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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 Jun 21

      10/n For example, the Elgazzar study. Low or uncertain risk for every element To me, this study is at a pretty high risk of bias!pic.twitter.com/9vfUArgcfE

      1 reply 3 retweets 31 likes
      Show this thread
    2. Health Nerd‏Verified account @GidMK Jun 21

      11/n Randomization sequence generation is rated at low risk, but here's the information we have on randomization. It contradicts the protocol, which isn't great (they should've had 6 groups, not 2)pic.twitter.com/6C1BKGFvwd

      2 replies 3 retweets 27 likes
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    3. Health Nerd‏Verified account @GidMK Jun 21

      12/n Allocation concealment is rated as low risk, but as far as I can tell from the study there's no information on how the allocation sequence was kept concealed except for those two sentences 🤷‍♂️

      1 reply 2 retweets 26 likes
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    4. Health Nerd‏Verified account @GidMK Jun 21

      13/n Technically there's no attrition bias because the authors report 100% follow-up data, but that in and of itself is weird. Usually you get at least a few dropouts!

      1 reply 5 retweets 34 likes
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    5. Health Nerd‏Verified account @GidMK Jun 21

      14/n I could go on. Suffice to say that my assessment of this study would place it at moderate to high risk of bias, especially considering that it's really quite short and there's a fair bit of important information missing

      2 replies 5 retweets 38 likes
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    6. Health Nerd‏Verified account @GidMK Jun 21

      15/n Worth noting that I don't disagree with the assessment for every study - I had a detailed read of Mahmud (2020) and it looks like a very well-done piece of research at a low risk of biaspic.twitter.com/Esr9s7DnC9

      3 replies 2 retweets 34 likes
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    7. Health Nerd‏Verified account @GidMK Jun 21

      16/n Another weird one is Niaee - on the risk of bias table, it looks pretty decent, but there are some really odd holes in the studypic.twitter.com/g0woK9ZPmF

      1 reply 1 retweet 21 likes
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    8. Health Nerd‏Verified account @GidMK Jun 21

      17/n For example, this was a randomized study of ivermectin for COVID-19, but they included people who were clinically positive and PCR-negative And somehow, the proportion of PCR negatives in the control group was far higher than in the intervention (47% vs 20%) 👀👀pic.twitter.com/MtZGuumDpP

      3 replies 5 retweets 39 likes
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    9. Health Nerd‏Verified account @GidMK Jun 21

      18/n If the study had a MUCH bigger proportion of people who had PCR +ve COVID-19 receiving the intervention, that's not a great sign wrt the allocation concealment procedures (which aren't that well described either)

      1 reply 1 retweet 25 likes
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    10. Health Nerd‏Verified account @GidMK Jun 21

      19/n This sort of finicky examination is where it gets really, really tough, because like I said, it's a bit subjective. I don't really care either way about the studies included, but people can (and probably will) disagree

      1 reply 1 retweet 20 likes
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      Health Nerd‏Verified account @GidMK Jun 21

      20/n That being said, I quickly redid the meta-analysis excluding these two quite weird studies, and the results completely change, with no significance at all (RR 0.72, 0.41-1.25) Make of that what you willpic.twitter.com/8ucUe40gq3

      5:57 PM - 21 Jun 2021
      • 13 Retweets
      • 75 Likes
      • two for us 💙 Heart Bridge Steeven Yeh Rizki Adrian Miriam Zago Gabriel Pettier Ⓥ 💉2/2 mRNA 😁 Adrian | DFX 🦇🔊 Kerry McCullough, PhD 🇵🇸🇲🇾محمد نبيهان🇲🇾🇵🇸
      1 reply 13 retweets 75 likes
        1. New conversation
        2. Health Nerd‏Verified account @GidMK Jun 21

          21/n Even if you ignore my opinions, limiting the analysis to only studies rated BY THE AUTHORS as "low" risk of bias gives you a completely inconclusive result (RR 0.65, 0.12-3.59) 🤷‍♂️

          1 reply 6 retweets 62 likes
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        3. Health Nerd‏Verified account @GidMK Jun 21

          22/n So I don't really have an issue with the methodology or the results of the study, except to say that I think the risk of bias here is generally quite high and publication bias is likely The conclusions however...

          1 reply 2 retweets 42 likes
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        4. Health Nerd‏Verified account @GidMK Jun 21

          23/n I don't think this is justified at all to be honest. Even if we ignore the issues that I mentioned in this thread, most of these studies are really short (probably because they're all preprints) containing only a fraction of the information you need to properly assess thempic.twitter.com/8tX77GMESA

          1 reply 6 retweets 46 likes
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        5. Health Nerd‏Verified account @GidMK Jun 21

          24/n There's a good reason the risk of bias for so many regions here is 'unclear' - the studies simply don't include enough information! Often the methods sections are 3-4 paragraphs long (v. short for an RCT)pic.twitter.com/8AP18DKtD2

          2 replies 2 retweets 33 likes
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        6. Health Nerd‏Verified account @GidMK Jun 21

          25/n Moreover, publication bias looks to be a bit of an issue, and it's not really addressed. Quite likely to be some null findings that are floating around but will be published eventually!

          1 reply 1 retweet 28 likes
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        7. Health Nerd‏Verified account @GidMK Jun 21

          26/n On top of this, if you only look at studies that the authors have rated as having a low risk of bias for all domains, the evidence is pretty much squarely null, although this is limited by the fact that there are only 3 good studies

          3 replies 4 retweets 33 likes
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        8. Health Nerd‏Verified account @GidMK Jun 21

          27/n I don't think that this study really supports the use of ivermectin as a treatment for COVID-19 outside of a clinical trial, which is a shame because it'd be fantastic to have another effective drug for the disease

          4 replies 7 retweets 74 likes
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        9. Health Nerd‏Verified account @GidMK Jun 21

          28/n The depressing thing is that 100s of millions of people, mostly in developing countries, have had ivermectin for COVID-19, and yet we've only got 3 low-risk studies with <700 participants total to use as good evidence 🤯🤯🤯

          6 replies 6 retweets 74 likes
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        10. Health Nerd‏Verified account @GidMK Jun 21

          29/n Oh, one other point is that the authors considered the Fonseca study an "outlier" because exclusion lowered the I^2, which I don't understand because excluding the Elgazzar study lowers the I^2 a lot as well 🤷‍♂️pic.twitter.com/49WMIzgXWe

          2 replies 1 retweet 31 likes
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        11. Health Nerd‏Verified account @GidMK Jun 21

          30/n Also, I should reiterate that while I disagree with the conclusions, the study itself is pretty strong. The methodology was well constructed, I have few if any criticisms of the actual research the authors conducted

          13 replies 2 retweets 42 likes
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        12. End of conversation

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