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awgaffney's profile
Adam W Gaffney
Adam W Gaffney
Adam W Gaffney
Verified account
@awgaffney

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Adam W GaffneyVerified account

@awgaffney

Critical care doctor @challiance, assistant professor @HarvardMed, healthcare researcher, past president @PNHP, author of "To Heal Humankind", tweets my own.

Boston, MA
dradamgaffney.com
Joined January 2012

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    Adam W Gaffney‏Verified account @awgaffney Jun 22

    Notable that one of the leading physician advocates for using ivermectin for COVID-19, Paul Marik, was once also convinced that he had cured sepsis with a combination of vitamins and steroids — a finding not replicated once a randomized trial was actually performed. /Thread

    1:13 PM - 22 Jun 2021
    • 138 Retweets
    • 420 Likes
    • Victor Bruno Besen amo o SUS Golpe Divago™ zé gotinha Gabriel Scorgie David Benson Cameron Baston MD Alfie Noakes
    18 replies 138 retweets 420 likes
      1. New conversation
      2. Adam W Gaffney‏Verified account @awgaffney Jun 22

        His words: "We haven't seen a patient die of sepsis since we began using the combination therapy a year ago. We have completely changed the natural history of sepsis."https://www.nbc12.com/story/34986689/virginia-doctors-possible-cure-could-save-millions-from-sepsis/ …

        2 replies 7 retweets 49 likes
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      3. Adam W Gaffney‏Verified account @awgaffney Jun 22

        He's a member of the FLCCC Alliance, along with Pierre Kory, who testified in the Senate for Ron Johnson that Ivermectin is "effectively a 'miracle drug' against COVID-19." Ivermectin is not the only FLCCC Alliance's recommendation that is not evidenced-based.

        5 replies 8 retweets 47 likes
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      4. Adam W Gaffney‏Verified account @awgaffney Jun 22

        For instance, here's their "Long COVID" protocol, which calls for treatment (on the basis of little to no evidence) with: -Ivermectin -Steroids -"Treatment of Suspected Mast Cell Activation" (various agents) -"Macrophage/Monocyte Repolarization Therapy" (various agents)pic.twitter.com/x6MkSontPg

        4 replies 6 retweets 40 likes
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      5. Adam W Gaffney‏Verified account @awgaffney Jun 22

        One can disagree about role that social media companies should (or shouldn't) play in censoring misinformation — I fall more on the ACLU end of the spectrum — but the push by @BretWeinstein & others to cast ivermectin as a suppressed miracle cure is goofy, and indeed harmful.

        3 replies 10 retweets 87 likes
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      6. Adam W Gaffney‏Verified account @awgaffney Jun 22

        A large, high-quality trial can be conducted. If benefit is demonstrated (and a priori that's improbable with such a re-purposed drug), that would be wonderful! But based on where things stand now, these individuals, including critical care doctors, are making extraordinary, ...

        2 replies 6 retweets 50 likes
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      7. Adam W Gaffney‏Verified account @awgaffney Jun 22

        ... indeed grandiose claims that is simply not backed by adequate evidence, both for ivermectin and their "protocols" more broadly. It's grossly irresponsible.

        4 replies 7 retweets 58 likes
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      8. Adam W Gaffney‏Verified account @awgaffney Jun 22

        It's not at all surprising that this happened- earlier with hydroxychloroquine and now with ivermectin. The "allure of the miracle cure" exerts such a strong pull - both patients and physicians are potentially prone to perceive such a cure based on narrow reading, or experience

        2 replies 10 retweets 56 likes
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      9. Adam W Gaffney‏Verified account @awgaffney Jun 22

        ... even if motives are the best (they aren't always). One takeaway is that we need a broader public understanding of why we need high-quality, randomized clinical trials with hard endpoints before approving / using the vast majority of drugs...

        4 replies 7 retweets 59 likes
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      10. Adam W Gaffney‏Verified account @awgaffney Jun 22

        There's a general sense that the direct observations of physicians ("My patients got better!") or patients ("I felt better!") is powerful evidence of efficacy. That's understandable, but it isn't: frequently such observations suggest efficacy for drugs that are useless or harmful

        4 replies 8 retweets 60 likes
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      11. Adam W Gaffney‏Verified account @awgaffney Jun 22

        The reality is that we are all prone to excessive belief in what our own observations and experiences reveal about cause-and-effect relationships — it's not a sign of an intellectual deficit but just the fundamental, invariable limitations of one particular mode of human inquiry.

        1 reply 16 retweets 67 likes
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      12. Adam W Gaffney‏Verified account @awgaffney Jun 22

        Similarly, we can be excessively credulous about physiologic explanations for efficacy, e.g. a molecular hypothesis for why drug X helps disease Y. At issue here is a biased assessment of how fully we understand real-world biological drug effects, which are profoundly complex.

        1 reply 7 retweets 39 likes
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      13. Adam W Gaffney‏Verified account @awgaffney Jun 22

        We also inappropriately accept "surrogate outcomes" - lab values or imaging findings that we can track, versus hard outcomes (e.g. death). If Alzheimer's is associated with more amyloid in the brain, and amyloid is bad, and a new drug reduces amyloid levels — isn't that good?

        2 replies 5 retweets 36 likes
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      14. Adam W Gaffney‏Verified account @awgaffney Jun 22

        Not necessarily — regardless of the overall correctness of the biological hypothesis. If the drug doesn't also improve either the length or quality of life, who cares what "the levels" do? Yet the FDA is using such surrogate outcomes for approvals more and more.

        1 reply 6 retweets 46 likes
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      15. Adam W Gaffney‏Verified account @awgaffney Jun 22

        Some of these issues didn't matter nearly as much say 100 years ago, except to scientists and physicians perhaps, but with the tremendous rise of medicine as a presence and force in our daily lives — and a major issue in politics and policy — I think that teaching of ...

        1 reply 6 retweets 35 likes
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      16. Adam W Gaffney‏Verified account @awgaffney Jun 22

        ... these and related issues should perhaps be a part of our basic primary education.

        6 replies 6 retweets 41 likes
        Show this thread
      17. End of conversation

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