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Flavio Abdenur Profile picture
Flavio Abdenur
@AbdenurFlavio
Mathematician and data scientist. Analyses my own. Trolls, belligerents, and pains-in-the-ass will be blocked.
7 subscribers
Nov 10, 2021 • 6 tweets • 2 min read
Eric is 100% correct. Curiously, both antivaxxers and antitreaters use the “absolute risk reduction (ARR) of this vaccine / drug is low, so it’s not very effective” against their pet targets. It’s the *relative* risk reduction (RRR) that matters. If a vaccine RCT finds that there was say a 0.1% incidence of severe COVID in vax group and a 0.01% incidence in placebo group, then the AAR was “just” 0.09% (= 0.001 - 0.0001) but the vax actually reduced the incidence to a tenth of baseline: the RRR was 90% (= 0.0001/0.001 - 1)
Oct 28, 2021 • 19 tweets • 5 min read
Com muitos, muitos milhares de mortes de atraso, o imprensa brasileira *finalmente* começa a falar sobre tratamento de pacientes ambulatoriais (i.e., “precoce”) com fluvoxamina:

g1.globo.com/saude/coronavi… Aqui a versão publicada, no Lancet Global Health, do randomizado de fluvoxamina ambulatorial do Together. Redução relativa de deterioração clínica de 32%, com p-valor baixíssimo. No subconjunto que fez o tratamento completo, redução relativa de 66%:

thelancet.com/journals/langl…
Sep 28, 2021 • 7 tweets • 4 min read
@PaulSaxMD Here’s a plot of all pre-exposure prophylaxis HCQ RCTs, using “symptomatic covid” as an outcome. Pooled relative risk reduction of 21%, with a p-value of 0.02. @PaulSaxMD Here, as a robustness check, is the forest plot excluding Rojas-Serrano, which was an outlier (which favored the HCQ group): relative risk reduction of 20%, with a p-value of 0.028
May 29, 2021 • 69 tweets • 17 min read
1/ There are now about 20 randomized clinical trials (RCTs) of ivermectin for covid. They overwhelmingly show reductions in mortality, when used in adequate doses and in patients who are in early enough stages of the disease. 2 / The Kory et al review encompasses both observational and RCT data. It was published in early May in a peer-reviewed journal, the American Journal of Therapeutics, and is already the most-viewed paper in the journal’s history. It's also very readable.

journals.lww.com/americantherap… ImageImage
Apr 18, 2021 • 11 tweets • 4 min read
i. O NHS, que reúne os serviços de saúde do Reino Unido, endossou no dia 12 de abril o tratamento pré-hospitalar de covid com budesonida inalada off-label. Isso mesmo, tratamento precoce, aquele que "não existe".

england.nhs.uk/coronavirus/pu… ImageImageImage ii. A nota do NHS foi motivada pelo randomizado do STOIC publicado no Lancet Respiratory Medicine e pelo anúncio dos dados preliminares do randomizado PRINCIPLE (ambos conduzidos por pesquisadores da universidade de Oxford).
Mar 29, 2021 • 27 tweets • 9 min read
1/ Há uma campanha em andamento para proibir médicos de receitarem ivermectina e outros tratamentos pré-hospitalares para covid. Isso é completamente insano. Há farta evidência de eficácia e segurança de randomizados de vários tratamentos. 2/ Fluvoxamina: um observacional prospectivo (a - Seftel) e um randomizado duplo-cego (b - Lenze) no JAMA. Ambos indicando alta eficácia com efeitos colaterais irrisórios:

a - academic.oup.com/ofid/article/8…

b - jamanetwork.com/journals/jama/…
Feb 13, 2021 • 39 tweets • 7 min read
1/ Vamos ao que os dados dos desfechos *clínicos* dos randomizados de HCQ *ambulatorial* (i.e., pré-hospitalar) mostram

Na figura, efeitos relativos no eixo X e p-valores no eixo Y. Efeitos acima da linha horizontal cinza são benéficos. Dá pra perceber um padrão, né? 2/ O resumo em português claro: Conjuntamente, estes estudos abarcam alguns milhares de pessoas. Não houve efeitos colaterais sérios. Consistentemente, os grupos de HCQ se saíram clinicamente melhor (em torno de 20% melhor) do que os seus respectivos grupos de controle
Oct 9, 2020 • 26 tweets • 6 min read
1/ Here are the clinical outcomes of the outpatient RCTs avaliable so far. Relative reductions (of HCQ vs control groups) in Y axis, p-values in X axis. Includes both prophylaxis and early treatment RCTs. At this point there's enough data for metanalyses. Image 2/ Here's a spreadsheet with notes and the plot itself. Pay special attention to the "Notes" column in the "summary_table" sheet:

hcq-outpatient-rcts.s3.amazonaws.com/outpatient_hcq…
Aug 29, 2020 • 20 tweets • 4 min read
1/ Here are the relative effects (Y axis) and the p-values (X axis) found for all the 6 clinical outcomes measured by the 3 outpatient RCTs of HCQ for covid (Boulware, Skipper, Mitjà).

Positive Y is benefit, negative Y is harm

See a pattern? Image 2/ To spell it out: the treatment groups did better than the control groups, with p-values > 0,05, in all 6 clinical outcomes -- hospitalization, duration and severity of symptoms -- in the 3 published RCTs of HCQ for outpatients (Boulware NEJM, Skipper AIM, Mitjà CID)
Aug 22, 2020 • 9 tweets • 2 min read
1/ Matéria na Veja sobre a má interpretação dos dados dos estudos randomizados de hidroxicloroquina precoce para covid:

veja.abril.com.br/saude/especial… 2/ O grupo citado contém especialistas de primeira em diversas áreas. Esmiuçamos a literatura e os dados sobre o assunto há meses. As especialidades abrangem medicina, imunologia, trials clínicos, bioestatística e matemática. A minha é matemática e ciência de dados em especial.