Folks, we need to talk about this Vitamin D trial. I have no stake in this game - take Vitamin D if you want but this pre-print is super sus.

The paper is presented as a randomized trial of vitamin D supplementation in hospitalized patients with COVID. Interesting and important question! And the results appear dramatic:
If true, this would be one of (if not THE most) effective treatments for COVID. But there are problems...
The first clue something is up is that the randomized groups aren't the same size:
It took me a while to figure out why this was, then I saw in the text that INDIVIDUALS were not randomized, WARDS in the hospital were.
OK - 8 wards, 5 randomized to Vitamin D, 3 to usual care. (Why not 4 and 4?? - but whatever). So this is actually a CLUSTER-randomized trial. That means you need to use CLUSTERED statistics to analyze it. They do not.
This is a big problem. But there is more. It seems that, even if the wards were randomized, the PATIENTS weren't randomized to the wards.
In other words, some hospital wards take different patients than others (different risk factors, etc). This is why we see this really weird finding in Table 1:
Baseline vitamin D levels dramatically lower in the "non-treated" group. Why? Preseumaby because different types of people got admitted to the wards than were randomized to usual care.
You'd expect people with low levels of Vitamin D to do worse - that has been shown multiple times - perhaps because higher Vitamin D levels are associated with less comorbidities.
Here's their Kaplan-Meier curve. It doesn't make sense. What do they mean by 'cumulative hazard' of mortality? What units are these? The overall mortality was 10% by their report.
I get frustrated with peer-review too, but this is why it's so important. This is super basic stuff - you don't call your study a randomized trial when it's a cluster randomized trial. And peer-reviewers would 100% have asked them to go back and redo the stats.
The authors could solve this, btw, by releasing a de-identified dataset (including the ward number) for this study. We could analyze it in about an hour at least for topline results using appropriate stats.
And again, is there harm from Vitamin D? Minimal honestly. The harm from promotion of studies like this is tweets like this that try to dissuade people from getting vaccinated and doing other protective measures.
https://t.co/XVmsiajpBr
So please, read skeptically. Pre-prints have been a boon in COVID times but this study is just... not well done. Be aware. (/END)

More from Health

this simple, counter narrative fact keeps cropping up all over the world.

hospital and ICU utilization has been and remains low this year.

it's terribly curious that so few of these monitoring tools provide historical baselines.

getting them is like pulling teeth.


we might think of this as an oversight until you see stuff like this:

this woman was arrested for filming and sharing the fact that their are empty hospitals in the UK.

that's full blown soviet. what possible honest purpose does that

this is the action of a police state and a propaganda ministry, not a well intentioned government and a public heath agency.

"we cannot let people see the truth for fear they might base their actions on real facts" is not much of a mantra for just governance.


90% full ICU sounds scary until you realize that 90-100% full is normal in flu season.

staffed ICU beds are expensive to leave empty. it's like flying with 15% of the plane empty. hospitals don't do that.

and all US hospitals are mandated to be able to flex to 120% ICU.

the US is currently at historically low ICU utilization for this time of year.

61% is "you're all going to go out of business" territory as is 66% full hospital use.

can you blame them for mining CARES act money? they'll die without it.

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Хајде да направимо мали осврт на случај Мика Алексић .

Алексић је жртва енглеске освете преко Оливере Иванчић .
Мика је одбио да снима филм о блаћењу Срба и мењању историје Срба , иза целокупног пројекта стоји дипломатски кор Британаца у Београду и Оливера Иванчић


Оливера Илинчић је иначе мајка једне од његових ученица .
Која је претила да ће се осветити .

Мика се налази у притвору због наводних оптужби глумице Милене Радуловић да ју је наводно силовао човек од 70 година , са три бајпаса и извађеном простатом пре пет година

Иста персона је и обезбедила финансије за филм преко Беча а филм је требао да се бави животом Десанке Максимовић .
А сетите се и ко је иницирао да се Десанка Максимовић избаци из уџбеника и школства у Србији .

И тако уместо романсиране верзије Десанке Максимовић утицај Британаца

У Србији стави на пиједестал и да се Британци у Србији позитивно афирмишу како би се на тај начин усмерила будућност али и мењао ток историје .
Зато Мика са гнушањем и поносно одбија да снима такав филм тада и почиње хајка и претње која потиче из британских дипломатских кругова

Најгоре од свега што је то Мика Алексић изговорио у присуству високих дипломатских представника , а одговор је био да се све неће на томе завршити и да ће га то скупо коштати .
Нашта им је Мика рекао да је он свој живот проживео и да могу да му раде шта хоће и силно их извређао
1/“What would need to be true for you to….X”

Why is this the most powerful question you can ask when attempting to reach an agreement with another human being or organization?

A thread, co-written by @deanmbrody:


2/ First, “X” could be lots of things. Examples: What would need to be true for you to

- “Feel it's in our best interest for me to be CMO"
- “Feel that we’re in a good place as a company”
- “Feel that we’re on the same page”
- “Feel that we both got what we wanted from this deal

3/ Normally, we aren’t that direct. Example from startup/VC land:

Founders leave VC meetings thinking that every VC will invest, but they rarely do.

Worse over, the founders don’t know what they need to do in order to be fundable.

4/ So why should you ask the magic Q?

To get clarity.

You want to know where you stand, and what it takes to get what you want in a way that also gets them what they want.

It also holds them (mentally) accountable once the thing they need becomes true.

5/ Staying in the context of soliciting investors, the question is “what would need to be true for you to want to invest (or partner with us on this journey, etc)?”

Multiple responses to this question are likely to deliver a positive result.