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Vinay Prasad MD MPH Profile picture
@VPrasadMDMPH
Jul 1 • 6 tweets • 2 min read Twitter logo Read on Twitter
Scrolly
New paper out in @JAMANetworkOpen @vkprasadlab
A SCOPING review of oncology meta-analyses

Of 21 studies w author funding from pharma, 17 (81.0%) were +
Of the 63 studies that did not have author or study funding from industry, 30 (47.6%) were +
🧵

https://t.co/PTlGDZfi7sjamanetwork.com/journals/jaman…
Interesting results by sponsorship
Some individuals are running meta-analysis factories
Fascinating, if you think about it
Multivariable analysis is interesting to me
How they handle heterogeneity is interesting to me as well.
Full paper is open access here
jamanetwork.com/journals/jaman…

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More from @VPrasadMDMPH

Vinay Prasad MD MPH Profile picture
Jun 17
Disgusting, unethical PLACEBO control trial in colon cancer just so Fruquitinib can win

I will show you that placebo should not have been the control arm, & the IRBs & FDA failed 🧵

First, this trial tests a new drug vs. placebo (sugar pill) in patients dying of colon cancer Image
Even against sugar pill; No one is cured, benefit is modest.

We are paying 200k/ yr for drugs like this
pubmed.ncbi.nlm.nih.gov/28290490/
What are we doing as a society?

But giving the control arm a sugar pill is unethical.
Here is why.... Image
1. Patients were all good performance status patients
AKA, they walk in your office, generally looking good, and ask for more options Image
Read 9 tweets
Vinay Prasad MD MPH Profile picture
Jun 8
This is so stupid. If you randomized neighborhoods to free n95 masks or nothing, nothing would be different in one week, one month or one year

There's no actual human behavioral data for forest fire n95.

Just empty signaling by people who don't understand behavior
You really have to be naive to think that people are going to wear this consistently enough to prevent long-term particulate inhalation.

Please try to study that so I watch your power calculation reveal your ignorance.
Many people not good at thinking about this. Pass out the masks in some locations and not others, and then randomly sample people and measure blood metabolites or whatever you want. You'll find no difference. The policy of the free masks will have no benefit. Just waste money
Read 4 tweets
Vinay Prasad MD MPH Profile picture
Apr 30
Here's what's under appreciated about Chat GPT paper🧵
PCP panel can be 2 to 5k
Doc in clinic 40 hours++ already
Doc not good at typing
Chat GPT can reply instantly
Chat GPT never fatigues
Can keep replying
Can reply day&night
Can read chart
Can type pleasantries, doc too busy 4
PCP may remember thousand people off the top of their head, but not 5k.
PCP's nearing total burnout
PCP is not paid for messaging
No one wants to be PCP already
Chat GPT is the first good news PCP has heard in a long time
Current system in busy practices is to have nurse take
First crack at replying
Soon it will be chat GPT, then nurse, then doc
I don't think Chat GPT will replace doctors
But doctors are drowning
Email and text messages particularly burdensome in ways verbal conversation is not
Read 16 tweets
Vinay Prasad MD MPH Profile picture
Apr 29
Most physicians and trainees consent to their own exploitation. The greatest exploitation is of time. Training is way longer than necessary. Medical school could be 2 years shorter, residency a year shorter, and even fellowship prolonged to keep big call pool. Junior faculty...
... are also mistreated with low pay. And no real potential for advancement. Entire system self-perpetuates by preventing trainees from seeing private practice opportunities as @jeff_sharman notes. To top it all off, system tries to add more years. Recently...
... I saw someone claim you need to do a heart failure year after internal medicine to be a heart failure hospitalist. You mean to tell me after 7 years of training, you still can't see the most common condition? 🤣 ..
Read 4 tweets
Vinay Prasad MD MPH Profile picture
Mar 26
Our LATEST in @JAMAInternalMed
FDA was aware of a SAFETY signal for Idelalisib in 2016. The drug remained on market till 2023!

Meanwhile trials failed & were halted, millions earned, & safety signal mounted.

Horrible @FDAOncology failure 👇
See 🧵
jamanetwork.com/journals/jamai…
The story of idelalisib began btw 2008 and 2014 when multiple, (mostly) uncontrolled trials led the @FDAOncology to approve the drug for CLL and FL based on shrinking tumors on CT scans and not living longer or better
Then in the years that followed, multiple trials had safety concerns, leading to a warning.
Read 15 tweets
Vinay Prasad MD MPH Profile picture
Mar 23
Just OUT @SSRN
By @KelleyKga, AH, @TracyBethHoeg @vkprasadlab

An Analysis of Statistical and Numerical Errors Made by the US @CDCgov

The errors are damning. Basic counts of dead kids, causes of childhood death.

Unacceptable incompetence 👇
papers.ssrn.com/sol3/papers.cf…
see 🧵
Here are the errors by year
2021
papers.ssrn.com/sol3/papers.cf…
2022
papers.ssrn.com/sol3/papers.cf…
Read 8 tweets

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