PhilosopherMD

This is my no politics Twitter account. I need some sanity occasionally. Physician & Meta-Physician #Theology #Philosophy #Oncology #Statistics #Investing

[PhilosopherMD @PhilosopherMD1]

Reminder Bayesian methods do not assign true or ontological probabilities to events such as the objective chance of a fair coin landing heads or a dice producing a six. Bayes treats probability as a measure of uncertainty or degree of belief that is through mathematical distributions like the beta, gamma, or normal curves, thus in the Bayesian framework, what is called “probability” is not the truth but a numerical representation derived from integrating areas under these curves being called "probability." Remember they depend on the chosen prior, thus changing the prior will alter the resulting “probabilities,” highlighting that they are not properties of the real world, but artifacts of the modeling assumptions. Theoretically they are just representations of your beliefs, which is why Bayes has been resisted as a foundation for stats.

[NonsparseOncologist @5_utr]

@PhilosopherMD1 @f2harrell @ColtonLadbury @drdavidpalma @NiuSanford @PhilosopherMD1 Cute concern. Meanwhile p-values gave us a replication crisis, p-hacking, and 50 years of irreproducible medicine. Bayes gives actual probabilities. Fix your own house first.

[PhilosopherMD @PhilosopherMD1]

@DrSpratticus @WallisCJD Big no no here!

[PhilosopherMD @PhilosopherMD1]

@PDBrownOnc Thank you so much for the response. Greatly appreciated!

[PhilosopherMD @PhilosopherMD1]

@TylerSbrt @DrYukselUrun @nataliagandur @DrTylerStewart @HimanshuNagarMD The total disrespect and disregard for XRT in bladder cancer with some of these new EVP trials is outstanding. Extremely discouraging

[PhilosopherMD @PhilosopherMD1]

@DrSpratticus @TylerSbrt @EvanThomas84 @angela_jia_ I would trade some OS and DMFS for ADT free survival

[PhilosopherMD @PhilosopherMD1]

@5_utr @f2harrell @ColtonLadbury @drdavidpalma @NiuSanford

[PhilosopherMD @PhilosopherMD1]

@f2harrell I was simply pointing out sarcastically that there can be flaws to any statistical system including Bayes and any system can be gamed, as our colleague @5_utr still has not admitted any flaws. If the field moves forward with Bayes it behooves us to know how to critique these Bayesian studies and not just point out flaws in freq methods. The incentives to have publish positive papers will not disappear by switching paradigms and I am sure we can agree in that much.

[PhilosopherMD @PhilosopherMD1]

@5_utr @ColtonLadbury @drdavidpalma @NiuSanford @f2harrell So now with MCMC and increased compute there are no flaws. So we can accept Bayes studies uncritically. You still have not pointed out any flaws…

[PhilosopherMD @PhilosopherMD1]

@dbittermanmd Kudos! This is the question of the current AI moment. I have been pondering about for years.

[PhilosopherMD @PhilosopherMD1]

@5_utr @ColtonLadbury @drdavidpalma @NiuSanford @f2harrell Do tell what are the imperfections of Bayes? Or do we uncritically accept every positive Bayes trial?

[PhilosopherMD @PhilosopherMD1]

@ColtonLadbury @5_utr @drdavidpalma @NiuSanford @f2harrell Ahhh @ColtonLadbury no worries. @5_utr and I have been going at it on this topic for years so you’re coming at the tail end of a long conversation. I am just getting @5_utr to admit these imperfections 😜

[PhilosopherMD @PhilosopherMD1]

@5_utr @drdavidpalma @NiuSanford @f2harrell You are correct. There are no flaws in Bayesian stats. My bad…

[David Palma, MD, PhD @drdavidpalma]

Totally agree with you @NiuSanford. The problem with Bayesian analyses is that our “priors” are often TOTALLY wrong, but they factor into the conclusions.

We might have said the RTOG0617 74 Gy arm was 80% likely to win, and that guess could have led to a different conclusion when the trial was read out. Same with PARTIQoL, stem cell transplants for breast cancer, and other trials with surprise negative results.

[PhilosopherMD @PhilosopherMD1]

@jjnaylor02

[PhilosopherMD @PhilosopherMD1]

@alison_tree @DrSpratticus @TylerSbrt @piet_ost @PCaParker @urotoday @neerajaiims @huntsmancancer @TDorffOnc @cityofhope @ChrisSweens1 @Prof_Nick_James @BertrandTOMBAL I feel just as strongly with EVP vs CRT for bladder

[PhilosopherMD @PhilosopherMD1]

@MichaelWellerMD @tompowles1 @ndesai2005 @montypal Ugh isn’t this trial unethical? I think it’s a very high risk to play with patients lives to enroll curative patients on a systemic only tx arm! I would never enroll a loved one onto this trial. Remember the physicians aren’t taking the risk it’s the patients!

[PhilosopherMD @PhilosopherMD1]

@jryckman3 Yes, but even with credentialism I think @DrewMoghanaki and @TonyFelefly have enough cred to comment 🤣