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califf001's profile
Robert M Califf
Robert M Califf
Robert M Califf
@califf001

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Robert M Califf

@califf001

cardiologist, trialist, outcomes researcher, former FDA Commissioner, trying to solve the health, healthcare, tech challenge

Verily,Google,Duke,Stanford
Joined May 2011

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    Robert M Califf‏ @califf001 24 May 2020

    Important statement from RECOVERY Trial in UK about continuing RCT of hydroxychloroquine. @texhern @HeartBobH @gcfmd @PCORnetwork @ASlavitt https://www.recoverytrial.net/files/professional-downloads/recovery_noticetoinvestigators_2020-05-24_1422.pdf …

    12:16 PM - 24 May 2020
    • 102 Retweets
    • 234 Likes
    • Regina Amy Proal, PhD Alex Walker keomucopoxepum Prashant Gupta🇮🇳 Yury Mareev Emma Anthony Kerry 💙 Christopher T. Rentsch
    13 replies 102 retweets 234 likes
      1. New conversation
      2. Robert M Califf‏ @califf001 24 May 2020

        I certainly agree with @US_FDA that HCQ should be reserved for use in properly designed adequately powered RCTs rather than used based on belief in absence of evidence. Multiple well-designed RCTs are underway.

        3 replies 4 retweets 43 likes
        Show this thread
      3. Robert M Califf‏ @califf001 24 May 2020

        But, frankly i'm disturbed by the number of highly health literate people (including some regulators) who look at observational studies and pronounce that the evidence in already in. Importantly, the ongoing RCTs have independent data monitoring committees.

        2 replies 21 retweets 119 likes
        Show this thread
      4. Robert M Califf‏ @califf001 24 May 2020

        These committees look at the data and determine whether the balance of benefits and risks to the participants has reached a threshold to either continue or stop the trial. There are multiple ongoing trials so many committees are looking at high quality data.

        2 replies 4 retweets 32 likes
        Show this thread
      5. Robert M Califf‏ @califf001 24 May 2020

        I'm sure they are looking more intensively with all the publicity. But even the large Lancet study concluded that RCTs are needed to answer the question of potential benefits weighed against risks. Collaboration among DMCs would probably be a good thing.

        1 reply 6 retweets 38 likes
        Show this thread
      6. Robert M Califf‏ @califf001 24 May 2020

        We have seen many examples of wrong answers from observational treatment comparisons. The methodology of non-randomized real world evidence is improving, but none of the published studies have been able to meet quality measures for design for causal inference.

        3 replies 7 retweets 48 likes
        Show this thread
      7. Robert M Califf‏ @califf001 24 May 2020

        And best have all concluded: RCTs are needed. So, let's get a definitive answer from RCTs asap rather than jumping to conclusions one way or another. Random assignment is a gift for which we should be grateful as we seek truth.

        4 replies 8 retweets 60 likes
        Show this thread
      8. Robert M Califf‏ @califf001 24 May 2020

        Finally, none of this implies that i know whether HCQ is beneficial (or net detrimental) for COVID-19. I will be happy if it is beneficial and sad for patients of not, but i will be happy for biomedical science if we get a definitive answer, positive or negative.

        5 replies 14 retweets 115 likes
        Show this thread
      9. End of conversation
      1. This Tweet is unavailable.
      2. Olivier Marz‏ @ReturnsJourney 24 May 2020

        Olivier laquiche

        0 replies 0 retweets 0 likes
      3. End of conversation
      1. New conversation
      2. Stephen Goldstein‏ @stgoldst 24 May 2020
        Replying to @califf001 @texhern and

        RCTs consume resources and should therefore be evidence-based. There is zero evidence to support expending resources on HCQ trials.

        8 replies 3 retweets 15 likes
      3. Harold Hickory‏ @DavidL_Hunt 24 May 2020
        Replying to @stgoldst @califf001 and

        There is good evidence. Particularly on studied that used zinc, which is how it works. Studies that did not use zinc, which is most, are useless. We need studies of early intervention used in conjunction with zinc.

        0 replies 1 retweet 5 likes
      4. End of conversation

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