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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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    Health Nerd‏Verified account @GidMK 8 Sep 2020

    Health Nerd Retweeted Health Nerd

    I thought I'd look at this paper in a little bit more detail because, well, there are some pretty big issues Let's do some peer-review on twitter!https://twitter.com/GidMK/status/1303539430024568832 …

    Health Nerd added,

    Health NerdVerified account @GidMK
    So, >80% of you people would either be pretty skeptical of a paper like this or wouldn't trust it at all Yes, it is indeed a real paper https://twitter.com/GidMK/status/1302857005531459584 … pic.twitter.com/iWFg5cEIdS
    Show this thread
    10:02 PM - 8 Sep 2020
    • 18 Retweets
    • 65 Likes
    • Kevin Harris Ryan Armstrong Gert van Dijk ⭕📡 Jake Kushner MD Brett Singer MS,RD,CSSD Mr. AC BavariaNephro Mykola Piotr Leski
    5 replies 18 retweets 65 likes
      1. New conversation
      2. Health Nerd‏Verified account @GidMK 8 Sep 2020

        The study is here: https://www.sciencedirect.com/science/article/pii/S0960076020302764?via%3Dihub#tbl0015 … Already up to an Altmetric of 2,543, the highest ever for the journal it's inpic.twitter.com/9GGjp7q8Gg

        2 replies 1 retweet 8 likes
        Show this thread
      3. Health Nerd‏Verified account @GidMK 8 Sep 2020

        The authors randomly assigned people to either get treatment as usual or calcifediol, which is a product of vitamin D metabolism, and then checked how many went into ICU or died in the two groups

        1 reply 1 retweet 5 likes
        Show this thread
      4. Health Nerd‏Verified account @GidMK 8 Sep 2020

        The findings were, to put it bluntly, astonishing Of the intervention group, only 1/50 patients went to ICU Of the control, 13/50 went to ICU, 2 of whom died So calcifediol reduced ICU admission by ~90%!pic.twitter.com/h9hSt4cL11

        3 replies 1 retweet 7 likes
        Show this thread
      5. Health Nerd‏Verified account @GidMK 8 Sep 2020

        However, it doesn't take long to see some major caveats to this research Firstly, it was not blinded. Treating clinicians - who were the ones in charge of sending a patient to ICU - knew who was getting the treatment and who wasn't

        2 replies 0 retweets 14 likes
        Show this thread
      6. Health Nerd‏Verified account @GidMK 8 Sep 2020

        There was also no placebo control, again introducing a potential source of bias into the arrangement On top of this, the sample was very small (n=76)

        1 reply 0 retweets 10 likes
        Show this thread
      7. Health Nerd‏Verified account @GidMK 8 Sep 2020

        Now, all of this is fine, because you see this was a PILOT trial The actual big research project is ongoing, and will involve >10x as many people!pic.twitter.com/cHPCo0z4P1

        1 reply 0 retweets 7 likes
        Show this thread
      8. Health Nerd‏Verified account @GidMK 8 Sep 2020

        But there are some issues in the study that don't have anything to do with the pilot nature For example, this flow diagrampic.twitter.com/J3c0GQSSQC

        1 reply 0 retweets 3 likes
        Show this thread
      9. Health Nerd‏Verified account @GidMK 8 Sep 2020

        This diagram implies that of the patients who were screened for the study (PCR+, pneumonia on radiograph, clinical infection) 100% were enrolled 100% of those patients were randomized 100% took the treatment as assigned 100% were followed up until the end of the study

        2 replies 0 retweets 7 likes
        Show this thread
      10. Health Nerd‏Verified account @GidMK 8 Sep 2020

        Now, I don't know if that is entirely unheard of, but thus far I have never seen such perfect numbers. Even other in-hospital trials of drugs for COVID-19 have a handful of patients drop out (or at least 1 patient screened who was not eligible!)

        3 replies 0 retweets 11 likes
        Show this thread
      11. Health Nerd‏Verified account @GidMK 8 Sep 2020

        Also, the control group had higher levels of hypertension and diabetes compared to the intervention group. This is acknowledged by the authors as a limitation, and is definitely not ideal when making conclusions based on the resultspic.twitter.com/XM3KjauodY

        2 replies 0 retweets 10 likes
        Show this thread
      12. Health Nerd‏Verified account @GidMK 8 Sep 2020

        It is entirely possible - perhaps even likely - that one of these potential sources of bias influenced the eventual results. A study like this would be rated as at a "very high" risk of bias in most formal assessments

        1 reply 0 retweets 7 likes
        Show this thread
      13. Health Nerd‏Verified account @GidMK 8 Sep 2020

        I think most scientists would just read this as a tiny pilot study, and await better data That's certainly my opinion - there are too many potential sources of bias here to make any solid conclusions

        1 reply 0 retweets 13 likes
        Show this thread
      14. Health Nerd‏Verified account @GidMK 8 Sep 2020

        Unfortunately, it is the age of COVID-19, so this study has instead gone viral on social media and is being used to recommend that people take vitamin D supplements Such is the way of 2020

        7 replies 0 retweets 18 likes
        Show this thread
      15. Health Nerd‏Verified account @GidMK 8 Sep 2020

        I should also mention that this is not in any way an indictment of the study's authors. This was clearly meant to be a pilot study, and should be read as such It is just a shame that people have instead sensationalized the research

        3 replies 1 retweet 29 likes
        Show this thread
      16. End of conversation

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