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GidMK's profile
Health Nerd
Health Nerd
Health Nerd
Verified account
@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 22 Nov 2018
      Replying to @MichaelMindrum @KCKlatt @virtahealth

      Actually, not so much. None of the clinicians I know has so far been impressed with Virta, particularly after seeing the ~$6,000 AUD per year price tag

      1 reply 0 retweets 0 likes
    2. Michael Mindrum‏ @MichaelMindrum 22 Nov 2018
      Replying to @GidMK @KCKlatt @virtahealth

      If finance is concern then you need to run the numbers. What is the cost savings of insulin reduction/elimination, other medications, and then estimate decrease in T2d complications based on lowering a1c, ldl-p, bp, crp, etc. etc Suspect $6000 is very cost effective.

      2 replies 0 retweets 0 likes
    3. Health Nerd‏Verified account @GidMK 22 Nov 2018
      Replying to @MichaelMindrum @KCKlatt @virtahealth

      But we have no way of knowing if it's cost-effective. For that, we'd have to have an RCT comparing Virta to at least normal care (or ideally best-practice care), and create an incremental cost-effectiveness ratio. That's kind of the problem with running a flawed trial!

      2 replies 0 retweets 0 likes
    4. Michael Mindrum‏ @MichaelMindrum 22 Nov 2018
      Replying to @GidMK @KCKlatt @virtahealth

      Do you think virta’s cost saving estimates per patient are out of keeping with reality? It would be neat to see Virta type IT platforms serve as a delivery system of different well designed dietary interventions for RCT purposes. Lot of $$ would be needed to develop resources.

      1 reply 0 retweets 0 likes
    5. Health Nerd‏Verified account @GidMK 22 Nov 2018
      Replying to @MichaelMindrum @KCKlatt @virtahealth

      I'm not saying they're out of keeping with reality, but I would say that they are, similarly to the study, misleading, because it's a case of comparing Virta to another effective treatment, not care as usual/nothing

      1 reply 0 retweets 0 likes
    6. Health Nerd‏Verified account @GidMK 22 Nov 2018
      Replying to @GidMK @KCKlatt @virtahealth

      For example, we are currently applying for grant funding to run a trial similar to DiRECT, and our cost per patient/year including supplying all meal replacement and drugs comes out somewhere between 1/4 and 1/3 of the cost of Virta including study costs

      1 reply 0 retweets 1 like
    7. Health Nerd‏Verified account @GidMK 22 Nov 2018
      Replying to @GidMK @KCKlatt @virtahealth

      The current Virta economics are basically comparing Virta with their control - no treatment What would they look like if they were compared to another, cheaper, intensive lifestyle control program? There's one at the hospital I work at that's run at a fraction of the cost

      2 replies 0 retweets 1 like
    8. Health Nerd‏Verified account @GidMK 22 Nov 2018
      Replying to @GidMK @KCKlatt @virtahealth

      But all of this comes back to a really rigorous RCT! If we had such results, and cost data, we could know exactly how effective Virta is compared to the next best treatment Alas, we don't have this information, which is a big issue

      1 reply 0 retweets 0 likes
    9. Michael Mindrum‏ @MichaelMindrum 22 Nov 2018
      Replying to @GidMK @KCKlatt @virtahealth

      Has anyone looked at cost effectiveness as it related to CSIRO study? Seems that could give a satisfactory answer with regards to cost savings from med reductions in the low carb arm.

      1 reply 0 retweets 0 likes
    10. Health Nerd‏Verified account @GidMK 22 Nov 2018
      Replying to @MichaelMindrum @KCKlatt @virtahealth

      I don't think they looked at costs from memory, they used a combination medication score. They also didn't use Virta, I believe their model was less intensive. Also, the cost-benefit of a 0.3 reduction in medication effect score might not be very high

      1 reply 0 retweets 1 like
      Health Nerd‏Verified account @GidMK 22 Nov 2018
      Replying to @GidMK @KCKlatt @virtahealth

      Also brings it back to one of the big problems with Virta - they didn't test ketogenic diets! They showed a benefit for $6,000/year subscription services, but do you think there'd still be the same benefit if the ctrl arm had been given a low-fat version of Virta?

      8:27 PM - 22 Nov 2018
      1 reply 0 retweets 0 likes
        1. New conversation
        2. Michael Mindrum‏ @MichaelMindrum 23 Nov 2018
          Replying to @GidMK @KCKlatt @virtahealth

          I’m sure it would cost a lot of $ generating the educational materials needed to mirror the LCHF approach but would be a brilliant way to do a RCT and collect large amounts of data.

          1 reply 0 retweets 0 likes
        3. Michael Mindrum‏ @MichaelMindrum 23 Nov 2018
          Replying to @MichaelMindrum @GidMK and

          Health Nerd, have you wondered why investors/researchers/clinicians have not rushed in to set up a "low fat" co. with Virta's approach? Given low fat has been standard of care for decades in T2D, this business concept should be a no brainer if there was confidence in approach.

          1 reply 0 retweets 0 likes
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