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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. Kyle Sheldrick‏ @K_Sheldrick Aug 24
      Replying to @GidMK @EdoajoEric @VaxScan

      Oh yeah I completely agree with that, can't pretend to be more certain than you are, can't hide potential harm, can't override autonomy. That being said... 1/

      1 reply 0 retweets 3 likes
    2. Kyle Sheldrick‏ @K_Sheldrick Aug 24
      Replying to @K_Sheldrick @GidMK and

      If point estimate for drug x for covid is 20% relative reduction in mortality, but 95% CI crosses 1, and we decline to prescribed. Then with more studies the CI tightens and point estimate doesn't change. Now clear it works 100 million patients not treated. 2/

      1 reply 0 retweets 9 likes
    3. Kyle Sheldrick‏ @K_Sheldrick Aug 24
      Replying to @K_Sheldrick @GidMK and

      Do we have moral culpability for those that died that would have survived? I'm not sure there is such a huge difference between harm caused and harm not prevented. Waiting for more info is still an active decision not to treat. 3/3

      2 replies 0 retweets 9 likes
    4. Health Nerd‏Verified account @GidMK Aug 24
      Replying to @K_Sheldrick @EdoajoEric @VaxScan

      But the converse is also extremely problematic - HCQ we justified based on similar arguments and it appears to cause modest increases in death rates from covid. If the end result is a treatment that does cause harm, what is the moral culpability?

      5 replies 0 retweets 3 likes
    5. Kyle Sheldrick‏ @K_Sheldrick Aug 24
      Replying to @GidMK @EdoajoEric @VaxScan

      High. Treatment decisions aren't no-risk. There's the argument about harms from drink driving vs punishment (moral culpability) too. 1/

      1 reply 0 retweets 2 likes
    6. Kyle Sheldrick‏ @K_Sheldrick Aug 24
      Replying to @K_Sheldrick @GidMK and

      Like in Australia if you speed drunk through a red light and there's nobody crossing the road you'll get your licence suspended. If a pedestrian happened to be there you get 10 years jail. I think this is wrong, there's no difference in the risks taken, just luck 2/

      1 reply 0 retweets 0 likes
    7. Kyle Sheldrick‏ @K_Sheldrick Aug 24
      Replying to @K_Sheldrick @GidMK and

      I think if the decision made was the best decision that could be made with the best info available at the time then the doctor is guiltless regardless of what comes out. I accept that that's slightly different to just chalking up deaths though. 3/

      1 reply 0 retweets 1 like
    8. Kyle Sheldrick‏ @K_Sheldrick Aug 24
      Replying to @K_Sheldrick @GidMK and

      I think that's different to saying declining to prescribe a drug that's more likely than not to have net benefit, because evidence doesn't meet an arbitrary certainty threshold, is ok. 4/

      1 reply 0 retweets 1 like
    9. Kyle Sheldrick‏ @K_Sheldrick Aug 24
      Replying to @K_Sheldrick @GidMK and

      I guess what I'd say is that I don't see any deaths caused by prescribing HCQ as more or less important than deaths caused by not prescribing dex. But the orthodox model would see the first as more important because we assign more weight to harms of action than inaction. 5/

      1 reply 0 retweets 1 like
    10. Kyle Sheldrick‏ @K_Sheldrick Aug 24
      Replying to @K_Sheldrick @GidMK and

      I recognise though that this is a minority view. Most of my colleagues DO see harms caused by taking weakly evidenced action as more important than harms caused by not taking weakly evidenced actions. 6/6

      2 replies 0 retweets 0 likes
      Health Nerd‏Verified account @GidMK Aug 24
      Replying to @K_Sheldrick @EdoajoEric @VaxScan

      I think in this context you could argue that the harms of not taking action are often better understood than the harms of taking action. Won't always change the calculus, but I think it's an important point

      10:46 PM - 24 Aug 2021
      • 2 Likes
      • Lars Mølgaard Saxhaug Kyle Sheldrick
      1 reply 0 retweets 2 likes
        1. New conversation
        2. Health Nerd‏Verified account @GidMK Aug 24
          Replying to @GidMK @K_Sheldrick and

          Moreover, the justification for using low-certainty evidence can apply to a massive net of treatments. I mean, rare cancers are one thing, but the evidence for any particular low-certainty drug for covid is not that different to a dozen or more other treatments

          1 reply 0 retweets 2 likes
        3. Kyle Sheldrick‏ @K_Sheldrick Aug 24
          Replying to @GidMK @EdoajoEric @VaxScan

          Yep, and I think we have to have an appropriately comprehensive understanding that isn't just point estimate but considers: - pre-test probability -potential harm + safety of drugs - sensitivity to single results being false - availability of alternative, evidenced therapies

          2 replies 0 retweets 0 likes
        4. Show replies

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