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…

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.

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.

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.

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.

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.

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.

What does a P value mean?
==================

A microtweetorial because I have been watching @anupampom and @JohnTuckerPhD chase each other like this for the last hour, which is distracting me from doing work.

Answer this and save them from circular argument.
#foamed #meded Francisomycin, my new natural anti-atherosclerotic antibiotic, has now been published in NEJM to reduce atherosclerosis by 173 arbitrary units (p=0.03).

I am really, really pleased with the result and the fact that I have the patent on this magical stuff.

Intention To Tweet
============

1. Why is intention-to-treat the ONLY right way to interpret trial results?
2. Why are these fine gentlemen wasting their prayers?

Tweetorial for cardiology fellows from ORBITA-HQ
#cardiology #meded #foamed Thank you to Ali Jazayeri for suggesting this subject on the highly secret DM contact address (@ProfDFrancis).

If you want to kill people, the most effective way to do this in the modern era (since gun laws and annoying people like the Police will make things awkward) is to persuade people to stop (or never start) a statin.

Over the long term, 1 in 10 will be killed by that choice. You can even write books about it and make money.
And be seen as a crusader against a crooked medicogovernmental conspiracy.
The internet is a good place to operate, because most lay people can't distinguish scientific reasoning from pseudoscience, and because ...

MYOCARDIAL VIABILITY
================

Lazarus revisited

[Tweetorial from ORBITA-hq: "Making cardiologists think again"(TM)]

Please retweet to cardiology fellows or anyone who might be interested to practice data interpretation. Let's start our story here, when I was first informed that viability testing saves lives.

Heh heh, the Amazing Yuripridio, world-conquering hypnotist But we must be careful on this. I have a PhD student at #ORBITA hq called Frances Wood. I met her first as a manager in a research unit a few years ago. She was the nicest, kindest person there, who would always make me tea when I visited anyone in the unit.

Considering #statin in 35-y-o man worried about extensive family history of MI+stroke: 2 parents, 3 of 4 sibs.

#Cholesterol 5.8 mM, 224 mg/dl. Subtypes typical for such a total.
Non-smoker. Otherwise average.

[Live-quiz from #orbita-HQ for #cardioTwitter fellows & the curious] Question C2.

First vote was for diet first, and quite right too! That is the guideline, and we must obey.

Natural, organic, eco-friendly and therefore best.

What effect size is a reasonable expectation, for patient and Dr, for the reduction of total cholesterol by diet?