As usual @apsmunro.bsky.social is a model of good sense More Fuss About Filters open.substack.com/pub/alasdair...
More Fuss About Filters
A new RCT of air filtration devices gets heads spinning...again
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Alasdair Munro
@apsmunro.bsky.social
NIHR Academic Clinical Lecturer in Paediatric Immunology and Infectious Diseases University of Southampton and Southampton Children’s Hospital UK alasdairmunro.substack.com
Huge numbers of neonates get long courses of IV antibiotics for suspected early onset sepsis, despite an incidence of only 0.5-1% New evidence shows these courses can stop earlier and babies can go home sooner Practice needs to change ASAP #Peds #PedsID 🧪
Switching or Stopping: Antibiotics for neonates with suspected sepsis
Two studies shine light on a previously difficult to research topic
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Does the (live) shingles vaccine protect against dementia? Fergus Hamilton and colleagues provide important evidence in a new preprint using hospital data from the whole of England in a regression discontinuity design from which we *don't* show evidence of a meaningful protective effect /cont
The JCVI announced they are now recommending the MenB vaccination for adolescents in the UK, which many people (including me!) will be very pleased about How did this change come about? The story is fascinating, and perhaps not without controversy...
MenB, teenagers, and the price of peace of mind
The JCVI changes its position on recommending adolescent vaccination against MenB
alasdairmunro.substack.com
The JCVI announced they are now recommending the MenB vaccination for adolescents in the UK, which many people (including me!) will be very pleased about How did this change come about? The story is fascinating, and perhaps not without controversy...
MenB, teenagers, and the price of peace of mind
The JCVI changes its position on recommending adolescent vaccination against MenB
alasdairmunro.substack.com
ICYMI my latest post looks at a common cause of concern for parents - infection related rashes! Why do they happen and when should you worry? Join me to find out all this and more! #Peds #PedsID 🧪
Making Rash Decisions
When to worry about rashes when a child is sick
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My latest post looks at a common cause of concern for parents - infection related rashes! Why do they happen and when should you worry? Join me to find out all this and more!
Making Rash Decisions
When to worry about rashes when a child is sick
alasdairmunro.substack.com
My latest post looks at a common cause of concern for parents - infection related rashes! Why do they happen and when should you worry? Join me to find out all this and more!
Making Rash Decisions
When to worry about rashes when a child is sick
alasdairmunro.substack.com
Oh no you’re way behind Jack (Can’t believe you made me dig out ttespoof.pdf)
Five-year-old Isla is a star today on BBC South Today 📺🤩 She and mum, Jennifer, are taking part in a major new clinical trial, funded by @nihr.bsky.social and co-led by @uhsft.bsky.social, to improve care for children and young people with severe acute asthma. Watch BBC One in the South at 6.30pm
@apsmunro.bsky.social does actually discuss this study and its limitations in quite a bit of detail in this fascinating blog reviewing this question. An interesting issue with study design and more questions than answers I think alasdairmunro.substack.com/p/the-truth-...
The truth about the shingles vaccine and dementia
Ground breaking intervention or senseless hype?
alasdairmunro.substack.com
Great article by @apsmunro.bsky.social on the dementia - shingles vaccine question. TLDR - The shingles vaccine is excellent at preventing shingles, but the evidence for a protective effect against dementia is pretty weak alasdairmunro.substack.com/p/the-truth-...
The truth about the shingles vaccine and dementia
Ground breaking intervention or senseless hype?
alasdairmunro.substack.com
tl;dr Despite what you've likely seen on socials the old Shingles vax probably isn't protective against dementia. Still good for shingle tho..
Alasdair Munro@apsmunro.bsky.social · last mo.Huge developments this past week in the question over whether the old, live-attenuated shingles vaccine prevents dementia The messaging around this topic from much of the Sci-Com field has been atrocious What is the truth?
"Then they looked at dementia, and found …. nothing. A complete null result, stable across sensitivity analyses, with no bias they could find to explain the gap with Wales."
Alasdair Munro@apsmunro.bsky.social · last mo.Huge developments this past week in the question over whether the old, live-attenuated shingles vaccine prevents dementia The messaging around this topic from much of the Sci-Com field has been atrocious What is the truth?
Huge developments this past week in the question over whether the old, live-attenuated shingles vaccine prevents dementia The messaging around this topic from much of the Sci-Com field has been atrocious What is the truth?
The truth about the shingles vaccine and dementia
Ground breaking intervention or senseless hype?
alasdairmunro.substack.com
Great post @apsmunro.bsky.social! Doing more is such a natural reaction. But even 'benign' interventions may likely be harmful when tested properly. I'm yet to know of a trial for sepsis where adding antibiotics has been beneficial (outside of TB where we do it to prevent emergence of resistance).
Alasdair Munro@apsmunro.bsky.social · 2mo agoMy new post looks at two antimicrobials which have been routinely used and even recommended in guidelines despite a lack of RCT evidence In the last few weeks they’ve both been shown to have no benefit, and worse, high probability of harm - killing patients A lesson we keep failing to learn
My new post looks at two antimicrobials which have been routinely used and even recommended in guidelines despite a lack of RCT evidence In the last few weeks they’ve both been shown to have no benefit, and worse, high probability of harm - killing patients A lesson we keep failing to learn
When doing more harms patients
Oseltamivir and adjunctive Clindamycin may have been increasing mortality
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Interesting read that I would like to discuss with some ID peeps I know to hear their thoughts 👀👀
Alasdair Munro@apsmunro.bsky.social · 2mo agoMy new post looks at two antimicrobials which have been routinely used and even recommended in guidelines despite a lack of RCT evidence In the last few weeks they’ve both been shown to have no benefit, and worse, high probability of harm - killing patients A lesson we keep failing to learn
Reminder that the big, trumpeted, wellcome trust-funded trial intended to be the FIRST EVIDENCE of a link between teen mental health and social media has been running for, uh, 3 months and doesn't finish unitil next summer. Evidence based policy, innit. www.bbc.co.uk/news/article...
New Ebola situation report is out (there was none yesterday) and numbers are still rising shockingly fast: 782 confirmed cases now (+72 in the last 24 hours) That includes 181 confirmed deaths. Follow-up of contacts is back down to 56,5%. Not good. insp.cd/sitrep-n30-m...
OMG "This is a firm reminder that “we must do more for the sickest” is a human reflex, not an evidence base. The discipline of waiting for a trial, rather than acting on what feels right, is the thing that actually protects patients." "More to follow when both papers are out in full."
My new post looks at two antimicrobials which have been routinely used and even recommended in guidelines despite a lack of RCT evidence In the last few weeks they’ve both been shown to have no benefit, and worse, high probability of harm - killing patients A lesson we keep failing to learn
When doing more harms patients
Oseltamivir and adjunctive Clindamycin may have been increasing mortality
substack.com
An AI-designed ‘universal’ coronavirus vaccine trialled at @uhsft.bsky.social @southamptoncrf.bsky.social could help protect against future viruses before they emerge 👇 Experts say this could potentially save millions of lives and avoid costly lockdowns. 🔗 research.uhs.nhs.uk/news/new-ai-...
The Ebola outbreak has been extremely fast moving, and the news has been mostly terrible News of potential trials of vaccines and therapeutics does lend some hope - but these are some way off Catch up on the latest developments with me and what it all means here
Ebola outbreak goes from bad to worse
A dire situation, but perhaps a glimmer of hope is on the horizon
alasdairmunro.substack.com
Indeed! Randomization + routinely collected data go back to Richard Peto's call for 'large and simple trials' that inspired the hugely succesfull RECOVERY trial in COVID-19. Nicely summarized important points.
2/ Emphasising the role of randomisation. Randomisation is entirely compatible with the use of routinely collected data. Importantly, the source of the data does not compensate for weaknesses in study design, and "real-world evidence" is no substitute for rigorous methodology...
"There have been reports of family members retrieving bodies from quarantine." -- all very normal, sadly. Same happened in 2014. The locals do a lot to make it worse, unfortunately :( Fingers crossed on getting it stopped ASAP & vaccine candidates
The Ebola outbreak has been extremely fast moving, and the news has been mostly terrible News of potential trials of vaccines and therapeutics does lend some hope - but these are some way off Catch up on the latest developments with me and what it all means here
Ebola outbreak goes from bad to worse
A dire situation, but perhaps a glimmer of hope is on the horizon
alasdairmunro.substack.com
New piece on arguments on the weight of evidence, following a post by @adamjkucharski.bsky.social We don't always need gold standard, sometimes aluminium standard is enough But when we disagree, it's not usually about the standard of evidence or science It's about decision thresholds and values
How much evidence is enough?
My thoughts on Adam Kucharski's recent piece on "Aluminium" grade evidence
alasdairmunro.substack.com
New piece on arguments on the weight of evidence, following a post by @adamjkucharski.bsky.social We don't always need gold standard, sometimes aluminium standard is enough But when we disagree, it's not usually about the standard of evidence or science It's about decision thresholds and values
How much evidence is enough?
My thoughts on Adam Kucharski's recent piece on "Aluminium" grade evidence
alasdairmunro.substack.com