profile-img
Michael Baum

@MichaelBaum11

Professor emeritus of surgery and visiting professor of medical humanities University College London. Artist, novelist, suffers from scepticaemia.

calendar_today28-05-2014 14:54:12

9,6K Tweets

2,2K Followers

471 Following

Michael Baum(@MichaelBaum11) 's Twitter Profile Photo

Michael Baum Doug McKechnie Paul Pharoah (R soul) πŸ‡ͺπŸ‡ΊπŸ‡΅πŸ‡¬πŸ‡ΏπŸ‡¦πŸ‡¬πŸ‡§ Ash Paul Susan Bewley Steven Laitner Naser Turabi Overall survival (OS) terrible endpoint for screening RCT. ~zero health interventions have been shown to improve OS. This for statistical reasons. Hard to show reduction in cancer mortality from eg 3% to 2.5%, but doable. ~impossible to show improvement in OS from 69.5% to 70%

account_circle
Michael Baum(@MichaelBaum11) 's Twitter Profile Photo

Boussageon RΓ©my Andrew Vickers Michael Baum Doug McKechnie Paul Pharoah (R soul) πŸ‡ͺπŸ‡ΊπŸ‡΅πŸ‡¬πŸ‡ΏπŸ‡¦πŸ‡¬πŸ‡§ Ash Paul Susan Bewley Steven Laitner Naser Turabi My question to Andrew is:
1. Is it possible that a screening test comes out that has off-target deaths that are difficult to quantify (bc they span domains) but in total negate deaths averted from screening?
2. If so, how would you discover this?

account_circle
Michael Baum(@MichaelBaum11) 's Twitter Profile Photo

Ash Paul Boussageon RΓ©my Vinay Prasad MD MPH Andrew Vickers Michael Baum Doug McKechnie Susan Bewley Steven Laitner Naser Turabi David Baldwin All screening trials are underpowered for ACM. The point is if you only include cause specific mortality the off target harms are effectively ignored. E.g. over treatment of breast cancer with radiotherapy causes death from heart disease.

account_circle