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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 18 Mar 2019

      Health Nerd Retweeted CNBC

      The reporting of this new Apple Watch study is not great - 0.5% rate of atrial fibrillation in the study (HUGE PROBLEM) - 34% positive predictive value in real-world conditions (rarely correct) - 71% PPV in ideal clinical conditions - watch mostly useless clinicallyhttps://twitter.com/CNBC/status/1107856005097054211 …

      Health Nerd added,

      CNBCVerified account @CNBC
      Apple’s groundbreaking heart study signals a new era of medicine, and doctors are debating the results https://cnb.cx/2TU3qIv 
      7 replies 68 retweets 101 likes
      Show this thread
    2. Health Nerd‏Verified account @GidMK 18 Mar 2019

      Let's think about this a bit. What does a 34% positive predictive value mean?pic.twitter.com/RfQQfiBfBX

      1 reply 0 retweets 5 likes
      Show this thread
    3. Health Nerd‏Verified account @GidMK 18 Mar 2019

      The basic idea is that, of the 450 people who had a warning for AF in the study AND got this confirmed with an actual EKG, only 34% actually had AF THIS IS NOT GREATpic.twitter.com/1snetnaQkE

      1 reply 0 retweets 7 likes
      Show this thread
    4. Health Nerd‏Verified account @GidMK 18 Mar 2019

      (Smart readers might note that this means that, in a sample of 420,000 PEOPLE, the Apple Watch correctly diagnosed just ~150 with AF which is PRETTY DAMN BAD)

      1 reply 1 retweet 7 likes
      Show this thread
    5. Health Nerd‏Verified account @GidMK 18 Mar 2019

      Now, in an unspecified sample of other people who wore both the Apple Watch and a continuous EKG, the prediction was better - 71% We have no idea if this is meaningful, because there's no sample size, which brings us to another issue here

      2 replies 1 retweet 5 likes
      Show this thread
    6. Health Nerd‏Verified account @GidMK 18 Mar 2019

      None of this research is published yet I honestly can't believe I have to say this, but if you're reporting on a study that you can't read you should be VERY SKEPTICALpic.twitter.com/pnvYns380n

      2 replies 0 retweets 23 likes
      Show this thread
    7. Health Nerd‏Verified account @GidMK 18 Mar 2019

      Anyway, in ideal conditions 71% of people who the watch said had AF actually had the condition Interesting, but largely unimportant A much more interesting figure is that, even in the best of conditions, 29% of people the watch said had AF probably didn't

      1 reply 1 retweet 8 likes
      Show this thread
    8. Health Nerd‏Verified account @GidMK 18 Mar 2019

      Without knowing the NPV, it's not possible to calculate the false positive rate, but given the information we have it's likely to be pretty high

      1 reply 0 retweets 6 likes
      Show this thread
    9. Health Nerd‏Verified account @GidMK 18 Mar 2019

      Health Nerd Retweeted Health Nerd

      And coming back to the original tweet, that's a really big problem because the population prevalence of AF in people who wear Apple Watches is very lowhttps://twitter.com/GidMK/status/1107871498667094016?s=19 …

      Health Nerd added,

      Health NerdVerified account @GidMK
      The reporting of this new Apple Watch study is not great - 0.5% rate of atrial fibrillation in the study (HUGE PROBLEM) - 34% positive predictive value in real-world conditions (rarely correct) - 71% PPV in ideal clinical conditions - watch mostly useless clinically https://twitter.com/CNBC/status/1107856005097054211 …
      Show this thread
      1 reply 0 retweets 5 likes
      Show this thread
    10. Health Nerd‏Verified account @GidMK 18 Mar 2019

      Without delving too far into the specifics, if you're screening large populations for a disease and only a few of them have it, your test has to be NEAR PERFECT Being wrong 29% of the time does not qualifypic.twitter.com/eluDH0aOBZ

      2 replies 2 retweets 11 likes
      Show this thread
      Health Nerd‏Verified account @GidMK 18 Mar 2019

      And on top of this all - something that NO ONE SEEMS TO MENTION ANYWHERE - is that AF screening >65 years is currently not recommended because we are unsure of the risks/benefits https://bjgp.org/content/67/660/296 …pic.twitter.com/q24z1MTL7o

      10:38 PM - 18 Mar 2019
      • 1 Retweet
      • 14 Likes
      • calvin tan Nick Genes Hollie Todd Cameron AZ x2 💥💪 司徒 Ben Harris-Roxas Paula Burnley
      1 reply 1 retweet 14 likes
        1. New conversation
        2. Health Nerd‏Verified account @GidMK 18 Mar 2019

          What about those <65 years? We haven't even looked at the question properly, because the population prevalence is so low that most epidemiologists agree it'd be a pointless waste of timepic.twitter.com/m6cOP1I9yC

          1 reply 0 retweets 8 likes
          Show this thread
        3. Health Nerd‏Verified account @GidMK 18 Mar 2019

          So on the one hand, we've got the Apple Watch study saying that the watch is pretty useless clinically On the other, we've got a dubious rationale for doing this in the first place and no demonstrated benefit And yet, the headlinespic.twitter.com/20e8PbkiLY

          1 reply 1 retweet 10 likes
          Show this thread
        4. Health Nerd‏Verified account @GidMK 18 Mar 2019

          (I'd like to point out that, in a wonderful twist, the Daily Mail has one of the best articles out on this all https://www.dailymail.co.uk/news/article-6816853/Apple-Watch-spot-heart-problem-research-needed.html …)

          1 reply 0 retweets 8 likes
          Show this thread
        5. Health Nerd‏Verified account @GidMK 18 Mar 2019

          Anyway, Apple is apparently doing a proper RCT looking at true clinical risk/benefit, so until those results are formally published and I can pick them apart I'm staying skeptical that this is anything interesting at all

          1 reply 2 retweets 12 likes
          Show this thread
        6. End of conversation

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