3 ms·

There is a ton of selection bias here, these are already generally speaking very unhealthy people.

azakai 6y ago
That's why the study looked at a control group, to try to account for that bias (as the abstract says, the control group was chosen to match "personal and clinical characteristics"). It's always possible they missed a factor, that's always a risk in such research, but they worked hard to address that possibility.
- peytn 6y ago
  Not matching for hospital admission status is a pretty big factor given the bold, highly publicized top-line numbers: > We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
  - azakai 6y ago
    (I disagree, see discussion above: https://news.ycombinator.com/item?id=26672461 https://news.ycombinator.com/item?id=26672461 )
    - peytn 6y ago
      Essentially any contact with a hospital in that population produces eye-popping statistics. Having worked in this area, I’m of the opinion that the presentation of this work is misleading.
      - mlyle 6y ago
        But the opposite would be misleading, too, in that the hospital contact was induced by COVID. It's all confounded. If you compare to other hospital admits, you're finding an even-less-healthy population (because they had a reason to show up to the hospital -without- COVID). If you compare to the general populace, you risk inadequately controlling the comparison. But if you want to know the increased risk people have subsequent to COVID hospitalization, perhaps the latter makes the most sense to measure.
        peytn 6y ago
        My beef isn’t with the measurement, but with the presentation thereof. This problem you have recognized is so common that a framework was developed [1]. I don’t feel the work addresses all element of that framework satisfactorily. Others may disagree, and that’s okay. [1]: https://en.m.wikipedia.org/wiki/Strengthening_the_reporting_of_observational_studies_in_epidemiology https://en.m.wikipedia.org/wiki/Strengthening_the_reporting_...
- arbitrage 6y ago
  > It's always possible they missed a factor in public health medical science? you don't say.
g8oz 6y ago
But plenty of people who are similarly unhealthy (obese, smokers etc.) live for years with those problems..Covid seems to be pushing them over the edge. Maybe a better question to ask would have been: typically do 1 in eight people who have been discharged from the hospital after non-covid issues and have the same co-morbidities as the group in the study die within 4 months?

That's why the study looked at a control group, to try to account for that bias (as the abstract says, the control group was chosen to match "personal and clinical characteristics"). It's always possible they missed a factor, that's always a risk in such research, but they worked hard to address that possibility.

peytn 6y ago
Not matching for hospital admission status is a pretty big factor given the bold, highly publicized top-line numbers: > We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
- azakai 6y ago
  (I disagree, see discussion above: https://news.ycombinator.com/item?id=26672461 https://news.ycombinator.com/item?id=26672461 )
  - peytn 6y ago
    Essentially any contact with a hospital in that population produces eye-popping statistics. Having worked in this area, I’m of the opinion that the presentation of this work is misleading.
    - mlyle 6y ago
      But the opposite would be misleading, too, in that the hospital contact was induced by COVID. It's all confounded. If you compare to other hospital admits, you're finding an even-less-healthy population (because they had a reason to show up to the hospital -without- COVID). If you compare to the general populace, you risk inadequately controlling the comparison. But if you want to know the increased risk people have subsequent to COVID hospitalization, perhaps the latter makes the most sense to measure.
      - peytn 6y ago
        My beef isn’t with the measurement, but with the presentation thereof. This problem you have recognized is so common that a framework was developed [1]. I don’t feel the work addresses all element of that framework satisfactorily. Others may disagree, and that’s okay. [1]: https://en.m.wikipedia.org/wiki/Strengthening_the_reporting_of_observational_studies_in_epidemiology https://en.m.wikipedia.org/wiki/Strengthening_the_reporting_...
arbitrage 6y ago
> It's always possible they missed a factor in public health medical science? you don't say.

g8oz 6y ago

But plenty of people who are similarly unhealthy (obese, smokers etc.) live for years with those problems..Covid seems to be pushing them over the edge. Maybe a better question to ask would have been: typically do 1 in eight people who have been discharged from the hospital after non-covid issues and have the same co-morbidities as the group in the study die within 4 months?