{"id":1238210563144065000,"conversation_id":"1238210563144065025","created_at":1584047377000,"date":"2020-03-12","time":"21:09:37","timezone":"UTC","user_id":40631172,"username":"ncasenmare","name":"Nicky Case","place":"","tweet":"If I made an \"interactive explanation\" sim of the new #coronavirus, what math/sci concepts do you think the public most needs to know?\n\n* Exponential/Logistic growth (why # cases matters less than growth rate)\n* Spatial SIR model (& how to \"flatten the curve\")\n\nWhat else?","mentions":[],"urls":[],"photos":[],"replies_count":100,"retweets_count":50,"likes_count":506,"hashtags":["#coronavirus"],"cashtags":[],"link":"https://twitter.com/ncasenmare/status/1238210563144065025","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"40631172","username":"ncasenmare"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1229803726476644400,"conversation_id":"1229803726476644355","created_at":1582043031000,"date":"2020-02-18","time":"16:23:51","timezone":"UTC","user_id":40631172,"username":"ncasenmare","name":"Nicky Case","place":"","tweet":"If I made an interactive \"explorable explanation\" about a very technical subject, which topic would you most want me to do? (Feel free to suggest other topics in replies!)","mentions":[],"urls":[],"photos":[],"replies_count":15,"retweets_count":2,"likes_count":51,"hashtags":[],"cashtags":[],"link":"https://twitter.com/ncasenmare/status/1229803726476644355","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"40631172","username":"ncasenmare"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1220849266639429600,"conversation_id":"1220793239046885376","created_at":1579908122000,"date":"2020-01-24","time":"23:22:02","timezone":"UTC","user_id":40631172,"username":"ncasenmare","name":"Nicky Case","place":"","tweet":"😻","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":0,"hashtags":[],"cashtags":[],"link":"https://twitter.com/ncasenmare/status/1220849266639429632","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"40631172","username":"ncasenmare"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1213950362656358400,"conversation_id":"1212878217834573824","created_at":1578263295000,"date":"2020-01-05","time":"22:28:15","timezone":"UTC","user_id":40631172,"username":"ncasenmare","name":"Nicky Case","place":"","tweet":"Yeah of course, thx for asking! :) (all my stuff is Creative Commons-licensed tho, so feel free for any of it)","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":1,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/ncasenmare/status/1213950362656358400","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"40631172","username":"ncasenmare"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270024836362858500,"conversation_id":"1270024650148339717","created_at":1591632491000,"date":"2020-06-08","time":"16:08:11","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"If you are looking for a great B cell biologist as a new faculty member, he should really be on your short list. Bob focuses on germinal center biology and immunodominance problems that help explain why it is so hard to make some vaccines.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":4,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1270024836362858502","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1267462731768066000,"conversation_id":"1267462360538640384","created_at":1591021638000,"date":"2020-06-01","time":"14:27:18","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"She has been putting in 12+ hour days for months, 7 days a week, and cranking out complex experiments and data analysis continuously. An amazing scientist. She’s a great team player and a true pleasure to work with. When she’s not in the lab her hobby is…sleeping I presume. 🤷‍♂️","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":3,"likes_count":18,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1267462731768066049","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1267460969053089800,"conversation_id":"1267460969053089794","created_at":1591021217000,"date":"2020-06-01","time":"14:20:17","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"It has been fun to see other labs post “lab member of the day”. I’m going to try to start that as well.","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1267460969053089794","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1261053619496824800,"conversation_id":"1261052353773363200","created_at":1589493586000,"date":"2020-05-14","time":"21:59:46","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"Whether this immunity is relevant in influencing clinical outcomes is unknown, but it is tempting to speculate that the crossreactive CD4+ T cells may be of value in protective immunity, based on SARS and flu data.","mentions":[],"urls":[],"photos":[],"replies_count":19,"retweets_count":89,"likes_count":416,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1261053619496824832","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1261053505302786000,"conversation_id":"1261052353773363200","created_at":1589493559000,"date":"2020-05-14","time":"21:59:19","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"Crossreactive T cells are also relevant for vaccine development, as cross-reactive immunity could influence responsiveness to candidate vaccines.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":48,"likes_count":309,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1261053505302786048","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1261053426475004000,"conversation_id":"1261052353773363200","created_at":1589493540000,"date":"2020-05-14","time":"21:59:00","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"Detecting SARS2-reactive T cells in ~50% of unexposed people suggests cross-reactive T cell recognition between circulating ‘common cold’ coronaviruses and SARS-CoV-2. This might influence susceptibility to COVID-19 disease.","mentions":[],"urls":[],"photos":[],"replies_count":45,"retweets_count":229,"likes_count":691,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1261053426475003904","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1261053318882705400,"conversation_id":"1261052353773363200","created_at":1589493515000,"date":"2020-05-14","time":"21:58:35","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"Additionally, any potential for crossreactive immunity from other coronaviruses has been predicted by epidemiologists to have significant implications for the pandemic going forwards. We detected SARS-CoV-2-reactive CD4+ T cells in ~50% of unexposed individuals.","mentions":[],"urls":[],"photos":[],"replies_count":22,"retweets_count":170,"likes_count":571,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1261053318882705408","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1261053166772093000,"conversation_id":"1261052353773363200","created_at":1589493478000,"date":"2020-05-14","time":"21:57:58","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"We specifically chose to study people who had an average COVID19 disease course—non-hospitalized—to provide a solid benchmark for what a normal immune response to SARS2 looks like.","mentions":[],"urls":[],"photos":[],"replies_count":9,"retweets_count":70,"likes_count":449,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1261053166772092928","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1261053041882525700,"conversation_id":"1261052353773363200","created_at":1589493449000,"date":"2020-05-14","time":"21:57:29","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"CD4+ T cell responses to spike, the main target of most vaccine efforts, were robust and correlated with the magnitude of the anti-SARS-CoV-2 IgG and IgA titers. Again, good news.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":77,"likes_count":404,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1261053041882525698","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1261052932604039200,"conversation_id":"1261052353773363200","created_at":1589493423000,"date":"2020-05-14","time":"21:57:03","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"In our study, 100% of COVID-19 cases made antibodies. 100% of COVID-19 cases made CD4 T cells. 70% of COVID-19 cases made measurable CD8 T cells. We believe these findings are good news, and consistent with normal antiviral immunity.","mentions":[],"urls":[],"photos":[],"replies_count":35,"retweets_count":702,"likes_count":1767,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1261052932604039171","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1261052577996652500,"conversation_id":"1261052353773363200","created_at":1589493338000,"date":"2020-05-14","time":"21:55:38","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"There has been a huge amount of uncertainty about immunity to SARS2—both in the context of COVID19 disease pathogenesis and in the context of how to develop a good vaccine.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":36,"likes_count":254,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1261052577996652544","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1261052523021918200,"conversation_id":"1261052353773363200","created_at":1589493325000,"date":"2020-05-14","time":"21:55:25","timezone":"UTC","user_id":712012171031420900,"username":"profshanecrotty","name":"Shane Crotty","place":"","tweet":"This is good news in multiple ways, for coronavirus vaccine development, understanding disease, and even modeling the future course of the pandemic.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":48,"likes_count":299,"hashtags":[],"cashtags":[],"link":"https://twitter.com/profshanecrotty/status/1261052523021918208","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"712012171031420928","username":"profshanecrotty"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1273037812703658000,"conversation_id":"1273037812703657985","created_at":1592350841000,"date":"2020-06-16","time":"23:40:41","timezone":"UTC","user_id":14095644,"username":"profvrr","name":"Vincent Racaniello","place":"","tweet":"I've been releasing #TWiV episodes recorded in February or before showing us without facemasks, before we started wearing them. I do not need to be scolded for poor behavior or for talking about racism. Grow up folks. And try paying attention, it works #grumpyvirologist","mentions":[],"urls":[],"photos":[],"replies_count":19,"retweets_count":21,"likes_count":354,"hashtags":["#twiv","#grumpyvirologist"],"cashtags":[],"link":"https://twitter.com/profvrr/status/1273037812703657985","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"14095644","username":"profvrr"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1258450823769518000,"conversation_id":"1258450823769518081","created_at":1588873031000,"date":"2020-05-07","time":"17:37:11","timezone":"UTC","user_id":14095644,"username":"profvrr","name":"Vincent Racaniello","place":"","tweet":"Please do not pay attention to anything said or written by Judy Mikovits. She is the definition of #fakescience - has everyone forgotten #XMRV ? More on #TWiV tomorrow.","mentions":[],"urls":[],"photos":[],"replies_count":35,"retweets_count":168,"likes_count":524,"hashtags":["#fakescience","#xmrv","#twiv"],"cashtags":[],"link":"https://twitter.com/profvrr/status/1258450823769518081","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"14095644","username":"profvrr"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1249301164992147500,"conversation_id":"1249300381873704961","created_at":1586691583000,"date":"2020-04-12","time":"11:39:43","timezone":"UTC","user_id":14095644,"username":"profvrr","name":"Vincent Racaniello","place":"","tweet":"Poliovirus was isolated in 1908 - it took nearly 50 years to develop the first vaccine! We have significantly improved vaccine development but it is still not instantaneous. 18 months for #SARSCoV2 will be a record","mentions":[],"urls":[],"photos":[],"replies_count":10,"retweets_count":99,"likes_count":264,"hashtags":["#sarscov2"],"cashtags":[],"link":"https://twitter.com/profvrr/status/1249301164992147456","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"14095644","username":"profvrr"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268643417850105900,"conversation_id":"1268643117550522379","created_at":1591303135000,"date":"2020-06-04","time":"20:38:55","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"It's extraordinary to consider how low standards and expectations are for the skillset of clinical researchers. \n\nWe would never allow such low standards for any patient care related activity.","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":7,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1268643417850105869","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268552867071303700,"conversation_id":"1268552867071303682","created_at":1591281546000,"date":"2020-06-04","time":"14:39:06","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"I think the moral of #IFGATE is that we need to standardize our data-bases for research purposes. Every dataset researchers use needs to go through some validation process. If you cant show that you are using a validated dataset, then its suspect.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":9,"likes_count":23,"hashtags":["#ifgate"],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1268552867071303682","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1264630965483327500,"conversation_id":"1264630953218945025","created_at":1590346492000,"date":"2020-05-24","time":"18:54:52","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"15/ Medical Decision making involves many steps. Having a framework to describe the (1) steps for Bayesian Inference, (2) assessment of Utility, and (3) areas of Uncertainty can hopefully clarify discussions on how we arrive at our decisions.\n\n/end","mentions":[],"urls":[],"photos":[],"replies_count":6,"retweets_count":1,"likes_count":11,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1264630965483327495","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1264630964719964200,"conversation_id":"1264630953218945025","created_at":1590346492000,"date":"2020-05-24","time":"18:54:52","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"14/ Uncertainty as ambiguity\n\nSometimes, we don’t know how to assign preferences, or we have disagreement about the right preferences. Many issues lack consensus! In these situations, uncertainty arises from ambiguity.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":4,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1264630964719964163","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1264630964002709500,"conversation_id":"1264630953218945025","created_at":1590346492000,"date":"2020-05-24","time":"18:54:52","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"13/ In situations with complexity, it often becomes necessary to model the various considerations. The optimal decision is not always easy and obvious! Even simple models can provides insight into decision making and clarify differences in disagreement.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1264630964002709505","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1264630963243487200,"conversation_id":"1264630953218945025","created_at":1590346492000,"date":"2020-05-24","time":"18:54:52","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"12/ Uncertainty as complexity\n\nWhen determining utility, different decision makers (physician, patients, etc), may have different preferences for multiple different outcomes. With each layer, we are adding more complexity and difficulty to our decision making process.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1264630963243487240","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1264630959552561200,"conversation_id":"1264630953218945025","created_at":1590346491000,"date":"2020-05-24","time":"18:54:51","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"8/ One of the important insights into utility is that rational decisions may not optimize outcomes. If we don't consider utility, we may be confused at the patient who forgoes life-saving treatment, or the clinician who finds an effective intervention clinically meaningless.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":8,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1264630959552561156","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1264630957790974000,"conversation_id":"1264630953218945025","created_at":1590346490000,"date":"2020-05-24","time":"18:54:50","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"6/ Utility\n\nRational decision making requires us to consider preferences in addition to outcomes.  Preference, in turn, determines the utility of various outcomes. Preferences can be represented by satisfaction for an outcome, risk aversion to an outcome, personal desires, etc.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":10,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1264630957790973954","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1264630957044314000,"conversation_id":"1264630953218945025","created_at":1590346490000,"date":"2020-05-24","time":"18:54:50","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"5/ Framing Questions:\n\nWhen asking questions about medical decision making, we should start by framing our question in terms of a bayesian inference. What is our prior? What is the evidence? What is our updated posterior (outcome)?","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":6,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1264630957044314113","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1264630954867507200,"conversation_id":"1264630953218945025","created_at":1590346490000,"date":"2020-05-24","time":"18:54:50","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"3/ Approaches to Medical decision making borrows from the broader field of decision theory. \n\nThe predominant framework (Statistical/Bayesian) integrates bayesian inference, utility, & uncertainty into a process to optimize rational decisions.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":7,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1264630954867507205","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1264630953218945000,"conversation_id":"1264630953218945025","created_at":1590346489000,"date":"2020-05-24","time":"18:54:49","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"1/ Tweetorial on Decision making and Evidence Based Medicine\n\nOr\n\nIntegrating Bayesian Inference, Utility, and Uncertainty to optimize rational Medical Decisions.","mentions":[],"urls":[],"photos":[],"replies_count":8,"retweets_count":52,"likes_count":130,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1264630953218945025","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1263949266806091800,"conversation_id":"1263949250813202432","created_at":1590183962000,"date":"2020-05-22","time":"21:46:02","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"13/ Of note, this is not to say masks have no harms! \n\nHarms are still possible; this example just illustrates why risk is asymmetric, and mask interventions have a much higher probability of causing benefit rather than harm.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":10,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1263949266806091782","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1263949265887539200,"conversation_id":"1263949250813202432","created_at":1590183962000,"date":"2020-05-22","time":"21:46:02","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"12/ Realistically, given our knowledge of the underlying disease epidemiology, the probability of harm vs benefit from masks cannot be equal. \n\nRegardless of the potential number, mechanisms, or severity of mask harms, the hazards cannot escape basic functions of disease spread.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":0,"likes_count":6,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1263949265887539204","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1263949253619187700,"conversation_id":"1263949250813202432","created_at":1590183959000,"date":"2020-05-22","time":"21:45:59","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"4/ Mask interventions are slightly different than traditional medical interventions. They do not directly cause harm or benefit in themselves. Rather, they change the transmission risk of infections, which in turn changes the risk of infection related outcomes (i.e. death).","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":0,"likes_count":8,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1263949253619187712","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1263949252742598700,"conversation_id":"1263949250813202432","created_at":1590183959000,"date":"2020-05-22","time":"21:45:59","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"3/ Medical interventions often involves uncertainty. If we think the direct risks of benefit vs harms are equal for an interventions, we call it clinical equipoise and it becomes a reason for further study.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":0,"likes_count":9,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1263949252742598664","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1263949250813202400,"conversation_id":"1263949250813202432","created_at":1590183959000,"date":"2020-05-22","time":"21:45:59","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"1/ Thread on evaluating benefits vs harms of masks for infectious diseases & #covid19.  \n\nor\n\nWhy i think the claim that masks have equal probability of causing harm & benefit is mistaken.","mentions":[],"urls":[],"photos":[],"replies_count":5,"retweets_count":22,"likes_count":55,"hashtags":["#covid19"],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1263949250813202432","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1261385026949636000,"conversation_id":"1261383340772388864","created_at":1589572600000,"date":"2020-05-15","time":"19:56:40","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"Apologies to authors for any harmful comments. No ill intent implied, but I think Dr. Fuster comments leave many open questions.\n\n I still believe benefit of doubt is that actions are done with best intentions.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1261385026949636096","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1258528123932401700,"conversation_id":"1257393803738189828","created_at":1588891461000,"date":"2020-05-07","time":"22:44:21","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"15/ *addendum* \nSomeone asks if controlling for \"survival at assignment\" can prevent immortal time  bias.\n\nUnfortunately no!  W/o knowing \"Rx assignment\", we can't decide the correct group for non-survivors (even if we know their #'s).\n\nUnknown Rx assignment = Immortal time bias","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1258528123932401664","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1257393819835916300,"conversation_id":"1257393803738189828","created_at":1588621022000,"date":"2020-05-04","time":"19:37:02","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"14/ Observational studies are always difficult to interpret. \n\nHaving a causal structure to identify common sources of bias can be helpful for education and for critical appraisal.\n\n/end","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":3,"likes_count":6,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1257393819835916289","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1257393818825109500,"conversation_id":"1257393803738189828","created_at":1588621022000,"date":"2020-05-04","time":"19:37:02","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"13/ This problem is known as \"immortal time bias.\" \n\nOnly people who are immortal during the gap between assignment and treatment can end up in the \"treated\" group. Those who should be assigned to treatment, but die during the gap, will end up in \"not treated\" group.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":8,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1257393818825109504","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1257035804595097600,"conversation_id":"1257033268886675456","created_at":1588535665000,"date":"2020-05-03","time":"19:54:25","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"4/ The current issue with EBM is one that can be fixed by improving and better defining the framework. We need to explain Bayesian decision formally in the context of decision making. We have define priors as well as evidence. And we need to teach more causal Inference.\n\n/End","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1257035804595097602","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1256270049691738000,"conversation_id":"1256270030595072002","created_at":1588353094000,"date":"2020-05-01","time":"17:11:34","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"13/ In adaptive study design like this trial, the flexibility to adjust primary outcomes is ultimately a net positive. \n\nWe want to pick outcomes and models that maximize study power, and offer us the best chance at detecting meaningful differences.\n\n/end","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":5,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1256270049691738112","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1256270048777339000,"conversation_id":"1256270030595072002","created_at":1588353094000,"date":"2020-05-01","time":"17:11:34","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"12/ This is a trade off. We are loosing power by going from an ordinal scale to a binary scale. But we gain power by adding time-to-event data.\n\nIs it worth it? Well, the NIAID statisticians thought so, based on modeling \"while still blinded to treatment assignments.\"","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1256270048777338880","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1256270047850434600,"conversation_id":"1256270030595072002","created_at":1588353094000,"date":"2020-05-01","time":"17:11:34","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"11/ However, the researchers decided to switch the ordinal category into a binary \"response\" category. Essentially, 1-5 in the old category are now \"not recovered\", and 6,7,&8 are considered \"recovered.\"\n\nSo that's where we get \"time to recovery.\" as our new primary outcome.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":0,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1256270047850434562","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1256270045833027600,"conversation_id":"1256270030595072002","created_at":1588353093000,"date":"2020-05-01","time":"17:11:33","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"9/ But once they realized that COVID19 had a longer recovery period, and the study would occur over 28, then the time-to-event information was hugely important! \n\nWithout time-to-event data, \"meaningful treatment effects could be missed.\"","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1256270045833027584","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1256270044826341400,"conversation_id":"1256270030595072002","created_at":1588353093000,"date":"2020-05-01","time":"17:11:33","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"8/ Per the researchers, the original measure was problematic because of \"... the reliance on a singe time point for evaluating treatment effects.\"\n\nEssentially, they thought that the drug would work quickly or fail quickly, and having the ordinal scale at 14 days would be enough.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1256270044826341377","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1256270040455921700,"conversation_id":"1256270030595072002","created_at":1588353092000,"date":"2020-05-01","time":"17:11:32","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"4/ One way to improve measurement is with \"Time to event.\"\n\nStandard measures that tally events at the end of a study will miss if one event occurs earlier than another. \n\nAdding time lets us compare both the speed to events as well as the tally of events, improving study power.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1256270040455921664","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1256270032499347500,"conversation_id":"1256270030595072002","created_at":1588353090000,"date":"2020-05-01","time":"17:11:30","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"2/ In study design, more study Power means we are more likely to notice a treatment effect (assuming an effect exists).\n\nOne way to improve study Power is to increase the sample size.\n\nAnother way is to improve our choice of measurement","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1256270032499347458","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1254858139385696300,"conversation_id":"1254858121010245633","created_at":1588016469000,"date":"2020-04-27","time":"19:41:09","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"13/ Examining Observational data to make causal inferences is always tricky. We should be cautious, attempt to model our variables in a sensible way, and accept that risk of bias is ever present.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":4,"likes_count":29,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1254858139385696257","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1254858129885585400,"conversation_id":"1254858121010245633","created_at":1588016466000,"date":"2020-04-27","time":"19:41:06","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"7/ The WSJ article did something interesting. They decided to add in one more variable, \"Days to Shutdown\".\n\n\"A state’s 'days to shutdown' was the time after a state crossed the 1 per million threshold until it ordered businesses shut down.\"","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":10,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1254858129885585413","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1253702405285392400,"conversation_id":"1253701931010310147","created_at":1587740920000,"date":"2020-04-24","time":"15:08:40","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"We need good data to make good decisions. \n\nBut we also need to discuss how to make decisions when data is imperfect and choices have to be made.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1253702405285392388","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1253370124138090500,"conversation_id":"1253370124138090498","created_at":1587661698000,"date":"2020-04-23","time":"17:08:18","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"Imagine caring for a pt, but w/o access to any of their chart data. \n\nInstead, other unpaid docs with only partial chart access must write time consuming letters on how the data is trending. \n\nLetters may duplicate. Some are drafts. Quality varies. Charge on delivery.","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1253370124138090498","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1252466616648024000,"conversation_id":"1252465237321756674","created_at":1587446285000,"date":"2020-04-21","time":"05:18:05","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"7/ I have not formed a judgement on this topic myself.\n\nBut the questions trouble me, and I hope others can weigh in with their thoughts. \n\nHopefully, we can all learn & improve on our own ethical communications of science.\n\n/End","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1252466616648024064","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1252465244485693400,"conversation_id":"1252465237321756674","created_at":1587445958000,"date":"2020-04-21","time":"05:12:38","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"6/ I do not know Dr. Ioannidis. No intent is made here to besmirch his character, intentions, or integrity as a researcher.\n\nBut comments made in public, and with considerable controversy, merits scrutiny.\n\nCan the claims here cause harm? If so, should their be accountability?","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1252465244485693440","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1252465243550290000,"conversation_id":"1252465237321756674","created_at":1587445958000,"date":"2020-04-21","time":"05:12:38","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"5/ Their are many uncertainties. \nIs a YouTube video a \"media role\"? \nHow do we judge the epistemic validity of a claim? \nIs a claim \"acceptable\" if it's done under the discussion of one study? Preprint? Anecdote?\nWhat if a claim is made without considering the cumulative data?","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1252465243550289920","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1252465242837221400,"conversation_id":"1252465237321756674","created_at":1587445958000,"date":"2020-04-21","time":"05:12:38","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"4/ \"... our data suggests that covid19 has an infection fatality rate that is in the same ballpark as seasonal influenza.\"\n\n(Statement made in context of pre-print study pending peer-review)\n\nIs this statement in conflict with physician media ethics?","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":0,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1252465242837221377","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1252465240207483000,"conversation_id":"1252465237321756674","created_at":1587445957000,"date":"2020-04-21","time":"05:12:37","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"2/ Given the above, can we judge physicians for failing these recs?\n\nFor example, what if Dr. Oz claimed Covid19 had \"the same risks as the flu\", a statement without scientific consensus nor sufficient evidence for proof.\n\nWould that be in conflict with physician media ethics?","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":0,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1252465240207482880","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1250440501603364900,"conversation_id":"1250435365002862594","created_at":1586963222000,"date":"2020-04-15","time":"15:07:02","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"9/ addendum:\n\nIt occurs to me that one could consider this argument as evaluating \"heterogeneity of disease effects\". \n\ni.e. we are looking for relative differences in events among a subgroup of diseases within the larger grouping of a syndrome.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1250440501603364864","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1250435375148830700,"conversation_id":"1250435365002862594","created_at":1586962000000,"date":"2020-04-15","time":"14:46:40","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"8/ It is important to consider theories compatible with both existing pathophysiologic models & the data.\n\nIf it leads to new interventions, we still should conduct appropriate studies to ensure benefits of interventions outweigh harms. \n\n/end","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1250435375148830721","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1250435372472889300,"conversation_id":"1250435365002862594","created_at":1586961999000,"date":"2020-04-15","time":"14:46:39","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"6/ However, now we have a pandemic, where viral disease make up 90% of all cases in our syndrome. Suddenly those smaller relative risk differences become more apparent.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1250435372472889344","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1250435371059441700,"conversation_id":"1250435365002862594","created_at":1586961999000,"date":"2020-04-15","time":"14:46:39","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"5/ Say if hypercoaguable risk is increased by 20% in a viral disease, but viruses only make up 30% of all cases in our syndrome. It's possible that in summary analysis of the syndrome, these small relative effects get missed.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1250435371059441675","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1250435369717207000,"conversation_id":"1250435365002862594","created_at":1586961998000,"date":"2020-04-15","time":"14:46:38","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"4/ Namely, it is possible that viral illnesses may always have had some small but difficult to detect increase in specific risks, such as hyper-coagulopathy?","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1250435369717207044","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1250435368555430000,"conversation_id":"1250435365002862594","created_at":1586961998000,"date":"2020-04-15","time":"14:46:38","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"3/ As such, their may be a different explanation for why COVID19, as a disease, appears to have variations from common Syndromes, without having to assume new pathophsyiology.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1250435368555429889","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1250435367146119200,"conversation_id":"1250435365002862594","created_at":1586961998000,"date":"2020-04-15","time":"14:46:38","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"2/ I am going to presume that the viral pathophysiology of COVID19 is not actually different form other similar viral illnesses, but rather the heterogeneous nature of disease presentations is magnified due to the exponential rise in cases.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1250435367146119168","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1249704648811872300,"conversation_id":"1249704007616139265","created_at":1586787781000,"date":"2020-04-13","time":"14:23:01","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"I say this with the greatest respect for researchers and the invaluable efforts to collect data and publish pre-prints. It is hard work and deserves accolades!\n\nBut it is work half-finished w/o appropriate statistical analysis. Please see it through!","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":1,"likes_count":7,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1249704648811872257","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1249013439499993000,"conversation_id":"1249013428041252864","created_at":1586622984000,"date":"2020-04-11","time":"16:36:24","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"7/ In summary, appraising unconventional arguments is hard. \n\nAssess for \"early information\" bias. Look to see if presented evidence is selective or all-inclusive (shared). And partner with topic experts when possible! \n\n/end","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":0,"likes_count":10,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1249013439499993089","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1249013438656979000,"conversation_id":"1249013428041252864","created_at":1586622983000,"date":"2020-04-11","time":"16:36:23","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"6/ Re #2: How do we know if evidence is selective? \n\nThis is hard. No easy answers. We have to do our homework on all existing data/research & all new information.\n\nNon-experts are at higher risk for confirmation bias, as by definition their knowledge on the topic is selective.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":0,"likes_count":8,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1249013438656978944","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1249013437746864000,"conversation_id":"1249013428041252864","created_at":1586622983000,"date":"2020-04-11","time":"16:36:23","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"5/ When assessing novel arguments, its important to consider: \n\n1. Does it consider both biases of \"early information\"? \n2. Does it evaluate all the evidence (shared facts), or is it selective?\n3. Are limitations addressed sincerely, or merely to \"say\" it was done?","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":6,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1249013437746864131","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1249013436694040600,"conversation_id":"1249013428041252864","created_at":1586622983000,"date":"2020-04-11","time":"16:36:23","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"4/ Early information may offer insights that make existing evidence less valid.\n\nAlternatively, early information may be more biased/erroneous, whereas known evidence is often more validated & robust.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":4,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1249013436694040576","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1249013436006236200,"conversation_id":"1249013428041252864","created_at":1586622983000,"date":"2020-04-11","time":"16:36:23","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"3/ The biases for \"early information\" can go two ways. \n\nOur preference for early information might weigh it more strongly.\n\nOr our preference for known information may weigh strongly against \"early information\".","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":7,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1249013436006236160","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1249013434844356600,"conversation_id":"1249013428041252864","created_at":1586622983000,"date":"2020-04-11","time":"16:36:23","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"2/ One difficulty with EBM is assessing novel arguments based on new information that go against the status quo. Especially if such views are unconventional!","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":9,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1249013434844356608","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489901688938500,"conversation_id":"1248489868121886721","created_at":1586498163000,"date":"2020-04-10","time":"05:56:03","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"22/ EBM appropriately requires us to ask questions about the quality of evidence, the degree of bias, etc, etc.\n\nDoing so within a framework causal inference shared by other fields will hopefully improve our skills at critical appraisal.\n\nEnd.","mentions":[],"urls":[],"photos":[],"replies_count":4,"retweets_count":2,"likes_count":19,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489901688938500","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489897561743400,"conversation_id":"1248489868121886721","created_at":1586498162000,"date":"2020-04-10","time":"05:56:02","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"19/ In fact, one of the most important skills in medicine is the ability to understand and predict the natural history of a disease. \n\nThis clinical skill is essentially a process of improving our causal inference, by allowing us to predict potential disease outcomes!","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":9,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489897561743362","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489895955325000,"conversation_id":"1248489868121886721","created_at":1586498161000,"date":"2020-04-10","time":"05:56:01","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"18/ But in medicine, human biology is complex. Our ability to accurately predict and imagine potential outcomes is limited. \n\nIf we cant predict how drug X will work, then we should require an RCT.\n\nIf we can predict the effects of a seizure on driving, then we dont need an RCT.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":10,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489895955324931","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489894919295000,"conversation_id":"1248489868121886721","created_at":1586498161000,"date":"2020-04-10","time":"05:56:01","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"17/ How worried should we be about confounders? Does every proof for cause and effect require evidence from an RCT?\n\nIn real life, the answer is obviously no! We can determine cause and effect quite easily just by imagining potential outcomes.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":8,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489894919294976","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489889827418000,"conversation_id":"1248489868121886721","created_at":1586498160000,"date":"2020-04-10","time":"05:56:00","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"13/ One important aspect is the randomization, which removes any concern for *Confounders*.\n\nWhat is a confounder? According toe Pearl, is the difference between \"doing\" and \"seeing\".","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":9,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489889827418113","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489888766288000,"conversation_id":"1248489868121886721","created_at":1586498159000,"date":"2020-04-10","time":"05:55:59","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"12/ Randomized experiments let us put exchangeable individuals in 2 different groups, each receiving a different intervention, and then compare data for any difference in outcomes. \n\nIts almost like a magic trick: RCTs lets us see the counter-factuals in large groups of people!","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":9,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489888766287873","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489878939000800,"conversation_id":"1248489868121886721","created_at":1586498157000,"date":"2020-04-10","time":"05:55:57","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"10/ \n- Observation is seeing an intervention & seeing the outcome. It is the weakest way to establish causation.\n- Act is doing an intervention & seeing the outcome. It is stronger than observation.\n- Counterfactual, as previously discussed, it the strongest way to causation.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":3,"likes_count":9,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489878939000835","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489877856895000,"conversation_id":"1248489868121886721","created_at":1586498157000,"date":"2020-04-10","time":"05:55:57","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"9/ Pearl outlines a 3 level hierarchy to establish causation:\n\n- We observe (Association)\n- We act (Intervention)\n- We compare 2 potential outcomes (Counterfactuals)\n\nCounterfactual >> Act (do) >> Observe (see)","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":3,"likes_count":11,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489877856894977","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489875348664300,"conversation_id":"1248489868121886721","created_at":1586498156000,"date":"2020-04-10","time":"05:55:56","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"7/ Side note: action can refer to a treatment, an intervention, or an exposure\n\nTreatment ~ clinical therapy (abx for an infection)\nIntervention ~ modification of non-disease factors or behavior (soda tax)\nExposure ~ any factor associated with an outcome (second hand smoke)","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":8,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489875348664322","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489874283348000,"conversation_id":"1248489868121886721","created_at":1586498156000,"date":"2020-04-10","time":"05:55:56","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"6/ Causal reasoning: \n\nWe compare (usually only mentally) the outcomes when an action is taken vs withheld. \n\nIf the two outcomes differ, we say that the action has a causal effect (causative or preventive).\n \nOtherwise, we say that the action has no causal effect.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":10,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489874283347970","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489871854858200,"conversation_id":"1248489868121886721","created_at":1586498155000,"date":"2020-04-10","time":"05:55:55","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"4/ We start a question:\n\nWhat is the difference between a “causation” and “association”?\n\nThe main difference between causal inference and inference of association is that the causation analyzes the response to an outcome when the action is changed.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":3,"likes_count":9,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489871854858243","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1248489868121886700,"conversation_id":"1248489868121886721","created_at":1586498155000,"date":"2020-04-10","time":"05:55:55","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"1/ Tweetorial on Cause & Effect in Evidence Based Medicine\n\nAlternatively: why we need to know the natural history of disease\n\nCausal reasoning is a core part of the practice of medicine, but it is sometimes neglected in our EBM curriculum. \n\nSo here is a brief introduction!","mentions":[],"urls":[],"photos":[],"replies_count":9,"retweets_count":51,"likes_count":125,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1248489868121886721","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1245723919463547000,"conversation_id":"1245723877507878912","created_at":1585838701000,"date":"2020-04-02","time":"14:45:01","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"15/ I hope this thread offers one way to think about null results in a clinically meaningful manner. \n\nIts often more useful to discuss the appropriate MCID for a specific study/hypothesis, rather than getting bogged into interpreting \"statistical significance\"\n\n/End","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1245723919463546880","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1245723918263939000,"conversation_id":"1245723877507878912","created_at":1585838701000,"date":"2020-04-02","time":"14:45:01","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"14/ One approach is to state the MCID & CI together: \n\n\"A relative MCID of 20% for 95% CI (0.85,1.11) suggests no clinically meaningful difference.\" \n\n\"A relative MCID of 20% for 95% CI (0.70,1.3) cannot exclude a clinically meaningful difference.\"\n\netc.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1245723918263939073","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1245723915797725200,"conversation_id":"1245723877507878912","created_at":1585838700000,"date":"2020-04-02","time":"14:45:00","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"12/ However, a 10% MCID is clearly way to high for a composite outcome of death, stroke, or MI!\n\nIf we used an MCID of say 2%, the -0.9% to 6.5% CI endpoints cant exclude this value. So we *cannot* conclude \"no clinically relevant difference\".","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":0,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1245723915797725184","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1245723914602332200,"conversation_id":"1245723877507878912","created_at":1585838700000,"date":"2020-04-02","time":"14:45:00","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"11/ The primary outcome was 22% vs 19.2%, with 95% CI (-0.9%, 6.5%).\n\nIf our relative MCID was 10% (i.e., values from -10% to 10% are clinically irrelevant), then the -0.9% to 6.5% CI endpoints fall within this boundary & we could conclude \"no clinically relevant difference.\"","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":0,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1245723914602332186","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1245723902682091500,"conversation_id":"1245723877507878912","created_at":1585838697000,"date":"2020-04-02","time":"14:44:57","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"8/ Also, remember that confidence intervals are only internally valid (only describe study patients). \n\nTo generalize CI to patients elsewhere, we have to consider external validity (i.e. differences in risks factors, exposures, etc) & our belief in the hypothesis itself.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":0,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1245723902682091530","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1245723898269794300,"conversation_id":"1245723877507878912","created_at":1585838696000,"date":"2020-04-02","time":"14:44:56","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"6/ Essentially, we cant just assume \"no statistical significant difference\" also means \"no clinically relevant difference\" between two groups.\n\nSo how do we determine decide on the clinical relevance of a study with a null result?","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":0,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1245723898269794306","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1245723879135268900,"conversation_id":"1245723877507878912","created_at":1585838691000,"date":"2020-04-02","time":"14:44:51","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"2/ Some definitions:\n\nNull results - p>0.05 in hypothesis testing, \"not statistically significant.\"\n\nConfidence Interval (CI) - range of plausible estimated values, compatible with the data and model under the P>0.05 criterion.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1245723879135268865","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1245398558049628200,"conversation_id":"1245398546125221888","created_at":1585761129000,"date":"2020-04-01","time":"17:12:09","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"9/ Admittedly, this is a lot of speculation. So I would love to hear from others. \nWhat are your thoughts on this study? \nWhy the discrepancy between \"RT-PCR confirmed influenza\" and \"reported influenza like illness\"?\nHow much faith do we have in influenza RT PCR testing?","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1245398558049628160","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1245398556908736500,"conversation_id":"1245398546125221888","created_at":1585761129000,"date":"2020-04-01","time":"17:12:09","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"8/ When I think about this study, im not sure we can place all our trust in viral RT PCR testing. I dont feel confident concluding N95 are equivalent to surgical masks. If anything, It seems data may support their superiority (though not \"statistically significant\").","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1245398556908736513","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1245398550525038600,"conversation_id":"1245398546125221888","created_at":1585761127000,"date":"2020-04-01","time":"17:12:07","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"4/ A key factor of using laboratory-confirmed influenza as the primary outcome is the sensitivity of the test. A high sensitivity of RT PCR (90+%) makes us much more confident that false-negatives arent adding bias to the results.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1245398550525038592","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1242049807989870600,"conversation_id":"1242049807989870592","created_at":1584962725000,"date":"2020-03-23","time":"11:25:25","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"Reject your sense of injury and the injury itself disappears.\n\nMarcus Aurelius","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":0,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1242049807989870592","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1241756141119512600,"conversation_id":"1241756141119512576","created_at":1584892709000,"date":"2020-03-22","time":"15:58:29","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"\"Accept the things to which fate binds you, and love the people with whom fate brings you together, but do so with all your heart.\"\n\nMarcus Aurelius","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":8,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1241756141119512576","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1241401233669308400,"conversation_id":"1241401229273686018","created_at":1584808092000,"date":"2020-03-21","time":"16:28:12","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"6/ That is all for now. If you have questions, please post and I will try to answer as best I can, or get answers from those with greater expertise.\n\nThanks!\n\n/End","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1241401233669308418","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1241401232964694000,"conversation_id":"1241401229273686018","created_at":1584808092000,"date":"2020-03-21","time":"16:28:12","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"5/ Step 5: Clinic roles\n\nAs workflows for each clinic may vary, be clear in expectations for Front desk, MA, providers, etc.\n\nHave a clear & distinct scheduling system\n\nIf non-providers start calls, consider how many parallel sessions you can handle (i.e. 3 MAs for 5 docs, etc)","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1241401232964694016","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1241401232255848400,"conversation_id":"1241401229273686018","created_at":1584808092000,"date":"2020-03-21","time":"16:28:12","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"4/ Step 4: Patient Rapport\n\nMake sure eye contact is felt. Where is camera? Keep it eye-level.\n\nMake sure background lighting is less than face lighting, so face is seen well.\n\nFirst time visit: take time for introduction, etc. Rapport over video is a different learning curve.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1241401232255848454","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1241401231580565500,"conversation_id":"1241401229273686018","created_at":1584808092000,"date":"2020-03-21","time":"16:28:12","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"3/\nStep 3: Calling patient\n\nDecide who video-calls patient. Provider? Staff? etc.\n\nIf non-provider starts call, have workflow to join/share tele-video to provider after intake. Consider ratio of staff to providers.\n\nIf provider calls, let patients know \"provider will call\".","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1241401231580565506","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1241401230825590800,"conversation_id":"1241401229273686018","created_at":1584808092000,"date":"2020-03-21","time":"16:28:12","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"2/ \nStep 2: Patient Instructions\n\nGive patients information on how to access telehealth in a short document. Flyers, etc. Can email to patients. \n\nIts better to have one institution wide vs different ones for each clinic. One common strategy reduces confusion.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1241401230825590785","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1241401230125076500,"conversation_id":"1241401229273686018","created_at":1584808092000,"date":"2020-03-21","time":"16:28:12","timezone":"UTC","user_id":32283096,"username":"raj_mehta","name":"Raj Mehta, MD","place":"","tweet":"1/ \nStep 1: Preferences\n\nHave phone & email of each pt. \n\nAsk & record in EHR the patients preference for video visit on computer (web-link) or phone (app). \n\nKeep in mind using phone requires downloading an app, and is a step-wise task.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":2,"hashtags":[],"cashtags":[],"link":"https://twitter.com/raj_mehta/status/1241401230125076480","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"32283096","username":"raj_mehta"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
