CR: COVID-19 --Political Talk

[Anastasis 23471]

22 minutes ago, Pig Bellmont said:

People put their own value judgment on whether it’s worth it.

So the angle on pandemic control now is "Everybody gets to make their own value judgement"?  Quite a departure from the earlier pages in this thread.  

Edited June 8, 2020 by Anastasis

[Anastasis 23471]

And I was not complaining about epidemiologist recommendations related to public health measures for church services. I support their recommendations to prevent spread.  I just wish that they could find a clear and consistent voice. Or perhaps they have, and it just hasn't been amplified as much. 

Edited June 8, 2020 by Anastasis

[Pig Bellmont 8744]

9 minutes ago, Anastasis said:

So the angle on pandemic control now is "Everybody gets to make their own value judgement"?  Quite a departure from the earlier pages in this thread.  

I don’t think protests are consistent with pandemic control and I don’t know anyone who thinks that way. I honestly don’t know what you’re arguing 

[Anastasis 23471]

2 minutes ago, Pig Bellmont said:

I don’t think protests are consistent with pandemic control and I don’t know anyone who thinks that way. I honestly don’t know what you’re arguing 

It wasn't exactly an argument.  I posted a picture of the protest crowd in response to an earlier exchange, I got a good natured both sides agreeing that it was a problem, and I posted a good natured quip calling back to the wide and vocal push back related to religious services. If you agree that mass protests (whether they are muh rights or as part of a worthy and overdue response to police violence and racism) represent a significant threat to pandemic control, we are in agreement.  

[GRHorn 105]

This is overused here, but some chef’s kiss tweets in retrospect. 
 

 

[HenryJames 66228]

 

[elfenix 34364]

Who in the hell would be against a vibrating quartz crystal on their sphincter?

Kaz matsui

[Bama Chick 28596]

lol I mean, just stay home.

They look ridiculous.

[Mapache 1117]

16 minutes ago, Bama Chick said:

lol I mean, just stay home.

They look ridiculous.

 

 

[Pig Bellmont 8744]

9 hours ago, HenryJames said:

 

Coming soon to other states too

[Anastasis 23471]

From the how to end your research career files.  Sub-continent medical research mafia in full effect. 

https://www.statnews.com/2020/06/07/researcher-involved-in-retracted-lancet-study-has-faculty-appointment-terminated-as-details-in-scandal-emerge/

The University of Utah has “mutually agreed” to terminate the faculty appointment of Amit Patel, who was among the authors of two retracted papers on Covid-19 and who appears to have played a key role in involving a little-known company that has ignited a firestorm of controversy.

...

How did Mehra meet Desai, and become connected to Surgisphere? “Dr. Patel introduced them,” a spokesperson for the Brigham told STAT. The spokesperson said Mehra knew Patel “through academic and medical circles.”

In his tweets on Sunday, Patel said that he was related to Dr. Desai by marriage. “That’s old news,” he wrote. “Many people from the Brigham were at that wedding, and media knew about it.” The bigger story, he wrote, was that despite requests from other authors for data, he does not have information from Surgisphere, he wrote. On Friday, STAT had asked Mehra if Patel and Desai were brothers-in-law. “Dr. Mehra indicated that he learned of that relationship today,” Mehra’s spokesperson said.

[TexLonghorn 5671]

Texas Reports a Record-high Number of Hospitalized Coronavirus Patients
 

Texas yesterday reported its highest number of hospitalized coronavirus patients at 1,935, up from the previous high of 1,888 over a month ago on May 5.

[PsychMike 1552]

My county is getting an uptick.

From the Galveston Daily News

Spoiler

One hundred days after the first Galveston County resident was tested for the coronavirus, the county Monday officially recorded its 1,000th local case of the virus.

The Galveston County Health District announced 32 new cases of COVID-19 among county residents on Monday, pushing the number of local cases diagnosed to date to 1,026.

Although the number of positive cases remains low as a percentage of the population — only about 3 percent of people tested have tested positive — local health officials said the number of positive cases is growing at increasing rates. The county recorded its first test for COVID-19 on March 2.

Officials attributed the increase in cases to the effects of reopening parts of Texas that were closed because of government-mandated social distancing.

“It’s disturbing that over the past four to five weeks we’ve seen an increase in the number of cases,” said Dr. Phillip Keiser, Galveston County’s local health authority. “We saw the biggest jump last week, and that was our largest number of cases ever.”

Of the 1,026 people diagnosed, 518 have recovered and 38 have died, according to the health district. The 470 active cases reported Monday were the most the county has reported at one time since the pandemic began.

The increase in cases is not because of an increase in the number of tests being conducted in Galveston County, Keiser said.

Galveston County has reported more than 2,000 COVID-19 tests every week since the beginning of April and recorded more tests in the month of April than it did in all of May, according to the health district.

“We have more cases than we’ve ever had, and the percentage of the tests coming back are higher,” Keiser said. “This is not a testing phenomenon. Actually, less people are being tested.”

The new increase in cases is notable because more cases of COVID-19 are being identified in young people — 89 of the 165 cases announced between March 31 and June 6 were in people younger than 40 — and the cases aren’t being tied to a single source, Keiser said.

Earlier large jumps in cases totals were tied to outbreaks in long-term care facilities. New recent cases are not tied to a single place or event, although the district is still performing contact tracing to try to identify common threads, Keiser said.

“We’re finding these cases all over,” Keiser said. “I don’t think we’ve found a connected line between everything.”

Galveston County, and the rest of Texas, began reopening from state-mandated closures May 1. In recent weeks, the state eased restrictions, allowing bars, restaurants, amusement parks, beaches, barbershops and beauty salons, among scores of other businesses and activities, to resume.

The new increases are not causing the same level of alarm the initial surge of cases caused, in part because of preparations made in recent weeks, said Dr. Ben Raimer, interim president of the University of Texas Medical Branch.

“The difference is now we’re prepared to handle the increase,” Raimer said. “Before, we were making some intelligent guesses, but at this point in time, we’ve taken the guess work out of it.”

The seriousness of the spread likely will be judged in coming days on the number of new hospitalizations connected to coronavirus and later by the number of deaths that occur, officials said.

As of Monday, 24 local people were hospitalized because of COVID-19, according to the health district. The number of people hospitalized locally reached a low point of 13 people May 15. Since then, the number of local hospitalizations has been in the mid-20s.

The medical branch, which manages hospitals in Galveston, League City and Webster, has reserved beds in case of a surge in COVID-19 patients needing hospital care, Raimer said. The number of people hospitalized Monday was “nowhere near a level of capacity that would worry us,” Raimer said.

For most people, the coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, it can cause more severe illness, including pneumonia. The vast majority of people recover from the virus.

People with mild illness recover in about two weeks; those with more severe illness might take three to six weeks to recover, according to the World Health Organization.

Still, Raimer and Keiser said the benchmark day in case totals should be used to remind people the pandemic has not passed and that they should continue to take safety measures to help slow the spread of COVID-19.

“We would remind people to be mindful,” Keiser said. “Wear a mask over your mouth in public. Practice social distancing as much as possible.

“I understand people are tired of being cooped up and people need a break, but we’re just asking people to be mindful and to have a good time carefully that doesn’t put you or your family at risk.”

 

[triplehorn 2664]

Interested to see what this Catalan study is all about after review:

Coronavirus - "Out of 150 drugs tested, two worked a little better: remdesivir and chloroquine"

translation (wording not perfect):

Quote

The study of the scientific journal The Lancet has revived the global debate around the use of hydroxychloroquine against Covid-19.

Study which indicated that hydroxychloroquine had no effect on the disease and especially that it presented dangers for the patients. The World Health Organization (WHO) had then suspended clinical trials with hydroxychloroquine before reversing, following revelations concerning the data provided to the doctors authoring the study. 

For Oriol Mitjà, expert in infectious diseases at the Germans Trias i Pujol Research Institute in Badalone, near Barcelona, the error "does not come from The Lancet, but from the authors of the study and especially the data". According to the Catalan, interviewed by TV3 , "these data were too perfect to be credible".

It is the work of "Australian researchers" who have highlighted the shortcomings of this study. "They saw that the data did not match".

Catalan study soon to be published

Elected Catalan of the Year in 2018, Oriol Mitjà himself is conducting a clinical trial on hydroxychloroquine, the results of which should be published soon. "The study is already finished and the conclusions await an external examination, precisely so that the results have all the guarantees," say our colleagues from Catalan television.

Without advancing on the results of his study Oriol Mitjà already finds that "of all the drugs tested in the laboratory (more than 150), only two worked a little better: remdesivir and chloroquine. Many people in our country have been treated with chloroquine. "

 

[DigDug 1684]

 

[TwiceHorn 31645]

On 6/5/2020 at 3:50 PM, Bama Chick said:

My friend died at 1:00 today.

He was 47.

He left behind a wife and 15 year old daughter and hundreds of friends.

He was a rare bird - an Alabama frat boy who was a proud liberal; so we bonded right away. He loved all kinds of music. He kicked all kinds of ass at bar trivia night. He was loud and funny and loved Alabama football.

Roll Tide and Godspeed, S. I hope you’re enjoying some Golden Flake chips and a Coca-Cola with The Bear right now.

Just caught this.  Condolences.

[triplehorn 2664]

notable:  Costa Rica to resume use of hydroxychloroquine for COVID-19 treatment

Quote

Costa Rican health authorities said Monday that the country plans to resume its use of hydroxychloroquine to treat coronavirus patients.

The announcement came from Román Macaya, the executive president of the Costa Rican Social Security System (CCSS), even as he acknowledged the drug’s efficacy against COVID-19 has not yet been proven.

“Efficacy is something we have to answer with a clinical study,” Macaya said.

The CCSS had temporarily stopped using hydroxychloroquine for COVID-19 in late May after a study published in The Lancet prompted the World Health Organization (WHO) to do the same.

That study — which indicated that using the drug on hospitalized coronavirus patients could increase their chances of dying — has since come under independent criticism, and the WHO has resumed its own hydroxychloroquine study.

In Costa Rica, all patients — including those with minor symptoms or who are asymptomatic — are offered the option to take hydroxychloroquine upon their diagnosis, as long as they don’t have contraindications to the drug, Macaya said.

The country has provided the drug to coronavirus patients since conferencing with Chinese experts in April, according to Mario Ruíz, Medical Manager of the CCSS.

Costa Rica has a low case fatality rate (.75%), and fewer than 5% of known active coronavirus cases are currently hospitalized.

“We can’t say that’s a result of this medication, but we can’t discard it either,” Macaya said last month. The CCSS has not released data comparing the outcomes of patients treated with hydroxychloroquine to other methods.

On Monday, Macaya suggested that CCSS’s commitment to daily check-in calls for everyone infected with SARS-CoV-2 has helped keep deaths low.

The daily conversations and ongoing symptom tracking ensure that patients are hospitalized at the appropriate time, Macaya said. 

National CFR of 0.75% and only 5% of actives needing hospitalization?  "Needs more research"  What are they testing, boner pills?

 

...while this is the fruit of scaremongering and politicization in a health care crisis:

 

think anyone will pity us when this is all said and done?

[Anastasis 23471]

14 hours ago, triplehorn said:

think anyone will pity us when this is all said and done?

I pity people who tweet post hoc power analyses in the context of a sample size discussion for a prospective interventional trial. 

[wildcat09 29447]

I can't help but see any Triple post on HCQ without thinking of grandpa Simpson.

[triplehorn 2664]

15 minutes ago, Anastasis said:

I pity people who tweet post hoc power analyses in the context of a sample size discussion for a prospective interventional trial. 

What prospective interventional trials?  That’s the point.  Evidently many were stalled or plain kneecapped in the US by lack of enrollees reacting to the hysteria.

[Anastasis 23471]

Just now, triplehorn said:

What prospective interventional trials?  That’s the point.  Evidently many were stalled or plain kneecapped in the US by lack of enrollees reacting to the hysteria.

The post-exposure prophy one.  Talking about post-hoc power analysis is nonsensical in this setting.  Power is a function of sample size and effect size.  The effect size associated with HCQ is apparently extremely small in PEprophy setting (v=0.03).  Yes, you can overpower your study to detect a very small and clinically insignificant effect. That is math, but it misses the point entirely.  The effect sizes suggested early on for HCQ have simply not materialized. These are arguments intended to mislead people who don't understand the concepts being discussed.  

[Homercles 10206]

43 minutes ago, wildcat09 said:

I can't help but see any Triple post on HCQ without thinking of grandpa Simpson.

missed the best part...

[Horn Under a Bad Sign 20538]

 

[triplehorn 2664]

18 minutes ago, Anastasis said:

The post-exposure prophy one.  Talking about post-hoc power analysis is nonsensical in this setting.  Power is a function of sample size and effect size.  The effect size associated with HCQ is apparently extremely small in PEprophy setting (v=0.03).  Yes, you can overpower your study to detect a very small and clinically insignificant effect. That is math, but it misses the point entirely.  The effect sizes suggested early on for HCQ have simply not materialized. These are arguments intended to mislead people who don't understand the concepts being discussed.  

Your’re on a tangent.  Whether or not post-exposure prophylaxis works or not (it appears to not work), it still leaves unanswered important questions about application for early infection mitigation and pre-exposure prophylaxis.  But our pool of enrollees for these studies collapsed due to scary distortions of information and irresponsible communication (Trump).

On the separate matter of overpowering a study, big pharma is known for this such as for repurposing a failed drug meant for something else.  They have unlimited funds for very large studies to pull statistically significant findings out of a hat, and unlimited funds to market it however they want.  “We found a statistically significant finding that subjects averaged 15min more sleep per night with this stuff.  At least we have ourselves a sleep med!”

 

[Horn Under a Bad Sign 20538]

Remember when Elon Musk defied state orders and reopened his Tesla factory early?  The result was predictable, wouldn't you say?

 

https://www.vox.com/recode/2020/6/9/21285625/coronavirus-tesla-elon-musk-fremont-factory

[Anastasis 23471]

13 minutes ago, triplehorn said:

Your’re on a tangent.  Whether or not post-exposure prophylaxis works or not (it appears to not work), it still leaves unanswered important questions about application for early infection mitigation and pre-exposure prophylaxis.  But our pool of enrollees for these studies collapsed due to scary distortions of information and irresponsible communication (Trump).

On the separate matter of overpowering a study, big pharma is known for this such as for repurposing a failed drug meant for something else.  They have unlimited funds for very large studies to pull statistically significant findings out of a hat, and unlimited funds to market it however they want.  “We found a statistically significant finding that subjects averaged 15min more sleep per night with this stuff.  At least we have ourselves a sleep med!”

 

You are all over the place with this man.  You posted a tweet discussing a post-hoc power analysis.  I responded that that was nonsensical, and explained why.  You respond by telling me I'm on a tangent, while simultaneously pointing at a Big Pharma boogeyman about overpowered studies, which has nothing to do with this exchange. 

 

BTW, I tend to agree re: analyses that obsess over p-values and disregard clinical significance.  Which is precisely what the person doing a back of the envelope post hoc power analysis is doing btw. 

[triplehorn 2664]

The relevant information (bolded) from the MD/MPH's tweets above :

" The 4/24 FDA announcement on dangers of #HCQ pretty much killed any further enrollment. (Graph is US only). This happened in all US trials."

The lack of study reports produced by the US compared to what the rest of the world is generating is striking.  If you don't have willing subjects, you don't get results one way or another across all experimental designs.

 

 

[4th&Five 41618]

too difficult for this dumb country.

 

[Guest Lobo]

^
Nope, fake news.  "Reuters?"  The hell is that, that shitty college in New Jersey?  I ain't trusting no East Coast elitist bullshit fakenews site.  

[gmr548 16617]

^
Nope, fake news.  "Reuters?"  The hell is that, that shitty college in New Jersey?  I ain't trusting no East Coast elitist bullshit fakenews site.  

Texas's coaching staff is full of professional reporters.

[Anastasis 23471]

4 hours ago, triplehorn said:

The lack of study reports produced by the US compared to what the rest of the world is generating is striking

Please point out all the RCT data coming out of Costa Rica, India, or whatever third world country that supports your argument. 

[Sawbonz 27706]

On 6/7/2020 at 10:44 PM, NameAlreadyInUse said:

I would love to but I’m not allowed since I caught the gay and periodically have sex with my husband to prove it. 
 

But I had a super hot science teacher in 7th grade and one of our experiments was typing our blood. I figured that’s how everyone found out, though that shows I was in 7th grade before AIDS was a thing. AB- here. 
 

question I have is when they say type A do they just mean Type A or do they mean all the Types that start with A?

This is such a bullshit rule. I did hear they were going to cut it back to three months. Still stupid. First of all, they test for the actual virus in the blood now not just antibodies. Second of all there are plenty of dirty dirty heterosexuals putting people at risk. I actually knew a guy in residency it would fuck anything that wasn’t nailed down. I asked him if he got tested regularly for HIV. His literal answer was I don’t need to. I give blood regularly and they will tell me if I am positive

[Pig Bellmont 8744]

Something something increase in testing 

[elfenix 34364]

3 hours ago, 4th&Five said:

too difficult for this dumb country.

 

THE GOVERNMENT CAN"T TELL ME TO WEAR A MASK!  IF A PRIVATE BUSINESS ASKS THAT"S ONE THING BUT THE GOVERNMENT DOES"T HAVE THE POWER!

[RomaVicta 30039]

4 hours ago, 4th&Five said:

too difficult for this dumb country.

 

I and the beloved just drove to and from New Hampshire from Austin for an urgent family matter. We drove so as not to have to be quarantined for two weeks prior to seeing the person we were visiting. We left here on the 14th and just returned today.

On the way up, pretty good mask wearing. Almost all clerks were wearing masks. Excellent precautions taken at Hampton Hotels we stayed in. In NH, very good COVID precautions.

We started back last Saturday afternoon. Hardly any masks anywhere. By the time we hit Missouri, we're getting weird looks because we would be the only ones in a gas station/store with masks. Even the employees weren't wearing any for the most part. Oklahoma and Texas the same now.

I think we likely came through okay. I wore gloves to put gas in the car and we did well avoinding touching things. We're boomers, so we're vulnerable. I may be a few pounds overweight. Maybe a coupla dozen pounds. Maybe I'm a planet. So, I need to be careful.

Sorry to read about Bama Chick's friend. It's still odd how abstract this disease feels. The police issue is vivid because we saw the Floyd slaying on video and now the brilliant demonstrations fill our TV screens. Covid remains a plague that looms like a math problem instead of a nasty disease that inflicts suffering and a bad death.

Now the numbers seem to be telling the story that the scientists expected. At least the scientists who remain true to the traditions of science.

[Ghost of LL 15559]

Condolences to @Bama Chick.  That's really terrible to hear.

[triplehorn 2664]

1 hour ago, Anastasis said:

Please point out all the RCT data coming out of Costa Rica, India, or whatever third world country that supports your argument. 

We can go round n round about it.  You've set your bar at RCT.  There are a lot of sound reasons a broad range of other study designs exist.  They have meaning and applicability.  The main advantage of HCQ, which I expect is backed by numerous RCTs spanning decades, has to do with established safety and known risks to consider.  Once you have safety in hand, it gives clinicians a lot more leeway to rapidly search for applications where saving lives can occur before you can complete comparatively time consuming RCTs on various specific targeted uses.  this is a war, not a half speed drill.

Other rapidly applied study designs have already been done that suggest a benefit under specific conditions.  If safety is known, and it costs about $0.60 per dose, there should at least be support for providers and their informed consenting patients opting to take it if it might help.  We're at 110,000 dead Americans just 3 months into this fight.  It's obvious from the actions of numerous nations and their medical communities that they are seeing benefits from how they are incorporating it, and that it's safe at a minimum.  I don't believe those involved in such national policy decisions are reckless or dumb.  In fact, most everyone is kicking our asses across the board in efforts to fight this virus. 

But again, it was Trump's gross mishandling of the subject of HCQ with the public that resulted in the FDA having to oversteer to keep the public from taking aquarium cleaner and gargling bleach, and to shut down access and use through legitimate medical pathways.  The secondary result was most everyone suddenly rejecting being in a HCQ study based on misplaced fear and/or negatively associating it with Trump.  Too much is still at stake to blow this.

[HenryJames 66228]

 

[Anastasis 23471]

  

38 minutes ago, triplehorn said:

We can go round n round about it.  You've set your bar at RCT.  There are a lot of sound reasons a broad range of other study designs exist.  They have meaning and applicability.  The main advantage of HCQ, which I expect is backed by numerous RCTs spanning decades, has to do with established safety and known risks to consider.  Once you have safety in hand, it gives clinicians a lot more leeway to rapidly search for applications where saving lives can occur before you can complete comparatively time consuming RCTs on various specific targeted uses.  this is a war, not a half speed drill.

Other rapidly applied study designs have already been done that suggest a benefit under specific conditions.  If safety is known, and it costs about $0.60 per dose, there should at least be support for providers and their informed consenting patients opting to take it if it might help.  We're at 110,000 dead Americans just 3 months into this fight.  It's obvious from the actions of numerous nations and their medical communities that they are seeing benefits from how they are incorporating it, and that it's safe at a minimum.  I don't believe those involved in such national policy decisions are reckless or dumb.  In fact, most everyone is kicking our asses across the board in efforts to fight this virus. 

But again, it was Trump's gross mishandling of the subject of HCQ with the public that resulted in the FDA having to oversteer to keep the public from taking aquarium cleaner and gargling bleach, and to shut down access and use through legitimate medical pathways.  The secondary result was most everyone suddenly rejecting being in a HCQ study based on misplaced fear and/or negatively associating it with Trump.  Too much is still at stake to blow this.

Lots of words to say that you don't have any level 1 evidence to support. 

 

38 minutes ago, triplehorn said:

You've set your bar at RCT. 

 

I think that we have gone over this before, but it is not my bar.  It is the bar of modern medical science.

If you want to fret about something related to COVID related research, you should fret about the time, energy and resources that have been wasted chasing the HCQ ghost based on that whacked out french data.  Those resources could have been better spent on other avenues of inquiry. 

Edited June 11, 2020 by Anastasis

[HenryJames 66228]

 

[triplehorn 2664]

16 minutes ago, Anastasis said:

  If you want to fret about something related to COVID related research, you should fret about the time, energy and resources that have been wasted chasing the HCQ ghost based on that whacked out french data.  Those resources could have been better spent on other avenues of inquiry. 

for someone so critical of having RCTs to back a stance, you're dealing in hypocrisy in that you clearly have made up your mind.

 

 

And another cheap, generic, FDA approved for safety antiparasitic with signs it's effective against Cov19.  This one helping late stage complicated illness:

 

 

[Anastasis 23471]

14 minutes ago, triplehorn said:

for someone so critical of having RCTs to back a stance, you're dealing in hypocrisy in that you clearly have made up your mind.

Approaching word salad my head shrinking friend.

I am actually totally in favor of exploring ivermectin as a therapy.  Better use of resources at this point than chasing HCQ delusions. 

[cactusflinthead 27609]

Hey, while y'all are arguing about HCQ you think we can find out which communities are getting hit in this spike?

Or is it the availability of more testing?

What's the body count? We're getting close to WW1 last I saw.

Are y'all going to continue to spam shit out of the thread or maybe find some goddamn news?

 

[triplehorn 2664]

32 minutes ago, Anastasis said:

Approaching word salad my head shrinking friend.

I am actually totally in favor of exploring ivermectin as a therapy.  Better use of resources at this point than chasing HCQ delusions. 

I recall you saying you have not been involved in clinical work for awhile.  Don't what you did in that capacity, but my sense is that you weren't engaged in direct medical decision making with patients having critical medical or mental illness.  Your approaches and tools aren't limited only for uses that have been subjected to randomized controlled studies.  RCTs are great to have to help inform understanding and use.  RCTs can be very important in what gets FDA approval or not.  They can form underpinnings of medical-legal considerations.  They help establish procedures and treatments that insurance will pay for and prescription uses for which people won't have to pay out of pocket to acquire. 

RCTs are the most solid reference point, but there is a vast territory in medicine that is not mapped out by RCTs.  There is an awful lot to be said for direct clinical experience - having lots of repetition, and lots of outcomes under careful observation.  A knowledgable and experienced clinician can navigate to safely give a person the best chance to survive and heal in the moment when their life and wellbeing is on the line, and when there is no textbook answer or randomized trial to reference.  That is what is happening here x10 with Covid-19.  

[NameAlreadyInUse 5132]

Can y’all go ahead and fuck already?

[Anastasis 23471]

 

1 minute ago, NameAlreadyInUse said:

Can y’all go ahead and fuck already?

Not until an RCT tells me that triple should clean up his chin. 

[Anastasis 23471]

14 minutes ago, triplehorn said:

I recall you saying you have not been involved in clinical work for awhile.  Don't what you did in that capacity, but my sense is that you weren't engaged in direct medical decision making with patients having critical medical or mental illness. 

Yes, I have not been in the clinic for quite some time, but your sense is wrong my friend. 

14 minutes ago, triplehorn said:

Your approaches and tools aren't limited only for uses that have been subjected to randomized controlled studies.

Once again, you fail to acknowledge the basic concepts underlying evidence based medicine, and how the various levels of evidence should translate to clinical practice. 

14 minutes ago, triplehorn said:

RCTs are great to have to help inform understanding and use. 

No shit? Random assignment balances out both measured and unmeasured confounders and allows us to make relatively unbiased conclusions regarding safety and efficacy. Who could know such a thing?

 

14 minutes ago, triplehorn said:

They can form underpinnings of medical-legal considerations.  They help establish procedures and treatments that insurance will pay for and prescription uses for which people won't have to pay out of pocket to acquire. 

Speaking of tangents.

14 minutes ago, triplehorn said:

RCTs are the most solid reference point, but there is a vast territory in medicine that is not mapped out by RCTs. 

This is quackery. 

 

 

Edited June 11, 2020 by Anastasis

[Bama Chick 28596]

Thanks again fellas.

The hospital where I work officially ran out of vents today and we are over ICU capacity and into overflow.

The whole state is seeing a huge spike in hospitalizations and deaths.

We lost a 42 year old female patient today. My office is next door to our palliative care nurse.

I had to go take a walk. The sobs of her teenage daughters was too much.

It’s been a really shitty couple of weeks.

[gmr548 16617]

7 minutes ago, Bama Chick said:

Thanks again fellas.

The hospital where I work officially ran out of vents today and we are over ICU capacity and into overflow.

The whole state is seeing a huge spike in hospitalizations and deaths.

We lost a 42 year old female patient today. My office is next door to our palliative care nurse.

I had to go take a walk. The sobs of her teenage daughters was too much.

It’s been a really shitty couple of weeks.

Damn. That is brutal, and of course, I am sorry for the loss of your friend. It sucks to feel so powerless. Hang in there - I know it's not much, but this anonymous internet community of dudes from Texas is wishing you the best. 

[6th Street 6509]

2 hours ago, HenryJames said: