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infectious diseases, human rights, harm reduction, surfing

North Shore, Oahu
Joined July 2020
🗑 in = 🗑 out Low-quality evidence from a bunch of retrospective cohort studies is still low-quality evidence from a bunch of retrospective cohort studies, even after being combined in a meta-analysis and published in Nature and tweeted by a cardiologist with a big following.
When individual studies come out, I sometimes spend time critiquing them on Twitter if they have issues. When those same studies end up in a meta analysis, I 🤷‍♂️.
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Thanks @Brianeno for spending 7,104 minutes with me in 2022. I couldn’t stop listening to 1/1 - Remastered 2004. #SpotifyWrapped open.spotify.com/artist/7MSU…
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No better soundtrack for charting and writing papers than @brianeno Ambient 1: Music for Airplanes. Never gets old. Really into @MtWolfOfficial too this year. @Spotify #SpotifyWrapped
Lance Burkhart retweeted
think there are maybe some issues with the 'intermediate' sequences described in that paper... think some folks are trying to get access to the raw data to take a closer look...
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Lance Burkhart retweeted
ADDITIONAL BOOSTERS: This corresponds to a Washington Post piece I wrote last spring about how older people persistently seem to be the ones who need additional boosters as opposed to everyone washingtonpost.com/outlook/2…
6-month follow-up study comparing antibody responses & vaccine effectiveness against infection amongst previously uninfected HCWs who got a 4th dose compared to those who got a 3rd TL;DR additional advantage of a 4th dose was minimal and short-lived nejm.org/doi/full/10.1056/NE…
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Help me acknowledge #WorldAIDSDay & #womenInSTEM by tagging a woman #HIV #AIDS researcher you admire! Here's some more: @ProfAdeeba @BasselNabila @DrJeanneM @DrMonicaMalta
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If only we could bill our chart biopsies as procedures
Infectious Diseases had a rough match this year w 44% of positions going unfilled. I will pick ID over again if I had to have a redo but it's clear that we need to do more more to recruit trainees into this exciting yet under-compensated specialty. ID is fun ain't cutting it!
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Lance Burkhart retweeted
Our research paper is online @NEJM in which we conclude that the reemergence of cholera in #Haiti is caused by a descendent of the V. cholerae strain that caused the 2010 epidemic 1/ nejm.org/doi/full/10.1056/NE…
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Lance Burkhart retweeted
I don’t think the N95 study vs surgical masks is the same. It’s more like saying my new parachute is so much better than the standard ones because it’s made of superior fabric. But then no evidence that in the real world it performs any better.
Replying to @CollignonPeter
Here is a similarly brilliant randomised study showing that parachutes do not prevent death or serious injury when jumping from airplanes.🤦 bmj.com/content/363/bmj.k509…
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It wasn’t “woefully underpowered,” as Dr Topol claims. It wasn’t underpowered at all. There are limitations, as is the case with every trial, but statistical power is not one of them.
Replying to @EricTopol
The study isn’t underpowered. It was a noninferiority trial which was sufficiently powered & designed to answer their research Q- & no difference was found in infection rates in the surgical mask vs N95 groups.
Lance Burkhart retweeted
Over the past few months something interesting has happened with the evolution of SARS-CoV-2 - rather than discrete clonal(ish) waves of BA.1, BA.2 and BA.5 we've seen huge diversification of lineages - to explain whats going on we've written a report: virological.org/t/sars-cov-2…
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Lance Burkhart retweeted
The paradox of the pandemic is that while vaccines against COVID were developed and deployed in record time, routine immunization programs were badly disrupted. Millions of kids missed out on life-saving vaccinations against deadly diseases like measles. cdc.gov/media/releases/2022/…
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Every single published study of Paxlovid in vaccinated people is unreliable because of 👇
Replying to @ABsteward
Repeat the mantra Unmeasured confounding Residual immortal time bias Confounding by indication Observational studies cannot replace RCTs to inform regulatory decisions for efficacy (as seen in the 50-60% success rate of RCT duplicate project)
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The hype around a possible “tripledemic” may be a false alarm, thanks to viral interference. We shall see… Fascinating article by @sciencecohen with insight from @bencowling88 and others.
SARS-CoV-2 and other respiratory viruses often “interfere” with each other. researchers who study these viral collisions say there is little chance the trio will peak together and collectively crash hospital systems the way COVID-19 did science.org/content/article/…
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Lance Burkhart retweeted
Jim and Sabrina Aston’s son Daniel died last night at Club Q. He was a bartender but last night he was also performing. He was a trans man and they feel strongly that speaking out may help others. This is a photo of them holding a photo of Dan at 5 years old. Story TK.
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Lance Burkhart retweeted
Great work from the Prof here. Covid has been a very real and serious public health emergency that we needed to take seriously. However the number of people that have exploited this moment has been disheartening. Intentional alarmism feeding an already anxious public.
Time for an update on BQ.1/BQ.1.1 in the US. 1/
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Lance Burkhart retweeted
🤔 who’s dying from COVID? I haven’t seen any. My 90 year olds are doing great. My 80 year old who got COVID during induction chemo did great too. Agree that early rx for high risk individuals such as above is 🔑, but really, who’s dying? Is it from COVID anymore or with COVID?
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2nd study: bit.ly/3ArPidN Observational retrospective cohort study based on EHR data, which is limited by multiple biases- “immortal time bias, confounding by indication & residual confounding…by vaccine & prior infection status,” as discussed by @DrToddLee et al 3
What is the place in therapy for nirmatrelvir/ritonavir? A thorough EBM Analysis by @DrToddLee, @jpogue1, @ErinMcCreary, @ASPphysician #FreeAccess #COVID Link: bit.ly/3OgppTY
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And lastly, “EPIC Research” This is unadjusted, unreliable, descriptive EHR data, from which we can’t infer anything about Paxlovid effectiveness, as @apsmunro notes: 4
Replying to @michaelzlin
This is *categorically NOT* Paxlovid efficacy This is a completely unadjusted analysis, it is literally descriptive data that says the outcomes are different We absolutely cannot infer anything causal from this at all, and to suggest otherwise is extremely misleading
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