This is an intriguing Q. A few hypotheses
1. Vax'd young healthy college kids have succumb to fear-mongering & have irrational worry about own breakthrough
2. This cognitive bias more common on Left, where most youth are... 1/5
3. Any student who protests is called ableist, eugenicist or white supremacist. Hyperbolic use of these terms is chilling for speech and demeans what these terms actually mean.
4. The culture of wanting to take retribution against someone for one little thing they said has reached an apogee, students want to take no risks.

No forgiveness and can poison job opportunities
5. Universities aren't doing as good a job in teaching analytical thinking skills as they used to.

6. Other ideas...?

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More from @VPrasadMDMPH

Feb 23
NEW Paper 2022! @vkprasadlab
Once again we analyze the use (& MISUSE) of the parachute analogy in biomedicine

This time we trace citations to the original BMJ 2004 paper & the Yeh remix!

Let me walk you through the paper..
[THREAD]
First, you need to know that a parachute has a huge effect size. Without one, falling from plane, u are sure but dead. With one, deaths are ~1 per 10 million jumps.

Effect size, ARR = 99.999....

AKA amazing. Such a huge effect size, you don't need any trial to know it works!
Second, know that many in medicine love to believe they have something just as good.

My chemotherapy drug -- it's a parachute
A cloth mask to prevent covid -- a parachute
The Impella or Aortic balloon pump - two parachutes
renal artery stenting - parachute
Read 17 tweets
Feb 21
Delighted to share visiting scholar's @Timothee_MD latest paper

We analyze a FDA failure: The rapid approval of "totally novel" Melflufen based on surrogate 👇

Followed by withdrawal b/c of increased deaths <8 mo later!

What is going on at FDA?
authors.elsevier.com/sd/article/S19…
First, of all there are many many treatment options, many many ongoing trials, and countless combinations already available to treat myeloma

Yes, we need new drugs, but we can wait for RCTs to show they extend survival, we don't need to use broken surrogates like response
Second, melflufen is like me-too melphalan, a drug used for decades.

The drug was approved based on uncontrolled response rate of 23.5%, but what if you just gave pts a different, older alkylator?
Read 9 tweets
Feb 20
Wow, the New York times has finally admitted 50% of the truth about kids & masks; conceding downsides & good outcomes in kids

One more year and they will admit that there is no evidence to show that masking kids slows viral spread.

Halfway there!
nytimes.com/article/mask-m… Image
I reviewed the evidence in July
medpagetoday.com/opinion/vinay-…
Read 5 tweets
Feb 17
Dazzling, daring, stunning piece by JH Russell and @DmpPatterson in @tabletmag tellin the true story of masking during COVID 👇

"The overselling of policies began in the early days of the pandemic with the problematic #masks4all movement...."
must read
🧵
tabletmag.com/sections/scien…
First, they are spot on. Many don't see it, but Trump is so influential, He sets the sides!

When he was for schools, Liberals lost their mind and worked to keep them closed; AAP did a bizarre flip flop & sided with unions to keep them closed.

And the same for masks 👇
Absolutely right again 👇

Inexperienced & naive twitter pundits kept saying the pandemic would vanish if we all worse a mask or n95 for 14, 21 days, a claim....

"neither true nor possible"
Read 20 tweets
Feb 11
Wow! 👇
secondary endpoint
potential for infinite looks at data
yet still, scant events (50?) of dubious clinical value (some asx?)
Plus other issues, including durability discussed in video

But postponing/ flip flopping is going to poison vax confidence

White house should not have pressured FDA on boosters
Gruber and Kraus should still be there
Politics cannot dictate vaccine approval
This is a total fiasco
This administration is doing serious, serious damage to vaccine confidence
The backlash will hurt a lot of people
States will get rid of good programs to encourage routine childhood immunization
Vaccines become even more political
This administration does not have a plan here
They should have awknowledged natural immunity
and tried for just 1 dose in people with no prior NI
Read 5 tweets
Feb 3
Lots of talk of wearing masks.
The policy question is: what happens when you advise people to:
Wear cloth masks
Wear surgical
Wear n95s

You have to combine mask properties with real world compliance

Ans:
No benefit
11% benefit in setting w no immunity & high bias rct
No trial
The 11% benefit should have an* because there is a serious risk of concealment being revealed in the study due to imbalance and study population by arm
If you pair this imbalance with the idea that people will be slightly less likely to report symptoms if they were enrolled on the margin. You have a big problem
Read 6 tweets

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