Vinay Prasad MD MPH @VPrasadMDMPH
Prof @ucsf, Physician-Scientist, IG @vprasadmdmph @vkprasadlab @plenary_session, YouTube, #vpzd podcast & @Sensible__Med; Views mine drvinayprasad.com sign up for long form thoughts Joined February 2013-
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My thoughts on DanGer Shock in the NEJM A few points you haven't heard
Mandrola and I are back on @Sensible__Med sensible-med.com/p/danger-shock…
I breakdown DanGer Shock. Lots to learn if you are interested in clinical trials. youtu.be/foLBOMKjngY?si…
Our latest paper led by med student Josh Elbaz👇 68% of cancer drug approvals don't have evidence they increase survival! Let me explain some key findings about the FDA #1. Both regular and accelerated approvals are based on surrogates... dx.doi.org/10.1002/cam4.7…
Great news. We have been talking about this since 2021. Glad to see this. pubmed.ncbi.nlm.nih.gov/33722420/
Great news. We have been talking about this since 2021. Glad to see this. pubmed.ncbi.nlm.nih.gov/33722420/
Astonishing to see the media coverage of Bird Flu. This is more accurate drvinayprasad.com/p/should-you-b…
Like anything else, randomize people to your intervention or not doing it and if you can't demonstrate benefits, don't offer it.
Like anything else, randomize people to your intervention or not doing it and if you can't demonstrate benefits, don't offer it.
Dark but well known secrets of #Drugapproval for Cancer... 68% of cancer drugs approved by FDA has NO survival benefits. This after rigorous pre clinical and clinical trials and reviews.
Dark but well known secrets of #Drugapproval for Cancer... 68% of cancer drugs approved by FDA has NO survival benefits. This after rigorous pre clinical and clinical trials and reviews.
Black men deserve better than recommendations based on modeling, an imperfect science. @NIH should fund a trial in black men testing this. Black men may end up with more incontinence & impotence, but no better survival. This is a dangerous and speculatory paper.
Black men deserve better than recommendations based on modeling, an imperfect science. @NIH should fund a trial in black men testing this. Black men may end up with more incontinence & impotence, but no better survival. This is a dangerous and speculatory paper.
To be honest, this is one of the best figure I have seen in the field ... so much informations, and so clear 💎! Well done Josh Elbaz, Alyson Haslam and Vinay Prasad ! @vkprasadlab 👇
To be honest, this is one of the best figure I have seen in the field ... so much informations, and so clear 💎! Well done Josh Elbaz, Alyson Haslam and Vinay Prasad ! @vkprasadlab 👇
@US_FDA 's cancer drug approval process is broken and needs a deep dive audit: Cancer is deadly, but 68% of the drugs approved by FDA have no evidence they increase survival open.substack.com/pub/sensibleme… via @VPrasadMDMPH Is @USGAO or @OIGatHHS going to do this audit?
Superb paper and thread 🧵providing an overview of the FDA regulatory pathway and highlighting the methods that Vinay has pioneered and developed in the field❗️ The alluvial diagram is so telling ! You should definitely bookmark it 👇
Superb paper and thread 🧵providing an overview of the FDA regulatory pathway and highlighting the methods that Vinay has pioneered and developed in the field❗️ The alluvial diagram is so telling ! You should definitely bookmark it 👇
Jay Bhattacharya @DrJBhattacharya
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14K Followers 685 Following Medical oncologist| interests: multiple myeloma, hemato-oncology, supportive care, geriatric oncology, translational research| History| tweets personal@VPrasadMDMPH Good points. A big challenge with taking 10 years for the study to complete is that is enough time for practicing cardiologists to develop their own beliefs based on their observations So the p 0.04 confirms what many "believe is right" for patients while naysayers will point…
@SagarLonialMD I’m a transplanter. But if the benefit was huge we would see survival benefit
I respect the office, but I don’t respect Joe Biden. He’s a pathological liar and has pursued cruel, inhumane policies his entire career. I hope another Democrat will replace him in Chicago.
@VPrasadMDMPH @First10EM @KirstyChallen @drjohnm @adamcifu Glad you liked it. Be skeptical of subgroups highlighted as significant in abstracts. “Attempts to corroborate statistically significant subgroup differences are rare; when done, the initially observed subgroup differences are not reproduced.” jamanetwork.com/journals/jamai…
With FDA poised to lean in to accelerated approval for gene therapies, I have to wonder how strongly product labeling should caution physicians and patients about the relatively short-term safety demonstration, as well as yet unconfirmed clinical benefits. It seems like…
Peter Marks, director of @US_FDA's CBER, plans to lean in to accelerated approval for gene therapy, believes gene editing could be game changer. buff.ly/3xSg2pt
Be skeptical of the findings in single-centre RCTs of critically ill patients published in high-impact journals claiming a mortality benefit. Only 1 out of 16 RCTs were replicated in a multi-centred RCT. ccforum.biomedcentral.com/articles/10.11… @First10EM @KirstyChallen @drjohnm @adamcifu
@VPrasadMDMPH The only patient lost to follow up was in the control group. What happens to p value if they are presumed to have made it to day 180 (They were lost late)
@VPrasadMDMPH All the difference appears late. How does that work, mechanistically for mechanical support during shock? Also look at reasons for readmissions and reasons for death, many of which look non cardiac. With P=0.04 this could all be noise from later deaths.
@WholeMarsBlog I’d like to apologize to Dustin Moskowitz for calling him a “retard”. That was wrong. What I meant to say is that he is a pompous idiot whose his head is so far up his own ass that he is legally blind. I wish him the best and hope that someday we can be friends.
Finally. This was not a microaggression. 👇
BREAKING: Khymani James, the leader of the anti-Israel encampment who said “Zionists don’t deserve to live” and who claimed people should “be grateful” he is “not just going out and murdering Zionists” has now been thrown out of school
If radiation had an accelerated approval pathway - also based on surrogate endpoints like response rate - it would probably be approved in most settings. Which doesn’t make sense. Just FYI.
On Accelerated Approval 1) In life threatening diseases like cancer the rapid approval of promising new drugs based on phase II data and/or surrogate endpoints is reasonable because waiting for full approval may result in more lives lost due to delay in approval of active drugs.
He painted himself into a corner when he announced that reading list and now this is his only way out
@VPrasadMDMPH I think 0.048 is the correct amount of spending for O'brien Fleming with 1 interim analysis at half way (what they said they'd do). analysis 2, k=2 (& mult by 2 for 2-sided 👇) Hard to interpret co-interventions/safety without accounting for imbalanced competing risk of death :(
95% of @APCCC_Lugano Panellists DO NOT recommend ARPI switch for mCRPC. Yet why do investigators (many of them Panellists) and FDA approve this as control arm for trials?? “Unethical” says @AnthonyMJoshua from the floor, as did @VPrasadMDMPH on GU Cast @gu_onc #APCCC24
New ONS survey data suggest 1.5 million people in UK have Long Covid theguardian.com/society/2024/a… But it's worth considering the methodological problems & pitfalls with these estimates Important paper by @TracyBethHoeg @ShamezLadhani @VPrasadMDMPH here: ebm.bmj.com/content/early/…
I doubt USC would have cancelled a football game for similar reasons.
@david_perell If it hurts to hear, look for the truth in it. If it sounds nice, be wary of lies.
In countries with practically no access to newer myeloma therapies, ASCT for multiple myeloma is alive and kicking. Long-term safety and efficacy of ASCT has been clearly demonstrated. I am reminded of a @BloodJournal study by Mehmet Samur, @NikhilMunshiMD et al where despite a…
Autologous transplant has been in the ICU for a while... thelancet.com/journals/lanha…