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

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

#321

Post by defaultprimate »

NotSammyHagar wrote: post #271
defaultprimate wrote: post #157

Studies are irrelevant at this point, when we have population level data of over a billion people across India and Africa, and the massive disparities between states/countries that utilized Ivermectin, and those that did not. The drug is safe enough to be used based on this data alone. https://www.thedesertreview.com/opinion/columnists/indias-iv... https://www.thedesertreview.com/news/national/indias-ivermec... https…

If you are fixated on conspiracy claims against your amazing scientific discovery - pretty much you are always wrong, that's true for perpetual motion machines, faster than light drives (that's the one I hope could be right), extra-ordinary life extensions for microbes applies to humans (wish that one could be right), and covid. If you use opinion columns from obscure news sources to prove you are right, almost alway…

If you don't know how citations and data work and are incapable of following them, even in an "opinion" piece, that's your problem.

>Safe and effective... Every day that becomes more untrue in highly vaccinated populations like the UK and Israel, whose hospitals and morgues are full of vaccinated people.

https://www.gov.uk/government/publications/investigation-of-...

https://www.gov.il/en/departments/guides/information-corona

There is substantial risk when it comes to mass vaccination in the middle of a pandemic as well, especially with highly infectious and rapidly mutating viruses, coupled with vaccines that are extremely ineffective at preventing spread.

https://www.geertvandenbossche.org/

Calling it "conspiracy claims" doesn't suddenly invalidate the overwhelming amount of empirical evidence.

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

#322

Post by eightysixfour »

motoboi wrote: post #32

Someone said it and I totally agree: Society is not ready to watch science in realtime.

And "science" wasn't prepared to display "science" to the public in real time. Instead of we have paywalls, twitter arguments, and media trying to report on scientific studies they don't understand.

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

#323

Post by evv555 »

atty wrote: post #311
rajin444 wrote: post #252

Earlier quoted context omitted.

Your post is assuming a lot of this science is "settled". I don't think science is settled - especially in this field. Acknowledging that your own statements may be incorrect might help you down the path to figuring out a fix. Hint: as soon as you know you're right, and you make statements based on that, when you're inevitably wrong (not saying this in a disparaging way - making sense and being right through all this…

Settled is a strong claim, but as far as I’m aware (I have many connections amongst the medical and epidemiological communities), the general consensus is that ivermectin does not work. For instance, the FDA, WHO, the AMA, the American Pharmacists Association, and the American Society of Health-System Pharmacists all say it should not be used outside of clinical trials because there is no good evidence for it, and ev…

>Instead, I’m interested in how these “treatments” with no strong evidence are getting weaponized by motivated agents (like the anti-vax crowd) to sow distrust both in scientific organizations (the CDC, and the FDA, Pfizer, Moderna, et al), and in the use of tools with proven effectiveness, like the vaccines themselves.

In this polarized environment CDC/FDA/WHO/AMA are political organizations first and authoritative ones second. The conflict of interest here is legitimate and the loss of their authority with the public is in great part their own doing.

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

#324

Post by UnFleshedOne »

defaultprimate wrote: post #157

Studies are irrelevant at this point, when we have population level data of over a billion people across India and Africa, and the massive disparities between states/countries that utilized Ivermectin, and those that did not. The drug is safe enough to be used based on this data alone. https://www.thedesertreview.com/opinion/columnists/indias-iv... https://www.thedesertreview.com/news/national/indias-ivermec... https…

It is possible that anti-parasitic action is what causes those disparities -- if parasites are widespread and cause complications with covid, then treating whole population with an anti-parasitic drug would improve outcomes.

So India and Africa should absolutely keep using IVM.

In high latitudes similar effect could possibly be had with treating everybody with vitamin D.

Unfortunately the current zeitgeist is to send you home with nothing to wait till your lips turn blue.

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

#325

Post by evv555 »

tigershark wrote: post #274
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…

It’s because on this website there is a huge number of people that just drink whatever is the kool-aid du jour that goes around in the right side disinformation circles and social networks. Imagine to oppose a perfectly safe vaccine that has been administered 6 BILLION times all around the world and that has a proven efficacy of at least one order of magnitude against delta variant and to push for a horse dewormer (t…

>Imagine to oppose a perfectly safe vaccine that has been administered 6 BILLION times all around the world and that has a proven efficacy of at least one order of magnitude against delta variant and to push for a horse dewormer (that bear in mind it’s perfectly effective for what is used for.. killing parasites, not viruses)

Who here is opposing vaccines? You've created quite the strawman in your head.

>I think it’s because a lot of the HN demographic has quite a big overlap with the people that use social networks where all this bullshit originates and it is amplified and it spreads.

In other words Ivermectin is a proxy issue in the culture war. Hence why it's so polarizing and people are quick to regress from critical thinking to group think narratives.

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

#326

Post by tootie »

rualca wrote: post #208
tootie wrote: post #205

Earlier quoted context omitted.

That's not the argument though. Listen to the segment. Giving people false hope and baseless medical advice is one thing, but the anti-ivermectin crowd was going overboard including amplifying specious stories about rampant ivermectin poisoning. Ivermectin is absolutely prescribed to humans for some conditions and is being actively studied as an anti-viral agent against other illnesses (notably dengue and yellow feve…

> That's not the argument though. It's not the argument? It is a statement of fact. There is no way around it. Consuming a placebo to subsequently validate and provide incentives to put yourself and others at risk is the whole reason why Ivermectin poses a major problem. No one complains that people take paracetamol even though it is not effective at reducing Covid19 spread. Why is that?

Just listen to it. It is absolutely not about advocating in favor of ivermectin. It is about very wrong information spread against ivermectin as a response to the misinformation spread in favor of it.

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

#327

Post by civilized »

antman wrote: post #223
nradov wrote: post #210

Earlier quoted context omitted.

There is no equivalent feedback mechanism in medical research. Other than looking for retracted papers, we don't have a reliable way to quantify whether a particular author is "correct" more often than another.

The author’s Hindex could be an initial weighting factor

"Initial"? You haven't proposed any way to improve the weighting, so it would just be H index forever. We'd be baking in a cultural presumption that researchers who are more cited are more likely to be correct. A really dystopian prospect.

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

#328

Post by alvah »

scoopertrooper wrote: post #61
nradov wrote: post #31

Earlier quoted context omitted.

Sure that's a good point. But is mortality the appropriate clinical trial endpoint? Mortality rates are already low when following the NIH treatment guidelines, so it would take a large study population to discern any statistically significant effects. https://www.covid19treatmentguidelines.nih.gov/ In addition to mortality it probably makes sense to look at other endpoints such as patient reported symptoms, RT PCR t…

Case fatality has been declining for sure, but it's still at about 3%. So it shouldn't be that hard to find a signal. https://www.abs.gov.au/articles/covid-19-mortality-0 https://www.ajtmh.org/view/journals/tpmd/104/6/article-p2176...

The reported CFR may be in that region, but most credible sources estimate a much lower real CFR, due both to many undetected / asymptomatic infections, and confusion between deaths with & deaths caused by Covid-19. For a statistical reporting agency such as the ABS to claim to know the actual CFR with any level of certainty seems careless at the very least.

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

#329

Post by ekianjo »

tantalor wrote: post #82
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…

FiveThirtyEight weights its averages by pollster accuracy/methodology. Next, we determine how much weight to give each poll in our average. First, polls conducted by pollsters with higher FiveThirtyEight pollster ratings — a letter grade measuring how accurate and methodologically sound pollsters are — are given more weight https://fivethirtyeight.com/features/how-were-tracking-joe-b...

FiveThirtyEight forecasts are very questionable themselves. Been completely wrong on multiple counts.

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

#330

Post by ekianjo »

gnicholas wrote: post #128
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…

Do researchers ever pre-register their studies when they do meta analyses? Pre-registration makes sense for the timing of doing actual studies, but not as much in the case of meta analyses (which presumably happen on a much faster timeline). But given what we've seen with p-hacking, it seems like it could be good if people pre-registered their meta analyses before crunching the numbers.

how would you know when they actually started the analysis?
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