Lesson of ivermectin: meta-analyses based on summary data alone are unreliable • Hacker News Board

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#231

Post by marcosdumay » Wed, Sep 22, 2021, 8:54 PM UTC

_2d30 wrote: post #74

acdha wrote: post #53

Earlier quoted context omitted.

> I hope the more science-literate proponents of IVM If they valued and were capable of reasoning about the science, they would not be “proponents” — they'd recognize the current scientific understanding (no known mechanism or benefits, significant side-effects) and wait for a solid study before recommending anything. The people you do see advocating it are almost always doing so for political or financial purposes a…

Ivermectin doesn’t really have significant side effects at appropriate doses. It’s quite safe. Don’t be fooled by overblown “horse dewormer stories”. I don’t say this to advocate Ivermectin, the only RCT I know of/trust found absolutely no effect. I say this to gently point out the mismatch between your claims and the premise in the first sentence.

Still, I don't think anybody talking about using ivermectin for treating COVID-19 ever recommended what is widely tested appropriate doses.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#232

Post by shapefrog » Wed, Sep 22, 2021, 8:55 PM UTC

sjwalter wrote: post #160

PaulDavisThe1st wrote: post #144

Earlier quoted context omitted.

> "The only science is real is expensive science done by large corporations!" The only science that's real when it comes to public health is the science done across large enough populations and with enough methodology to rule out many confounding issues. That tends to cost money, indeed.

This is a neutered philosophy. You surrender you're ability to actually know things outside the purview of large pharma corps. Hey, I guess my view is never gonna get approved: Eat healthy meat, exercise, and get plenty of sunlight. Since that's never gonna get a big Pfizer RCT, you should wait. Don't exercise. Don't get sunlight. Just wait until a big pharmacorp tells you what is healthy.

> I guess my view is never gonna get approved: Eat healthy meat, exercise, and get plenty of sunlight.

Study has been approved 1,000s of times and been done 1,000s of times.

Eating shit, sitting inside on your sofa all day is less healthy. The jury is out on your so called controversial view, has been for a long time.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#233

Post by VikingCoder » Wed, Sep 22, 2021, 8:56 PM UTC

rory wrote: post #25

Ivermectin probably doesn't do anything to fight Covid-19, but the American media has really shown their corruption in the way they've treated it. It's clearly a safe drug to take in human-designed doses, and it's cheap to produce. Laughing at people for poisoning themselves with "horse dewormer" instead of pointing out that they are turning to the vet store because their access to medicine has been marginalized is s…

> Unproven != disproven.

How many people have been convinced by the supposed effectiveness of Ivermectin and Hydroxychloroquine that they then decided to not get vaccinated?

It's really not as simple as "unproven != disproven".

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#234

Post by burkaman » Wed, Sep 22, 2021, 8:56 PM UTC

cyounkins wrote: post #224

There is a lot of confusion on whether there actually was a significant increase in calls to poison control centers due to ingestion of ivermectin. This [1] official Mississippi government document says, "At least 70% of the recent calls have been related to ingestion of livestock or animal formulations of ivermectin purchased at livestock supply centers." But then the AP [2] seemed to say that was incorrect: "The As…

The sources agree, look at the bullet point above the one you quoted.

• The Mississippi Poison Control Center has received an increasing number of calls from individuals with potential ivermectin exposure taken to treat or prevent COVID-19 infection.

• At least 70% of the recent calls have been related to ingestion of livestock or animal formulations of ivermectin purchased at livestock supply centers.

So, 70% of "calls from individuals with potential ivermectin exposure" were "related to ingestion of livestock or animal formulations of ivermectin", which is what the AP's correction says.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#235

Post by threeseed » Wed, Sep 22, 2021, 8:56 PM UTC

brandonmenc wrote: post #54

ashtonkem wrote: post #30

Earlier quoted context omitted.

People are literally taking horse formulations of ivermectin because doctors are rightfully refusing to prescribe ivermectin for an off label and ineffective use. Oh, and the access to this medicine is “marginalized” BECAUSE IT DOESNT WORK TO TREAT COVID. We generally do not expect doctors to prescribe medicine that will not work or is not appropriate for the patients condition. Complaining about their access being m…

> People are literally taking horse formulations of ivermectin People are taking the horse formulation because most pharmacists won't even fill an off-label prescription for the drug, which - even if it has no effect on COVID - is safe and taken by a quarter billion people every year. Let people take it. It's not harmful. Or, make a big huge deal about people taking it and, well, then it becomes a big huge deal.

> is safe and taken by a quarter billion people every year

When taken in dosages that have been determined based on extensive studies and research.

This doesn't apply to COVID so it is completely responsible for them not to supply it.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#236

Post by mlyle » Wed, Sep 22, 2021, 8:58 PM UTC

chana_masala wrote: post #192

ashtonkem wrote: post #165

Earlier quoted context omitted.

“Zero deaths” should have set off your alarm bells. That’s way too neat of a number for the real world; you only get that kind of result with small sample sizes or fraud. Even the vaccines, which are very effective, do not have a 0% death rate from infection.

Officially the FDA and CDC say there have been 0 deaths from adverse events. I agree, that's way too neat of a number for the real world.

You're saying re: vaccines? There's been several deaths believed to be caused by the vaccines and attributed as such by the FDA/CDC.

And, you know, a few hundred thousand lives saved.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#237

Post by threeseed » Wed, Sep 22, 2021, 8:58 PM UTC

brandonmenc wrote: post #119

sgt101 wrote: post #104

Earlier quoted context omitted.

I get where you are coming from, but I think that there is a nuance that you have missed. Like many, many drugs - and vaccines - ivemectin has some unpleasant and dangerous side effects in some people rarely. You can see these if you look the drug up : https://www.medicalnewstoday.com/articles/ivermectin-oral-ta... for example. The point is that if this drug did help people make it through covid (like the vaccines do…

All of this is for the patient and their doctor to decide. Not the pharmacist. Not the FDA.

Pharmacists are not there to blindly dispense drugs.

They have a legal and moral obligation to understand how those drugs are going to be used and whether the patient is at risk for taking them.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#238

Post by shapefrog » Wed, Sep 22, 2021, 8:59 PM UTC

swader999 wrote: post #173

brandonmenc wrote: post #54

Earlier quoted context omitted.

> People are literally taking horse formulations of ivermectin People are taking the horse formulation because most pharmacists won't even fill an off-label prescription for the drug, which - even if it has no effect on COVID - is safe and taken by a quarter billion people every year. Let people take it. It's not harmful. Or, make a big huge deal about people taking it and, well, then it becomes a big huge deal.

Ivermectin from horse paste cleared up all of my long covid symptoms except for lung inflammation which prednisone fixed after the ivm. Pretty incredible. Felt better after a few hours and after each subsequent daily dose of five total. A lot of the studies don't seem to be using enough doses or they use too low of a dose. I was at .06g/kg body weight per dose. Also you need to take it with zinq!

You should take at lest 1g/kg daily for a month to clear up the lung inflamation.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#239

Post by mlyle » Wed, Sep 22, 2021, 8:59 PM UTC

nradov wrote: post #221

mlyle wrote: post #189

Earlier quoted context omitted.

> Calling the investigatory and experiential evidence of thousands of highly-trained doctors (some of whom pioneered the standard of care for covid) as "weak evidence" is something that only somebody carrying water for large pharmaceutical companies would say. Keep in mind that bleeding with leeches was once the standard of care-- based on clinical intuition and observational evidence. People-- even very smart, well-…

The RCT is the gold standard, but observational studies can be sufficient to establish causality when the effect size is large enough with a clear dose response curve. No one has ever conducted an RCT to prove that cigarette smoking causes lung cancer, but we're pretty sure that it does.

> to establish causality when the effect size is large enough with a clear dose response curve.

And when there's some plausible underlying mechanism that can be studied by more rigorous means. Otherwise, observational studies can find correlation, not causation-- and they're not even very robust at that.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#240

Post by cyounkins » Wed, Sep 22, 2021, 9:02 PM UTC

burkaman wrote: post #234

cyounkins wrote: post #224

There is a lot of confusion on whether there actually was a significant increase in calls to poison control centers due to ingestion of ivermectin. This [1] official Mississippi government document says, "At least 70% of the recent calls have been related to ingestion of livestock or animal formulations of ivermectin purchased at livestock supply centers." But then the AP [2] seemed to say that was incorrect: "The As…

The sources agree, look at the bullet point above the one you quoted. • The Mississippi Poison Control Center has received an increasing number of calls from individuals with potential ivermectin exposure taken to treat or prevent COVID-19 infection. • At least 70% of the recent calls have been related to ingestion of livestock or animal formulations of ivermectin purchased at livestock supply centers. So, 70% of "ca…

Ah, I see now. "the recent calls" refers only to calls about ivermectin, not ALL recent calls.

Still, the AP misunderstood as well, misreported it, and later issued a correction. Before the correction, it was syndicated by many news outlets like New York Times. I think most people are unaware of the important correction.