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Vinay Prasad MD MPH Profile picture
Vinay Prasad MD MPH
@VPrasadMDMPH
Professor @ucsf, Physician-Scientist, Writer; More at @vkprasadlab @plenary_session, YouTube, #vpzd podcast & @Sensible__Med; Views are mine
Amy at ThreadReaderApp Profile picture 1 subscribed
Jan 26, 2022 • 6 tweets • 2 min read
Touching piece. It's sad but vaccines and masking have become anchored to a culture war where people feel glee about misfortune of their political opponents. It has made everyone cruel and blind to the scientific truth... 1/6 Cloth masking never had good data. We didn't run proper studies in high income nations. We didn't run any good studies in kids. And now we are escalating to higher quality masks precisely in a moment when they serve less societal purpose, than pre vaccine, where they held value
Jan 26, 2022 • 6 tweets • 2 min read
Great essay in the @TheAtlantic on masking kids

You can't impose restrictions for year after year with no credible data. 👇👇. Check it out

theatlantic.com/ideas/archive/… My take from last week
tabletmag.com/sections/scien…
Jan 25, 2022 • 6 tweets • 2 min read
Can people help me add to this list of op-eds critical of the ridiculous restrictions on vax'd college kids on campus?

👇👇🧵👇👇
medpagetoday.com/opinion/vinay-… bostonglobe.com/2022/01/20/opi…
Jan 25, 2022 • 4 tweets • 2 min read
New paper out led by @mlythoe @vkprasadlab

We summarize comments received by FDA in response to their proposal that you don't need to receive standard of care to enroll in trials

We detailed the proposal first in NRCO...
🧵
authors.elsevier.com/a/1eTQf7tJEDOI… Here was that summary along with pitfalls
Jan 24, 2022 • 6 tweets • 2 min read
Yes! Vax booster mandates are just like seat belts. In 3 months in 1984, for anyone who didn't buckle up 100%, they were fired from their place of employment and not allowed to work again in that sector. Enforcement was absolute... Also people who had seat belts already (natural immunity) That didn't count. You had to install the special new seat belt. And you only had a few months to do it.
Jan 24, 2022 • 6 tweets • 2 min read
Brilliant essay by John Ioannidis and Michaela Schippers in @tabletmag

I share their concern that suppression of democratic norms to combat the pandemic is a dangerous precedent, and has no checks or balances

Censorship fuels this

tabletmag.com/sections/scien… Who decides when a public health crisis rises to emergency levels?

Once the decision is made, wide scale suppression of democracy can follow.

Including freedom of Assembly, freedom of speech, limitations on political protest
Jan 24, 2022 • 4 tweets • 1 min read
Everything in this article is spot on. A mask is more than a filter, it is a behavioral intervention. 👇👇👇 Totally agree
tabletmag.com/sections/scien…
Jan 24, 2022 • 23 tweets • 6 min read
NYTimes pandemic coverage is so off the mark, it does not even get the errors correct.

Allow me to detail what the administration REALLY got wrong in 2021

🧵

nytimes.com/2022/01/23/us/… The administration should have pursued a 1 dose vaccine strategy. Give 1 dose to more people and delay dose 2.

The UK did this, and multiple modeling papers show it would save more lives

Wrongly, Fauci disagreed, and they stuck to 1 dose & 21 and 28 day time table of vax
Jul 25, 2018 • 7 tweets • 2 min read
Yes, I appreciate the gesture by FDA, but in this brief thread I will explain why it is pretty much useless.

THREAD First, look at what the FDA put out
fda.gov/Drugs/Developm…
Jul 21, 2018 • 15 tweets • 4 min read
DEVASTATING Letter to the Editor in @BloodJournal for a paper published in @NEJM which (Wrongly) claims brentuximab AVD is superior to ABVD.

Care for a TWEETORIAL?

FYI I have a commentary under review that trashes this bad, bad trial but makes totally different points! This is an AWFUL trial used to expand market share of a UBER costly drug Brentuximab and not actually answer the question of whether patients are better off..... In other words, par for the course in 2018

Lets take a look at key objections of the letter

First this....
POW!
Jul 8, 2018 • 28 tweets • 8 min read
My feed has blown up over the last day with
Persistent Reservations against Reforming the First 2 Years of Medical School Curriculum aka bad arguments

I find it funny because 6 years ago, I thought I had heard it all and wrote this
drive.google.com/file/d/1mLepDy…
[Well, Here's 2 cents] Let's be very clear about this topic: there are lots of stupid & inefficient parts to medical training, (especially scut work & bad work hours, rotating w disinterested attgs, bad teachers, etc.) I can't tackle it all !

I want to talk about the content of yr1-2 of med school
Jul 6, 2018 • 20 tweets • 7 min read
Care for a TWEETORIAL on this paper?
(This will HURT)
This paper highlights the continued and abject FAILURE of cancer clinical trials & regulators to provide information for average cancer patients
Total failure
nejm.org/doi/full/10.10… First, consider the first FDA approved therapy for advanced or metastatic HCC-> Sorafenib
Approved based on these data
improvement in median survival from 7.9 to 10.7 months (typical for cancer drugs)
Jul 6, 2018 • 12 tweets • 6 min read
This is a DEVASTATING look at the continued, perverse role of financial conflicts of interest that dominate FDA interactions by @cpiller in @sciencemagazine
This is a vitally important topic for drug safety
Some highlights:
science.sciencemag.org/content/361/63… These drug advisory committees (DAC) are very important
Not JUST because they decide on whether marginal drugs should be approved, but also because when the FDA makes up new, surrogate endpoints they use the DACs to "justify" them
Jul 4, 2018 • 17 tweets • 5 min read
Care for a TWEETORIAL #1 on colorectal cancer screening for avg risk people?
Today, we will review on this paper
@JAMA_current 2010
FYI Its a bit... controversial! First, test your knowledge: which of the following screening interventions for colorectal cancer have RCTs showing reduction in cause specific (colon ca) death?
Jul 2, 2018 • 22 tweets • 6 min read
I finally read this paper and feel prepared to comment
Because I don't think it is being interpreted properly by the Twitter community

Sorry folks, there is nuance here, and I hope to explain it to you.
[THREAD] First, let's define health care waste
This is my definition. POLL COMING
Jun 28, 2018 • 17 tweets • 5 min read
This is DEEPLY CONCERNING editorial behavior... and
I think its time we start talking about the Use, Misuse and Abuse of Academic Power. [THREAD] #cardiotwitter medscape.com/viewarticle/89… First, the ISCHEMIA trial is clearly ruffling feathers since the primary endpoint was changed. It is a costly 100mi buck FEDERAL funded trial, and it just switched from a bias resistant to a bias prone endpoint

That's a big deal
Jun 24, 2018 • 23 tweets • 6 min read
TIme for TWEETORIAL PART 2 on mammographic screening.
A MULTI-part series on this topic

Today, we we will review this 2012 paper by
Archie Bleyer, a fellow OHSU faculty member, and.... H. Gilbert Welch

Sit down, It's a doozy. Quick recap: In Part 1, we covered this provocative paper by Juni & Zwalen in the @AnnalsofIM on the randomized data for mammography.

Here we take a CLOSE LOOK at what mammography screening has brought us over the last 30 years in the USA
Jun 24, 2018 • 21 tweets • 5 min read
I want to do a TWEETORIAL on a controversial topic...
Mammographic screening
This is the first of a MULTIPART SERIES on Mammographic screening

This one will summarize one important paper in 2014

I start here because, this one is a dagger
annals.org/aim/article-ab… First, There are 2 things you need to know.
1 Most of the randomized trials we use to make inferences about the value of mammograms are old...
REAL OLD
From an era where breast cancer care bore no resemblance to today
Jun 22, 2018 • 24 tweets • 7 min read
Care for a brief TWEETORIAL on the problem with TALKING POINTS?
and their blind acceptance
This one is for @AndraeVandross Talking points are things we repeat or hear repeated that come to frame the way we think about a topic.
Problem is, after a few repetitions, the speaker believes the statement is true w/o question, and mind closes off to the idea it may not be
What do you think?
Jun 17, 2018 • 14 tweets • 5 min read
As promised, my TWEETORIAL on @JohnCarreyrou's BAD BLOOD!
(This ain't a book review; the book is excellent, pls read it)
This is about the broader problem Theranos reveals that underlies so much of Biotechnology and Medical start-ups I think the story of Theranos is particularly insightful because it shows how hype, lack of skeptical or clear thinking, money and hope can lead us to fail to adequately assess medical technologies until too late. Let me take you through the problem as I see it.
Jun 14, 2018 • 36 tweets • 8 min read
PINNED TWEET: This is going to be a place I store prior TWEETORIALS for easy reading