The final large published trial on ivermectin for COVID-19, PRINCIPLE, is now out. Main findings:

1. Clinically unimportant (~1-2day reduction) in time to resolution of symptoms.
2. No benefit for hospitalization/death. Now, you may be asking "why does anyone care at all any more about ivermectin for COVID?" to which I would respond "yes"

We already knew pretty much everything this study shows. That being said, always good to have more data!

Fascinating study.

What's particularly interesting is a finding that the authors don't really discuss in their conclusion. These results appear to show that gender affirming care is associated with a reduction in suicide risk 1/n

https://twitter.com/segm_ebm/status/1758916991535194153

2/n The paper is a retrospective cohort study that compares young adults and some teens who were referred for gender related services in Finland with a cohort that was matched using age and sex. The median age in the study was 19, so the majority of the population are adults.

These headlines have to be some of the most ridiculous I've seen in a while

The study tested 18 different PFAS in a tiny sample of 176 people. Of those, one had a barely significant association with thyroid cancer

This is genuinely just not news at all Here's the study. I'm somewhat surprised it even got published if I'm honest. A tiny case-control study, they looked at 88 people with thyroid cancer and 88 controls thelancet.com/journals/ebiom…

A new study has gone viral for purportedly showing that running therapy had similar efficacy to medication for depression

Which is weird, because a) it's not a very good study and b) seems not to show that at all 1/n

2/n The study is here. The authors describe it as a "partially randomized patient preference design", which is a wildly misleading term. In practice, this is simply a cohort study, where ~90% of the patients self-selected into their preferred treatment sciencedirect.com/science/articl…

This is SO MISLEADING

The study showed that COVID-19 had, if anything, very few long-term issues for children! As a new father, I find this data very reassuring regarding #LongCovid in kids 1/n 2/n The study is here, it's a retrospective cohort comparing children aged 0-14 who had COVID-19 to a matched control using a database of primary care visits in Italy
onlinelibrary.wiley.com/doi/10.1111/ap…

This study has recently gone viral, with people saying that it shows that nearly 20% of highly vaccinated people get Long COVID

I don't think it's reasonable to draw these conclusions based on this research. Let's talk about bias 1/n 2/n The study is here. It is a survey of people who tested positive to COVID-19 in Western Australia from July-Aug 2022 medrxiv.org/content/10.110…

Long COVID remains relatively prevalent - about 3-6% of people report long-term symptoms right now

But a really interesting question is Long COVID INCIDENCE - i.e. your risk of getting LC if infected today

I think the data we've got is reassuring 1/n 2/n The best source on COVID-19 data is, I think, the Office for National Statistics (ONS) survey data in the UK

This data looks at the COVID-19 infection survey participants, a (now discontinued) national sample of people who reported having COVID-19 ons.gov.uk/peoplepopulati…

As someone who looks at data a lot, I don't trust anecdotes even a tiny bit

Why? Because people have AWFUL memories and get all of the facts wrong regularly People will swear blind that every patient treated with a drug did well, even though most of them died. They'll be absolutely certain that a surgery helped a person out, but the person will disagree

Another big study on #LongCOVID out. It's being reported as showing that Long COVID is really bad, even two years after the initial infection

I'm not so sure that's true 1/n

2/n The study is here. It is the newest in a long line of papers using the same database and methodology by the same authors, but this time they've got 2 years of follow-up to review the long-term impact of COVID-19 nature.com/articles/s4159…

This very weak ivermectin paper out, of course in Cureus, the journal that will publish literally anything

As far as I can tell, it hasn't changed much from preprint form I looked into this paper waaaay back in 2021. At the time, it was filled with obvious mistakes, and it doesn't appear to have improved since then

https://twitter.com/GidMK/status/1424525769242406915?s=20

In response to this article, people have been arguing at me that hydroxychloroquine works for COVID-19, you just have to "give it early"

This is a common myth. I thought I'd explain 1/n

https://twitter.com/GidMK/status/1689026844878835712

2/n Firstly, it's simply untrue to say that trials didn't give HCQ 'early'. The idea that early treatment would be more effective was taken seriously, and entire RCTs have been run to see if earlier administration of HCQ would have a benefit

This study has gone somewhat viral for suggesting that COVID-19 mRNA vaccines cause an increased risk of cardiac-related mortality

However, the paper has a fairly massive issue 1/n

https://twitter.com/tylerblack32/status/1688274450276663296

2/n The paper is here. It is a meta-analysis of self-controlled case series looking at mRNA immunization and the risk of future mortality. The authors found just three studies, and included just two of those in their cardiac model: tandfonline.com/doi/full/10.10…

Remember hydroxychloroquine?

Remember the French microbiology lab that did the awful initial research that was used to justify numerous dodgy COVID-19 cures?

We've got a new paper out looking at ethical issues with many papers from the institution 1/n https://t.co/eKCurWeby7…rchintegrityjournal.biomedcentral.com/articles/10.11…
2/n The institution, called the IHU Marseille, is already being investigated by the French government. They have also had serious issues revealed related to research integrity: timeshighereducation.com/news/concerns-…

Someone asked me to take a look at this study

I think it's a really interesting example of how Long COVID research is often all up to the interpretation

I find this data fairly reassuring! 1/n

https://twitter.com/EricTopol/status/1682788757001637893

2/n The study is here. It's a longitudinal assessment of cognitive ability in people who signed up to a COVID-19 Symptom Study. From a pool of 8k people, the authors got follow-up cognitive assessments on about 2k (~25%) thelancet.com/journals/eclin…

A few people have asked me for my opinion on this new large RCT on vitamin D for cardiovascular (heart) health

In general, it doesn't shift my opinions much on the utility of vitamin D as a treatment for anything - not much of a benefit The study is here. They randomized a large number of people to either take vitamin D for 5 years or a matched placebo. Compliance was reportedly decent, and in general it looks like a very good RCT bmj.com/content/381/bm…

The discussion about these IARC decisions is a bit ridiculous, so I thought I'd outline why I am still perfectly happy personally to drink aspartame (and do it regularly) 1/n

https://twitter.com/Reuters/status/1674309239974576128

2/n The IARC is an agency of the World Health Organization that looks into research on cancer. One of the main things they do is produce a list of substances classified by whether those things are likely to cause cancer in humans monographs.iarc.who.int/list-of-classi…

Invariably, people who think that facts win out in open debate have never actually had the experience of a discussion with someone who is more than happy to lie If you are debating live, you only have so much time to point out your opponent's errors. If you watch people who are really good at public debate, they pick one or two things their opponent said and argue that this is the entire basis of their argument (even when it's not)

This is just a deeply ridiculous opinion

Even if you believe that gender identity is a direct result of the expression of sex characteristics in society you STILL BELIEVE IN GENDER IDENTITY Having a term for a gender that matches sex is entirely consistent with every single naming system in science, it's not some buy-in to a grand conspiratorial belief system

Excellent article from @liammannix on what we still don't know about NPIs for COVID-19:

"When the next pandemic rolls around, we should know whether the stuff we’re being asked to do actually works."
theage.com.au/national/all-t… This is a very similar message to the one that @GYamey and I published in @TIME recently:

time.com/6252107/we-don…

Live debate is basically an ego contest

There is no ability to fact-check, no chance to review statements and refine them, just two people trying to see who can trip up their opponent the most

Complete waste of time if you're interested in the truth Being scientifically accurate and being confident on stage are two ENTIRELY different skills

Frankly, it's hard to be a good debater and a good scientist at the same time

I have no particularly strong opinions about the very hot debate about medical transition, but I came across this article and thought it might be useful to point out how quite a lot of the factual claims appear to be largely unsupported and/or wrong 1/n

https://twitter.com/segm_ebm/status/1667652975710597121

2/n The blog describes this recently-published paper: link.springer.com/article/10.100…

It's a perspective piece aiming to arm "clinicians with the latest information so they can support patients navigating the challenges of regret and detransition"