Daniel Grint
@danieljgrint.bsky.social
Associate Prof of Medical Statistics @lshtm.bsky.social | TB and HIV treatment trialist | Electronic health records analyst | Running shoe geek
📢Funded fellowships available📢 We have two fully funded medical statistics fellowships available for applicants from sub-Saharan Africa, covering ▶️1 yr MSc in Medical Statistics at LSHTM ▶️1 yr placement at a partnering research institution 🗓️Closing date 31st March www.lshtm.ac.uk/research/cen...
International Statistics and Epidemiology Group | LSHTM
Collaborating with international research partners to improve health in low and middle-income countries
lshtm.ac.uk
In a new preprint (NOT PEER REVIEWED) we continue to explore the challenge of overtreatment in community screening. It seems the benefits of TB treatment far outweigh the harms, especially once we accept that sputum culture is not perfect. Important food for thought. www.medrxiv.org/content/10.1...
Do no harm - re-evaluating the risks of overtreatment in community-wide tuberculosis screening
Background Community-wide screening is a crucial strategy to end tuberculosis (TB), but a common concern is potential harm from overtreatment following false positive diagnoses. However, current refer...
medrxiv.org
Xpert MTB/RIF® cycle threshold as a marker of TB disease severity; Implications for TB treatment stratification ✅ Just Accepted #IDSky 🔗 https://bit.ly/3WbLI1G
This paper has now been peer reviewed and is available open access at CID.
Xpert MTB/RIF® cycle threshold as a marker of TB disease severity; Implications for TB treatment stratification
Xpert MTB/RIF® and chest radiography at TB treatment initiation identify a majority of patients for whom a 4-month treatment duration is non-inferior to th
doi.org
Daniel Grint@danieljgrint.bsky.social · last yr.NEW PRE-PRINT (currently going through peer review) In this secondary analysis of the RIFASHORT trial we classified TB disease severity at baseline and show that for the majority of people 4-months of rifampicin-based treatment, without the use of a quinolone, was non-inferior to the 6-month SOC.
Nutritional status is a key determinant of TB. In this updated systematic review and dose-response meta-analysis (43 cohorts inc > 26 million people) we redefined the relationship between body mass index (BMI) and TB. doi.org/10.1093/ije/...
Body mass index and tuberculosis risk: an updated systematic literature review and dose–response meta-analysis
AbstractBackground. The relationship between nutritional status and tuberculosis is critically important but poorly understood. We extended a 2009 review c
doi.org
At a time when global resources for #TB research, development, prevention, and care are limited, which interventions should be prioritised in high burden settings? 📢 Our new pre-print compares the impact, cost, and cost-effectiveness of 9 TB interventions in 3 countries. 1/n bit.ly/3V3vXth
The potential impact, cost and cost-effectiveness of tuberculosis interventions - a modelling exercise
Background While a range of interventions exist for tuberculosis prevention, screening, diagnosis, and treatment, their potential population impact and cost-effectiveness are seldom directly compared,...
bit.ly
Academia may not give you job security, flexibility, or wealth, but it will let you unexpectedly connect to eduroam in foreign cities
I really dislike how science has started calling almost any fancy computational technique AI. 🧪 The framing of this entire article makes it sound like a benevolent AI independently made these drugs. That is *pure fantasy*. Instead: a team of scientists made a machine learning model for a study.
⚡️New preprint (not peer-reviewed)⚡️ In the SaDAPT trial with people with #HIV and #tuberculosis symptoms in 🇲🇼🇱🇸, we investigated if antiretroviral therapy should be initiated immediately, or delayed until TB results available. ssrn.com/abstract=523... Outcomes (incl. IRIS) similar across both arms.
Delighted to see our long-acting injectible ART trial (IMPALA) presented at #IAS2025. 2-monthly injections are non-inferior to daily pill taking and overwhelmingly preferred. Next challenge is expanding access to LA ART; excellent news the WHO has recommended LA CAB+RPV in treatment guidelines.
aidsmap@aidsmap.bsky.social · last yr.News from #IAS2025: Injectable HIV treatment works for people with poor HIV control in Africa www.aidsmap.com/news/jul-2025/injectable-hiv-treatment-works-people-poor-hiv-control-africa @iasociety.bsky.social
Describing the hawkeye automated line calling at Wimbledon as 'AI' can seriously get in the sea.
🚨 NEW PRE-PRINT (currently going through peer review) We conducted a statistical simulation study to assess the impact of imperfect sensitivity and specificity, in the primary outcome definition of tuberculosis infection, in vaccine trials testing a non-inferiority hypothesis.
Imprecision in tuberculosis infection outcomes; implications for non-inferiority vaccine trials
Introduction Randomised trials comparing new vaccines against tuberculosis for use in neonates and infants, for whom Bacille Calmette-Guérin (BCG) vaccination is established practice, are using tuberc...
medrxiv.org
NEW PRE-PRINT (currently going through peer review) In this secondary analysis of the RIFASHORT trial we classified TB disease severity at baseline and show that for the majority of people 4-months of rifampicin-based treatment, without the use of a quinolone, was non-inferior to the 6-month SOC.
Xpert MTB/RIF® cycle threshold as a marker of TB disease severity; Implications for TB treatment stratification
Introduction Recent trials have demonstrated that shortened four-month treatment durations are effective for the majority of people with tuberculosis (TB). However, there is a population of TB patient...
doi.org
NEW PRE-PRINT (currently going through peer review) In this secondary analysis of the RIFASHORT trial we classified TB disease severity at baseline and show that for the majority of people 4-months of rifampicin-based treatment, without the use of a quinolone, was non-inferior to the 6-month SOC.
Xpert MTB/RIF® cycle threshold as a marker of TB disease severity; Implications for TB treatment stratification
Introduction Recent trials have demonstrated that shortened four-month treatment durations are effective for the majority of people with tuberculosis (TB). However, there is a population of TB patient...
doi.org
If you are at a loose end next Tuesday, come hear me and @danieljgrint.bsky.social talk about endpoints in TB trials Hybrid event, in London and online Most of the same ideas available in written form here www.thelancet.com/journals/lan... #IDSky #TBSky @sgschumacher.bsky.social
TB Centre LSHTM@tb-lshtm.bsky.social · last yr.Diary date: 27 May 12.45 BST "Defining efficacy endpoints for late phase tuberculosis treatment non-inferiority trials"@danieljgrint.bsky.social @tomayates.bsky.social www.lshtm.ac.uk/newsevents/e...
Diary date: 27 May 12.45 BST "Defining efficacy endpoints for late phase tuberculosis treatment non-inferiority trials"@danieljgrint.bsky.social @tomayates.bsky.social www.lshtm.ac.uk/newsevents/e...
Defining efficacy endpoints for late phase tuberculosis treatment
Randomised trials of new TB treatment regimens use a non-inferiority design, comparing new regimens to the established standard of care. In the last 20-years, these trials have used a composite
lshtm.ac.uk
Oh good ‘ITT analyses are biased’ is back, here using the euphemism ‘diluted’ 🙃 The rules are that you have to: 1. say what your estimand is before saying an analysis is ‘diluted’/‘biased’ 2. admit that there are other reasonable estimands 3. describe how it could be realised in a future population
Reposting for the Monday morning crowd
Daniel Grint@danieljgrint.bsky.social · 2y agoIt was a pleasure working with @tomayates.bsky.social on this comment in @lancetmicrobe.bsky.social It's time for new TB treatment trials to use a more focused primary outcome definition, moving on from the composite outcome that has prevailed for the last decade www.thelancet.com/journals/lan...
It was a pleasure working with @tomayates.bsky.social on this comment in @lancetmicrobe.bsky.social It's time for new TB treatment trials to use a more focused primary outcome definition, moving on from the composite outcome that has prevailed for the last decade www.thelancet.com/journals/lan...
Primary efficacy endpoints in phase 3 non-inferiority trials to establish new tuberculosis treatment regimens should only include microbiological outcomes
Treatment regimens for tuberculosis remain protracted and burdensome, both for patients to adhere to and for health-care providers to administer. Particularly, many current regimens for drug-resistant...
thelancet.com
Phase I results often don't translate into proven efficacy in late phase trials, but once yearly PrEP against HIV is a tantalising prospect. Very promising.
The Lancet@thelancet.com · 2y agoOnce-a-year injection to protect against HIV is safe and shows promise as a long-acting prevention medication, phase 1 study finds. Explore the research 👉 tinyurl.com/bduenm99 #MedSky
Interesting trial showing the effect of pre- and post-test counselling and cash transfers on TB treatment outcomes. LTFU outcomes lower in the intervention arm. Evidence that there is scope to improve outcomes beyond new drug regimens; no need to wait for a goldilocks regimen to solve everything.
BK. Titanji@boghuma.bsky.social · 2y agoTB is a disease of poverty A new RCT in @thelancetinfdis.bsky.social shows that pre-test & post-test TB counseling + conditional cash transfers significantly improved treatment outcomes in South Africa. The intervention cut unsuccessful TB outcomes nearly in half! www.thelancet.com/journals/lan...
After falling for 10 years, rates of #tuberculosis in the UK are on the rise. 📈 Join the latest free webinar from @ucltb.bsky.social to discuss why this is happening, and how we can best respond. 📆 Thurs 6 February 🕒 3pm - 5pm 📍 Online Sign up now 👉 https://buff.ly/4agqAxE
