How to Read and Interpret Randomized Controlled Trials | Medicine vs. Law Professors & More
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- čas přidán 6. 07. 2022
- Vinay Prasad, MD MPH; Physician & Associate Professor
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
Thank you for helping me understand why I have a hard time communicating with administrators. Our world views are so different. I am the idea guy. My patients benefit but I feel like the administrators wish I would go away.
As a retired lifetime prosecutor in CA, I decided to listen to Amarica's Constitution and thoroughly appreciated and enjoyed listening to the podcast. And yes, we attorneys are required to think about both sides / arguments if we are ever to be successful in court.
Ex of mine was a huge talent in criminal law (over in Europe btw) - She always said it would suit me. I do love building arguments and am wise enough to realize I am a man of words for a reason: words are like magic to those not well versed in their use. Basically it means I'm a bullshitter.
Getting better since I've embraced numbers.
Being good with words comes with great responsibility really. Glad I'm lazy.
Let’s talk about SADS doc, tell us more about how your buddies are liable for this? We want your hot take on it
Rigorous science and rigorous ethics -- the combination we need! Thank you, Dr. Prasad.
That was a long time out.
You've probably been busy, though.
I can't wait to catch up.
You’re a genius with ethics out the roof! 😍 What excellent framing and analysis!
Thanks for being you and being a voice for TRUTH!!!!!
Love you Vinay❤️ your articulation and cadence are so on point. You are brilliant. Thank you for your work.
This channel has definitely been suppressed. Your sub/view count was growing fast... then it stagnated. Keep up the great work! We appreciate you
as a longtime listener of plenary session from before the pandemic, I can attest that topics like these just have a much smaller potential audience than videos on COVID
Hmmm. I wonder if that throttling has anything to do with vaccinations?
Thank you. Most people don’t do their due diligence. Whether it may be from lack of not understanding, or simply laziness. When the majority throws out all common sense because the Inundated of information regarding drug trials, viruses, diseases, results in fear, or persecution. Confusing, fatigue, compliance happens in the end.
Great work! Much appreciated!
My mom was an oncology nurse, and her favorite doctor to work with left medicine. He had a double whammy of a divorce, followed by a discontinuance of a cancer treatment he used with great success. He had a high long-term survival rate in his practice. When the drug was discontinued, he felt there was no purpose to practicing medicine, when the incentive was to keep patients coming back for expensive treatments paid for by Medicare, but no long-term survival or improvement of quality of life. That doctor no longer practices medicine, and that's a shame.
In 2019, Mom was diagnosed with cancer. She went into remission following the standard course of radiation and chemo, but within the year she had a relapse. She didn't even know about it for weeks after the scan, because nobody from her oncologist's office called her to tell her. She phoned the office after a week, but couldn't get anyone to talk to her about the results. Finally, someone did call her to tell her the cancer was back, but it had been 3 or 4 weeks since her scan. She asked what the treatment options were, and whoever called her (it wasn't the doctor) didn't give her any hope. Mom said they just gave up on her, since the only suggestion was to repeat the same radiation and chemo treatments. So she went to a hospital in the big city, an hour away. That's not as bad as some people have it, but we supposedly have a good cancer treatment hospital 15 minutes from her house. It's just that they didn't seem to want to do anything more. She couldn't even get an appointment with the oncologist. After she had her records sent to the bigger hospital they phoned her to apologize for not getting back with her, and said the oncologist could see her the next day. Of course Mom declined the offer. She's doing quite well on the immunotherapy, still no further growth. Of course we'd all prefer that she had access to whatever treatment her favorite oncologist had used before it was discontinued. She said that treatment was discontinued because it wasn't profitable for the drug company. I get that they have to stay in business, but what's their definition of "profitable"? Couldn't some company product the drug with a modest profit?
Dang, what was the specific cancer treatment he used?
PS I love VP & am grateful for his channel, but he doesn't acknowledge IVM for cancer. I don't blame him, as I'm sure it would be bad for his career.
Hope yr Mum is doing well.!! Read yr blog and i do not find surprising that they discontinued the drug.
So much for democracy huh???? It really is infuriating that drugs that actually work on people are eliminated from the roster. Little do these drs realize. That one day they will need this drug for their own survival. !!!! Pls tell yr Mum to avoid meat and all dairy products. !!!
My comment was deleted because I mentioned an alternative treatment.
You still think these companies aren't evil?
@@MK-ih6wp if you could site some randomized clinical trials which show benefit for CR/OS with IVM, I'm sure he would be willing to vet the data and give his opinion. Do you know of any RCTs in humans or is this benchwork or anecdotes/case studies?
New ideas in managerial settings are often taken as a threat, as tho trying to start your own thing rather than fall in line. Independent thinking can threaten group cohesion. Etc.
They never watched episodes of House.
House's selected team of collaborating Drs could be hard to be brought to agree.
An Inquisition always punishes those they deem heretical in thought...
They do not want the best and brightest problem solvers. Those people expose too much dirt & are a corporate liability.
How do these two facts co-exist in medicine: the WHO does NOT recommend remdesivir for COVID treatment (posted on WHO’s site), and we are administering it to patients on doctor’s orders in a US hospital months after this “not-recommended” and sending the patients back to the ICU due to no improvement after the full course of treatment?
How do these two facts coexist with zero explanation?
same way hospitals charged for a Covid positive DX for BOTH "asymptomatic Covid + test" and "symptomatic Covid - test"...I just witnessed an asymptomatic Covid positive patient and no one could find the test...
Dr Prasad. This was a great talk.
In another vein of occurrences happening,
CERN has been starting up to full power again.
I wondered about your opinion about that.
Funny I was told that expert opinion is the undeniable science of the day. Who needs RCT for evidence when our politicians can tell us all the “truths”.
I love how you always go back to your core message. Just like what you wrote in your book malignant!
YAY! Thank you for this video! I actually asked another CZcamsr to cover this very subject about a week ago! :)
Thanks, hope it helps, glad you are well. Those of us on the frontlines saw it wasn't about helping.
Love your videos doc! One thing I'd personally be very grateful for, would be some sort of list to explain some of the abbreviations and terms that get thrown around, but don't immediately ring a bell for the layman.
Sure I could Google it.
Maybe I'm lazy, maybe I'm clever? Either way, keep doing what you do, you are clearly not lacking in media talent.
I am enrolled in a trial called PSMAdddition for Advanced Metastatic Prostate Cancer using Lu-PSMA-617 and standard of care vs, standard of care alone. It is randomized and I end up in the standard of care arm. They say it is a crossover trial. However tin he 20 pages of documentation the phrase "If standard of care fails I MAY be eligible to crossover and receive the Lu-PSMA-617.
When I asked about the term "MAY be eligible" and why it is phrased like that? I would think failing of the standard would make me eligible.
I signed up for this trial because The treatments would cost $220,000 and that would be if I went through all others treatments first. That would include chemotherapy, radiation ADT etc.
Thank you, Vinay, for always shining the light on these dark and dirty practices in medicine /drug approval studies/ policy making. Keep up the good work!
Brushing up on my science skills... why I love this channel!
Thank you, Dr. Prasad. I know this is a bit older, but this is very good!
This should be what's taught in public schools as critical thinking. You make this interesting for your field, I am sure, but also meaningful, relevant for the laymen, fantastic as usual!
"More than 9 in 10 healthcare interventions studied within recent Cochrane Reviews are not supported by high-quality evidence, and harms are under-reported." - - Journal of Clinical Epidemiology; Volume 148, August 2022, Pages 160-169
This channel should have definitely reached a quarter million Subs by now
More WPM words per minute than any other CZcams channel. Although I didn’t look for Auctioneer videos to test this.
0.75 speed works very well for me 🙏🌿🦻🧠☕️
I have been listening to Vinay for quite some time now. I actually learned of him from watching a Zdogg video. I always found Vinay to be open and reasonable in his approach and as he has seen the insanity that ensued after COVID and the lack of strong scientific evidence, he was not afraid to voice his concerns. Zdogg has been very much less open and seems that his opinions change just to please the majority. I'm surprised that they still co-host a podcast because even though they are on the left, their views are very very different.
Zdogg is outed as a Big Pharma shill by Robert F. Kennedy, Jr. in _The Real Anthony Fauci_
@@Lp78Ch really? Is this true? Please don't make me buy and read that book if it isn't. But I wouldn't be surprised. Zdogg was the first person I heard advocating for rewarding people with "freedom" if they take the vaccine.
Just like giving ivrrmectin for 3 days at a low dose in a study?
You are a gem
You’ve got to start selling merch, I would love me a “Show me the randomized controlled trial!” tshirt. I’m surrounded by people who believe fervently after hearing Buzzfeed summarize an observational study.
Does it make sense to peer review the trial design before the trial starts? Could this avoid many of the flawed designs? Not sure if this would be time/cost prohibitive
*4:00** write this into a real short book, & go on the supreme court oration tour.* a crowd listening to some1 from a field that isnt thr's, but is still speaking about them (in a positive light): they always love that! & it is a novel crowd to sell books/book speeches. Plus, judges are oft on the older end: so theyll love your CA work next. which may start to bring about common law change for the better. that may get back to the regulators. gr8 entry. -JC
Great vid.
Thanks!
I see you have presented a lot of very important content in this CZcams channel (and others). IMHO the public at large and your findings in particular deserve a more permanent statement in the pubic discourse and historical record. Do you think that your body of knowledge could be included into a study appraisal, big data ethics, acceptance of scientific method courses and text books?
I appreciate you
27:30 i should say: i think this is _far_ too kind to law (& dark money in law). but im not saying dont make the comparison. bc it will annoy people. but bus/law or GLLB/JD/MBA are not accidentally paired so often. but bus/law is made to go together (all law is defense of property). MD/MBA are not meant to go together. & we all know it. even those of us doing it. (also, you get a lot more PhD/MBA than you do MD/MBAs in pharmDev. but thats just a vibe.) gr8 entry. -JC
This podcast must be a mandatory med school / residency education item.
Will you be addressing Pfizer vaccine trial documents now that they are available, being currently released and need to be assessed. I’m surprised you still haven’t addressed these or are you waiting until later this year?
So bottom line is those designing the studies are less than honest and those reading and giving the thumbs up on the studies don't know what a proper study looks like or the implications that will have on patient care. Yikes!!! Loved the law vs academic medicine comparison and let's not forget politics, they both have to play that game - the unifying bridge. You're being too kind to academic medicine - though being called a not too clever manager could be considered an insult.
Do you think in medicine that sources of funding introduce a bias into the questions that are asked? The search for truth seems to be a distant second to the goal of showing the result that I (the company or agency involved) wants to see to somehow gain or defend market share. Somehow funding pure science/investigation has to find a place again, if it ever had a place.
👍
I’m currently a first year MD student in the US and I just wanted to say I love your and ZD’s content! However, I do get pretty lost when you get into the nitty gritty of how trials are designed (power, alpha value, etc.). I don’t think we’re gonna get many classes on that in med school🤣 Any advice on how I can improve my ability to read and analyze different studies critically?
Follow plenary session podcast!
Dr. Prasad-
Can you go over the Polarix trial-
Polatuzumab vedotin + CHP VS R-CHOP ?
In 1L DLBCL
FDA just got rid of clinical trials though
The cutthroat, opportunist type is heavily rewarded in the legal world. The public interest lawyer is discounted in the big picture, unless they're doing the right politics at the right time.
And wellbeing/ health is the last thing on anyone's mind...
Law only rewards new thinking when it's poltically advantageous to private business interests.
Public interest law is damage control & for each of those bleeding hearts, there are exponentially more private interest lawyers actively undoing their efforts.
You're not a farm animal. No more vaccines until mandating them is illegal. Stay Strong...
I genuinely pray that is Trump gets another term or DeSantis runs & wins that they have you (at the very least) on an advisory Board if not in charge of the FDA or some regulatory clinical board head.
We need more Drs w/ the integrity that you have proven to have. Your not a “yes sir” man, but will speak up and do so strongly but w/ humility.
Anyone else not getting audio?
Cleverness is not paramount and is often “overruled” as too clever as to be wrong, unconstitutional.
To rhetorically “convince” doesn’t make it right or correct. Ask Aristotle.
Or ask/ read Ginsberg in Roe. She was right. Cleverness dug a deep hole; deeper than necessary
With European population greater than the US, why is the US a “larger market”?
Could it be that the US “subsidizes” ROW by feeding the R&D/profit machine?
I comment because I know you do this for the clicks! ;)
I thought we stopped doing RCTs......
If you like law you need to check out Viva Frei and Robert Barnes. super duper smart and often on the youtube channel The Duran. Much appreciated as always
*35:00** who do you think does most of the work for research & writing/editing on scotus etal (inc opinions/dissents); the judges associates or those fossils?* tho that is not the academy, technically. it's the philosopher in you: academic law & theoretical jurisprudence is fun. applied law: pretty similar problems to medicine. Except w no regulator. unless you count congress & appellate cts. which i do not. as always, gr8 entry. -JC
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Wow! How’s that possible please I’ll appreciate your assistance on how to go about it.
I’ve heard a lot about trading and investing with Mrs Angela Cole Carr and how good she is.
Her good reputation already speaks for her last month i invested over $100,000 with her and I've already made over $250,000 profit.
Same here I earn $13,000 a week. GOD bless Angela Cole Carr, she has been a blessing to my family.
@@beuladegraffenreid4210 How, I'm in need of her assistance?
NOOO LOOOOL if you have an issue w academic fraud & no critical thinking EXPLICITLY, please do not delude yourself about legal scholarship 🥲 holy shet