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

1/
Remember woman who tuk multiple @SriSriTattva products 4 range of problems frm diabetes 2 gas 2 liver disease & developed liver failure, listed for liver transplant?
Here is original thread:
https://t.co/PXxI1Slyv2
23 samples, Analysis results
#MedTwitter #livertwitter


2/
Before I go into results, I must say this was overwhelming. There was SO MUCH the lab identified, impossible to put everything here. So I made a summary. At the end of this thread, I have linked a full analysis described in Excel format. Some results were VERY concerning

3/
How did we analyse?
Here R links 2 methods
They R high end, done under strict protocols
Frm Ministry of Forest, Environment, Climate / NABL approvd Lab
ICP-OES https://t.co/O1CLhqVQAu
GC MSMS https://t.co/zRJoXyWQIr
FTIR https://t.co/goAembQ08p
Here is list V analysed 👇


4/
Sample names written on top (each column).
First 5 samples: C what we identified in #Ayurveda #medicines
Antibiotics
Steroids (anabolic/synthetic)
#NARCOTICS - LSD, Morphine
Blood thinners (possible reason Y bleeding tests were off the roof in the patient)
Heavy metals!


5/
Next 5 samples (total 10 now)
Mercury is clear winner. Almost all samples
See controlled substances - Butyrolactones https://t.co/CPz0FwPEOm, methylamine https://t.co/OZnXY7U9UQ
Alcohols, industrial solvents
Rare metals - cobalt, lithium
Again lots of blood thinners
#Ayush

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Great article from @AsheSchow. I lived thru the 'Satanic Panic' of the 1980's/early 1990's asking myself "Has eveyrbody lost their GODDAMN MINDS?!"


The 3 big things that made the 1980's/early 1990's surreal for me.

1) Satanic Panic - satanism in the day cares ahhhh!

2) "Repressed memory" syndrome

3) Facilitated Communication [FC]

All 3 led to massive abuse.

"Therapists" -and I use the term to describe these quacks loosely - would hypnotize people & convince they they were 'reliving' past memories of Mom & Dad killing babies in Satanic rituals in the basement while they were growing up.

Other 'therapists' would badger kids until they invented stories about watching alligators eat babies dropped into a lake from a hot air balloon. Kids would deny anything happened for hours until the therapist 'broke through' and 'found' the 'truth'.

FC was a movement that started with the claim severely handicapped individuals were able to 'type' legible sentences & communicate if a 'helper' guided their hands over a keyboard.