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Andrew Vickers @vickersbiostats.bsky.social · 2d

Guidelines group argues against lymph node dissection in radical prostatectomy by cherry-picking outlying studies eg systematic review finds 5 studies on lymphedema only 1 with p<5%; authors cite that one study and ignore systematic review. www.europeanurology.com/article/S030...

Re: Matthew J. Roberts, Giorgio Gandaglia, Daniela E. Oprea-Lager, et al. Pelvic Lymph Node Dissection in Prostate Cancer: Evidence and Implications. Eur Urol 2025;87:619–21

There is an ongoing debate about whether the benefits of lymph node dissection (LND) during radical prostatectomy outweigh the harms. We previously published a commentary describing how opponents of L...

www.europeanurology.com

Andrew Vickers @vickersbiostats.bsky.social · 2d

Sepsis prediction not my field, but my anecdotal experience is that these models not well validated in the first place and don't work well in practice. Clinicians pick up on that and don't trust the model.

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Andrew Vickers @vickersbiostats.bsky.social · 5d

It is the power of ideology. Fight it.

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Andrew Vickers @vickersbiostats.bsky.social · 6d

All wrapped up in a neat little bow. Covid conspiracy theorist encourages her lymphoma afflicted daughter to refuse chemotherapy. The daughter dies. The mother blames paramedics for the death. www.theguardian.com/society/2025...

UK woman who refused cancer drugs was influenced by mother, inquest finds

Paloma Shemirani, 23, died after refusing chemotherapy for non-Hodgkin lymphoma despite doctors’ concerns

www.theguardian.com

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Andrew Vickers @vickersbiostats.bsky.social · 9d

Large multicenter study: "When grade group discordant between systematic & targeted biopsy, risk is intermediate. Current approach assigning highest grade should be abandoned ... consider de-escalating treatment when grade discordant." academic.oup.com/jnci/advance...

Assessing the oncologic risk when systematic and multiparametric magnetic resonance imaging-targeted prostate biopsy grade groups are discordant

AbstractBackground and Objective. In the systematic biopsy (SBx) era, prostate biopsy grading followed the rule that the ISUP grade group (GG) assigned was

academic.oup.com

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Andrew Vickers @vickersbiostats.bsky.social · 14d

This has a long history: see Hofstadter on the paranoid style.

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Reposted by Andrew Vickers

Benjamin Mazer @mazer.us · 16d

My theory of medical evidence is simple: observational studies for me, RCTs for you.

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Andrew Vickers @vickersbiostats.bsky.social · 17d

Remarkable study from the Malmo Preventive Project: ~1000 men with blood at 60 in 1981; no PSA screening, *lifetime* follow-up. >50% life years lost to prostate cancer in PSA>4.0; 85% for PSA >2.0. Focus screening for men in 60s in men with higher PSAs! academic.oup.com/jnci/advance...

Prostate-specific antigen levels at age 60 and lifetime risk of lethal prostate cancer

AbstractIntroduction. We investigated the natural history of the relationship between PSA at age 60 and lifetime risk of prostate cancer death in an unscre

academic.oup.com

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Andrew Vickers @vickersbiostats.bsky.social · 23d

Now seen two papers claiming PLND not needed in a subgroup with relatively low incidence of positive nodes at radical prostatectomy. Neither cite the RCT showing benefit of PLND. When RCT says “do X”, don’t eyeball a case-series to conclude “don’t do X”.

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Andrew Vickers @vickersbiostats.bsky.social · Sep 9

yes, in the paper!

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Andrew Vickers @vickersbiostats.bsky.social · Sep 8

Most common pitfall: ignoring it entirely!

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Andrew Vickers @vickersbiostats.bsky.social · Sep 5

@richarddriley.bsky.social

Andrew Vickers @vickersbiostats.bsky.social · Sep 5

This is big! Worked with great statisticians on guidelines for meta-analysis & systematic review. We discuss rationales for systematic review, evaluation & interpretation of heterogeneity, & common errors in network meta-analysis, funnel plots etc. www.europeanurology.com/article/S030...

Guidelines for Meta-analyses and Systematic Reviews in Urology

Our guideline comprises points addressing the conduct and interpretation of systematic reviews and meta-analyses in urology. Application of the guideline would lead to a more considered interpretation...

www.europeanurology.com

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Andrew Vickers @vickersbiostats.bsky.social · Sep 4

exactly so! ANCOVA great for experimental, not always appropriate for observational. If your question is "does regimen A or B build strength faster?" and you e.g. randomized to A vs. B, your question is "if you started at a given strength level, would A or B make you stronger".

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Andrew Vickers @vickersbiostats.bsky.social · Sep 4

It is not about bias, it is about the question you are asking. ANCCOVA asks the question "would increases in strength from training be the same in men vs. women if it were true that men and women had the same strength at baseline?". I don't find that a very interesting question.

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Andrew Vickers @vickersbiostats.bsky.social · Sep 3

Urologists do well with probability estimates vs. clinical scenarios. Goes against 25 years of me hearing "clinicians are too dumb to understand numbers, just tell them what to do". doi.org/10.1097/UPJ....

How Do Urologists Interpret Risk? Differences in Appropriateness of Active Surveillance Based on Clinical-Based vs Probability-Based Risk Assessments | Urology Practice

doi.org

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Reposted by Andrew Vickers

Dr Jonathan OLIVIER @jo-uro.bsky.social · Aug 27

Thrilled to share our new @BJUIjournal study!
📊 Quantifying Gleason pattern 4 via MRI & targeted biopsy predicts prostate cancer metastasis better than standard Gleason grading & risk scores.
Precision matters in risk stratification.
🔗 doi.org/10.1111/bju.... @vickersbiostats.bsky.social

Quantification of prostate cancer Gleason pattern 4 to predict oncological outcome

Objectives To determine if quantifying Gleason pattern 4 (GP4) is superior to Grade Group (GG) in predicting any and distant metastatic recurrence after radical prostatectomy (RP) for prostate cance...

doi.org

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Reposted by Andrew Vickers

Maarten van Smeden @maartenvsmeden.bsky.social · Aug 19

No.

Adam L @lauretig.bsky.social · Jul 27

5. You should use a precision-recall curve for a binary classifier, not an ROC curve

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Andrew Vickers @vickersbiostats.bsky.social · Aug 14

I've used that analogy for several years! Great that my elders and betters got there first!

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Andrew Vickers @vickersbiostats.bsky.social · Aug 14

I'm pretty sure this has been documented, but you could probably do the appropriate search better than I.

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Andrew Vickers @vickersbiostats.bsky.social · Aug 14

Talk to any psychologist working in a cancer center and the will tell you that they routinely deal with patients thinking it is their own fault, or worrying that they have to "think positive".

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Andrew Vickers @vickersbiostats.bsky.social · Aug 14

It isn't really a case of "I read Eysenck and now I feel guilty". But Eysenck was a prime mover in what became a host of books, magazine article and scientific papers claiming that the origin of cancer was influenced by the mind (eg stress) & that attitude affects survival (fighting attitude = good)

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Andrew Vickers @vickersbiostats.bsky.social · Aug 12

Interesting to see. Ronald Grossarth-Maticek is responsible for so much suffering, cancer patients believing that somehow their diagnosis and death was their own fault.

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Andrew Vickers @vickersbiostats.bsky.social · Aug 12

Completely agree with you! That was part of the point of my post!

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Andrew Vickers @vickersbiostats.bsky.social · Aug 12

Folks discuss replication crisis as if something new. But remember Hans Eysenck (an OG scientific racist)? Both "Eysenck was the most frequently cited living psychologist" & "14 papers retracted, 60 statements of concern issued by journals"
en.wikipedia.org/wiki/Hans_Ey...

Hans Eysenck - Wikipedia

en.wikipedia.org

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