Benjamin Ryan Profile picture
Sep 25 10 tweets 4 min read Twitter logo Read on Twitter
In a bold new paper, three academics criticize how #longCovid has been studied. They say the term itself is so ill defined it should be discarded and that the studies have often been riddled with bias.
By: @VPrasadMDMPH @TracyBethHoeg @ShamezLadhani
🧵⬇️
ebm.bmj.com/lookup/doi/10.…
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#LongCovid prevalence, @VPrasadMDMPH @TracyBethHoeg @ShamezLadhani argue in @BMJ_EBM, has been over-estimated due to "overly broad definitions, lack of control groups, inappropriate control groups and other methodological flaws." This has caused "undue concern and anxiety." 2/ Image
The paper's authors define #longCovid as a syndrome or individual symptoms that are a direct effect of Covid lasting at least 12 weeks. But they advise others in their field to discard the term "and instead more narrowly define certain post-Covid syndromes or symptoms." 3/ Image
@VPrasadMDMPH, @TracyBethHoeg and @ShamezLadhani criticize four international health organizations, including the @CDCgov, @WHO and others, for not requiring a causal link between coronavirus infection and long Covid (aka post-acute sequelae of Covid-19, or PASC). 4/ Image
A review paper found that, of studies that looked at long Covid interventions, only 54% required that the members of the study have lab-confirmed Covid. One study found that self reporting LC was more strongly tied to a belief of having had Covid than a Covid diagnosis. 5/
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Long Covid, @VPrasadMDMPH, @TracyBethHoeg and @ShamezLadhani write, also suggests a permanent condition. However, there is good evidence that the associated symptoms do indeed improve over time. 6/ Image
@VPrasadMDMPH, @TracyBethHoeg and @ShamezLadhani criticize the lack of control groups in many #longCovid studies. 7/ Image
@VPrasadMDMPH, @TracyBethHoeg and @ShamezLadhani criticize many #longCovid studies for having what they characterize as inappropriately matched control groups. 8/ Image
@VPrasadMDMPH @TracyBethHoeg @ShamezLadhani suggest improvements to long Covid research:
Avoid: misclassification bias, selection bias, detection bias, confounding by underlying health, information bias, sampling bias and mischaracterization; and reduce diagnostic ambiguity. 10/ Image
This is one of the most stunning examples, if not the most egregious example, of someone with a doctorate exaggerating the threat of #longCovid and sowing fear and panic.

Ladies and gentlemen, I give you @fitterhappierAJ: Image

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More from @benryanwriter

Sep 25
People get very upset when they learn about older men pairing with younger women. What is driving this seemingly resurgent attitudes? Is it admirable protectiveness for vulnerable young women? Is it resurgent Puritanism? Who gets to decide where to draw the sexual boundaries? Image
Pundits have expressed disgust that Chris Evans, 42, has married the much younger Alba Baptista, 26. These attitudes come from the left. Does this mean that the left is expressing protection of women, or prudishness that runs contrary to sexual liberation? thenews.com.pk/latest/1113274…
Here we have the typical reactions gaining traction on Twitter to Dane Cook, 51, marrying a 24 year old. They accuse him of being a grooming pedophile.


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Read 5 tweets
Sep 7
A randomized controlled trial of 64 trans & gender-diverse adults, mostly in their 20s, gave them testosterone immediately or on a 3-month delay. At 3 months, the treatment group had lower gender dysphoria, depression and suicidality. 1/
jamanetwork.com/journals/jaman…
This study is a rare randomized controlled trial of transition treatment for trans people. However, it was small, with 64 participants, and the follow-up time was quite short, at 3 months. Also, it was in adults, not minors. So it does not provide direct insight into outcomes among children. 2/
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Of the 62 people analyzed, divided evenly into the treatment and delay groups:
*Depression improved by an average of 5.6 points on a 19-point scale in treatment v delay group
*Suicidality resolved in 52% of the treatment group, 5% of the delay group.
3/
jamanetwork.com/journals/jaman…
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Read 17 tweets
Aug 31
Tennis legend @Martina Navratilova doesn't mince words, referring to trans women as "male athletes who 'identify as women'" and insists that even with hormonal treatment they maintain performance advantages in women's sports. 1/
genspect.org/martina-navrat…
I'll post studies examining the competitiveness in sports of transgender women compared with cisgender women in the thread: "The 15–31% athletic advantage that transwomen displayed over their female counterparts prior to starting gender affirming hormones declined with feminising therapy. However, transwomen still had a 9% faster mean run speed after the 1 year period of testosterone suppression that is recommended by World Athletics for inclusion in women’s events." 2/
"In contrast, despite significant decreases in muscle cross-sectional area, lean body mass and strength after 12–36 months of hormone therapy, values remain higher than that in cisgender women...It is possible that transwomen competing in sports may retain strength advantages over cisgender women, even after 3 years of hormone therapy.” 3/
Read 6 tweets
Aug 23
A new study finds the annual number of gender-transition surgeries nearly tripled from 2016 to 2019. Curiously, in breaking down the data by age group, the authors made the youngest group 12-18 years old, not 12-17. So trends in minors are unclear. 🧵⬇️ jamanetwork.com/journals/jaman…
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The authors scoured multiple surgical databases. The findings remain limited by the possibility of under-capture of surgery data. They identified that from 2016-2020, 48,019 people received gender-transition surgeries, of whom 52% were 19-30 years old, 7.7% were 12-18. 2/ Image
The most common gender-affirming surgeries (GAS) were breast and chest surgeries (57%), followed by genital surgeries (35%). Breast/chest surgery was more common in younger people and genital surgery more common in older ones. 3/ jamanetwork.com/journals/jaman…
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Read 15 tweets
Aug 4
Michael Hobbes doesn’t understand the significance of the American Academy of Pediatrics agreeing to commission a systematic review of the evidence behind gender affirming care. 1) The AAP has resisted pressure to do so for years; 2) Other such reviews have undermined such care,… https://t.co/QL4EMKtT27 https://t.co/cKzB7jiSKItwitter.com/i/web/status/1…

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The AAP has also never responded to the scathing criticisms and fact check of the 2018 Rafferty statement in this 2019 paper by @JamesCantorPhD. By reaffirming the use of the statement, the AAP ignores these criticisms as a matter of policy. https://t.co/xUGz6Yhq8Tohchr.org/sites/default/…
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@JamesCantorPhD @RottenInDenmark Hobbes also misses the point with this statement. A central purpose of a systematic review is to asses the *quality* of the evidence. Other systematic reviews of transition care for kids have found the evidence is of low quality. https://t.co/g6T8GPvtjb
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Read 13 tweets
Aug 1
After the Covid vaccine came out, the adjusted excess death rate in Ohio and Florida was 43% higher among Republican voters compared with Democratic voters, this study found. There was no such gap based on political party before the vaccine. jamanetwork.com/journals/jamai…
@VPrasadMDMPH, meanwhile, says this study is no good:
@VPrasadMDMPH Here are the details of the JAMA study’s findings, from the abstract: https://t.co/Z94bciT7gljamanetwork.com/journals/jamai…
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Read 4 tweets

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