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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 8 Aug 2020

      8/n It is hard to know why the authors chose to use the terminology they did. It is entirely incorrect, but I'm not here to litigate intentions, only facts, and the fact is that this website is wrong Many, many times

      2 replies 4 retweets 66 likes
      Show this thread
    2. Health Nerd‏Verified account @GidMK 8 Aug 2020

      9/n Moving on, the authors classified countries into either HCQ or no HCQ How did they choose these groups? Well, long story short, it appears almost entirely arbitrary

      1 reply 4 retweets 57 likes
      Show this thread
    3. Health Nerd‏Verified account @GidMK 8 Aug 2020

      10/n Pretty much every single country was assessed in the same way - the authors cite a single (or maybe 2) news articles, and/or a tweet, to decide whether a country was in the intervention or control This is manifestly inadequate to actually define HCQ usagepic.twitter.com/4dMXFij3yA

      1 reply 5 retweets 59 likes
      Show this thread
    4. Health Nerd‏Verified account @GidMK 8 Aug 2020

      11/n There is no attempt to actually assess HCQ usage, despite this being SOMETHING YOU COULD DO You could look at HCQ doses given/purchases made in countries by date, for example Instead, the authors reference tweetspic.twitter.com/1QATjL1c0m

      2 replies 7 retweets 68 likes
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    5. Health Nerd‏Verified account @GidMK 8 Aug 2020

      12/n So right off the bat, any analysis is meaningless. We have no idea whatsoever whether people in the 'intervention' group ACTUALLY RECEIVED HCQ, making the calculations largely a waste of time But that's just the start of the errors here

      1 reply 10 retweets 65 likes
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    6. Health Nerd‏Verified account @GidMK 8 Aug 2020

      13/n Next, we can look at the analysis itself Or, rather, we can't, because the authors don't describe what they did, only giving relative risks and p-values

      1 reply 4 retweets 49 likes
      Show this thread
    7. Health Nerd‏Verified account @GidMK 8 Aug 2020

      14/n Without any description of the analysis whatsoever, we cannot trust a single number that is portrayed on this site, because the stats could be simply incorrect Impossible to know!

      2 replies 3 retweets 45 likes
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    8. Health Nerd‏Verified account @GidMK 8 Aug 2020

      15/n The authors then report using "controls" to adjust the estimates, but these controls are again incredibly misleading For example, country-level obesity ratespic.twitter.com/HGHc9md58T

      1 reply 3 retweets 36 likes
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    9. Health Nerd‏Verified account @GidMK 8 Aug 2020

      16/n The obesity rates are referenced to the CIA world factbook Problem is, this data was last entered in 2016, and often is cited to sources up to a decade old So it's really very out of date!

      2 replies 3 retweets 47 likes
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    10. Health Nerd‏Verified account @GidMK 8 Aug 2020

      17/n But forgetting that, this is a classic example of the ecological fallacy You CANNOT assume that country-level obesity rates apply to the people who got COVID-19 - if you don't check that this is true, whatever you produce is basically nonsensicalhttps://medium.com/@gidmk/why-you-might-be-wrong-about-covid-19-the-ecological-fallacy-e8a47a030902 …

      2 replies 5 retweets 53 likes
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      Health Nerd‏Verified account @GidMK 8 Aug 2020

      18/n On top of this, the outcome measure is terrible. There is no attempt to clarify whether the reported deaths from Our World In Data are correct for the country, simply the assumption that Algeria and France have comparable death reporting systems

      8:53 PM - 8 Aug 2020
      • 3 Retweets
      • 39 Likes
      • Dr. Julii Brainard Kelly Olga Leonenko  🇨🇦 Robin Marwick blah Ronnie (Wear a Mask!) Zwierz 🇨🇦 Kelly Grey Demosthenes Locke (((Dorit Reiss)))
      3 replies 3 retweets 39 likes
        1. New conversation
        2. Health Nerd‏Verified account @GidMK 8 Aug 2020

          19/n The ecological fallacy is at play in terms of death rates as well - deaths/million is a meaningless measure if you don't take infections into account!

          3 replies 3 retweets 39 likes
          Show this thread
        3. Health Nerd‏Verified account @GidMK 8 Aug 2020

          20/n In short, the website fails in every possible way: - not a trial - entirely observational - countless errors - numerically meaningless - arbitrary decisions

          3 replies 11 retweets 82 likes
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        4. Health Nerd‏Verified account @GidMK 8 Aug 2020

          21/n Again, I am not here to litigate people's intentions - I'll leave that to others - but I will say that this is remarkably similar to the trash science produced by tech bros in the first few weeks of March No understanding of the underlying issues at all

          2 replies 11 retweets 66 likes
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        5. Health Nerd‏Verified account @GidMK 8 Aug 2020

          22/n Whatever your opinion on HCQ - whether you are pro or for - you cannot conclude anything of value from this website It is misleading and wrong

          2 replies 6 retweets 60 likes
          Show this thread
        6. Health Nerd‏Verified account @GidMK 8 Aug 2020

          23/n The discussion section is also, it must be said, a sight to behold They defend their decision to use the term "country-randomized controlled trial" despite CONTRADICTING THEMSELVES (countries deciding is by definition NOT RANDOM)pic.twitter.com/CVmzKGNCoc

          1 reply 5 retweets 46 likes
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        7. Health Nerd‏Verified account @GidMK 8 Aug 2020

          24/n We already have a term for this kind of research - observational ecological study - so as I said, inventing a new term that is wrong is simply misleading. Just use the correct terminology if you're going to do something like this!

          1 reply 5 retweets 54 likes
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        8. Health Nerd‏Verified account @GidMK 8 Aug 2020

          25/n If nothing else, the most basic additions that would make the website slightly less worthless would be - details of statistical analysis - measure of HCQ CONSUMPTION by country - deaths BY INFECTION as the outcome - control for other govt measures to prevent COVID-19

          5 replies 4 retweets 52 likes
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        9. Health Nerd‏Verified account @GidMK 8 Aug 2020

          26/n Another point that's worth making - the authors say that HCQ is preventive of COVID-19 The methodology is not even vaguely close to what you'd need to know if that's true

          1 reply 5 retweets 41 likes
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        10. Health Nerd‏Verified account @GidMK 8 Aug 2020

          27/n You'd want to see case numbers by day, along with every intervention (i.e. social distancing, school closures etc) and the day they were implemented for every country on the list Then, number of HCQ doses given by day AT AN ABSOLUTE MINIMUM

          4 replies 3 retweets 45 likes
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        11. Health Nerd‏Verified account @GidMK 8 Aug 2020

          28/n Even if the authors make the suggested changes up until 25/n, they'd just end up with a meaningless correlation without measures like these, which are an enormous amount of work The thing about ecological studies is that the good ones take A LOT of time

          2 replies 7 retweets 41 likes
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        12. Health Nerd‏Verified account @GidMK 9 Aug 2020

          29/n Oh, another thing The authors keep maintaining on Twitter that this study was "random" because patients didn't choose what treatment they got, countries did This is absolute nonsense

          3 replies 4 retweets 43 likes
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        13. Health Nerd‏Verified account @GidMK 9 Aug 2020

          30/n Firstly, it is misdefining random If ANYONE chooses the treatment, then it's not random BY DEFINITION Random means no one chooses, it's that simple

          1 reply 4 retweets 45 likes
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        14. Health Nerd‏Verified account @GidMK 9 Aug 2020

          31/n But also - PATIENTS DID CHOOSE This is where we get back to the ecological fallacy - it is absurd to suggest that individuals within countries didn't choose to take HCQ. Even countries that authorised it had adopters and non-adopters

          3 replies 3 retweets 36 likes
          Show this thread
        15. Health Nerd‏Verified account @GidMK 9 Aug 2020

          32/n This protocol was BY NO POSSIBLE DEFINITION "random" Using the term is incorrect, and at best ignorant not just of the scientific terminology but also the colloquial meaning of the word

          4 replies 3 retweets 34 likes
          Show this thread
        16. End of conversation

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