Vinay Prasad MD MPH Profile picture
Aug 23 8 tweets 3 min read Twitter logo Read on Twitter
Here is the complete list of concerning COVID variants I am tracking 1/8 Image
And here is the list of precautions wise people are taking 2/8 Image
Here is all the evidence Paxlovid works in someone who has been vaccinated and/or had covid 3/8 Image
Here is all the relevant evidence to support the new fall booster 4/8 Image
Here is all the high quality data to support why you should keep masking 5/8 Image
And here is the list of smart people who still give a shit about COVID 6/8 Image
Here is a complete list of journalists who work at NPR or NYTimes who got COVID right. 7/8 Image
Finally, here is all the high quality evidence to support testing yourself when you feel sick 8/8 Image

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More from @VPrasadMDMPH

Jul 20
OUT NOW in @JAMAOnc
Led by great @pharmatinib

We calc. the cost of the PILL WASTE that happens when patients DOSE REDUCE or DISCONTINUE and throw out rest of bottle!

An entirely novel approach
tl;dr
For some drugs this is 10% of drug cost!

🧵 https://t.co/s8ue1Kyo7cjamanetwork.com/journals/jamao…
Image
Basically, cancer drugs come in certain size pills and have certain sized dose reductions if you have side effects

Also, lots of people have side effects

Ergo, the dose reductions take on a big role

We have written about this before
@Timothee_MD https://t.co/U1OfuGhzWlpubmed.ncbi.nlm.nih.gov/35830842/
Image
With that information and the drug price, (also since dose reduction is not always a clean fraction of the original pill, i.e. can it be split?).

we can estimate how much is lost from drug wastage

And it is a lot, depending on the drug Image
Read 8 tweets
Jul 1
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
Read 6 tweets
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
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
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
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

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