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

#261

Post by makomk » Wed, Sep 22, 2021, 9:30 PM UTC

ashtonkem wrote: post #245

chana_masala wrote: post #190

Earlier quoted context omitted.

So what were those other things, then?

Dexamethasone, Remdesivir, and monoclonal antibodies are part of the go to treatments for severe Covid cases. They’re the major exotic bits of what they gave trump when he got sick, along with a bunch of over the counter stuff (zinc, vitamin D, melatonin, etc.) My understanding is that the monoclonal antibodies are the really expensive treatments. The Dexamethasone one is an interesting story. It started out as a mor…

Of course, what made Dexamethasone such a breakthrough wasn't really the drug itself; I think there's some evidence now that other steroids might actually work better. The big breakthrough was that some UK researchers managed to use the fact that the country got hit hard early on in the pandemic to immediately run a bunch of large randomized controlled trials on all the most promising throw-things-at-the-wall treatments to get evidence on which actually worked as soon as possible.

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

#262

Post by robbiep » Wed, Sep 22, 2021, 9:30 PM UTC

rajin444 wrote: post #248

VikingCoder wrote: post #233

Earlier quoted context omitted.

> 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".

How many people were convinced of the "95+%" effectiveness of the vaccine only to learn that it fades? Why weren't they told it would fade up front?

Firstly, it wasn’t at all clear how quickly antibody levels would fall, because the data wasn’t available. But it was clear to everybody with scientific literacy that antibody levels would fall over time, because that’s how immune responses work.

What’s been fascinating about the data arising from Pfizer, moderne and astra Zeneca dosing intervals is that it seems quite likely that the spacing is quite to highly responsible for this rather than something inherent to the formulation which is adding to our body of evidence and understanding

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

#263

Post by doliveira » Wed, Sep 22, 2021, 9:31 PM UTC

atty wrote: post #218

What I find almost more interesting than the article itself is the comments that show a non-zero portion of the HN community (which I think is generally more intellectually curious and educated than average) are actually strongly arguing that ivermectin has strong effect, and even crazier, that it may be safer or more effective than the mRNA vaccines. Is this from being incapable of following science and drawing rati…

Seems like you guys should take a look at Brazil as a cautionary tale for what happens when these miracle treatments are adopted by politically inclined doctors and sold to the masses as the magical solution.

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

#264

Post by tedunangst » Wed, Sep 22, 2021, 9:31 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…

There was an absurd rush to report that ivermectin is bad that resulted in a pretty bad breakdown of the fact checking process. A lot of semi-adjacent facts and statements got merged. A hospital is full and a hospital treated someone for overdose became all the hospitals are filled with overdose victims.

(I think eating horse paste is dumb, but that doesn't excuse rolling stone lying about the consequences of doing so.)

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

#265

Post by shapefrog » Wed, Sep 22, 2021, 9:32 PM UTC

rory wrote: post #254

shapefrog wrote: post #247

Earlier quoted context omitted.

Why not all drugs of all types. Why call it an opiod crisis and not just here is what happens when you give everyone whatever drugs they hear on the internet make you feel good? First you deny someone ivermectin, next minute you are saying only 1 oxycotin with your beer.

The important difference between these drugs is that opiates are incredibly addictive, while ketamine is less addictive than tobacco or alcohol. Ivermectin isn't addictive at all. Ironically, the opioid crisis is caused far more by people's trust in mainstream medicine than by any internet fad.

> people's trust in mainstream medicine

Mainstream medicine says it is incredibly addictive with an incredibly low lethal dose.

People like to get high, a lot. Probably second only to triggering the libs / whatever the lib version is.

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

#266

Post by mgamache » Wed, Sep 22, 2021, 9:32 PM UTC

And yet the Authors of this letter fail to address the most cited meta-analyses (by Dr Lawrie). She's publicly stated the removing the Elgazzar data did effect her numbers, but not the conclusion. Also, if you read the paper she downgrades the Niaee data for several potential biases.

https://pubmed.ncbi.nlm.nih.gov/34145166/

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

#267

Post by 8note » Wed, Sep 22, 2021, 9:35 PM UTC

sjwalter wrote: post #56

mlyle wrote: post #49

Earlier quoted context omitted.

> The vast majority of the studies about Ivermectin have been observational, run by front-line clinicians. OK, so weak evidence. > Prior to 2020, basically everyone on earth agreed (including the WHO, who STILL agrees) that front-line clinicians and observational studies are excellent signals that can lead to scientific investigations that can lead to medical breakthroughs. Sure-- weak/crappy evidence and practitione…

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. Doctors in my area are prescribing IVM to treat covid because in their experience and that of their peers IT WORKS. They have fewer deaths, fewer complications.…

I'd consider it weak because covid mostly has non-severe symptoms.

A sugar pill could also get the same observational results because the number of severe cases is very low.

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

#268

Post by julianz » Wed, Sep 22, 2021, 9:35 PM UTC

cableshaft wrote: post #111

vernie wrote: post #84

Earlier quoted context omitted.

Is that really the reason or is it that they can't get a doctor to write them an off-label prescription?

A friend of mine found a doctor to prescribe it but his pharmacy won't fill it. He is so pissed. He was only planning to take small doses here or there as he's a teacher and around sick kids all the time, as if it were like Zinc to hopefully help reduce the severity of Covid-19 if he does get it, but despite going through the effort and succeeding in finding a doctor willing to prescribe it (and my friend even signed…

This "friend of yours" should probably get vaccinated then, because we know that works pretty well.

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

#269

Post by pigeonhole123 » Wed, Sep 22, 2021, 9:35 PM UTC

atty wrote: post #218

What I find almost more interesting than the article itself is the comments that show a non-zero portion of the HN community (which I think is generally more intellectually curious and educated than average) are actually strongly arguing that ivermectin has strong effect, and even crazier, that it may be safer or more effective than the mRNA vaccines. Is this from being incapable of following science and drawing rati…

I could change every assumption in this comment to the opposite and it would make just as much or little sense.

You can’t pretend to be searching for truth if your solution to the problem of people making mistakes is to shut down any possible way to discuss the disagreement. I just find the cognitive dissonance on display here staggering. How do you you know you’re right? Have you ever been wrong? I suppose you knew at the time that you were wrong? Or maybe you just know that this time you’re right?

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

#270

Post by mikeyouse » Wed, Sep 22, 2021, 9:36 PM UTC

fullstop wrote: post #214

gonational wrote: post #203

Earlier quoted context omitted.

What evidence did you have that people were doing this, which presumably affected your opinion on this topic?

1. Facebook groups where people have admitted to taking more than they should have, causing incontinence. Not public groups, but one local to my area. 2. The FDA themselves I have to ask, are you actually advocating for self-medicating with products from Tractor Supply? I've not once said anything about my opinion of Ivermectin, only that of self medication.

As one more piece of evidence - two of my family members are internal medicine physicians who are running covid units -- just a shocking number of people are showing up to hospitals with severe Covid after having self-medicated with IVM.