1/ This may be a case where a placebo is not needed/appropriate; I'm not expert enough about ALS, or this subtype, to judge.

But as a general statement, this is too quick.

🧵

https://twitter.com/ScottGottliebMD/status/1428353880996286464

2/ For starters, to my knowledge, there is no established efficacious treatment, so we can take noninferiority trials off the table as an option. That leaves us with the question of a single-arm trial, as @ScottGottliebMD suggests.

1/ The hints that single doses of the Pfizer/BioNTech & Moderna vaccine are protective are really important, & I'm glad @zeynep & @michaelmina_lab call for studying them. The case for comparing 2 doses to 1 dose plus placebo is compelling. nytimes.com/2020/12/18/opi… 2/ Ideal would have been for Pfizer & Moderna to invite participants in the placebo group to be randomized between 1 vs. 2 doses, but unfortunately that is not going to happen.

Not quite right, for several reasons.
1. I can't find the 35% figure in relation to 30 day mortality anywhere in the @DrMJoyner preprint. That (35% relative reduction in mortality) is reported at 7 days. 2. Crude mortality at 30 days was 26.7% for those who received CP 4+ days after diagnosis, vs. 21.6% for those who received it ≤3 days after diagnosis. This is a 19% relative reduction in mortality.*

This is a terrible story. It also highlights individual and philosophical links between the anti-vaccine and anti-covid-prevention forces that have important implications for public health (short thread).

https://twitter.com/KBibbinsDomingo/status/1270897845919346688

2/ The person who appears to have instigated the harassment against Dr. Quick is an attorney named Leigh Dundas.

https://twitter.com/jlmarr1622/status/1270918488840794112?s=20

I have collected a list of my favorite guides to aspects of academic life. Please @ me if you know of others that should be added (apologies in advance if, in the interest of parsimony, I don't include them all).
Link here: dropbox.com/s/e9t1o9n8kfnq… 2/ First up, a classic from Joe Simone, which has something for everyone from the most junior trainee to chairs and deans (and not just those who work in academic medicine). doi.org/10.1353/pbm.19…

1/ Reminds me of last July, when my 75 year old mother in law, living alone in Brooklyn & just back from visiting family in rural Northern California, checked herself into the ER of a @usnews top hospital in NYC.

https://twitter.com/hshanawaniMD/status/1121892356981252097

2/ She'd had >1 week of sleeping most of the time, rash, minimal oral intake, and severe all-over aches. The attentive doc at her local Brooklyn hospital had diagnosed her (wrongly, as it turned out, but no matter) with Rocky Mountain Spotted Fever, and prescribed doxycycline.

1/ Interesting & troubling @drewharwell story. Even assuming that these AI screens of social media are unbiased and valid predictors (a major assumption), they're still deeply problematic. Analogizing it to a screening test shows why. washingtonpost.com/technology/201… 2/ As with any test, there's a sensitivity/specificity tradeoff. If the algorithm is set to be very specific, it will let more false negatives through (i.e., will be more likely to give problematic babysitters a pass). That will make customers unhappy.

I tweeted earlier that @Carolynyjohnson's article in yesterday's @washingtonpost is the basis for a health policy course unto itself. Here's the syllabus, with references. cc @HankGreelyLSJU washingtonpost.com/graphics/2018/… /1 We are blessed to have amazing drugs and other therapies for many awful conditions. /2

FASCINATING analysis of the landscape of immuno-oncology trials, from @Annals_Oncology. h/t @nickhaining watermark.silverchair.com/mdx755.pdf?tok… Remarkable findings: >2000 agents, >900 in clinical stage, against 300 targets, from >800 companies.