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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 May 2020

      A lot of antibody surveillance results coming out at the moment, which gives us a chance to think about the fatality rate of #COVID19 But, there's a catch. Let's talk about right-censoring and why it's important 🧵

      16 replies 94 retweets 243 likes
      Show this thread
    2. Health Nerd‏Verified account @GidMK 18 May 2020

      The basic idea of right-censoring is simple: if someone leaves a study before their event happens, it's not counted and therefore the study's results are skewedpic.twitter.com/Fx2UNaZTas

      1 reply 8 retweets 62 likes
      Show this thread
    3. Health Nerd‏Verified account @GidMK 18 May 2020

      Say we want to know the impact of smoking on lung cancer. We take two groups of 20 year olds who do and don't smoke and follow them up for 5 years Say, 1,000 smokers and 1,000 non-smokers

      1 reply 5 retweets 39 likes
      Show this thread
    4. Health Nerd‏Verified account @GidMK 18 May 2020

      At the end of the study, 10 non-smokers and 11 smokers have developed lung cancer The difference is non significant statistically Does this mean that smoking isn't associated with lung cancer?

      1 reply 5 retweets 25 likes
      Show this thread
      Health Nerd‏Verified account @GidMK 18 May 2020

      Think about it - how many 30 years olds develop cancer by the age of 35? Might this make our study's results biased towards a conclusion?

      7:00 PM - 18 May 2020
      • 2 Retweets
      • 51 Likes
      • Hassan formerly known as Hussain The Meme Guy JP Enrica Croda Gerard Crotty #CareCantWait Guto Rossetti laura iskra BaoGiang HoangVu Alex Kaufman
      1 reply 2 retweets 51 likes
        1. New conversation
        2. Health Nerd‏Verified account @GidMK 18 May 2020

          The answer is...this study is probably wrong! If we extend the timeline, and look at the LIFETIME risk of smoking for 30 year olds, suddenly there's a HUGE increase in the risk of lung cancerpic.twitter.com/f0bZz5SfXq

          2 replies 7 retweets 58 likes
          Show this thread
        3. Health Nerd‏Verified account @GidMK 18 May 2020

          The problem is that initially, we stopped the clock BEFORE PEOPLE HAD THE OUTCOME WE ARE INTERESTED IN This meant that the difference - even though it was there! - was impossible to see in our data

          1 reply 7 retweets 72 likes
          Show this thread
        4. Health Nerd‏Verified account @GidMK 18 May 2020

          That's right-censoring in a nutshell If you stop counting results too early, suddenly your study has a significant bias (often towards low/no difference)

          1 reply 7 retweets 81 likes
          Show this thread
        5. Health Nerd‏Verified account @GidMK 18 May 2020

          What does this mean to antibody results for COVID-19? Well, think about how these studies are conducted. We test a bunch of people randomly on day x to get an idea of how many people are immune to COVID-19 on that day

          1 reply 6 retweets 44 likes
          Show this thread
        6. Health Nerd‏Verified account @GidMK 18 May 2020

          Then, to calculate mortality, most people take the number of deaths on day x and divide by the denominator implied by the results

          1 reply 5 retweets 42 likes
          Show this thread
        7. Health Nerd‏Verified account @GidMK 18 May 2020

          So, if we think 4% of 100,000 people have had COVID-19, and 10 of them have died on day x, we'd say that the infection-fatality rate is 10/4000 = 0.025%

          2 replies 7 retweets 38 likes
          Show this thread
        8. Health Nerd‏Verified account @GidMK 18 May 2020

          BUT there's an issue here People don't die from COVID-19 immediately. It usually takes somewhere between 15-20 days from when they get infected The data is right-censored!

          7 replies 13 retweets 81 likes
          Show this thread
        9. Health Nerd‏Verified account @GidMK 18 May 2020

          There are probably a bunch of people who HAVE the disease on day x who are counted in our sample and will die but haven't yet!

          1 reply 2 retweets 45 likes
          Show this thread
        10. Health Nerd‏Verified account @GidMK 18 May 2020

          So, what we SHOULD do in cases like these is either: a) use a statistical model to account for this issue b) wait a few weeks and use different death estimates to correct for potential right-censoring

          2 replies 5 retweets 69 likes
          Show this thread
        11. Health Nerd‏Verified account @GidMK 18 May 2020

          Instead, most people just take the proportion immune on day x and divide by deaths on the same day This will almost certainly underestimate the 'true' infection-fatality rate, and is a big worry

          9 replies 12 retweets 135 likes
          Show this thread
        12. End of conversation

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