Earlier quoted context omitted.
>Having been given a solid diagnosis once for that initial $150 charge, instead of relatively-inexpensive maintenance of health that could be done without doctor intervention, we require doctors to re-see and re-prescribe when a patient has a chronic condition. >There is some wisdom in that It's pretty convenient for the doctors as well. $150 to write some shit on a pad and sign it. Good work if you can get it.
Humans are very complicated, and writing the wrong stuff on a pad can get someone killed. Amoxicillin isn't available without a prescription because using the wrong antibiotic on a disease can make the patient worse.
Lesson of ivermectin: meta-analyses based on summary data alone are unreliable
301–310 of 493 posts
Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable
#302Earlier quoted context omitted.
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
#303Earlier quoted context omitted.
I think you answered your own question -- Remdesivir is an antiviral and Ivermectin is an antiparasite.
It's not that simple. For example, a protease inhibitor could have effects on biological functions that exist in viral and parasitic infections. And both Remdesivir and Ivermectin [1] have been observed to have antiviral properties in vitro. [1] https://www.sciencedirect.com/science/article/pii/S016635422...
Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable
#304I'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…
I will re-post some thoughts I have previously shared from John P.A. Ioannidis who is a professor of medicine and thoughtful critic of medical research. He often raises good points about trends in research and research ethics. His view is that meta-analyses are mass produced, redundant, misleading, and conflicted [1]!
One criticism of meta-analyses in [1], using anti-depressants as a case study: "the results of several meta‐analytic evaluations that addressed the effectiveness of and/or tolerability for diverse antidepressants showed that their ranking of antidepressants was markedly different. These studies had been conducted by some of the best meta‐analysts in the world, all of them researchers with major contributions in the methods of meta‐analysis and extremely experienced in its conduct. However, among 12 considered drugs, paroxetine ranked anywhere from first to tenth best and sertraline ranked anywhere from second to tenth best."
I like this quote because it highlights the conflict of interest and misleading-ness(or at least reproducibility problems) with meta-analyses. Antidepressants have a huge amount of primary research dedicated to them. They also have the attention of researchers experienced in meta-analysis. Yet, meta-analyses do not agree with each other (and in fact they strongly disagree with each other).
Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable
#305The other takeaway is that preprint publication is a pathway ripe for abuse. The major paper that drove most of this situation, and the meta analysis, appears to have been a straight up fraud. But it got circulated a lot as a preprint to people who didn’t understand the difference between a preprint and a peer reviewed paper. If the preprint had been more private, this might have been averted.
> The major paper that drove most of this situation, and the meta analysis, appears to have been a straight up fraud. Umm, wat?! The vast majority of the studies about Ivermectin have been observational, run by front-line clinicians. 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 scient…
This and
> The vast majority of the studies about Ivermectin have been observational, run by front-line clinicians.
> 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.
and
> 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.
Don't really add up. Best case interpretation of your argument is that you think doctors are split in half - not wholly aligned behind novel treatments - the "throw shit at the wall and see what sticks" group and the "only throw new custom expensive stuff at it" group, but even that doesn't really match what I'm seeing.
A large number of doctors are out there throwing all sorts of things at a new disease because nobody knows what works yet. The data is going to be incredibly messy. One thing that has looked effective in many cases is steroids, very much not new. Other things that looked potentially effective haven't continued to look effective as more studies have been done.
Where's the massive pushback against steroid treatment if this is an institutional greed thing?
It looks to me much more like some people get married to their early hunches and dig in hard when the evidence doesn't pan out.
Throw enough shit at the wall in enough places and all sorts of false leads are going to appear. Some of them getting shot down isn't a conspiracy. It's how we learn.
Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable
#306Earlier quoted context omitted.
You're packing enough untrue things into that comment that it's hard to believe you're acting in good faith but: * It's dismissing the studies which show effects due to errors, which leaves the studies not showing beneficial effects. Science is built on evidence and thus far it hasn't been shown that Ivermectin has a benefit for COVID. * Similarly, it's untrue to the point of being a flagrant lie to claim that the va…
For anybody else that comes across the above comment, ignore the fake news, do some reading of scientific studies (e.g., nih.gov, etc.), and you will come to the same conclusion: that everything stated in the comment above is untrue (except for the countries with the vaccination rates - I don't actually know the latest stats on that). I've been trying to do my part to help prevent the spread of misinformation that's…
I can't tell if this is a real account, or gpt-3 generated comments seeded from a couple Breitbart and Infowars articles.
Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable
#307What 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…
I also never said shut down disagreement. That’s a straw man you created. Anti-vax is not a good-intentioned disagreement with sound scientific merit, it is a pseudo-science movement that actively and knowingly disregards the truth. Scientific freedom and discussion is important. Allowing pseudoscience to flourish under some strange argument that their positions are as scientifically valid as actual science, is, frankly, nonsense.
Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable
#308And 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/
Now the totally true headlines say that ivermectin studies are discredited, and it matters not one jot that the study that was discredited was already of low credibility to begin with and was never a substantial reason for believing one way or the other.
Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable
#309Earlier quoted context omitted.
So I'm someone who has published several meta-analyses of different forms, and written about meta-analysis as a topic. I won't disagree with you that there are many poorly conducted meta-analyses. However, I think there's many well-done meta-analyses as well, and most importantly maybe meta-analyses aren't really different from anything else in life: some are good, some are bad, and many are in between. One thing I'v…
Even meta-analysis conducted strictly according to PRISMA can be fraught with many issues. IMO, meta analysis is very vulnerable to bias in the base data and the honesty of multiple researchers, all while p-hacking and various other tricks to make papers sexier are already the norm. Forcing open data would certainly improve things but would not solve the problem of dishonesty in research, since authors would simply b…
I agree about open data, for what it's worth, and even things like preregistration to some extent. There's a lot about dishonest research that has nothing to do with the statistics you use, or maybe even your design. It's sort of a never-ending arms race in that regard, and just as important to address the incentive structures that drive it in the first place.
Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable
#310With all the criticism of the mRNA and other COVID vaccines, which actually do have science backing them up, what is the science that would make ivermectin actually work? It's an antiparasitic drug. I see a lot of criticism of the COVID vaccines, especially from the right, but then they are fine taking hydroxychloroquine or ivermectin if there is any glimmer of hope that they will work. I just don't get it. Maybe, ju…