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

nature.com

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

#351

Post by cableshaft »

mint2 wrote: post #211
cableshaft wrote: post #111

Earlier quoted context omitted.

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…

Is your friend vaccinated?

Yes, he's been vaccinated since April, around the same time I got it.

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

#352

Post by jjeaff »

alvah wrote: post #328
scoopertrooper wrote: post #61

Earlier quoted context omitted.

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.

Case fatality ratio is only counting diagnosed cases. Unknown, asymptomatic cases are irrelevant.

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

#353

Post by brandonmenc »

threeseed wrote: post #237
brandonmenc wrote: post #119

Earlier quoted context omitted.

All of this is for the patient and their doctor to decide. Not the pharmacist. Not the FDA.

Pharmacists are not there to blindly dispense drugs. They have a legal and moral obligation to understand how those drugs are going to be used and whether the patient is at risk for taking them.

My understanding is that - depending on the jurisdiction - a pharmacist is allowed to refuse filling a prescription if:

- They are morally opposed to the medication, ex: "abortion pills"

- They know that the patient is taking another drug that would result in a deadly interaction

- The patient is drug-seeking a scheduled drug, ex: they've brought multiple valid prescriptions for opiates, but from different doctors

The pharmacist doesn't know why you've been prescribed Ivermectin. They can ask, but you're under no obligation to tell them. Maybe you need it for river blindness. Unlikely, but it's none of their business.

I guess a pharmacist could claim moral opposition to filling an Ivermectin prescription if they believe that sans Ivermectin the patient would instead get a COVID vaccine. That makes sense to me. But it's a slippery slope I'm uncomfortable with.

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

#354

Post by brigandish »

sydthrowaway wrote: post #339

There is no good faith argument against the vaccine. Just take it.

> First: the opinion which it is attempted to suppress by authority may possibly be true. Those who desire to suppress it, of course deny its truth; but they are not infallible. They have no authority to decide the question for all mankind, and exclude every other person from the means of judging. To refuse a hearing to an opinion, because they are sure that it is false, is to assume that their certainty is the same thing as absolute certainty. All silencing of discussion is an assumption of infallibility. Its condemnation may be allowed to rest on this common argument, not the worse for being common.

J. S. Mill wrote the rebuttal to your argument 160+ years ago. He wasn't using it as an anti-vaxx argument either, so it might be time to stop the moralising and simply try to make a persuasive case. I'd wager it's easier without the moralising anyway.

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

#355

Post by bongcloud420 »

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 find it interesting that the people that call other people irrational and say things like "follow the science" ignore things like the fact that a whole lot of people died from being intubated before the doctors (the smart people, right) figured it out. Or the "science" that said the vaccines are gonna stop covid and it's important that we all get it so we can go back to normal but then we all got it and oops it doesn't actually stop covid at all and uhhh oops it turns out we didn't even test for that...

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

#356

Post by brigandish »

jxramos wrote: post #333
UnFleshedOne wrote: post #324

Earlier quoted context omitted.

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?

It almost certainly depends where you are.

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

#357

Post by bongcloud420 »

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 see this a lot and it's very strange to see super smart people such as yourself conflate with . We cannot observe long-term effects through number of people.

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

#358

Post by maxerickson »

nradov wrote: post #3

Yes the quality of scientific research in this area has been rather bad with rushes to publish and ineffective peer review. Drs. Paul Marik and Pierre Kory recently updated their meta analysis to remove the retracted Elgazzar paper, and still found a significant effect. I'm not endorsing their letter, just pointing out that it exists and isn't mentioned in this Nature article. https://journals.lww.com/americantherape…

The mectin we need!

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

#359

Post by KennyBlanken »

dekhn wrote: post #256
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…

It's best to understand that the vast majority of literature is just faulty. Either it's technically wrong (experimental mistakes), or missing information (left out a step in the methods), or the conclusions are not supported the (valid) experiment. Learning how to filter literature is non-trivial and I don't think very many people do it successfully. I've found the best thing is to take a group of aggressive smart g…

> I've found the best thing is to take a group of aggressive smart grad students and have them tear every paper apart

That's a pretty passable simplification of meta-analysis studies.

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

#360

Post by _2d30 »

swader999 wrote: post #302
_2d30 wrote: post #297

Earlier quoted context omitted.

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.

Why don't you pay for them lol. It's off patent there's no money for large trials. See the links supplied above, there's data from entire countries now at least.

LOL pay for what? You can't even point me to the study you trust most and you're sitting here recommending a dosing schedule!! It's a comedy. I've looked at what's posted and the studies are mostly trash! This has 24 patients, not randomized and the treatment contains far more than Ivermectin! https://www.medrxiv.org/content/10.1101/2021.07.06.21259924v...

You people are clowns.

> there's data from entire countries now at least.

Entire countries have been given Ivermectin? News to me!

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