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

#291

Post by godzulu » Wed, Sep 22, 2021, 10:09 PM UTC

_2d30 wrote: post #27

gonational wrote: post #9

Because there are so many studies of ivermectin and because it is so widely used, of course there are going to be bunk studies and scientifically invalid studies. Do you know how I know this? I know this because it was recently shown (within the past ten years) that something like 70% of scientific studies can't be reproduced (read: they're BS). So if were going to use scientific studies at all, to inform our decisio…

> There are literally no studies proving that the Pfizer or Moderna gene therapies are safe and effective, or even that they are safe or effective, at both treating and preventing the spread of COVID-19. This is... wildly incorrect.

https://www.sec.gov/Archives/edgar/data/1682852/000168285220... Currently, mRNA is considered a gene therapy product by the FDA. Unlike certain gene therapies that irreversibly alter cell DNA and could act as a source of side effects, mRNA-based medicines are designed to not irreversibly change cell DNA; however, side effects observed in gene therapy could negatively impact the perception of mRNA medicines despite the differences in mechanism. In addition, because no product in which mRNA is the primary active ingredient has been approved, the regulatory pathway for approval is uncertain. The number and design of the clinical trials and preclinical studies required for the approval of these types of medicines have not been established, may be different from those required for gene therapy products, or may require safety testing like gene therapy products. Moreover, the length of time necessary to complete clinical trials and to submit an application for marketing approval for a final decision by a regulatory authority varies significantly from one pharmaceutical product to the next, and may be difficult to predict.

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

#292

Post by listless » Wed, Sep 22, 2021, 10:09 PM UTC

doliveira wrote: post #263

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.

Source?

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

#293

Post by obelos » Wed, Sep 22, 2021, 10:14 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…

Is there a name for a cognitive bias that predisposes one toward favoring iconoclastic positions solely for their novelty? Because that seems fairly endemic in the tech industry.

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

#294

Post by josephcsible » Wed, Sep 22, 2021, 10:14 PM UTC

anoonmoose wrote: post #112

mechE321 wrote: post #71

The Bayesian gambler in me wants to think this: The studies on ivermectin seem to be split between "good effect" and "no effect," and there don't seem to be any (by my extremely informal review! going off of memory here) in the camp of "bad effect." Seems reasonable to take ivermectin as a decent gamble to me while we wait on the dang science to get its head out of its butt.

We did this last year with hydroxychloroquine...all that happened was that some Lupus patients had a hard time getting their normal prescriptions filled. The "bad effect" doesn't have to be strictly medical, and may not show up in studies. It could be that other people who need the medicine can't get it, it could be that it discourages people from getting the vaccine, it could just be that we are lighting a pile of m…

> all that happened was that some Lupus patients had a hard time getting their normal prescriptions filled.

Could we actually not manufacture enough of it, or were activist pharmacists just refusing to fill prescriptions of it?

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

#295

Post by tigershark » Wed, Sep 22, 2021, 10:18 PM UTC

sjwalter wrote: post #50

burkaman wrote: post #43

Earlier quoted context omitted.

There is a federally funded widespread trial, but they take a while to do correctly: https://www.nih.gov/research-training/medical-research-initi... There was also a federally funded trial of hydroxychloroquine last year which has since concluded: https://www.nih.gov/news-events/news-releases/nih-halts-clin...

And in the meantime, if you buy into the crazed insanity of "pandemic! pandemic! omg we'll all die", then it makes tonnes of sense to treat people with a highly-available, incredibly safe medication that frontline clinicians all over earth are reporting success with, especially a drug that has been dosed ~4 billion times over two generations, that has been most often dosed by illiterate people and delivered by non-do…

Chillies have been used for thousands of years as a medication and they are perfectly safe. You may want to follow the advice of someone else in this thread and shove them up your ass.

For sure they will have less side effects than ivermectin and they have exactly the same chance of curing covid.

And for your information the covid vaccines have been administered 6 billion times, so roughly 50% more than the number that you cited about ivermectin.

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

#296

Post by hackerNoose » Wed, Sep 22, 2021, 10:29 PM UTC

wombatpm wrote: post #287

mpalczewski wrote: post #285

Earlier quoted context omitted.

Calling it horse dewormer is either propaganda, or just a plain bad faith argument. The inventors of this drug won a Nobel prize for the discovery and it’s use in humans. It’s recognized as an essential drug.

But people are purchasing the horse version. What is the conversion between a 50 mg tables and a tube of paste for a 1200 lb animal? By using the wrong formulation you run the risk of liver damage due to an overdose of ivermectin.

That's a straw man. These people are of course doing something dangerous but mainstream newspapers are routinely calling doctor prescribed Ivermectin 'horse dewormer'. Both 'camps' treatment of this subject has been a real low water mark and it looks like the science might be as well.

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

#297

Post by _2d30 » Wed, Sep 22, 2021, 10:31 PM UTC

swader999 wrote: post #288

_2d30 wrote: post #100

Earlier quoted context omitted.

I vouched for your comment. You're allowed to believe whatever irrational things you'd like and comment about them as much as you'd like as far as I'm concerned. Seems it got flagged to death even after the vouch, though. Let's, however, consider your inane views on the RNA vaccines (note that not only is this what everyone refers to them as, it's also the case that they are very specifically NOT therapies as they ar…

The Together trial only did 3 doses and only 400 mcg/kg - nobody else is finding results at that dosage rate either. Needs to be 5 days or longer, 600mcg/kg the earlier the better.

Some shocking non-linearities in dose-response you’re expecting. Point me to the most credible study you have. Tired of being shown poorly randomized trials with like 50 subjects.

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

#298

Post by shapefrog » Wed, Sep 22, 2021, 10:31 PM UTC

rory wrote: post #282

shapefrog wrote: post #265

Earlier quoted context omitted.

> 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.

> In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to opioid pain relievers and healthcare providers began to prescribe them at greater rates. > Increased prescription of opioid medications led to widespread misuse of both prescription and non-prescription opioids before it became clear that these medications could indeed be highly addictive. I assume…

> The Opium Wars were two wars waged between the Qing dynasty and Western powers in the mid-19th century.

I assumed this was well-known.

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

#299

Post by ysleepy » Wed, Sep 22, 2021, 10:35 PM UTC

obelos wrote: post #293

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…

Is there a name for a cognitive bias that predisposes one toward favoring iconoclastic positions solely for their novelty? Because that seems fairly endemic in the tech industry.

Being a contrarian fits that description somewhat.

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

#300

Post by aeternum » Wed, Sep 22, 2021, 10:43 PM UTC

Spellman wrote: post #90

gwerbret wrote: post #44

I'm going to make what is probably a controversial statement, which is that, in my experience, most meta-analyses are trash. A meta-analysis is usually grounded on the assumption that an aggregation of multiple, well-conducted studies can provide significant information that may not be evident by taking each study individually. Essential to this assumption is the premise that those studies included in the meta-analys…

Meta-analysis have a good place. But they also have known flaws/assumptions. Often it is impractical to perform large studies. Partially by logistics and often by funding. But if there are lots of smaller studies you can aggregate the data to check for overall significant results. But mainly they are helpful to give a "survey" of the current research instead of having to link to 10 different studies and hope someone…

What do you think about the ability for researches to pick & choose which papers to include in a meta-analysis?

Double-blind is important for a reason, researchers are exceedingly good at proving what they want to prove even if subconscious, can meta-analysis studies ever overcome this?