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GidMK's profile
Health Nerd
Health Nerd
Health Nerd
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@GidMK

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Health NerdVerified account

@GidMK

Epidemiologist. Writer (Guardian, Observer etc). "Well known research trouble-maker". PhDing at @UoW Host of @senscipod Email gidmk.healthnerd@gmail.com he/him

Sydney, New South Wales
theguardian.com/profile/gideon…
Joined November 2015

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    1. Health Nerd‏Verified account @GidMK 27 Aug 2018

      Firstly: what is an epidemiological trial? Most of the studies that are talked about this way are either case-control or cohort studies of some kind, but actually it covers pretty much all research done in humans outside of a lab

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    2. Health Nerd‏Verified account @GidMK 27 Aug 2018

      So we could be talking about a trial where the authors simply reviewed medical records or a randomized trial where they intervened I'm personally currently involved in both, and everything in between

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    3. Health Nerd‏Verified account @GidMK 27 Aug 2018

      Now, when we talk about issues with epidemiological research, there is one key word: Bias

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    4. Health Nerd‏Verified account @GidMK 27 Aug 2018

      Bias is essentially influences that could have impacted the study's results that were not accounted for in the studypic.twitter.com/RdQxn6o6wk

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    5. Health Nerd‏Verified account @GidMK 27 Aug 2018

      Key point here: IF SOMEONE IS NOT TALKING ABOUT BIAS, THEY ARE PROBABLY WRONG ABOUT THE STUDY

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    6. Health Nerd‏Verified account @GidMK 27 Aug 2018

      When you see people saying "this research is garbage" without elucidation of HOW and WHY the issue they've raised influences the results, they are talking nonsense

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    7. Health Nerd‏Verified account @GidMK 27 Aug 2018

      So, what is bias? There are many and varied types - I could spend another entire thread on just a handful - but the easiest way to think of it is anything that could've influenced the outcome

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    8. Health Nerd‏Verified account @GidMK 27 Aug 2018

      So, an example. This is the recent Virta Health trial that has attracted so much attention. If you aren't familiar with the research, you can find it here: https://link.springer.com/article/10.1007%2Fs13300-018-0373-9 …pic.twitter.com/X5SUDmYmdw

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    9. Health Nerd‏Verified account @GidMK 27 Aug 2018

      It's a great study to look at, because there are a truly wonderful number of potential sources of bias in the methods Note: I say POTENTIAL sources of bias for a reason. Generally, you can't tell definitively whether things have biased a study without access to the raw data

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    10. Health Nerd‏Verified account @GidMK 27 Aug 2018

      Our first example of potential bias: recruitment bias. It is possible - even likely - that these recruitment methods might have influenced the people enrolled in the studypic.twitter.com/O9CJwjCkfY

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      Health Nerd‏Verified account @GidMK 27 Aug 2018

      Why do you think this is?

      6:32 PM - 27 Aug 2018
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        2. Health Nerd‏Verified account @GidMK 27 Aug 2018

          Another potential source of bias: they allowed patients to self-select into treatment groupspic.twitter.com/vPI2Iah9Tw

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        3. Health Nerd‏Verified account @GidMK 27 Aug 2018

          Why is this a potential source of bias?

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        4. Health Nerd‏Verified account @GidMK 27 Aug 2018

          The answer to both polls is, of course, all of these things. Most potential sources of bias have many causes and indeed many impacts

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        5. Health Nerd‏Verified account @GidMK 27 Aug 2018

          Both of these sources of bias would likely make the treatment group appear better - if they did have an impact - and so reduce the strength of the study's results

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        6. Health Nerd‏Verified account @GidMK 27 Aug 2018

          HOWEVER it's important to remember that this is not true for all sources of bias What you need to look for is whether the bias applies equally to all groups, or unequally to one or more groups in the study

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        7. Health Nerd‏Verified account @GidMK 27 Aug 2018

          What do I mean by this? Well, here's an example from the recent study on carbs and health in the Lancet: reporting biaspic.twitter.com/ef2Q4Kw7Hg

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        8. Health Nerd‏Verified account @GidMK 27 Aug 2018

          We know that people under-report their food intake to medical professionals This is not surprising. No one likes to admit to their doctor that they aren't following the diet they're supposed topic.twitter.com/7MMFIzIlGe

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        9. Health Nerd‏Verified account @GidMK 27 Aug 2018

          But, AND THIS IS IMPORTANT, this reporting bias impacts every single person in the study in a similar way Thus, it shouldn't impact the results, except to potentially make them seem LESS meaningful than they actually are

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        10. Health Nerd‏Verified account @GidMK 27 Aug 2018

          If someone is bashing a piece of research, take a look at their arguments and think: "Is this really going to influence the results?" "Will it impact all groups equally?" "WHAT impact will it have?" These are all vital questions to answer

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        11. Health Nerd‏Verified account @GidMK 27 Aug 2018

          They are also important for you yourself if you want to know more about the research and its usefulness

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        12. Health Nerd‏Verified account @GidMK 27 Aug 2018

          This has been my brief thread on bias. If anyone's interested, let me know and I'll do another on different sources of bias or expand on this one

          2 replies 0 retweets 7 likes
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        13. End of conversation

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