361–370 of 379 posts
Given that I need hydroxychloroquine to treat my rheumatoid arthritis, I'd like this hypothesis to be either proven or disproven as rapidly and as unambiguously as possible.
Novartis has committed to donate up to 130 million doses which should cover a fair bit.
It's important to interpret these results carefully: "no evidence of efficacy" does not imply evidence of no efficacy, and in fact the uncertainty in this study is quite large. The sample size is small enough that it would be very hard for this study to detect the effect of hydroxychloroquine unless that effect is very, very large. From the abstract: > In the HCQ group, 2.8% of the patients died within 7 days vs 4.6%…
The reason they aren't doing large randomised controlled trials is because the hydroxychloroquine itself is killing people, and it's unethical to continue.
People have said they'd rather have malaria than take it, and that should tell you something. The side-effects for hydroxychloroquine include death, which is not immediately obvious from reading HN.
Doctors aren't just making this up and ignoring evidence, the drug is bad, and not effective for covid-19
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Imagine if Obama had "endorsed" Biden using the same language. Would you have considered it an endorsement? I find the interpretation of what he said to be very peculiar.
My mother, a pharmacist by training, has repeatedly communicated her impression that "this whole coronavirus thing would be gone in a week if we just gave everyone HCQ!" She got that impression from somewhere, but certainly not from any of the studies I've read, leaving the conservative news sphere as the likely source. Whoever is making the exaggerations, they're egregious.
which may have influenced her and the POTUS
It's important to interpret these results carefully: "no evidence of efficacy" does not imply evidence of no efficacy, and in fact the uncertainty in this study is quite large. The sample size is small enough that it would be very hard for this study to detect the effect of hydroxychloroquine unless that effect is very, very large. From the abstract: > In the HCQ group, 2.8% of the patients died within 7 days vs 4.6%…
> Other commenters are correct that large randomized trials will be more definitive. The reason they aren't doing large randomised controlled trials is because the hydroxychloroquine itself is killing people, and it's unethical to continue. People have said they'd rather have malaria than take it, and that should tell you something. The side-effects for hydroxychloroquine include death, which is not immediately obvio…
I call shenanigans.
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It is important to remember we also do not have evidence of no efficacy for chocolate milk. Yet we do not waste our time testing it.
Okay but there are actually good reasons to test hydroxychloroquine, as it is effective against viruses with relevant similarities to Covid-19. The same is not true for chocolate milk. To address the elephant in the room: yes, Trump did come out in favor of hydroxychloroquine, but his opinion on medical issues is literally meaningless noise in both the informational and auditory senses of the phrase. We certainly sho…
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To be clear, this claim > For example, it's highly unlikely (roughly less than 2.5%) that HCQ reduces the onset of ARDS by half. is not one that can be justified by frequentist statistics such as those used in the article. We can't make probabilistic claims like that unless we go Bayesian. Well-designed drug trials typically plan in advance to have the sample size necessary to detect an effect of clinical significanc…
Actually, I CAN make that claim based upon the data in the article. The relative risk [RR] of developing ARDS on HCQ vs. in the control group was 1.14, with 95% confidence interval of 0.65 - 2.00. That means that 95% of the time, the relative risk will fall between those two guardrails. If we take the single-sided probability, then the relative risk will be less 0.65 2.5% of the time. "Reducing the onset by half" mea…
In frequentist statistics, the true population parameter is fixed, not random, so the claim "the relative risk will be less 0.65 2.5% of the time" has no meaning. The 95% claim is that if we repeatedly sample new data, 95% of the time we will generate a confidence interval covering the true parameter; but that does not say anything about the individual confidence interval in this specific case, about which we have no probability claim. Indeed, it's not clear what a 95% chance would mean for a specific interval, since probability in frequentist statistics is defined in terms of long-run probabilities over repeated samples of data.
But the impulse to interpret confidence intervals in a Bayesian way is common, since it's the question we want confidence intervals to answer. You can find a lot of academic papers arguing about this as a sign of the inadequacy of frequentist statistics.
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> Other commenters are correct that large randomized trials will be more definitive. The reason they aren't doing large randomised controlled trials is because the hydroxychloroquine itself is killing people, and it's unethical to continue. People have said they'd rather have malaria than take it, and that should tell you something. The side-effects for hydroxychloroquine include death, which is not immediately obvio…
I have a friend who takes it for lupus, and has taken it for years. Clearly, he hasn't died, in part because it is a prescription drug and requires a doctor's script. He understands the risks and the benefits. He has taken it for years, as I mentioned, so your "people have said" is clearly not inclusive of a large number of people. The medicine is made by several manufacturers, and if there wasn't a market, that woul…
There's a reason it's not licensed for viruses, and why only a tiny number of people take it, and there's a reason why wide scale trials are being cancelled. There isn't a huge anti-hydroxychloroquine conspiracy here
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By the time we have lots of it, we will have good statistics on demographics of people most likely to need it, so you could make educated guesses and still see a benefit.
To offer some perspective, in Montgomery County, just north of Philly (a suburban metro county harder hit than most), 10% of positive tests have been admitted to hospital, and 2.6% of positive tests have gone on ventilators. So the subpopulation needing remdesivir is probably less than 5% of the positive cases (or 1250 of the 25,000 who tested positive here). BTW, the county population is 900,000.
...so a targeted application of anti-virals is definitely worthwhile.
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There were multiple papers out of Europe and China by then. This was already floating around before Trump latched onto it because it was indeed promising, which is exactly what Trump said. What else do you think the words "hopefully" and "real chance" are here to communicate? What do you think "move fast" means? Administer the cure to everyone, or figure out if it works? This was a clearly promising avenue and as the…
It's neither vitriol nor irrational to expect a leader to yield to experts and to relay only reliable information. What he did instead lacked context or information necessary to mass communicate. There's a way to communicate it and it wasn't this.
And you want to tell me that from his tweet you already know he didn't get this information from so called experts? How exactly does this tweet indicate otherwise?
>What he did instead lacked context or information necessary to mass communicate. There's a way to communicate it and it wasn't this
Welcome to the new normal, where politicians communicate via tweet. I agree that it is inappropriate but this particular example is just being used to project the usual anger onto him with multiple plausible but ultimately inappropriate rationalizations. There was, again, nothing inappropriate about a passing mention of a safe, cheap, promising drug. He could have done the same in the middle of a speech for similar effect.
Besides, what did you expect him to do, cite the relevant studies on Twitter? Sure, ideally he would, but let's not pretend that more than, say, .01 percent of the population is even capable of reading studies...
This is a shitty hill to die on.
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This matches what I've read, too. It's less about the virus during the later stages and more about the infected person's immune system. If they've entered a state of amplified immune response, colloquially called a "cytokine storm," organs are damaged when their cells are mistakenly attacked. If you can moderate the immune system's reaction you can prevent significant damage. HCQ is useful for this type of immuno-sup…
The problem is that the immunosuppression by hcq takes a few weeks to kick in [1]. So it will not stop the Cytokine storm in time. tocilizumab seems to be a better option. 1. https://www.versusarthritis.org/about-arthritis/treatments/d... 2. https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_In...