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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. MEmilitant‏ @MEMilitant1 11 Apr 2019
      Replying to @GidMK @Students4BE

      Moderate-low? My understanding was that non-blinding; A vs A+B design; cognitive aspects to treatment; and subjective self-report outcomes of this sort; are almost definitive examples of a high-risk of bias: https://handbook-5-1.cochrane.org/chapter_8/table_8_5_d_criteria_for_judging_risk_of_bias_in_the_risk_of.htm … https://handbook-5-1.cochrane.org/chapter_8/8_11_2_assessing_risk_of_bias_in_relation_to_adequate_or.htm … https://drive.google.com/file/d/1pbkUAco17D0lVziiVeUTuvaBME7dACmD/view …

      1 reply 0 retweets 0 likes
    2. Health Nerd‏Verified account @GidMK 11 Apr 2019
      Replying to @MEMilitant1 @Students4BE

      Not sure what you mean by cognitive aspects to treatment, but not necessarily. As I said, RoB assessment can be a bit subjective, but as an example it's literally impossible to blind to CBT, but within that constraint the study was very rigorous, so I'd put it as a "probably no"

      1 reply 0 retweets 0 likes
    3. Health Nerd‏Verified account @GidMK 11 Apr 2019
      Replying to @GidMK @MEMilitant1 @Students4BE

      Similarly, subjective measures are pretty difficult to use in a study like this. I can't think of any that are feasible to collect, although happy to be proven wrong. The study did, however, use a large number of subjective measures, all of which improved. So again "probably no"

      1 reply 0 retweets 0 likes
    4. Health Nerd‏Verified account @GidMK 11 Apr 2019
      Replying to @GidMK @MEMilitant1 @Students4BE

      If I was to put it all into the RoB 2 calculator it would probably come up with "Some risk of bias", so moderate most likely. Then a judgement call - it's about as rigorous as a study could be on this topic - to say that it's probably moderate-low

      1 reply 0 retweets 0 likes
    5. MEmilitant‏ @MEMilitant1 11 Apr 2019
      Replying to @GidMK @Students4BE

      re cognitive aspects. eg:That participants knew they were being encouraged to adopt cognitive strategies emphasising a sense of control, etc, make it difficult to judge that lack of blinding was unlikely to have on influence on self-reports on how IBS interferes with their life.

      1 reply 0 retweets 0 likes
    6. MEmilitant‏ @MEMilitant1 11 Apr 2019
      Replying to @MEMilitant1 @GidMK @Students4BE

      For 4.5 of RoB 2 they give "patient-reported symptoms in trials of homeopathy" as an example of an outcome where knowledge of intervention received would be likely to influence assessment of outcome. Why do you think this would be less of an issue with CBT?

      1 reply 0 retweets 0 likes
    7. Health Nerd‏Verified account @GidMK 11 Apr 2019
      Replying to @MEMilitant1 @Students4BE

      ? Not what I said. I said this study controlled for that by using quite a wide variety of self-reported measures. Given that it's impossible to assess IBS objectively, that's likely the best you can do

      1 reply 0 retweets 0 likes
    8. MEmilitant‏ @MEMilitant1 11 Apr 2019
      Replying to @GidMK @Students4BE

      So0rry if I misunderstood, but if you agree 4.5 is 'yes', then isn't it necessarily a high-risk of bias? That was the only section where I thought we might be disagreeing. For overall risk of bias, trial classed as 'high risk' even if only one domain is high risk.

      1 reply 0 retweets 0 likes
    9. Health Nerd‏Verified account @GidMK 11 Apr 2019
      Replying to @MEMilitant1 @Students4BE

      Apologies, I'm getting confused with the new tool. The answer would be that they used patient-reported outcomes, but whether that indicates a high risk of bias is a judgement call, and I'd say no in this case due to the things I've mentioned

      1 reply 0 retweets 0 likes
    10. MEmilitant‏ @MEMilitant1 11 Apr 2019
      Replying to @GidMK @Students4BE

      "Is it likely that assessment of the outcome was influenced by knowledge of intervention received?" with patient-reported symptoms in trials of homeopathy given as example of 'yes', & you'd answer 'no' for this CBT trial relying on subjective self-report? I don't understand why.

      2 replies 0 retweets 0 likes
      Health Nerd‏Verified account @GidMK 11 Apr 2019
      Replying to @MEMilitant1 @Students4BE

      No it is certainly likely that the assessment was influenced. Whether this biases the study, however, is another question, and that's the point. They implemented a number of controls to reduce this bias, so I'd argue that it's not a high risk

      3:39 PM - 11 Apr 2019
      1 reply 0 retweets 0 likes
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        2. MEmilitant‏ @MEMilitant1 11 Apr 2019
          Replying to @GidMK @Students4BE

          But if you agree assessment was likely influenced then following RoB2 you necessarily get a high risk of bias in that domain. I'm not so impressed by their other controls to reduce bias, but subjective judgements on that are outside of this assessment tool anyway.pic.twitter.com/N71k4eBTat

          1 reply 0 retweets 0 likes
        3. Health Nerd‏Verified account @GidMK 11 Apr 2019
          Replying to @MEMilitant1 @Students4BE

          Mmm that's the default, but as I said RoB assessment isn't a hard rule. Look at the sentence underneath the title of that graphicpic.twitter.com/ZhtiXjh7bq

          1 reply 0 retweets 1 like
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