It's amazing we made children as young as 2 wear a mask that has no evidence of benefit for prolonged periods of time, inflicting harm without upside.

Total policy failure, I wrote about it for the Atlantic months ago and MedPage before that

google.com/amp/s/amp.thea…
The fact nearly no one would say that the AAP and CDC were off their rocker to defy the World Health Organization and UNICEF to push this foolish recommendation down to 2 will be a shameful blemish on their reputations, I doubt they will recover in next 25 yrs.
Data from Spain, of regression discontinuity design, showed it did not work months ago. Sadly CDC pushed embarrassingly flawed studies in MMWR to defend their failed policy instead.

See Zweig, Atlantic.
Don't forget the 2-4 year olds took the mask off to nap for 2 hours a day in the same room, so even someone with minimal training in evidence appraisal could recognize it was pointless.

• • •

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

Keep Current with Vinay Prasad, MD MPH 🎙️📷

Vinay Prasad, MD MPH 🎙️📷 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 @VPrasadMDMPH

23 Dec
Our new @vkprasadlab article is now out in Cancer Reports

We tackle the frequency (spoiler alert: BRISK) of assessment of progression in RCTs of cancer drugs

Want to learn more?
onlinelibrary.wiley.com/doi/epdf/10.10…
[thread]
First, remember that progression free survival is a time to event, composite endpoint

It is typically the time until 1 of 4 things happen
Death, New lesions, Growth (without shrinkage) or Growth (from Nadir).

Watch my free lecture series to learn more:
As a result PFS is binned

It has a stair-step pattern b/c imaging is assessed not continuously, but at pre-specified time points
Read 8 tweets
23 Dec
Our new paper is now out in European Journal of Cancer

We analyze 55 cancer drugs that target genomic abnormalities & assess the evidence

Only 24% reported an improvement in survival 👇

A seductive mechanism of action apparently means low levels of evidence

[thread]
Modern oncology has several classes of drugs
Cytotoxic drugs
Checkpoint inhibitors
CAR-T therapies
General targeted drugs &
Drugs that target specific cancer genomic abnormalities
(Genome drugs!)
Genome drugs get outsized attention; Previously we found that (best case scenario) 13% of US cancer patients were eligible for these drugs; leaving 87% not eligible

pubmed.ncbi.nlm.nih.gov/33862157/
Read 10 tweets
21 Dec
In our new paper in @JAMANetworkOpen we take a deep look into cost-effectiveness (CEA) studies of cancer drugs

Bottom line: If a CEA study is funded by pharma, it is 40x (OMG!) more likely to find the drug is cost effective

A 🧵 explaining what we found
jamanetwork.com/journals/jaman…
For every cancer drug indication approved between 2015-20, we searched for cost-effectiveness studies

we found between 0 and 9 per drug!!

Some trials were industry sponsored & others neutral
Here are the baseline characteristics of the studies we looked it.

Only 1/2 to 2/3 of drugs have even shown they improve survival

The rest have unknown effects on survival

That is not good enough

It is FDA failure! (these days that's common)
Read 8 tweets
19 Dec
Our new paper in @EJCI_News argues that Randomized trials are necessary in medicine & PH for interventions w putative benefit & at best MED to LG effect size.

Parachutes & smoking are not good counter examples

Here is the explanation 🧵
onlinelibrary.wiley.com/doi/abs/10.111…
Some people argue that b/c we did not need RCTs to know smoking is harmful or Parachutes are life saving, we don't need them to test cloth masking, or the Impella, or some new cancer drug, or HCQ, or <insert ur favorite practice>

But this is based on misunderstanding
There is a huge range of things we can do to someone that might hurt them or save them, imagine the spectrum (below)

Let's start on the harms side
Read 14 tweets
18 Dec
Swimmers, Spider, & Waterfall Plots are everywhere in Oncology

Led by @mlythoe & Olivier
We offer an improvement in our new paper
The Iceberg Plot

Let me explain why it is preferable & teach you about all 4....
[Tweetorial]
ejcancer.com/article/S0959-… Image
All other plots we use in oncology
Tell you what happens AFTER you start the protocol

A swimmers plot shows when treatment was given, and when response and progression occurred for each individual Image
A spider plot shows the tumor size for each patient, every time they were assessed, over time. Image
Read 11 tweets
16 Dec
Now out in @EJCI_News
Logan Powell & I show where randomized trials necessary

When people say 'we don't need an RCT of smoking (to prove harm) or parachutes (to prove benefit)' does that apply to widespread medical interventions?
🧵
onlinelibrary.wiley.com/doi/10.1111/ec…
2
Read 4 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

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!

:(