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

#331

Post by [deleted] » Thu, Sep 23, 2021, 12:19 AM UTC

slibhb wrote: post #320

atty wrote: post #307

Earlier quoted context omitted.

I am not arguing that I know anything to be right or wrong - I am not an epidemiologist or an infectious disease expert, or a doctor. I explicitly said that us non-experts are not able to verify these things on our own. I am saying that those communities of experts have decided that the question of ivermectin’s effectiveness is effectively settled. There are of course experts that disagree - there always are (I work…

You've confused science with politics. There is no scientific consensus on whether ivermectin is an effective treatment for covid. The people claiming this are engaging in politics. There is a consensus that people should not use ivermectin (or any medicine) except as directed by a doctor and not until there is extremely good clinical evidence for its efficacy. But that doesn't imply that ivermectin isn't effective,…

[deleted]

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

#332

Post by [deleted] » Thu, Sep 23, 2021, 12:19 AM UTC

slibhb wrote: post #320

atty wrote: post #307

Earlier quoted context omitted.

I am not arguing that I know anything to be right or wrong - I am not an epidemiologist or an infectious disease expert, or a doctor. I explicitly said that us non-experts are not able to verify these things on our own. I am saying that those communities of experts have decided that the question of ivermectin’s effectiveness is effectively settled. There are of course experts that disagree - there always are (I work…

You've confused science with politics. There is no scientific consensus on whether ivermectin is an effective treatment for covid. The people claiming this are engaging in politics. There is a consensus that people should not use ivermectin (or any medicine) except as directed by a doctor and not until there is extremely good clinical evidence for its efficacy. But that doesn't imply that ivermectin isn't effective,…

[deleted]

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

#333

Post by jxramos » Thu, Sep 23, 2021, 12:22 AM UTC

UnFleshedOne wrote: post #324

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…

is that right, if I see my Dr and test positive for covid I get sent home to rest up much like if I had came in with a cold? I think even with the cold they have some sort of medications like cough medicine etc, do they lend no home treatment instructions for those ill with covid?

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

#334

Post by RustyRussell » Thu, Sep 23, 2021, 12:28 AM UTC

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…

I hate to weigh in here, but nothing is "perfectly safe"! This kind of absolute language seems to create distrust when people discover it's not quite true.

At this stage, the safety is fairly quantifiable, too: https://www.publichealthontario.ca/en/health-topics/immuniza... has a weekly adverse effects report which breaks down myocarditis/pericarditis by sex and age, per million population (the most common dangerous side effect for mRNA vaccines).

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

#335

Post by stefan_ » Thu, Sep 23, 2021, 12:29 AM UTC

anshorei wrote: post #150

hackingforfun wrote: post #99

With 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…

Something being designed to help people doesn't make it good. There's reason to believe vaccinating using a non-sterilizing vaccine during a pandemic exerts an evolutionary pressure on the virus that will lead to the vaccine becoming ineffective and the the virus endemic. Considering the current effectiveness of the vaccines a fully vaccinated population will be worse off than a fully recovered population (though the…

It's 2021, some 40 years since the eradication of smallpox and nearing the eradication of measles, the latter absurdly contagious on a level much higher than COVID ever was.

But what's that? "anshorei" on HN wants us to stop vaccines, cause clearly that will just cause a super mutation to evolve?

If you believe that, you might just jump off a bridge right now. Because if it's not a COVID mutation, it will just be another virus evolving. They evolve every day! Evolutions big random number generator never stops! Theres a cell multiplying in your body right now, chances are it might just turn into cancer! Is that a risk you are willing to take?

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

#336

Post by stefan_ » Thu, Sep 23, 2021, 12:35 AM 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…

"intellectually curious and educated" is a nice way to describe "at the peak of Dunning-Kruger". It's ivermectin now, the same people were writing last year that whoever were suppressing Vitamin D, the obvious COVID prevention protocol. You don't hear much of the latter anymore (it hasn't solved cancer, either).

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

#337

Post by jjeaff » Thu, Sep 23, 2021, 12:37 AM UTC

sjwalter wrote: post #45

ashtonkem wrote: post #26

The 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…

Your assertion of the financial incentives of on patent vs off patent doesn't make sense for ivermectin.

For one, the company that sells ivermectin in the US (Bayer) does not currently have an alternative covid treatment. They have publicly stayed that they do not believe ivermectin helps against covid. Secondly, an RX of ivermectin (for humans) appears to cost more ($35) than the vaccine ($20). Additionally, the vaccine is already paid for, whether or not people use it, many countries (especially the US) pre-purchased hundreds of millions of vaccine doses.

Given that vaccines are already sold and adding ivermectin is pretty safe and is being added to the cocktail of treatments, already being used, I see no financial incentives for drug companies to discourage it.

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

#338

Post by dboreham » Thu, Sep 23, 2021, 12:40 AM UTC

trts wrote: post #162

Spellman wrote: post #90

Earlier quoted context omitted.

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…

The problem I saw with the Ivermectin metastudies (which I did a fair amount of research on given that people close to me had decided to employ it as a prophylactic against Covid) was that the people who did the metanalyses were trained to read the results rather than grapple with the methodology and statistics. None of the study results were robust, but many of the study outcomes were positive. So they were counting…

In my mind, there is also underlying all this the idea that if a drug actually works, then there will be many doctors going on CNN to say that it totally works; that they're super excited by their patients recovering. In other words, the effect should be profound. If the effect is marginal, why bother, even if it is a real measurable effect in well conducted trials? I mean : that doctors observe that some therapy or drug works well is step 1, then step 2 is to conduct trials to prove conclusively that step 1 wasn't a statistical fluke. In this case we seem to have it backwards : we first observed that there is an effect in vitro, then ran trials which proved nothing much, then extracted noise from that data to prove whatever we wanted.

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

#339

Post by sydthrowaway » Thu, Sep 23, 2021, 12:40 AM UTC

There is no good faith argument against the vaccine.

Just take it.

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

#340

Post by tawmec » Thu, Sep 23, 2021, 12:42 AM UTC

davidw wrote: post #179

swader999 wrote: post #176

Earlier quoted context omitted.

No they aren't. All of those reports have been retracted.

https://news.ohsu.edu/2021/09/17/five-oregonians-hospitalize... doesn't look retracted to me. Only stands to reason that if people are taking it kind of randomly, a few are going to screw up and take too much.

Not once in that article is an overdose mentioned.