RCTs are the gold standard, yes.
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HOWEVER, that doesn’t mean that, when RCTs are either impractical or unethical (e.g., an RCT of vaccinated vs. unvaccinated children, which would leave the control group vulnerable to vaccine-preventable disease), we can’t still make strong conclusions from other study designs.
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Or NAC as an antidote to acetaminophen. No RCTs to support that. But before we used NAC OD of 180mg/kg was uniformly fatal w/o liver transplant. Now you can eat a Costco bottle of APAP, but if you get NAC in 4 hrs it's universal survival. Try getting an RCT past an IRB for NAC.
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Replying to @RNickGorton @gorskon and
Even in the operating room, use of surgical masks is basically for ‘tradition’ and maintaining order. Mask use has been studied time and time again with similar results. But sure, all of a sudden they work..https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480558/ …
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Replying to @JonathanWHendry @RNickGorton and
The literature I linked was a review of RCTs genius.... keep up
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Replying to @leeloyd1 @JonathanWHendry and
You’re very silly if you think this is a “gotcha.” I’m way ahead of you there, skippy. (Masks in the OR are also discussed.)https://sciencebasedmedicine.org/bouffant-caps-versus-skull-caps-in-the-operating-room-a-no-holds-barred-cage-match/ …
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Now let’s see if our genius can tell us the difference between masks and wound contamination in the OR with bacteria and mask use and aerosol transmission of a contagious respiratory virus.
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Replying to @gorskon @JonathanWHendry and
The literature review included viruses as well. Considering a viral particle is many times smaller than a bacteria, and the fact that n95 masks are the only useful measures for aerosols...except they protect the wearer...I can offer quite a bit to that convo
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The droplet/aerosol claim is a false dichotomy, and because COVID-19 isn't traveling 'naked' in the air and is less contagious than virii like measles, droplet transmission is far more important than aerosol. https://www.acpjournals.org/doi/10.7326/M20-5008 …
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Yep. It’s a continuum. Yes, aerosol transmission can occur, but it’s much less important than larger respiratory droplets.
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