An excellent thread on epistemology
What do we know and how do we know it?
A narrow view of what we know, what is data can lead us into mental traps
This is not about delayed vs immediate vaccine doses
This is about what do we mean when we say, follow the science. H/T @zeynephttps://twitter.com/robertwiblin/status/1345800480144945152 …
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OK, sorry I misread the response in this case.
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No problem. It's pretty clear that there are reasoned arguments for and against any schedule changes, though it may well be that it doesn't matter anyway because we are so slow. But important to watch what happens in UK, which should give us more information.
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In my case, when we wrote an op-ed calling for a *trial*—just a trial—for a later dose to increase coverage, we did get many people saying we had no data to call for even a trial, how dare we call for changing the protocol from a phase III trial. Not you. But it was widespread.
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I am a big proponent of phase IV studies--phase III should never be the be-all/end-all. But I wish we had as much enthusiasm about solving delivery, production problems as we have for stretching out the meagre supplies we have now as a temporary stop-gap.
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And sorry but the epistemology stuff is slightly annoying. We've had three decades of assault on the regulatory state pushing for less evidence for public policies, particularly at FDA, eroding evidence base, while we pay higher prices than ever for what we get. 1/
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And the call: rely on real world evidence, other kinds of data, personalized medicine, because RCTs are the 20th century's tool. The same logic applies: people are dying we have to move more quickly, trade answers for access. 2/
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