Grand Rounds Wash U St Louis. ISSUES with Cancer Trial design

[@mpoharper]

Really great analysis. Mucosal Melanoma patient here. 5 year survival is horrible. I have had ipi/nivo, opualog, and Keytruda. I am doing well. My cancer is under control. Diet and exercise I believe has helped.

[@SasquatchPicker]

If a meteor was to hit the planet in an extinction level event; Vinay Prasad, as a survivor would be asking himself. . ."where are the randomized control trials?!" LOVE YOU

[@theprogressivemichigander6588]

Someone has to make sure humanity's understanding of medicine doesn't devolve to mere superstition in the after times. I don't want my post-apocalyptic diseases to be treated with leaches by a doctor who doesn't know if hand washing works.

[@patrickhaarhues2870]

Yes he is a bit of a tool like that. Without a RCT he would not be able to find his ass from a hole in the ground. Did you see his early Covid vaccine videos? He was so wrong. He knew he was wrong.

[@Holly-days]

@@theprogressivemichigander6588 As it happens, leeches are still in use in medicine. And, I don't know any medical personnel who don't think handwashing works. But yeah, Vinay is making sure as best he can that medicine is contolled by "mob science."

[@robfreeman5783]

Would be awesome if we could claim CME credit for these vids.

[@ben.tanner]

You may be able to claim category 2 CME for this. I can (as a PA).

[@thegamejunkie1]

👍

[@DylanYoung]

Can you take the observational studies that match the RCTs and try to determine the attributes of the observational studies that (appear to) make them higher quality / more reliable?

[@DylanYoung]

Seems like study design might be a good use of AI? Or at least study validation.

[@ben.tanner]

They've tried to do something kind of similar, but even the experts aren't able to figure it out a lot of the time. Vinay has referenced this a few times.

[@johnranalletta9249]

Why do we allow cancer physicians to "buy" chemo from suppliers and "sell" them to patients. Conflict of interest, no? 94 y/o SIL taking a chemo treatment every day this week. Really?

[@traianliviudanciu8665]

Did we know at what tissue temperature did SARS COV2 better replicate ? Why ? Because at TWiV 659 at min29 virologist Christian Drosten suggest that SARS COV2 better replicate at very low tissue temperature. May be only virologists that work in a BSL3 or 4 can know If new variants of SARS COV2 really replicate at very low tissue temperature ? But If IT replicate at very low tissue temperature, theoretically high mucouseal respiratory temperature protect against SARS COV2 infection and Covid19 disease. How can increase upper respiratory temperature,If body thermogenesis are weakened by different causes ? Rapidly,I guess, by bandana or surgical mask wearing. But how can improve thermogenesis ? May be must avoid to decrease lung temperature If SARS COV2 infection occur ?

[@LilJbm1]

I apologize it's difficult to understand you but I question some of the conclusions you seem to draw here. Those findings don't surprise me in the sense that generally microbes survive worse in warmer tissue hence why our bodies produce fever for 2 reasons. Either 1) higher temperatures less hospitable to the microbe or 2) Immunological cells function at higher levels more efficiently at higher temperatures giving better defense. Masks don't really do anything and this data is more supporting allowing fever to run its course rather than treat with antipyretics unless temperatures become dangerously high risking tissue damage (like fever above 104F)

[@traianliviudanciu8665]

@@LilJbm1 If fever occur,and we wear surgical mask or bandana, mucouseal respiratory temperature increase more at that level and can stop viral replication. With a non contact, infrared, termometre,can measure that temperature at faringial level

[@traianliviudanciu8665]

@@LilJbm1 but If SARS COV2 infection occur,may be must use more warmed oxigen mix to avoid decrease lung temperature

[@traianliviudanciu8665]

@@LilJbm1 did tendency of erytocyte to agregate at higher globuline level increase If blood temperature decrease ?