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The First Randomized Controlled Trial on Vitamin D and Covid-19

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Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#311

Post by gridlockd »

learc83 wrote: post #233
burfog wrote: post #163

Earlier quoted context omitted.

Wikipedia is pretty reliable for math, old computer hardware, and other dry technical subjects. This is not one. This is a political subject. Wikipedia is a complete disaster for anything that even remotely touches upon modern politics. There are teams of people paid to impose an opinion on Wikipedia, relentlessly wearing down any neutral editor with 24x7 edits and every kind of bureaucratic fight. The people who edi…

>"ineffective and may cause dangerous side effects" Dangerous on an individual level, not really. But at a population level if hundreds of millions of people start taking it, you're going to have high absolute numbers of bad side effects. > is a purely political attack on the US president. As for ineffective, there isn't one single national health agency that recommends taking it for covid. Surely the entire globe is…

> As for ineffective, there isn't one single national health agency that recommends taking it for covid. Surely the entire globe isn't killing scores of their citizens by preventing the use of an effective treatment just to make the US President look bad.

Not true:

https://www.mohfw.gov.in/pdf/AdvisoryontheuseofHydroxychloro...

Of course, it's controversial because the WHO recommended against it and most health agencies just follow suit.

Also, American politics don't end at the border. There are countries that favor Trump, India being one of them.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#312

Post by tempestn »

giardini wrote: post #170
ReflectedImage wrote: post #36

Earlier quoted context omitted.

There are other drugs now that both work and have a large effect (20%). Hydroxychloroquine possible 5% increase in survival rate pales in comparsion. Given it's also poisonous I don't see why you would want to use it.

ReflectedImage says >"There are other drugs now that both work and have a large effect (20%). Hydroxychloroquine possible 5% increase in survival rate pales in comparsion. Given it's also poisonous I don't see why you would want to use it." Please name the other drugs that "both work and have a large effect (20%)".

Probably referring to Remdesivir.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#313

Post by Reelin »

zaroth wrote: post #277
Reelin wrote: post #256

Earlier quoted context omitted.

> nearly overweight according to BMI while very fit, with low fat and high muscle Not knowing you personally, it seems statistically more likely to me that your idea of "fit, low fat, high muscle" is what's at fault here (as opposed to BMI). Sure, you could be an exception. But all things being equal, you probably aren't. (Also maybe I misunderstand - if you mean that BMI was saying you were at the high end of normal…

I understand the desire to be contrarian, but BMI is widely regarded as totally obsolete with cheap and accurate ways to actually measure body fat percentages. It’s well understood that BMI is totally wrong for athletes or anyone remotely muscular.

> I understand the desire to be contrarian

I assure you that's not my motivation at all. I'm not an expert in that field so I tend to trust the metrics used by the health professionals I encounter.

> BMI is widely regarded as totally obsolete

That is not my impression at all, but again I'm not a subject matter expert here. If you have reliable (ie academic or medical) sources I would be interested in learning more about any current preferred metrics.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#314

Post by ridaj »

shajznnckfke wrote: post #257
Reelin wrote: post #256

Earlier quoted context omitted.

> nearly overweight according to BMI while very fit, with low fat and high muscle Not knowing you personally, it seems statistically more likely to me that your idea of "fit, low fat, high muscle" is what's at fault here (as opposed to BMI). Sure, you could be an exception. But all things being equal, you probably aren't. (Also maybe I misunderstand - if you mean that BMI was saying you were at the high end of normal…

I can believe it. I’m curious what typical body types were like in the hunter/gather societies human evolved in, and whether those are ideal for longevity and quality of life in modern society.

The kind of hunt that humans are believed to have practiced early on was persistence hunting, which consists of chasing prey over long distances until they are exhausted (the gazelle can outrun any human on a scale of minutes, but not on a scale of hours).

https://en.m.wikipedia.org/wiki/Persistence_hunting

If that is the case then the body type would have been low mass overall, like marathoners.

As for best body type for quality of life today (at least from a health perspective), that seems relatively aligned.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#315

Post by ptest1 »

The problem I see with this trial is that it’s open-label, small n, and has subjective endpoints (ICU admission as the primary outcome). The study is underpowered to detect mortality. Given the open-label nature of the trial, the subjective outcome with the small n makes this result less strong.

Why is this the case? Well, for this trial the physicians treating patients knew who got the Vitamin D and who didn’t, and thus they may have been more likely to admit those who didn’t to the ICU (subjective). Something like mortality is not as subjective, but there are too few study participants to detect a mortality signal in this trial.

If I had been conducting this small open label trial I would have picked some less subjective outcomes, like maybe P/F Ratio.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#316

Post by rsynnott »

gridlockd wrote: post #311
learc83 wrote: post #233

Earlier quoted context omitted.

>"ineffective and may cause dangerous side effects" Dangerous on an individual level, not really. But at a population level if hundreds of millions of people start taking it, you're going to have high absolute numbers of bad side effects. > is a purely political attack on the US president. As for ineffective, there isn't one single national health agency that recommends taking it for covid. Surely the entire globe is…

> As for ineffective, there isn't one single national health agency that recommends taking it for covid. Surely the entire globe isn't killing scores of their citizens by preventing the use of an effective treatment just to make the US President look bad. Not true: https://www.mohfw.gov.in/pdf/AdvisoryontheuseofHydroxychloro... Of course, it's controversial because the WHO recommended against it and most health agenc…

> There are countries that favor Trump, India being one of them.

Most countries' health authorities don't take into account public opinion about Important Orange Personages when setting policy, astonishingly.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#317

Post by gridlockd »

scrollaway wrote: post #234
burfog wrote: post #163

Earlier quoted context omitted.

Wikipedia is pretty reliable for math, old computer hardware, and other dry technical subjects. This is not one. This is a political subject. Wikipedia is a complete disaster for anything that even remotely touches upon modern politics. There are teams of people paid to impose an opinion on Wikipedia, relentlessly wearing down any neutral editor with 24x7 edits and every kind of bureaucratic fight. The people who edi…

Sometimes I feel like I have to remind americans that other countries exist. How incredibly self centered must it be to think that everything relates to you, your country, your awful president. Please.

Other countries may exist, but nobody knows or cares who their head of state is and whether they're any good.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#318

Post by mlyle »

acqq wrote: post #285
mlyle wrote: post #188

Earlier quoted context omitted.

Randomization doesn't ensure perfectly balanced groups-- it just ensures that the imbalances of variables you don't measure (including things that change after randomization not related to your intervention, with blinding) are drawn from a distribution that you can apply rigorous statistical reasoning about. Yes, we can see some things are a little unbalanced. But the effect is so massive: we might see 4/5 of the con…

> we might see 4/5 of the control's rate of ICU admissions if the "one prognostic bad risk factor" determined outcome entirely But we still don't know if the persons with multiple bad risk factors were those who ended with bad outcomes? As far as I understand, if it was like that or not can't be seen from the paper at all, and I can imagine that it could have happened. I would really prefer the more raw data to the t…

You have to get very, very unlucky on the dice rolls to get samples that are so tilted-- to pick 26 people out of 76, and somehow come up with 13/14 of those requiring ICU in the smaller group, if vitamin D has no effect. Outside of deliberate rigging... (it might even be difficult to deliberately sort and get this much of an imbalance).

Indeed, checking that the two groups look similar after randomization is completely optional. This study does an OK job of doing so.

There's both known and unknown reasons why someone might be predisposed to have a bad outcome. The reason we randomize, rather than try and make "balanced" groups, is that it addresses both unknown and known factors.

Yes, you can, by chance, get more people who are going to have a bad outcome in one group; about 5% of the time you'll get a p<0.05 finding this way. :P

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#319

Post by gridlockd »

rsynnott wrote: post #316
gridlockd wrote: post #311

Earlier quoted context omitted.

> As for ineffective, there isn't one single national health agency that recommends taking it for covid. Surely the entire globe isn't killing scores of their citizens by preventing the use of an effective treatment just to make the US President look bad. Not true: https://www.mohfw.gov.in/pdf/AdvisoryontheuseofHydroxychloro... Of course, it's controversial because the WHO recommended against it and most health agenc…

> There are countries that favor Trump, India being one of them. Most countries' health authorities don't take into account public opinion about Important Orange Personages when setting policy, astonishingly.

You'd be surprised.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#320

Post by JumpCrisscross »

mattmanser wrote: post #275
ellyagg wrote: post #203

Earlier quoted context omitted.

It's useful to note that this study doesn't need to stand on its own as evidence. It contributes to a growing body. As most of you may have already seen, there is a lot of observational evidence that people with low vitamin D have the worst C19 outcomes. Obviously, correlation by itself doesn't mean causation. But it is a hint. On top of the hint, we already have dozens of RCTs that vitamin D supplements suppress res…

We actually have an expert on this comment here quite often, too high Vit D dose can cause problems with calcium: https://news.ycombinator.com/user?id=devaboone And she's done a series on it: https://www.devaboone.com/post/vitamin-d-part-1-back-to-basi...

> too high Vit D dose can cause problems

Many over-the-counter vitamin D supplements appear dosed for people with problems absorbing the chemical.

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