More Basics On RCTs | NI vs superiority, surrogates, control arms, crossover and more

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  • Опубліковано 28 лис 2024

КОМЕНТАРІ • 72

  • @Carolleemakesthings
    @Carolleemakesthings Рік тому +28

    I listen to Dr. Prasad, because it reestablishes my respect for scientists. Thank you, you did it again!

  • @thel1355
    @thel1355 Рік тому +5

    Dr. Prasad is looking and sounding more and more like a grumpy homeless man with each video and I like it.

    • @JCResDoc94
      @JCResDoc94 Рік тому +1

      *actually he lives behind the 3rd orange dumpster, on the left, you know the south east side of golden gate park? yep, w his whole family. & it's STILL $4050/M!* also, rather than addressing the problem: we say 'unhoused' now -_-. bigot. -_-.

  • @jmc8076
    @jmc8076 Рік тому +11

    Dr Prasad I subb to only a few MDs on YT and refer to in comments or in person for current health issues: you, Dr Mobeen, Dr Suneel Dhand, York Cardiology and as I’m Canadian Merogenomics. All unbiased politically + evidence based trying to educate and be on side of good. We can only imagine how draining and hard it is but you are all appreciated incl those not on YT. ✌️🌎

    • @mballer
      @mballer Рік тому +2

      Everyone has a bias and Vinay is not an exception.

    • @transkryption
      @transkryption Рік тому +2

      @@mballer how would you describe it? You're right, as my English teachet said generally avoid using the word "bias" as it has connotations.
      Partisan? But I feel like the polarisation of people into camps over not-innately political issues is a recent thing.
      At least for thia generation.

    • @surgerystudio7654
      @surgerystudio7654 Рік тому

      Add Dr John Campbell to your list 😊

    • @johnsheehy4192
      @johnsheehy4192 Рік тому

      @@mballer Yes, although he requires quality data to accept any new notions in general, he seems to start out with the assumption that the j4bs actually have a net positive for some groups, but it seems to me that this might only seem to be based on semantic tricks of definitions and timing, and the assumption that any C fatality is an excess one well before its expected time. If you look at any trend of cumulative C fatalities for the world or smaller areas, there is no downward deflection whatsoever upon rollout, and the whole curve is simply explained by building natural immunity to C fatality. If you look at all-cause fatality, it only gets worse after massive intervention. The hard outcomes seem to be saying that nothing positive actually happened.

    • @johnsheehy4192
      @johnsheehy4192 Рік тому

      @@transkryption Yes, politics has broken out of its container and is polluting the entire landscape.

  • @M.-.D
    @M.-.D Рік тому +5

    Prasad with Zeb got me through the pandemic.

  • @marchhair01
    @marchhair01 Рік тому +5

    I've called on medical oncologists for 20 years and very few think as deeply about clinical trials as Dr V.

  • @FreeSpeechWilderness
    @FreeSpeechWilderness Рік тому +2

    The CDC and FDA could use reviewers like Dr Prasad. We would all benefit.

  • @danielhaag-Spidermantat
    @danielhaag-Spidermantat Рік тому +4

    This is what needs to be heard. Thanks

  • @marchhair01
    @marchhair01 Рік тому +3

    I heard Dr Keating from MDACC call Chlorambucil a toxic placebo which makes it a perfect control arm if your goal is regulatory approval.

  • @talhawaheed6098
    @talhawaheed6098 Рік тому

    Can definitely see the justified frustration you have with the trial designs.
    Very informative. Thank you!

  • @lesjchristianson
    @lesjchristianson Рік тому +2

    I made it this far!! All the way to the end! So there, be shocked Dr. Prasad! I hope that one day you take a sabbatical and are appointed to be the FDA director.

  • @hrmpk26
    @hrmpk26 Рік тому +2

    I just watched this to soak my brain in good thinking outside my field. I don’t know most of those drugs or acronyms, but the main thing is good thinking and understanding and mitigating corruption. Just a comp sci dropout living with his parents, honestly. I think when bad studies are taken out of the veil of technical jargon they fall apart by themselves. Computer scientists face similar problems when they write tests and manage bug reports. How can we prove our code isn’t buggy?

  • @marybee2089
    @marybee2089 Рік тому +4

    Thank you for all you do.

  • @sherylh97
    @sherylh97 Рік тому +1

    Yall.... I think I've just had the wrong doctors ...
    There's a few select that really can relay and make it understood.
    Finally.

  • @trucid2
    @trucid2 Рік тому +4

    Dr. Prasad, I've read that all cause mortality isn't a realistic endpoint for most studies. That it would need way too many participants to have the needed statistical power. Is this true? What are the ramifications of this? Could you address this in a future video. Thanks.

    • @mballer
      @mballer Рік тому

      It's all BS.
      If something helped ten percent of people but harmed ninety percent of the people a randomized trial would show it to be a failure.
      Our bodies are not random.
      Categorizing those ten percent would show who could be helped.
      Vinay has an educational bias.

    • @edkeller8078
      @edkeller8078 Рік тому

      Great comment / request

  • @randytucker3083
    @randytucker3083 Рік тому

    Excellent video. I probably will need to study more to take full advantage but the video's availability sure helps.

  • @novascheller5957
    @novascheller5957 Рік тому

    Outstanding!

  • @danno94
    @danno94 Рік тому +1

    Would love if you would have tracey beth hoeg do some of these for observational studies

  • @lilchi721
    @lilchi721 Рік тому

    I like the rebel look Vinyay

  • @teresaharris2279
    @teresaharris2279 Рік тому

    Thank you for sharing !

  • @gardenvariety-
    @gardenvariety- Рік тому

    I would definitely take the course!!

  • @JCResDoc94
    @JCResDoc94 Рік тому +1

    *13:34** oh thats good,* rule out, dont always aim to rule in. how good would it have to be to matr: power for that. bc it can not matr otherwise anyway. that is a nice thing to have in a clear statement. not for publication or career, but for science. so, most scientists arent doing science. arguably. _JC

  • @garrettkajmowicz
    @garrettkajmowicz Рік тому +1

    Might you provide more details on crossover? I managed to understand the first example (where it wasn't desired), but everything after that fell into Chemo acronym soup and I failed to understand why you might want it. Otherwise, a great series!

    • @danno94
      @danno94 Рік тому +1

      Also got lost in the soup a little, my takeaway: the second example is where crossover could be used, if you have control group (standard of care, get treatment X and then Y if they progress), and you want to test a new treatment giving X and Y at the same time before progression, you can crossover some of the control patients at a specific time to see what performs better, even if they havent progressed yet. If the new intervention is superior, one result may be that patients crossing over from control to treatment have slower progression.

    • @HeyYall398
      @HeyYall398 Рік тому

      ​@@danno94Thank you. I appreciate the explanation.

  • @JCResDoc94
    @JCResDoc94 Рік тому +1

    19:00 non-inferiority is inferior wo justification. _JC

  • @bobthebuilder9553
    @bobthebuilder9553 Рік тому +4

    Dr. Prasad, you grow a great beard!

  • @tallard666
    @tallard666 Рік тому

    Aw ! Rooting for Canada!

  • @Edward-my9nk
    @Edward-my9nk Рік тому +2

    Tremendous!

  • @HeyYall398
    @HeyYall398 Рік тому

    Please talk about how big data can enhance observational studies.

  • @olibertosoto5470
    @olibertosoto5470 Рік тому +1

    So marginal or non superiority would be ethical if the drug being tested is cheaper and available to everyone. Wouldn't that be a wonderful world!

  • @sherylh97
    @sherylh97 Рік тому

    It could possibly occur more so there are during times of heavy allocated stress

  • @lhanlon1278
    @lhanlon1278 Рік тому

    The Roots Canada hoodie he is wearing is confusing me.. why?

  • @hrmpk26
    @hrmpk26 Рік тому +1

    Don’t you understand they’re just trying to get stuff approved and make money? It’s not about actually doing science or actually improving lives. It’s business.

  • @marianlorenz8910
    @marianlorenz8910 Рік тому

    Please review the new meta analysis by Tom Jefferson et al re: physical interventions to interrupt or reduce the spread of respiratory viruses.

    • @lesjchristianson
      @lesjchristianson Рік тому +1

      He’s already done that.

    • @JCResDoc94
      @JCResDoc94 Рік тому +1

      are you srs rn? _JC

    • @JCResDoc94
      @JCResDoc94 Рік тому +1

      type masks into the yt search on his main pg, youll find a lot, including that.

  • @ConradJupiter77
    @ConradJupiter77 Рік тому

    fasting for a min of 4 days removes vii rushes

  • @JCResDoc94
    @JCResDoc94 Рік тому +1

    21:21 ima post you some duct tape. bet that mic stand is expensive too. they got you good. _JC

  • @ChrisCapoccia
    @ChrisCapoccia Рік тому +1

    For as fussy as your mic stand is, I'd be putting black electrical tape over the logo 🤣

  • @sherylh97
    @sherylh97 Рік тому +1

    Flu vaccine and c19 vac. How many people got that combination

  • @sherylh97
    @sherylh97 Рік тому

    Cortisol =fight or flight adrenaline.
    Should have a score for anxiety and see what chemicals cause the anxiety damage .. cortisol affects the hairs in the ears... this tinnitus stuff can make you crazy on weak days. . I like the videos like this because it gives you the background why we say safe and what that means .. and why it likely should not have been presented like that to people. Like you said .. We have to hold them accountable this goes all the way up everything is just lacking in accountability and I mean there are oathes. And you know the fail thing I mean more importantly maybe now at this point is if you did fail be willing to admit it you know be willing to say OK at the beginning I thought one way and then figure it out something else later be willing to admit that that way we can get on to the point where We might start to recognize if it's causing actual problems because they're being told that it isn't and just believing in that Once again blindly the same way that they took the shot And then instantly had a false sense of security even on who was the good guy who was the bad guy and who's the guy that's gonna get sick and who's gonna make everyone else sick and whose fault is it and all this other craziness that was madness we never need to go through that again so I feel like these types of things where you're telling us all this background like that is the most beneficial thing for some of us right now honestly . Like it's better medicine than anything honestly. I learned that when having to learn a lot about parasites you have to be careful without when you can really get the OCD going but the more you learn about it the more it finally starts to make sense and then you start to see how you become a magnet for something that's gonna feed off of you because you have all this excess the body is the house

  • @Zyphera
    @Zyphera 10 місяців тому

    Why play fair when its cheaper to just cheat your resolut?

  • @theFijian
    @theFijian Рік тому

    Hi Casey Neistat's Indian cousin

  • @Steve147-v8f
    @Steve147-v8f Рік тому +1

    Why has Vinay stopped dressing smart for podcasts? And stopped shaving? Hope he’s ok…

    • @lesjchristianson
      @lesjchristianson Рік тому +1

      Please

    • @JCResDoc94
      @JCResDoc94 Рік тому +1

      *actually he joined the nation of islam, & i think thats gr8! . . . &, unrelated, lives behind the 3rd orange dumpster, on the left, you know the south east side of golden gate park? yep, w his whole family. & it's STILL $4050/M!* a
      ive already used half this jk. but i like that it is a cmts topic. _JC

  • @mballer
    @mballer Рік тому

    Unrandomized trials are better than randomized trials.
    Vinay has been brainwashed.

    • @pancakelizard00
      @pancakelizard00 Рік тому

      Huh?

    • @laveraparato258
      @laveraparato258 Рік тому +1

      Did you watch the entire video. He talks about what a good randomized trial versus a shoddy one, but observational studies have way too many problems.

    • @mballer
      @mballer Рік тому

      @@laveraparato258
      I've watched many of his videos and many of other doctors who have all had the same biased medical education.
      Randomized trials are crap compared to categorizing people, and not by relatively worthless categories of age.
      He lives in a bubble of doctors.
      He's inside the forest.

    • @mballer
      @mballer Рік тому

      @@laveraparato258
      One thing he talked about was taking blood pressure readings and being biased, that is blinding, not randomization.
      Two totally different things, why did he conflate them?

    • @ricottalaw
      @ricottalaw Рік тому

      @@mballer Lack of blinding introduces more bias into a study.