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

nature.com

71–80 of 493 posts

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

#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.

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

#72
post #47

Earlier quoted context omitted.

People are literally taking horse formulations of ivermectin because doctors are rightfully refusing to prescribe ivermectin for an off label and ineffective use. Oh, and the access to this medicine is “marginalized” BECAUSE IT DOESNT WORK TO TREAT COVID. We generally do not expect doctors to prescribe medicine that will not work or is not appropriate for the patients condition. Complaining about their access being m…

Although it has more dangers than ivermectin, why shouldn't you have access to ketamine if you feel it helps you? A lot of people believe it has off-label benefits for their mental health, and maybe it does. Perhaps we just have different general perspectives on the individual and society.

I suspect most people would disagree, and I think I might too, but it's curious to examine the arguments and justifications for disagreeing

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

#73
post #27

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.

Would you mind linking me to the evidence that this is incorrect?

Posts like mine are being censored across-the-board on the Internet because of "interests". I mean, how much more evidence could you possibly linked to then 119 studies, yet my comment was flagged out of existence. We are literally living in a George Orwell novel and the people with jackboots are just ordinary citizens, putting the boots on their own necks. We are under the spell of like a self-prescribed global brainwashing campaign. Nobody cares about science anymore, nobody cares about the scientific method, nobody cares about actual data anymore, only propaganda. 119 studies show evidence of one thing. That's not enough though. But then the media says another thing and everybody believes it, despite the fact that there are dozens of studies with conflicting data showing various counter arguments (such as the Israeli pre-print from three weeks ago showing that The gene therapy is less effective than natural immunity by a factor of 13 to 27 times). This was practically completely ignored by the media and everybody on this site. In the past everybody here would've been on that shit immediately, trying to figure out if it was correct, I mean don't we want out of this mess? Does anybody want out of this or does everybody feel good about having a boot on their neck for the rest of their lives? Let go of your ego for a minute and ask yourself that question for real. If you're one of the people who will down vote this comment, there is no help for you in the long run. But if you want to be honest with yourself, and you want this bullshit situation to end, then you need to look at the real science in the real data and ask real questions and be open to the answers. Even if it means you made a terrible mistake somewhere along the way.

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

#74
post #53

Earlier quoted context omitted.

Calling them gene therapies too.. wow. I hope the more science-literate proponents of IVM can appreciate how much it harms their case for the vast majority of IVM advocates to be this loud and wrong..

> I hope the more science-literate proponents of IVM If they valued and were capable of reasoning about the science, they would not be “proponents” — they'd recognize the current scientific understanding (no known mechanism or benefits, significant side-effects) and wait for a solid study before recommending anything. The people you do see advocating it are almost always doing so for political or financial purposes a…

Ivermectin doesn’t really have significant side effects at appropriate doses. It’s quite safe. Don’t be fooled by overblown “horse dewormer stories”.

I don’t say this to advocate Ivermectin, the only RCT I know of/trust found absolutely no effect. I say this to gently point out the mismatch between your claims and the premise in the first sentence.

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

#75

The premature smear of potentially effective medications like HCQ and Ivermectin by scientifically illiterate media is unforgivable. Especially in the case of Ivermectin, given that it has one of the most benign safety profiles of any known drug. There is no excuse. There should have been federally funded widespread trials a year ago, there is no downside. Instead you now have hospitals forbidding off label prescript…

"How the coronavirus infects cells — and why Delta is so dangerous"

https://www.nature.com/articles/d41586-021-02039-y

"The virus then ejects its genome directly into the cell. By invading in this spring-loaded manner, SARS-CoV-2 infects faster than SARS-CoV and avoids being trapped in endosomes, according to work published in April by Barclay and her colleagues at Imperial College London9.

The virus’s speedy entry using TMPRSS2 explains why the malaria drug chloroquine didn’t work in clinical trials as a COVID-19 treatment, despite early promising studies in the lab10. Those turned out to have used cells that rely exclusively on cathepsins for endosomal entry. “When the virus transmits and replicates in the human airway, it doesn’t use endosomes, so chloroquine, which is an endosomal disrupting drug, is not effective in real life,” says Barclay."

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

#77
post #11
post #4

Earlier quoted context omitted.

that doesn't make scientific sense. Replicating the original experiment and doing a meta-analysis have two completely different goals. I would have argued that back to the professor (and been right).

How useful is meta analysis if half or more of the experiments don't replicate? As we increasingly discover with the replication crisis.

I said they had different goals, not that they don't overlap.

If you're in a class teaching medical studies, and you tell people "go replicate the original experiment instead of doing meta analysis", you're doing your students a disservice.

Instead say: "It's always important to be able to replicate experiments and I encourage everybody in the class who is going on to do science or medicine spend at least some time in the lab replicating a basic experiment. But medical studies are so large and complicated that we can't typically repeat them in a reproducible way. Instead, we use statistics and probability to make reasonable decisions based on the data we have. Sometimes that means removing a suspect paper from a meta-analysis because we lack confidence in its reproducibility."

For some of the most sophisticated medical science experiments we have today, the only way to replicate an experiment is to be a postdoc and join the lab that does the research, master the technique there, then take your reagents and other material to your professor job, and then get your local set up to replicate what you did in the original lab. This is how it normally works, for example in labs like Mina Bissell's where few people in the work even have the skills to replicate her experiments.

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

#78

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…

> Do you think the public health authorities in Uttar Pradesh (https://indianexpress.com/article/cities/lucknow/uttar-prade...) are lying?

It's possible, the number of excess deaths in the region over a period (1 July 2020 and 31 March 2021) was measured at 197k compared to other years, but they only reported 4500 covid deaths.

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

#79

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.

> ... to people who didn’t understand the difference between a preprint and a peer reviewed paper.

It's worse than that; if you're reading individual papers without the context of the larger body of research in a domain, you're setting yourself up to get a distorted view of the world.

Peer review isn't magic; peer reviewed papers can still have errors, oversights, mistakes, outright fraud, or just get unlucky in how random chance played out. Peer review just filters out the obviously fraudulent or flawed papers so that only three reviewers have to spend an afternoon reading and understanding why they are useless, and not a thousand journal subscribers.

There's nothing wrong with following scientific developments as a layperson, but you shouldn't make the mistake of thinking because you read something in a published, peer-reviewed paper -- even one in a prestigious, well-respected journal like Science or Nature -- that it must be true.

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

#80
post #57
post #28

Earlier quoted context omitted.

It matters a lot if ivermectin doesn't do anything to stop C19, even if it is otherwise safe (it surely is, dosed professionally). People take ivermectin instead of vaccinating or complying with NPIs. If ivermectin doesn't work, that is a very, very big deal.

> People take ivermectin instead of vaccinating or complying with NPIs Doing one thing but not another doesn't imply you're doing one thing instead of another. Do you truly believe the people ODing on ivermectin would be lining up for vaccinations if it didn't exist?

Lining up? Not necessarily.

But it seems almost certain to me that at least some people feel safe thanks to taking ivermectin (while distrusting mainstream vaccines), and those people would turn eventually to the vaccines if those were the only perceived path towards C19 safety.

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