Summer Sunday quiz
-----------------------

from Sunny Plymouth, Pearl of Europe

#DreadMed #DooMed
Look at this table of baseline characteristics.

Control arm consists of 22+2 = 24 people.
Therapy arm consists of 20+1=21 people.
How many people is that, altogether?
Nothing in life is that easy.

Think again.
NOW, how many people were randomized?
Don't rush to judgement.

Try this.
Third time lucky:

How many people were randomized?
Glad I've made you skeptical.
Now the arithmetic puzzle of the day. No need for 13 times table this time , as I can't bear being humiliated by my own PhD students (have a demotion @mshunshin).

Calculate the mean increase in EF in the active arm.
What is the mean increase in EF in the cell therapy arm? (Ignore the other arm for the purpose of this question)
Suppose 10 staff of ORBITA HQ drink different amounts of orange juice at Rasha's (and PCI's) 40th birthday party.

5 glasses
6.5 glasses
8 glasses

Etc.

Suppose the MEAN amount drunk is 7.0 glasses.

If i listed the individual number of glasses drunk, what would the mean be?
Look at the coloured bars on the right (ignore the black ones on the left).

Imagine they are the number of glasses of orange juice drunk by ORBITA HQ revellers.
The company providing the bar give Rasha a bill saying "the mean number of glasses drunk was 7, so hand over the £"

What will she say?
Well, now let me tell you that those were in fact the individual patient EF changes in the cell therapy arm.

Is there any (any, ANY, A N Y) possibility that their mean is 7.0?
Review of pic without red line:
If the graph is correct, is there any chance that the statement in the abstract, of a 7.0 unit mean increase in EF in the cell arm is true?
But actually it has to be true because this information was used to bring in investors.
The prospectus to the investors says a 25% improvement in ejection fraction.

I guess they are arguing a 7 percentage point increase from about 27 points is about 25%.

Cheeky but defensible.

But not if even the 7 is a lie.
Sergio good question.
It's not the fault of the journal or the peer reviewers.

It's the fault of the authors for submitting incorrect stuff.

And the fault of the journal for not resolving the situation once pointed out.
When the research was redone properly, the treatment was of course found totally ineffective.

The company kept the investors money though, and changed its name.

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More from @ProfDFrancis

Jul 29, 2018
If anyone wants to know how incorrect causal inference arises in cardiology, there's no need to do a PhD on it.

It's encapsulated in this thread. Unlike most of my threads it has a happy ending though !

First, a whole load of unsuspecting patients have PCI.
Then a bunch of cardiologists who are normally ultracompetitive decide to do something constructive for a change, instead of just doing each other down in cross-London acrimony.

Let's get together and ...

google.co.uk/url?sa=t&sourc…
They do what we always do when we cardiologists get together. Tell stories.

"I had a guy with 3 vessel thrombosis in cardiogenic shock, going into asystole as he was put on the table, but we still saved him!"
Read 64 tweets
May 27, 2018
How to make your
correlations correlate.
Even if they don't.
==============

A practical tweetorial for aspiring research fraudsters, cardiology fellows doing research, and others in need of a strong association when there isn't one.

#meded #foamed

Please retweet to fellows.
Thank you to @rallamee for loaning me the use of her garden and boating lake to do a few demonstrations in this weekend's tweetorial.
Thank you also to a colleague, for sending me this just now. It is enlightening and I am genuinely sorry.
Read 58 tweets
May 13, 2018
Joel Giblett @joelgiblett brings up a very important question.

Where does scientific integrity come from? What makes me think I can trust papers written by him? I've never heard of him before this tweet, and I have no idea of his background.
Well, first of all, he seems genuinely curious about integrity. This is a good sign.

Second, he is scared of R&D and MHRA. This is a good sign that he tries to toe the line, pays his taxes, doesn't park in the disabled spots (unless entitled) and doesn't drop litter.
But it is not non-littering, or trembling when the R&D office sends an email, that CAUSES his research to be non-fake.

It is his own personal attitude, those of his colleagues, and the lack of tremendous incentives to fiddle.
Read 22 tweets
Apr 21, 2018
Risk Ratio, Odds Ratio, Hazard Ratio
========================

2nd and final part of the tweetorial, from ORBITA-HQ!

Fun, easy and informative [*]

#MedEd #FOAMed #cardiology #cardiotwitter
[*] Results may vary and are not guaranteed. See small print.

Not all fears are alike.

* Some fears are one-and-done:
I get a cold which progresses to pneumonia. Will I die, or recover?

* Other things hang over us for much longer, perhaps all your life.
Will you get hit by a bus?
Get a heart attack?
There's no "sell by" date on the fear.
Practice Qs

You are walking through Hyde park, minding your own business.
Hardly causing any trouble at all.
Perhaps the odd humorous tweet.

You get a Direct Message:
"Enough of ur abuse!
You will be hearing form my agent shortly.
kthxbai
AJ Kirtane"

You see the agent:
Read 89 tweets
Apr 13, 2018
Can you get into the mindset of a probability?

You thought you had a simple and easy life, roaring along the highway from 0 upwards.

Until you see this ahead of you.
You have a twin sister, who in her youth was similar to you in many respects.
But she was always more vivacious and sporty.

When you read comic books, she preferred to dance.

When you watched TV, she joined a cycling club.

Now you are almost at a dead end.
And she is running free.
Read 30 tweets
Apr 7, 2018
RELATIVE RISK, ODDS RATIO, HAZARD RATIO
=============================

What are they?
Why do we need 3 of the damn things?
Which should I use?
Are they the same, or different, or a bit samey?

An #ORBITA-HQ #tweetorial.
#Meded #FOAMed
All 3 of these are about comparing the scale of dangerousness of one thing AGAINST ANOTHER.

Suppose you are walking through an unfamiliar forest and the road comes to a fork: you have to choose one path.

As you stand, uncertain, a troll pops out of the ground.
You ask for advice on which path is safer.

As always, the advice he offers is scrupulously correct, but not necessarily instantly interpretable to the layperson.
Read 65 tweets

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