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.
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.
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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
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
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)
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…