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Ebola Is Now Curable

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Re: Ebola Is Now Curable

#121

Post by TheSpiceIsLife »

hanniabu wrote: post #115
IfOnlyYouKnew wrote: post #53

Earlier quoted context omitted.

It's only a "great way to create statistical fraud" if you assume that the statisticians, and the FDA, are either stupid or corrupt. And contrary to popular belief, they tend to be competent enough to at least cope with the sort of hair-brained schemes HN believes would fool them.[0] Stopping a trial early and it's statistical implications should, by the way, be somewhat familiar with web developers: it's commonly do…

> It's only a "great way to create statistical fraud" if you assume that the statisticians, and the FDA, are either stupid or corrupt. Considering how much money is in pharmaceuticals, I'd definitely go with corrupt, especially considering this explains how a majority of the world works now and also since there's currently an outbreak and likely want to capitalize on it. I'm not at all saying this is the case, but th…

Are you familiar with what PJ O'Rouke says about politicians?

Have a listen to this https://www.youtube.com/watch?v=JbIqKqojOZU

He is the author of Parliament of Whores

Parliament of Whores is an international best-selling political humor book by P. J. O'Rourke published by Atlantic Monthly Press in 1991. Subtitled "A Lone Humorist Attempts to Explain the Entire US Government"

Re: Ebola Is Now Curable

#122

Post by excalibur »

hanniabu wrote: post #115
IfOnlyYouKnew wrote: post #53

Earlier quoted context omitted.

It's only a "great way to create statistical fraud" if you assume that the statisticians, and the FDA, are either stupid or corrupt. And contrary to popular belief, they tend to be competent enough to at least cope with the sort of hair-brained schemes HN believes would fool them.[0] Stopping a trial early and it's statistical implications should, by the way, be somewhat familiar with web developers: it's commonly do…

> It's only a "great way to create statistical fraud" if you assume that the statisticians, and the FDA, are either stupid or corrupt. Considering how much money is in pharmaceuticals, I'd definitely go with corrupt, especially considering this explains how a majority of the world works now and also since there's currently an outbreak and likely want to capitalize on it. I'm not at all saying this is the case, but th…

I feel like Hanlon's razor is applicable here.

Re: Ebola Is Now Curable

#123

Post by excalibur »

mlevental wrote: post #111
IfOnlyYouKnew wrote: post #53

Earlier quoted context omitted.

It's only a "great way to create statistical fraud" if you assume that the statisticians, and the FDA, are either stupid or corrupt. And contrary to popular belief, they tend to be competent enough to at least cope with the sort of hair-brained schemes HN believes would fool them.[0] Stopping a trial early and it's statistical implications should, by the way, be somewhat familiar with web developers: it's commonly do…

rule #1 of hn: anyone on hn is smarter than everyone not on hn no matter the domain. we could solve all the world's problems by just getting everyone into hn!

We have the best brains!

Re: Ebola Is Now Curable

#124

Post by class4behavior »

billpg wrote: post #92
ladon86 wrote: post #67

I really have to apologize if this is not a HN-quality comment, but I initially read this as a startup rebrand announcement. Ebola is now Curable (YC 17)

I did that too. "Who the f... calls their business Ebola?".

May I suggest to you two HN's noprocrast feature. I think, you spend way too much time here. ;)

Re: Ebola Is Now Curable

#125

Post by dahart »

singingboyo wrote: post #45
jcranmer wrote: post #43

Earlier quoted context omitted.

Actually, it's quite terrifying when you remember that stopping a clinical trial early is a great way to create statistical fraud. https://blogs.sciencemag.org/pipeline/archives/2019/08/08/st... cites an example of a drug whose clinical trial was stopped early due to obviously effective success... only to discover later on that the "obviously effective" was a statistically spurious event, and the drug did not confer…

While I agree in general, the article indicates this was stopped after 681 of a planned 725 patients, which seems okay. Additionally, my understanding from a quick read is that the SPMS trials were aiming to delay progression in disability, rather than eliminate the effects altogether. That seems trickier to measure, and also more subject to just... not spending enough time looking at it. Ebola, on the other hand, ha…

> While I agree in general, the article indicates this was stopped after 681 of a planned 725 patients, which seems okay.

Are you talking about the European trial, referring to “358 patients with SP-MS were allocated placebo and 360 were allocated interferon beta-1b; 57 patients (31 placebo, 26 interferon beta-1b) were lost to follow-up.”?

If so, your interpretation isn’t quite right. It’s not saying they stopped 57 patients short, it’s saying those 57 people didn’t participate at all, but that’s irrelevant to the early ending. The trial stopped short of it’s intended completion time, not short of a number of patients. The blog post indicates it was stopped 2 years early, out of a planned 2-3 year study period.

Re: Ebola Is Now Curable

#127

Post by millisecond »

taneq wrote: post #20
throwaway5752 wrote: post #5

It's great news, but they're observing a 30% mortality rate for the "cure". Absent medical intervention there is still a nontrivial survival rate (mortality rate of 75-90%). With supporting medical treatment before this new treatment - fluid support, etc - I think it's up to 50%? It sounds like the monoclonal antibody treatment has improved odds of survival from 1:10-1:2 to 2:3. edit: The 6% figure is population rest…

If I were facing a 75-90% chance of dying, I think I’d be pretty happy to reduce that to 6-30%.

But I wouldn’t call the disease “cured”.

Re: Ebola Is Now Curable

#129

Post by skosuri »

powerbroker wrote: post #119
mlevental wrote: post #111

Earlier quoted context omitted.

rule #1 of hn: anyone on hn is smarter than everyone not on hn no matter the domain. we could solve all the world's problems by just getting everyone into hn!

rule #2 of hn: High signal to noise is preferred over low signal to noise. HN > twitter.

To be fair, and when it comes to health and biology, Twitter >> HN. The comments on most bio-related posts here make me cringe.

Re: Ebola Is Now Curable

#130

Post by WhompingWindows »

jcranmer wrote: post #43
dankohn1 wrote: post #29

There is no news I enjoy reading more than that a clinical trial had to be ended early because the treatment was so effective that it would be unethical to continue with alternative treatments (or a placebo).

Actually, it's quite terrifying when you remember that stopping a clinical trial early is a great way to create statistical fraud. https://blogs.sciencemag.org/pipeline/archives/2019/08/08/st... cites an example of a drug whose clinical trial was stopped early due to obviously effective success... only to discover later on that the "obviously effective" was a statistically spurious event, and the drug did not confer…

It's not that terrifying, there are many drugs approved that are not even more effective than cheaper, older drugs on the market. It takes a wild-scale deployment with 1000's of patients to find rare side effects and to measure the true population-level effectiveness of a drug. This is contrary to the clinical-trial level "efficacy" of a drug, which is with a more limited in terms of N= and in terms of diversity, population.

Really, the whole drug approval process is filled with uncertainty. Partly it's how the sausage is made in biotech, but also pharma companies love this method as it allows them to put forward non-inferior drugs with higher margins. We can reform the process, and should, but there will still be statistical uncertainty for 100's of new candidates, until they reach the post-market study phase.

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