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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. Health Nerd‏Verified account @GidMK Apr 26

      11/n If you correct for this, instead of the percentages given in the results, you get much higher values for all the treatments, and a potentially reduced protective effect

      1 reply 2 retweets 25 likes
      Show this thread
    2. Health Nerd‏Verified account @GidMK Apr 26

      12/n Also, the study excluded people who already had COVID-19 antibodies at the start, but there isn't much information about these people, which is an issue given that they were excluded after already being randomized (and treated?)pic.twitter.com/yEXwne5m9a

      1 reply 1 retweet 31 likes
      Show this thread
    3. Health Nerd‏Verified account @GidMK Apr 26

      13/n Moreover, a full 20% of the sample was excluded because they were not from randomized floors, which is bizarre. How were they recruited, randomized, and apparently treated if they were not on randomized floors?pic.twitter.com/9okIdHU8zy

      2 replies 2 retweets 33 likes
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    4. Health Nerd‏Verified account @GidMK Apr 26

      14/n It seems very much like this trial was conceived, planned, AND RUN as a randomized parallel-arm trial and then halfway through switched to a cluster RCT

      2 replies 1 retweet 29 likes
      Show this thread
    5. Health Nerd‏Verified account @GidMK Apr 26

      15/n Ok, so that's all pretty worrying. The results may not be statistically viable, the methodology has quite a few flaws But there's actually a potentially bigger issue

      1 reply 2 retweets 23 likes
      Show this thread
    6. Health Nerd‏Verified account @GidMK Apr 26

      16/n The primary outcome reported in the trial was laboratory-confirmed (through either PCR or serology) COVID-19. This is the measure that the headline results is based onpic.twitter.com/R2Uj9MhpHc

      1 reply 1 retweet 27 likes
      Show this thread
    7. Health Nerd‏Verified account @GidMK Apr 26

      17/n But if we go to the pre-registration for the study (which, incidentally, doesn't talk about controlling for a clustered design), there's something a bit weird The primary outcome was originally "acute respiratory illness"pic.twitter.com/00efREicTD

      1 reply 1 retweet 29 likes
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    8. Health Nerd‏Verified account @GidMK Apr 26

      18/n So when the study was registered, in June 2020, the primary outcome was acute illness. A month after the final results came in, the primary outcome was changed to laboratory-confirmed COVID-19pic.twitter.com/bvnQFLBIc3

      2 replies 3 retweets 30 likes
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    9. Health Nerd‏Verified account @GidMK Apr 26

      19/n Moreover, the outcome that was registered in advance as the primary outcome has completely different results, showing a statistically significant effect for ivermectin but nothing elsepic.twitter.com/9uEHLguDRc

      1 reply 3 retweets 34 likes
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    10. Health Nerd‏Verified account @GidMK Apr 26

      20/n Now, there's nothing inherently wrong about switching outcomes, and the authors do mention a reason for changing it, but the fact that it was only changed after the study was finished is very strangepic.twitter.com/2S6fIGLb9G

      2 replies 1 retweet 31 likes
      Show this thread
      Health Nerd‏Verified account @GidMK Apr 26

      21/n The explanation in the text also doesn't quite make sense. The paper reports excluding people who had a positive serological test at baseline - how can these people have been tested if there were no serological tests when the study started?pic.twitter.com/I561MZ8JsA

      10:37 PM - 26 Apr 2021
      • 1 Retweet
      • 28 Likes
      • Nicolas Jacob Harry Hong Doremi Laura Brianna, DrPH MPH MGIS Cleber Tumoli Seidi Pedro Octávio, O Wishiful Thinking™ THEmonio A Dad who enjoys nerdy things
      1 reply 1 retweet 28 likes
        1. New conversation
        2. Health Nerd‏Verified account @GidMK Apr 26

          22/n So what does this all mean? Well, overall, it's quite hard to trust the trial's results

          1 reply 1 retweet 30 likes
          Show this thread
        3. Health Nerd‏Verified account @GidMK Apr 26

          23/n The study does not appear to follow the guidelines for implementation and analysis for cluster RCTs, which means that it's hard to know what to make of the analysishttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881078/ …

          1 reply 1 retweet 34 likes
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        4. Health Nerd‏Verified account @GidMK Apr 26

          24/n The primary outcome was also switched, with a bunch of other odd inconsistencies in the research that make it a bit hard to know if the conclusions hold water

          1 reply 0 retweets 25 likes
          Show this thread
        5. Health Nerd‏Verified account @GidMK Apr 26

          25/n To their credit, the authors talk about some of these things in the limitations section of the study, but not all of them and I'm not sure they really explain why these are not issuespic.twitter.com/KaUEJBj2ki

          1 reply 0 retweets 32 likes
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        6. Health Nerd‏Verified account @GidMK Apr 26

          26/n Anyway, I'm not sure I would rely on this study as evidence for much, despite the large size

          3 replies 0 retweets 31 likes
          Show this thread
        7. Health Nerd‏Verified account @GidMK Apr 26

          Health Nerd Retweeted Jason Kerwin

          27/n Apologies, one of the above tweets is wrong. The authors did indeed take into account the clustering in their statistical analysishttps://twitter.com/jt_kerwin/status/1386920483916947464?s=20 …

          Health Nerd added,

          Jason Kerwin @jt_kerwin
          Replying to @GidMK
          They do in fact analyze the data correctly, accounting for the clustered design: pic.twitter.com/gx0VbHjQ5p
          2 replies 2 retweets 34 likes
          Show this thread
        8. Health Nerd‏Verified account @GidMK Apr 26

          Health Nerd Retweeted Saloni

          28/n The more I read this paper, the weirder it sounds. So they randomized ineligible people (how?) from two floors that were not clustered, and then assigned them to vitamin C if the other medications were contraindicated?https://twitter.com/salonium/status/1386922872317247489?s=20 …

          Health Nerd added,

          Saloni @salonium
          Replying to @GidMK
          They sort of explain it here but it's pretty strange. They seem to be from the extra 2 floors, and only excluded from the primary analysis pic.twitter.com/aOpbBPNdxH
          2 replies 0 retweets 26 likes
          Show this thread
        9. End of conversation

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