Alasdair Munro @apsmunro
@NIHRresearch Academic Clinical Lecturer | Paediatric Immunology and Infectious Diseases | Clinical trials | Vaccines | Antibiotics | @apsmunro.bsky.social alasdairmunro.substack.com United Kingdom Joined April 2013-
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@ShiraDoronMD @PaulSaxMD @snap_trial @remap_cap @PulmCrit @NEJM @NEJMClinician @wbranchelliman You didn't go far enough - a pre-print would be a luxury compared to a 20min conference presentation!
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Alasdair Munro retweeted
Some comments on two important randomized clinical trials in ID, @snap_trial and @remap_cap -- and the benefits and limitations of peer review. Shout outs to @apsmunro @PulmCrit and the SNAP investigators. @NEJM @NEJMClinician Link in first reply.
Alasdair Munro retweeted
When it comes to dementia prevention and/or the effects of treatment, my field seems completely unable to exercise a healthy degree of scepticism. Get the shingles vaccine because shingles is horribly painful. Don’t expect it to reduce your dementia risk!
Have you heard the shingles vaccine cuts the risk of dementia by one fifth? New analysis from last week suggests this may not be true at all So why did so many people present this as fact, and why do so many scientists keep bungling the messaging? munro-link.alasdairmunro.workers.dev/p/the-truth-ab…
@drpeterlange The article is not paywalled my friend 🙂
Huge developments this past week in the question over whether the old, live-attenuated shingles vaccine prevents dementia The messaging around this topic from much of the Sci-Com field has been atrocious What is the truth? munro-link.alasdairmunro.workers.dev/p/the-truth-ab…
Alasdair Munro retweeted
The truth about the shingles vaccine and dementia, by @apsmunro open.substack.com/pub/alasdairmu…
Alasdair Munro retweeted
Useful, skeptical take on the efficacy of shingles vax for dementia prevention. Tho I remain bullish on the intervention and less doubtful that Alasdair that there are plausible mechanisms here, I also have always thought the effect size in the most cited studies seemed improbably large. (Nonetheless - I love the shingles vaccine and preference it as a rec for my elders over other shots!! Shingles sucks)
Huge developments this past week in the question over whether the old, live-attenuated shingles vaccine prevents dementia The messaging around this topic from much of the Sci-Com field has been atrocious What is the truth? munro-link.alasdairmunro.workers.dev/p/the-truth-ab…
Have you heard the shingles vaccine cuts the risk of dementia by one fifth? New analysis from last week suggests this may not be true at all So why did so many people present this as fact, and why do so many scientists keep bungling the messaging? munro-link.alasdairmunro.workers.dev/p/the-truth-ab…
Alasdair Munro retweeted
"Then they looked at dementia, and found …. nothing. A complete null result, stable across sensitivity analyses, with no bias they could find to explain the gap with Wales."
Huge developments this past week in the question over whether the old, live-attenuated shingles vaccine prevents dementia The messaging around this topic from much of the Sci-Com field has been atrocious What is the truth? munro-link.alasdairmunro.workers.dev/p/the-truth-ab…
@gushamilton @DrToddLee @charlot_summers @PulmCrit FYI the presentation is online, has some more info! They don't use flat priors, they use weak neutral priors Adjustment is for baseline variables, there is info borrowing from other arms but the effect did not change (only the power) criticalcarereviews.com/meetings/ccr26
@gushamilton @DrToddLee @charlot_summers @PulmCrit The difficulty is that we’re all interested in the specific analytical choices that led to such strong posterior probs but we don’t have the info Not sure it’s fair to say it’s “hiding”, nor that it’s more confident than it is without knowing this?
@gushamilton @DrToddLee @charlot_summers @PulmCrit This discussion would be a great podcast, except that only about 18 people would be interested in it (I am one of the 18)
@JeanThomasR @DrToddLee @PulmCrit Baloxavir is also another arm of REMAP-CAP at many sites It’s another arm of the antiviral domain Currently paused since the oseltamivir hold for futility - waiting to see if it reopens
@gushamilton Ah I see, essentially using a weak neutral prior instead of flat to pull back a “lucky” (or unlucky) early run IMHO flat priors in general make no sense That’s not at all the point the blog is making though?
@gushamilton Also he wrongly states Bayesian priors don’t add enough weight to the null vs frequentist As you know, priors add the same and weak neutral priors add MORE weight to null Not understanding bayes leads to fear of bayes
@gushamilton Surely you cannot have a sceptical prior on a stopping rule for futility/harm, how can that be ethically justifiable?! Besides, we don’t need an answer on increased mortality and should never power for this It does not help - no question. More likely harms. That’s when to stop
The saga of the shingles vaccine preventing dementia has really blown up over the past ten days Communications on this have been woeful I’ll be covering what’s happened and what it all means early this week munro-link.alasdairmunro.workers.dev
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