Randomized Trials 101 | 2:1 randomization |K-M plots | Time to Event Endpoints & More
ฝัง
- เผยแพร่เมื่อ 26 ก.พ. 2023
- Vinay Prasad, MD MPH; Physician & Professor
Hematologist/ Oncologist
Professor of Epidemiology, Biostatistics and Medicine
Author of 450+ Peer Reviewed papers, 2 Books, 2 Podcasts, 100+ op-eds.
If you want to contact me, do it here: www.vinayakkprasad.com/contact
Google Scholar: scholar.google.com/citations?...
Substack: vinayprasadmdmph.substack.com/
Podcast: podcasts.apple.com/us/podcast...
Personal Website: www.vinayakkprasad.com
Laboratory Website: www.vkprasadlab.com
Podcast Website: www.plenarysessionpodcast.com
Academic Publications: www.vinayakkprasad.com/papers
Follow me on:
Twitter @vprasadmdmph
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Wow, free education that I can use in my daily life to make informed decisions. Dr Prasad is a rare treasure. Thank you!
I love the fact that Vinay looks more irritated with the covid BS every single video he puts out.
I always circle back to the T Dawg Laughing video.. yea he looks so angry
Probably because they’re tarnishing his name too. Same thing happened to Dr John Campbell
Well yes but it took a while.but it was a bit more gradual. The camble went 180 degree in like 4 weeks
Agreed... but the BS can get any person annoyed who recognizes logic apart from trash.......
His acting is improving 💯
I think the insanities are inspiring Vinay to develop a captain Ahab look . Love it!
"To learn who rules over you, find out who you can't criticize."
Rev 3:9 "Behold, I will make them of the synagogue of Satan, which say they are Jews, and are not, but do lie; behold, I will make them to come and worship before thy feet, and to know that I have loved thee."
In the words of the Dark Horse folks, the complexity of the problem or situation is underappreciated.......thanks for you comprehensive insights.
Dr. Prasad’s shredding of horrendous mask studies is exactly like Bret’s meticulous review of studies focused on another treatment, with an oppositely favored outcome. Someday I hope Dr. Prasad spends an afternoon looking over them instead of assuming masks are the only corrupt area of study. After that maybe he can spend an afternoon looking at court ordered trial data for another treatment.
They disagree on some things, which is something I like a lot. Listening to Sam Harris, Vinay Prasad, and Bret W. Gives a pretty broad view of the subject
I love your honesty and your bravery to stand up!!
his smile and optimism: gone
Dr. Prasad, just wanted to let you know that your work here on youtube is extremely valuable to me
Thank you doctor. The popularity of the lie in pop culture weighs heavily on my spirit. Respectful disciplined dissent is just so rare with the pressures to win in our feudal landscape. Understanding the function of the tools better, would help the partially educated such as myself, stand against the myriad cons that are played for power and profit.
In both my professional and personal life making mistakes is part of the growing and learning process. The key part is learning from those mistakes and trying not to repeat. It’s not easy admitting wrong. Especially in this area which has negatively affected tens of millions of people. It takes special courage to do so. Too many are still clinging to the false and disproven narratives. Thank you sir for not being one of those people.
Dude Vinay, I have absolutely loved watching your physical appearance change over the years.
Thank you Dr Prasad. Love your no BS straight shooter approach. Much appreciated that you continue to keep it real.
Dr. Prasad, can you have some simple guide to laymen over how to identify common pitfalls in treatment studies?
There is nothing simple.
You have to look at the data and have at least some knowledge of what it means.
You have to be able to spot errors.
You have to read a lot.
Look for anomalies.
Look for positives when the title says it's negative.
As an example, stopping a trial and saying it didn't reach the endpoint goal when all the data showed trends to the point where you might see benefits.
You have to have knowledge to know what you are looking at.
Another example when you see a study of giving treatment one time and declaring it a failure when you already know it would be closer to one hundred treatments to see an effect.
Headlines would declare it a worthless treatment and people such as ignorant news script readers will amplify the false message.
Look for who paid for the study.
Find people who disagree with the study.
Nothing is simple.
As a layperson, WOW! What a valuable presentation for my health groups. Key study design concepts elegantly expressed! Thank you.
Thanks, Dr. Prasad! As a medical student and EBM fan, I'm looking forward to the new substack.
Wow! That was amazing. Watching you over the last several years, I was familiar with much of what you spoke about. But it was really inspirationally informative to hear you so clearly and concisely explain it. I'm not a medical professional. Many years ago I built software. Now I build houses. Both are far removed from medicine, but with a little effort, I had no problem understanding your explanations. That's a huge kudos to you. The only thing I would ask you to consider changing is if you could provide a single place where we could support your efforts. Several times I have started to go and subscribe to you. Every time I have been thwarted, because I'm not sure if I should subscribe here on your TH-cam channel, on sensible medicine, or now on your drug development letter? I will choose someplace soon and subscribe because I want to support your work. But if you gave us a single place to do that, I believe you would get more support.
Thank you again; there continues to be an abundance of preference for propaganda/ fake science among mainstream. You don't need to have deep understanding of statistics to be able to identify profit centered advertising.... it persists and takes along in its wake too many health professionals
Vinay should put together video courses in statistics and statistical analysis of science. I would pay to watch those.
"What I was really eager for is the ability to really learn how to read and interpret research. Statistics are vital in our proper understanding of the world. You are an expert in that domain, and an authentic one at that. I really appreciate when you go over research (Barney -style) and give us Plebians a rudimentary, but necessary interpretation in real time of how proper research is conducted. I think that you would be amazing at telling the general populace how to properly interpret research specifically to become successful in learning. That would be a great niché for you." ..... Glad to see that you are moving into this space. Hell yes
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Your passion for analytical precision reminds me of Thomas Sowell! Great content as always!
I am sure VP will appreciate that comparison.
The beard is getting for real.
Based on the thumbnail progression I fully expect him to emit psionic lightning within the month... "involuntarily", of course.
Thank you! Learned all this way back in my college days, in statistics and research testing, development and design. Some of the finer points have been lost in the fog of time so I really appreciated this! After those classes I never accepted new information without asking questions about how the results were obtained.
Incredible. Please keep the education on RCTs coming. So important imo
Dude you’re amazing. I dig your eclectic coverage of many things that pique my interest. Thank you for unbiased thoughts and proofs. You rock !!
beard is look good my dude
I'm watching more and more of your channel. And I really really like it. But I just wish you would acknowledge Peter McCullough and Robert Malone. Ask them to come on your show and ask them the questions that you are qualified to ask which would be very enlightening given their answers. Maybe you could dispel Unsubstantiated believes one way or the other.
Thank you for speaking up.
This is a great educational lecture!
Wonderful~ thanks so much. Shared!
The most fascinating part of reading RCTs is looking for really clever sham treatments, all the details they got into to maintain blinding
Thank you Vinay, I've learned so much from your channel ~👍
Very nice Vinay, a voice of reason in a sea of emotional insanity.
Thank you Vinay
Master class! Thank you 🤗
Vinay you're looking very "Hollywood" these days. It suits you. Keep up the great work. Thanks.
Very nice. Glad I woke up early today.
I've been waiting for this video topic!
Thank you ❤
Thank you.
Nice. Great job and information, thank you from Canada 💜
This is so interesting. I would love to see a RCT in the future on whether the placebo effect can actually extend life. Also, I love the lighting.
Medicine has plenty of parachutes. Insulin for diabetics and antibiotics for simple infections are two obvious ones.
*lovely.* sounds lovely. _JC
I have really enjoyed your analysis on all of the covid bs research. I would love for you to do the same analysis for all of research to date for the vaccines on the current schedule. I’m quite sure what has occurred over the last 3 years is not by chance but rather a climax of the major corruption within the big government agencies over a long period of time.
There was an interesting article by a Dr. Lucky Tran in the Guardian titled, "Don't believe those who claim science proves masks don't work" in regards to the Cochrane report, as well as linking to the studies that CDC cites. Would be very curious on your response to those. Thank you for the information and effort you provide for ethical science. God bless :)
Dr. Lucky Tran should only be seen in a hazmat suit with respirator in public, they work.
See Vinay's earlier videos. He covered the Cochrane study and the responses to it.
“To prevent disease place this moist, mucus filled, soggy cloth on your face for 8 hours and during all public interaction” - “and by cloth we actually meant n95 but let’s not harp on it” - “and the years of censorship of opposing views, that’s just evidence of Gods will in protecting the Holy Masks” - Does anyone else feel this is the start of a religious cult? I’ve rejected masks on the grounds of religious freedom for a long time and it’s only become more and more valid.
Grifter Tran likes CDC "studies" that are all crap including the haridressers!
@@trucid2 I had seen the video, but hadn't caught any response for comments like the ones Dr. Tran had presented. Very easily may have forgotten as well, but given it being a proper doctor's response and the sourcing to CDC cited studies, I was/am interested in a more in-depth evaluation.
As you mentioned - the problem is bias, so if you don't like the outcome you may not show it to your boss or maybe give it a little push here and there so it looks better! What happened to going all in on trying to disprove your own hypothesis - a tough thing to do unless you realize you better be damn right. I don't think that matters much today - no serious consequences.
Do such an RCT comparing the most basic protocol from ancient Chinese bodywork (not even acupuncture or anything complicated) and you will find that for at least 90%, or possibly more, of all 'disease' that we track in 'medical science', the prescriptions from this old school healing modality will be found to be more effective and far, far, far more safe than 100% of the interventions recommended currently by 'medical science'. This is why I put quotes around that fraudulently-constructed term that is more industry marketing than actual science of any kind. Your beard looks great. Love you.
I would love to hear more of Dr Prasad's thoughts on placebo. It would seem that in cancer research at least you are looking at hard outcomes and no one really thinks that placebo is driving 5 year survival. How would one study psychedelics for PTSD? Or SSRIs for migraine prophylaxis?
Hey, Vinay, I’m liking the new shaggy look you’ve got going on.
Thank you for doing different content than covid policy
Is dr Prasad growing a beard as a way to call BS on masks?? Appreciate the information in this podcast!
This is what I found out when I began looking into HIV1. late 80s and early 90s.
Wish I could remember the doctors that explained this. They were all persecuted as homophobic. How the deadliest disease known to man went to an asymptomatic virus we had to test for. Seen this hustle done way better 40 years ago.
The recent world scale trial had time + 2 weeks (3 in some countries) and any negative effects within that period were loudly and gleefully thrown into the control group. How do we eliminate that type of cartoonish level of fraud?
Naatu naatu naatu veer naatu
Just thinking about tourniquets. When you see the number of single and multiple amputees from combats such as Afghanistan or Ukraine, the tourniquet has to be one of the most cost effective "medical treatments" there is.
🙌
He looks like he's been through a rough patch.
Why does Dr. Prasad look like he's shooting a hostage video?
Loving the beard V! For real
Have you seen the study that says erythitol (sugar substitue- think that's how it's spelled) causes heart attacks? Would like to hear your thoughts on this if you can.
Only associations, not causality.
Ref: The artificial sweetener erythritol and cardiovascular event risk (nature medicine, Jan 2023)
I develop models of complex systems (space, terrorism, biometrics, & even pandemix detection)
Models, like RCT’s are imperfect. We are sometimes unaware of an important factor. In short, RCT’s may produce incorrect conclusions.
As both a writer and reviewer of peer reviewed publications I know that peer review isn’t short hand for “correct”
Please discuss risks and unknown unknowns
Respectfully
As a person re entering the cancer world again (breast cancer spread to bones) I appreciate knowing smart people are still out there fighting for us. I know everyone is exhausted after the past 3+years but there are always new people needing help who want to live!!!
Totally agree. I have CRC, and navigating the fairly useless standard of care while trying to pore through studies on repurposed drugs and plant based supplements becomes a full-time job.
You are epic
My sons Dr. wanted to give my 8 year old son the covid shot today. He said, my 2 year old son is vaccinated, I trust that they are safe and will give my son all available vaccines.
I asked if he kept up with recent studies and told him I have lost “faith” in the CDC. He said there’s a lot of misinformation out there.
If I had young children I would vaccinate them. Yes their chance of bad outcomes from Covid is tiny……but it’s not zero.
My sons are adults and have had three shots and mild cases of Covid. I think they are probably okay for immunity now, unless something really whacky happens.
You’re the mother and at the end of the day it’s your decision. However if I was in your shoes, I would have my kids vaccinated.
Retired Nurse
@@karenkaren3189 my family has all had it, likely omicron- did not see any symptoms at all with the exception of my 51 year husband who tested to avoid spreading it at work and enjoyed some paid time off. We haven’t tested again, since even with a positive test your okay to attend school and work.
I truly do not understand why anyone would currently give a healthy child an outdated vaccine with known risks .
Kids do well with the virus overall... and every child has their individual issues.. the mrna of the vaccine lasts in the body at least 28 days; normal mrna lasts minutes. truly discuss with your pediatrician the risk benefit ratio. myocarditis is never mild. evidence based medicine doesn't exist when the drug company does the study. local hospital month of January: 247 people tested for covid 27 positive. 10 hospitalized of those 5 fully vaccinated for covid. comorbities such as asthma, obesity, dm, play a big role in disease outcome Talk with your doctor, pray on it. best wishes...
@@karenkaren3189 you do know they've been banned for anyone 55 and under in several Euro countries, right? Amazing how the Scandinavians are the smart people until they don't agree with the main stream media.
@@karenkaren3189 you should have been a terrible nurse....
Hope you’re feeling better! Can you comment on fda approval of rsv vaccine? 🙏🏻
Vinay, really appreciate your work. Each time I see you with your "new look-beard" and longer hair I wonder if you are trying out for role on The Chosen :) just have to rib you a bit :)
I didn’t even recognize you with all that hair on your face -when I was scrolling videos.
Intervention on mic-stand, successful, p < .05.
Gleevec is a parachute
I had no idea how poorly I understood this concept. Gotta geek out and takes notes on this one, maybe on x.75 speed.
Wow the beard is giving FallOut vibe 😅
Loving the beard
Have you heard that Metformin is being studied as a possible treatment for Covid?
I've been watching a lot of your podcasts. I really wish you would have on Peter McCullough and doctor Malone and take them to task on their experience. It's hard for me to believe that you have not investigated people who've been dealing with aids, Ebola And someone that has Patton's on the creation of MRNA. Or Peter McCullough and over 600 peer Reviewed publications.
Come-on man, he's got Zdogg.
*that will never hapn. also, youd find they talk differently in front of him, to other places youve seen them.* & i have nothing against them, neither said *much* too crazy, they are credentialed, & they did suffer for standing up early at all. _but_ Malone has a personal stake, & McCullough has a long Hx of taking pharma money. ive seen some of thr more general interviews, & some when they are talking to other scientists: & it is different. (i also get a 'vibe' that cameras off, but on stage: things get a little wild - but that is just a vibe, which isnt fair.)
i may be wrong, & many are similarly conflicted even here (& certainly, say, on zubins channel...& just bc the world is what it is. i dont think those 2 are bad actors.) but i feel like that is a hard ask. *what would be the benefit?* but im just in a cmt section, maybe im not thinking enough about it. either way, i guess we'll see. _JC
@@mballer friends get a pass. dont be dumb. _JC
@@JCResDoc94
Dr. Z isn't my friend.
I do give him credit for not blocking people on his channel.
It's good to have people on who disagree or have greater knowledge, otherwise what's the point?
McCullough is not a reliable source for anything covid.
Ref: Claims baselessly link COVID vaccines to athlete deaths
Hey Doc, haven’t watched in quite awhile…the beard’s a good look. Keep up the good work!
Data analytics is maturing as a discipline… poor analysis does not mean analysis is not productive. This is particularly true if one can use multiple data sets. Much like mining studies
I am not anti RCT, I’m simply tired of the dogmatism regarding findings.
Researchers will simply cite a paper and assume that question(s) is resolved. See potentially flawed Alzheimer’s study
95% behind you…
Recently, the CA prison system released data on COVID-19 infection rates for three populations (bivalent vaccine, monovalent valent, and did not receive vaccine). While this was not part of a designed study, do you think a statistical analysis after the fact can be conducted that would be meaningful for researchers?
Lookin meaner with the beardddd :)
You need rest Vinay! I think you’ve seen too much. ❤
Anyone ever heard of Dr. DAVID HEALY, psychiatrist & pharma-critic?
I would dearly love Vinay Prasad to have a dialogue w evolutionary biologist duo Bret Weinstein & Heather Heying aka Dark Horse podcast concerning "evidence based medicine" & the statistical landmines inherent in RCTs.
Sadly, I doubt this will ever happen.
Prasad appearance increasingly reminds me of Viva Frei (Canadian lawyer now living in Florida [David Freiheit] to escape Trudeau totalitarianism).
Vinay is still in "true believer" camp that believes observational studies offer no benefit. I disagree. They provide future paths of discernment between confounding factors & heuristic anomalies.
Compared to most other videos, the volume on your channel is too low. I guess I will turn on the Closed Captions. Very impressed with your content otherwise.
I've noticed that too.
label cmts like this *TECH:* . & i havent noticed that (& i do complain about this kind of thing on other channels.) but that is important feedback. sometimes you get too into making your wave forms look nice, & forget to just listen to the thing. _JC
Your brightest "white" in you video has an RGB value of 183 across the board. I noticed this in some PDFs you screen capped into your videos before the Sensible Medicine podcast launched. I'm not sure why you're bringing down your 100% white to ~70%, but as a photographer, it is okay to clip light sources. Darkening images, video or still, like this just makes them look worse.
You audio is way down too. I'm guessing it is in response to the podcast and comments saying you're loud. If you upload ahead of time, have the video private and watch it with "stats for nerds" turned on, you should be aiming for audio levels of about -6 dB. You're about -13 dB and that's way quiet. Video production is hard. You're doing this in you spare time and we thank you mightily for it. Hope this helps
PDF's white is @ ~170
Stop asking questions, and just do what you're told...
RIGHT NOW!
Talk to Bret Weinstein about these subjects....I can picture a very interesting conversation
why's the image so dark ?
Random Uncontrolled Beard!
Brother, do you need support with sleep? Let me know, I'll be in the Bay Area next month and can share some Ayurveda tips with you
pls get on rumble
First!!
Are you ok?
I have been wondering the same
That thumbnail, I think you broke bad.
This was great thanks
*25:25** oh, i thought you were saying censoring was good for a moment.* it is interesting, we have to always consider all these things - ideally in the paper, but certainly after. KM...unless the math breaks to just drop the pts, do not do that _(ah, but enrolling pts is a hassle. legit. sometimes thats not an excuse (pandemic was one), but...sometimes it is. i guess the argument has to be when to make that call. cost is the other problem. but we can print the money, if you remove the private sector [evn just from research] & we can use all pts everywhere, forever. the entire medical sys should be trials, & that should be known. as ethical as possible, but forever striving for answers. having any procedure done, you should know youre entering a trial.)_
doesnt everyone, including (especially?) the 1% want to live forever? why is this difficult. do they not want to know what works, even if it kxlls them in the end, steve jobs? gr8 vid. just upsetting enough. _JC
Is the Doc transforming into a mountain man?
Vinay, you look tired. Get some rest!!
Vinay, you are starting to look as bad-ass as you really are.
Why do countries with 80% vaccination rates show elevated excess deaths (7-14%) compared to countries with 30% vaccination, with low excess deaths (negative 10 to negative 4) as of July 2023?
Source: Human Mortality Database (2023); World Mortality Dataset (2023).
Interesting oversaturation in the thumbnail lol.