4 ms·

>considering that there has only ever been one RCT done on SARS-2, and it showed no significant difference for its primary endpoint (self-infection). It didn't

by scythe 5y ago

>considering that there has only ever been one RCT done on SARS-2, and it showed no significant difference for its primary endpoint (self-infection). It didn't measure community spread, presumably because actually measuring that is extremely difficult, which is exactly why no study exists to confirm your statement. This argument only makes sense if you think it also makes sense to disregard all non-RCT evidence for transmissibility, such as the number and momentum of droplets expelled. As the joke goes, there are no randomized controlled trials of the effectiveness of parachutes in falls from airplanes.

__blockcipher__ 5y ago
I'm happy to get into the philosophy of this, but you should know that mechanistic studies in the absence of RCTs are as good as useless. I can show you how to kill cancer cells in a petri dish. I can't show you how to cure cancer. They're very different beasts. BTW I noticed you mentioned "number and momentum of droplets", which seems to suggest you're still stuck in the old respiratory droplet transmission model and aren't aware of the overwhelming evidence that SARS-2 is transmitted primarily via aerosols, which even mechanistically masks can't do anything against?
- scythe 5y ago
  >mechanistic studies in the absence of RCTs are as good as useless. This is of course not true. You also neglect other forms of evidence, like natural experiments: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877582/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877582/ Demanding RCTs or bust is basically poisoning the well. And for all your "happiness" your posts have no shortage of vitriol. Aerosols are composed of droplets which can be caught in masks, also: https://news.ycombinator.com/item?id=28144885 https://news.ycombinator.com/item?id=28144885
  - __blockcipher__ 5y ago
    > Aerosols are composed of droplets This is backwards. Aerosols are smaller than droplets. You can’t be composed of something bigger than yourself. Aerosol essentially means it doesn’t fall to the ground like a saliva droplet does. — The “natural experiment” you linked is a great example of why RCTs are so important (particularly for anything you’re proposing mandating). Saying “after masking was adopted cases went down” isn’t proof because if you look at the non-mask areas, cases also went down during the period. — I’m on mobile so can’t dig up the quote but I’d really recommend reading Medical Nihilism by Stegenga. You seem to have a backwards view of evidentiary standards. That is to say, most findings are false (Ionnidis has a famous paper on this too). That’s why RCTs and the like are so incredibly important.

by scythe 5y ago

__blockcipher__ 5y ago

I'm happy to get into the philosophy of this, but you should know that mechanistic studies in the absence of RCTs are as good as useless. I can show you how to kill cancer cells in a petri dish. I can't show you how to cure cancer. They're very different beasts. BTW I noticed you mentioned "number and momentum of droplets", which seems to suggest you're still stuck in the old respiratory droplet transmission model and aren't aware of the overwhelming evidence that SARS-2 is transmitted primarily via aerosols, which even mechanistically masks can't do anything against?

scythe 5y ago
>mechanistic studies in the absence of RCTs are as good as useless. This is of course not true. You also neglect other forms of evidence, like natural experiments: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877582/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877582/ Demanding RCTs or bust is basically poisoning the well. And for all your "happiness" your posts have no shortage of vitriol. Aerosols are composed of droplets which can be caught in masks, also: https://news.ycombinator.com/item?id=28144885 https://news.ycombinator.com/item?id=28144885
- __blockcipher__ 5y ago
  > Aerosols are composed of droplets This is backwards. Aerosols are smaller than droplets. You can’t be composed of something bigger than yourself. Aerosol essentially means it doesn’t fall to the ground like a saliva droplet does. — The “natural experiment” you linked is a great example of why RCTs are so important (particularly for anything you’re proposing mandating). Saying “after masking was adopted cases went down” isn’t proof because if you look at the non-mask areas, cases also went down during the period. — I’m on mobile so can’t dig up the quote but I’d really recommend reading Medical Nihilism by Stegenga. You seem to have a backwards view of evidentiary standards. That is to say, most findings are false (Ionnidis has a famous paper on this too). That’s why RCTs and the like are so incredibly important.