is the verbiage from the study —> an 11% relative risk reduction in symptomatic seroprevalence with the treatment group that was given surgical masks, Image
The tables to support these words are here ..

The authors could have chosen to give us the actual raw numbers of symptomatic sero positives in treatment vs control, but instead we get interventional prevalence ratios and interventional coefficients ..

But they don’t. ImageImage
Read 7 tweets
23 Nov
Trying to make sense of all things COVID with @VPrasadMDMPH

What does Foucault have to do with COVID epistemology, you ask?

Listen to find out :)
The strongest case I’ve heard for vaccinating kids against COVID : @DrPaulOffit (Part 1)
accadandkoka.com/episodes/episo…
Important considerations for parents choosing to vaccinate their kids. Cody Meissner : Chief of peds ID, VRBPAC member.

Not as easy a decision as some would suggest..

accadandkoka.com/episodes/episo…
Read 7 tweets
17 Oct
I did appreciate the conversation, but it’s telling that one of the main data points @drsanjaygupta , chief medical correspondent @CNN ,chose to educate @joerogan on probably isn’t correct.

Here’s the citation/claim about COVID myocarditis cdc.gov/mmwr/volumes/7…
Pretty simple math : (myocarditis diagnosed / ppl with Covid) was found to be 16x higher than (myocarditis diagnosed / ppl without COVID)

But did the study get the denominator of people who had COVID right?
Ppl with COVID was based on those who received a diagnosis of COVID-19 in an encounter w/ the health system.

That mild cold the 5 year old had that u didn’t call anyone about?

Not included in the denominator per this CDC reported.
Read 19 tweets
28 Sep
In order to be a vaccine provider in philly, months long application process, hours of webinar (mid-day), upload vaxx administered, wasted, in stock to 2 different websites every 24 hours, unpredictable allocation from local DOH, 30 day expiration in a -4 fridge. 1/
After we vaxxed everyone who wanted vax in the practice, walked to almost every business <1mile, street cleaning crews, random passerby’s etc .. declining demand / reg. requirements made it 2 hard to maintain vax stock.
Federal allocation schemes that have wide popular support generally favor big players that can navigate regulatory thicket, grease the right wheels to get early disbursements of product, (and make a small killing doing it)
Read 4 tweets
11 Sep
Lots of great discussion about myocarditis and how its defined In a recent preprint from authors (pictured below)

medrxiv.org/content/10.110… Image
In this preprint , the VAERS database was interrogated for anyone given a diagnosis of myocarditis/pericarditis/myopericarditis/chest pain AND appears to require an abnormal very sensitive blood marker of cardiac damage (troponin) Image
A few bites about the VAERs database. It was legislated into existence via the National Childhood Vaccine Injury Act (NCVIA) in 1986, which was a mechanism to shield vax manufacturers from litigation related to potential adverse events after getting vaccinated
Read 27 tweets
6 Sep
Increasingly difficult to break through to many patients skeptical of recommendations seen coming from the medical establishment or through the mainstream media 🧵
Why is there a growing segment of the population that doesn’t believe experts/media ? Let’s start with a tragic non-med story of the last week.

Here’s the @AP account on a drone attack & what comes to light after someone actually investigates.

Everyone now knows about the fake ivermectin overdoses flooding ER story.

Journalists clearly know the headlines their audience will lap up — almost anything that will paint the half of the country that didn’t vote with them in a bad light will do
Read 10 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Thank you for your support!

Follow Us on Twitter!

:(