This isn't a randomized controlled trial, so I wouldn't put much stock in the results, although it should provide a catalyst for further study (if it hasn't already).
Fetishizing RCTs is a source of much harm in medical policy.
A correctly-designed RCT can give more confidence in a result, particularly to non-statisticians, but very large effect and cohort sizes should not be ignored. We could tell just from the topical statistics that smoking was a major cause of lung cancer and other harms, despite the tobacco industry insisting nothing was proven.
Typical RCTs with only a few hundred patients deliver much less resolution than this result. We do still need trials to home in on the molecular agent, but Tdap is already proven safe, and wise to stay current on, so it would be foolish to "wait and see". If it turns out Tdap (e.g.) protects only some patients from dementia, you are anyway safe from tetanus infection.
It is similar to the case where arginine supplements appear to cut epithelial tissue side effects of SARS-2 vaccines. It needs more study, but arginine is cheap and perfectly safe, so starting immediately to administer arginine supplements alongside vaccination is the prudent course.
Some RCTs even yield spurious results, as a consequence of poor design or execution, such as those lately promoted as showing that anti-depressants have no effect.
"Fetishizing" RCTs (i.e. realizing their importance) is a source of no harm, because it is the best design we have to determine whether some intervention actually helps people live longer or better. Effects from other kinds of studies should of course be weighed accordingly. Fetishizing observational/non-random studies is the source of harm. Taking the Tdap is very unlikely to hurt you, but calling this single study "astonishing" and implying that it indeed shows a 40% reduction in risk (it doesn't) is hyperbolic.
ncmncm|4 years ago
A correctly-designed RCT can give more confidence in a result, particularly to non-statisticians, but very large effect and cohort sizes should not be ignored. We could tell just from the topical statistics that smoking was a major cause of lung cancer and other harms, despite the tobacco industry insisting nothing was proven.
Typical RCTs with only a few hundred patients deliver much less resolution than this result. We do still need trials to home in on the molecular agent, but Tdap is already proven safe, and wise to stay current on, so it would be foolish to "wait and see". If it turns out Tdap (e.g.) protects only some patients from dementia, you are anyway safe from tetanus infection.
It is similar to the case where arginine supplements appear to cut epithelial tissue side effects of SARS-2 vaccines. It needs more study, but arginine is cheap and perfectly safe, so starting immediately to administer arginine supplements alongside vaccination is the prudent course.
Some RCTs even yield spurious results, as a consequence of poor design or execution, such as those lately promoted as showing that anti-depressants have no effect.
Fetishism should have no place in medicine.
TaupeRanger|4 years ago