Great introduction that should whet everyone's appetite for this series. Dr. John Ioannidis pointed out that 95% of medical journal articles are nothing but junk science. One can quibble about the percentages but, in my opinion, he is pretty close to the truth. I am especially interested in analysis of studies that purport to show the benefits of statin drugs since all three of you seem to support their use for optimal medical therapy to prevent the complications of coronary artery disease.
Shouldn't this kind of teaching be part of standard pre-medical teaching too? I don't think it is--correct me if I'm wrong. Especially if it's not even standard in 4-year medical training. (I'm surprised by the suggestion below to wait until the 4th year. I think first-year med students could handle reading Prasad's Malignant.) I'm a political scientist, and I know that standard training in quantitative methods is quite sophisticated at the graduate level, possibly even more sophisticated than in medical schools (?). That's not to say I'm all that impressed by published quantitative research in my field. And see what Ioannadis says about what gets published in economics journals! But in the end, that doesn't matter as much. As I like to say, as PhD's we're doctors too, but a big difference is that we can't kill people legally.
Have any medical schools expressed interest in this course or have any integrated them into their curriculum? I wonder if 4th year in medical school might be a better time for med students to hear this information after getting a little experience under their belts?
Regarding the issue of bias in RCTs, hope you will discuss the increasing use of complex combined and surrogate endpoints. This has led to degradation of information quality in cardiology and probably other fields. Also, run-in periods like they used in the ARNI pivotal trial - they seem designed to "weed out" subjects destined to have a bad reaction to the agent. Is there a legitimate use for them?
Finally, the deepest source of bias is that investigators have a strong professional stake in the outcome of an RCT. This is understandable, given the amount of time and effort invested and the differential professional consequences of a "positive" and "negative" trial, but if we are really acting as scientists, we should not care whether the null hypothesis is true or not, only what the truth is.
Or at least more wider ranging political discussions, and perhaps more detailed pros and cons of using untrammeled (unconstitutional) executive power to club universities (along with law firms, news organizations, judges, etc.,) into submission--with lots of collateral damage to innocent people and American values.
The longer I practice medicine, the more I realize that without the skills you are teaching, my decisions are much more likely to take my patients down a rabbit hole. I feel that the amount of studies appears to grow every year and choosing what to read is getting more difficult. Finding knowledgeable teachers who do not conflicts of interest is also difficult. I am very happy that you are undertaking this important project for the benefit of all our patients.
Great introduction that should whet everyone's appetite for this series. Dr. John Ioannidis pointed out that 95% of medical journal articles are nothing but junk science. One can quibble about the percentages but, in my opinion, he is pretty close to the truth. I am especially interested in analysis of studies that purport to show the benefits of statin drugs since all three of you seem to support their use for optimal medical therapy to prevent the complications of coronary artery disease.
Even from just the first video, I can tell that this needs to be required viewing in every medical school in the country
Shouldn't this kind of teaching be part of standard pre-medical teaching too? I don't think it is--correct me if I'm wrong. Especially if it's not even standard in 4-year medical training. (I'm surprised by the suggestion below to wait until the 4th year. I think first-year med students could handle reading Prasad's Malignant.) I'm a political scientist, and I know that standard training in quantitative methods is quite sophisticated at the graduate level, possibly even more sophisticated than in medical schools (?). That's not to say I'm all that impressed by published quantitative research in my field. And see what Ioannadis says about what gets published in economics journals! But in the end, that doesn't matter as much. As I like to say, as PhD's we're doctors too, but a big difference is that we can't kill people legally.
Looking forward to this. Been fooled for 45 years.
Have any medical schools expressed interest in this course or have any integrated them into their curriculum? I wonder if 4th year in medical school might be a better time for med students to hear this information after getting a little experience under their belts?
Great start, I will look forward to this series.
Regarding the issue of bias in RCTs, hope you will discuss the increasing use of complex combined and surrogate endpoints. This has led to degradation of information quality in cardiology and probably other fields. Also, run-in periods like they used in the ARNI pivotal trial - they seem designed to "weed out" subjects destined to have a bad reaction to the agent. Is there a legitimate use for them?
Finally, the deepest source of bias is that investigators have a strong professional stake in the outcome of an RCT. This is understandable, given the amount of time and effort invested and the differential professional consequences of a "positive" and "negative" trial, but if we are really acting as scientists, we should not care whether the null hypothesis is true or not, only what the truth is.
This is the valuable stuff I expected when I signed up for your newsletter- not political comments about quashing Harvard
Or at least more wider ranging political discussions, and perhaps more detailed pros and cons of using untrammeled (unconstitutional) executive power to club universities (along with law firms, news organizations, judges, etc.,) into submission--with lots of collateral damage to innocent people and American values.
This is exactly what I’ve been looking for! 👏
This is awesome, can't wait to see the first lecture!
Excited for this! Filling a huge gap in medical training 👏
This is Amazing!! More please!!!
The longer I practice medicine, the more I realize that without the skills you are teaching, my decisions are much more likely to take my patients down a rabbit hole. I feel that the amount of studies appears to grow every year and choosing what to read is getting more difficult. Finding knowledgeable teachers who do not conflicts of interest is also difficult. I am very happy that you are undertaking this important project for the benefit of all our patients.
Fantastic kick-off! Sending to everyone I know and hope they’ll all subscribe. Thanks!
Great, Thanks!!!