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
Pinned
Daniel Grint
@danieljgrint.bsky.social
· Mar 15
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...
www.thelancet.com
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...
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...
Reposted by Daniel Grint
In a new preprint (NOT PEER REVIEWED) we continue to explore the challenge of overtreatment in community screening.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...
www.medrxiv.org
October 7, 2025 at 9:17 AM
In a new preprint (NOT PEER REVIEWED) we continue to explore the challenge of overtreatment in community screening.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...
Reposted by Daniel Grint
Xpert MTB/RIF® cycle threshold as a marker of TB disease severity; Implications for TB treatment stratification
✅ Just Accepted
#IDSky
🔗 https://bit.ly/3WbLI1G
✅ Just Accepted
#IDSky
🔗 https://bit.ly/3WbLI1G
September 28, 2025 at 7:17 PM
Xpert MTB/RIF® cycle threshold as a marker of TB disease severity; Implications for TB treatment stratification
✅ Just Accepted
#IDSky
🔗 https://bit.ly/3WbLI1G
✅ Just Accepted
#IDSky
🔗 https://bit.ly/3WbLI1G
This paper has now been peer reviewed and is available open access at CID.
September 25, 2025 at 6:38 PM
This paper has now been peer reviewed and is available open access at CID.
apropos of nothing
Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability
This nationwide cohort study with sibling control analysis examines the association of acetaminophen use during pregnancy with children’s risk of autism, ADHD, and intellectual disability.
jamanetwork.com
September 23, 2025 at 10:28 AM
apropos of nothing
Reposted by Daniel Grint
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
September 9, 2025 at 8:35 AM
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/...
Reposted by Daniel Grint
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
📢 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
September 5, 2025 at 10:05 AM
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
📢 Our new pre-print compares the impact, cost, and cost-effectiveness of 9 TB interventions in 3 countries. 1/n
bit.ly/3V3vXth
Reposted by Daniel Grint
Academia may not give you job security, flexibility, or wealth, but it will let you unexpectedly connect to eduroam in foreign cities
August 20, 2025 at 4:58 PM
Academia may not give you job security, flexibility, or wealth, but it will let you unexpectedly connect to eduroam in foreign cities
Reposted by Daniel Grint
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.
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.
August 15, 2025 at 6:14 AM
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.
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.
Reposted by Daniel Grint
⚡️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.
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.
May 1, 2025 at 7:10 AM
⚡️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.
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.
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
www.aidsmap.com/news/jul-2025/injectable-hiv-treatment-works-people-poor-hiv-control-africa
@iasociety.bsky.social
Injectable HIV treatment works for people with poor HIV control in Africa
Injectable treatment with long-acting cabotegravir and rilpivirine is as effective as dolutegravir-based oral treatment in adults with HIV in sub-Saharan Africa who have a history of treatment non-adh...
www.aidsmap.com
July 18, 2025 at 3:03 PM
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.
Describing the hawkeye automated line calling at Wimbledon as 'AI' can seriously get in the sea.
July 5, 2025 at 11:46 AM
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.
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...
www.medrxiv.org
June 25, 2025 at 8:16 PM
🚨 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.
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.
Reposted by Daniel Grint
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.
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
June 13, 2025 at 8:19 AM
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.
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.
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.
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
June 13, 2025 at 8:19 AM
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.
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.
Reposted by Daniel Grint
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
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
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...
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
www.lshtm.ac.uk
May 20, 2025 at 3:40 PM
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
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
Reposted by Daniel Grint
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...
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
www.lshtm.ac.uk
April 30, 2025 at 9:31 AM
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...
www.lshtm.ac.uk/newsevents/e...
Reposted by Daniel Grint
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
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
April 29, 2025 at 6:42 AM
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
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
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...
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...
www.thelancet.com
March 17, 2025 at 8:51 AM
Reposting for the Monday morning crowd
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...
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...
www.thelancet.com
March 15, 2025 at 1:30 PM
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...
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...
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.
Once-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
Explore the research 👉 tinyurl.com/bduenm99 #MedSky
March 12, 2025 at 12:57 PM
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.
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.
TB 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...
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...
Effects of conditional cash transfers and pre-test and post-test tuberculosis counselling on patient outcomes and loss to follow-up across the continuum of care in South Africa: a randomised controlle...
The package of interventions consisting of pre-test and post-test tuberculosis counselling
with conditional cash transfers significantly reduced the risk of unsuccessful tuberculosis
patient outcomes,...
www.thelancet.com
February 10, 2025 at 9:54 AM
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.
Reposted by Daniel Grint
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
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
January 22, 2025 at 12:00 PM
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
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
<old man sigh> let's give this thing a try
January 16, 2025 at 9:17 PM
<old man sigh> let's give this thing a try