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

nature.com

81–90 of 493 posts

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

#81
post #27

Earlier quoted context omitted.

> 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.

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..

The United States CDC literally changed the definition of "vaccine" this year, so that these products could still be identified as vaccines. You're going to tell me that it's "science illiterate" to consider mRNA therapy as gene therapy, because the genes are not actually changed, but instead only expressed to create the therapeutic effect. But it is "scientifically literate" to call such a therapy a "vaccine"?

I hope more common sense literate proponents of science can appreciate how much it harms their case for a vast majority of science advocates to be loud and wrong.

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

#82

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...

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

#83

How does the current field of studies compare to Remdesivir? Remdesivir is a repurposed antiviral (originally designed for Ebola) with fairly low efficacy, and very severe side effects, and it breezed through FDA emergency authorization. I don't understand why it seems that the bar is set so low for Remdesivir, but so high for Ivermectin.

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

#84

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…

> People are literally taking horse formulations of ivermectin People are taking the horse formulation because most pharmacists won't even fill an off-label prescription for the drug, which - even if it has no effect on COVID - is safe and taken by a quarter billion people every year. Let people take it. It's not harmful. Or, make a big huge deal about people taking it and, well, then it becomes a big huge deal.

Is that really the reason or is it that they can't get a doctor to write them an off-label prescription?

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

#85
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…

Yeah, because nothing says "recognize the current scientific understanding" like dismissing hundreds of studies because of a couple bunk meta-analysis. Also, nothing says "recognize the current scientific understanding" like injecting an untested medicine into your veins to avoid what amounts to the common cold for younger people; while ignoring the fact that it does not help prevent the spread, and according to the latest study on this from Israel (the highest vaccine rate in the world), actually enhances the spread, so if the argument is "what about the old people that you're going to infect", then I guess you've answered that question already.

It pays nothing to pretend that you are smarter than other people if you're not willing to follow your own advice.

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

#86
post #84

Earlier quoted context omitted.

> People are literally taking horse formulations of ivermectin People are taking the horse formulation because most pharmacists won't even fill an off-label prescription for the drug, which - even if it has no effect on COVID - is safe and taken by a quarter billion people every year. Let people take it. It's not harmful. Or, make a big huge deal about people taking it and, well, then it becomes a big huge deal.

Is that really the reason or is it that they can't get a doctor to write them an off-label prescription?

It's probably both, but why would a doctor risk losing their license over this? Yet another unintended consequence. Doctors are supposed to be able to write prescriptions for off-label use.

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

#87
post #74
post #53

Earlier quoted context omitted.

> 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.

I agree that it is safe at appropriate doses. The issue is that people are self medicating and incorrectly calculating doses, since the product was intended for livestock.

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

#88

For those interested to learn more about Ivermectin, watch JRE#1671 podcast episode. Lots of interesting information covered about the drug by 2 biologists. It may change your views on this for the better, or the worse.

You're better off if you only associate "JRE" with Java.

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

#89
post #32

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

I agree, though there are two obvious courses of action that result from this: 1. Prevent the viewing 2. Increase the readiness Of which I think #2 is most preferable.

#2 is for sure bviously preferable, but Good Luck With That.

Once you get below the top N% in intelligence levels (5%-20% in my experience), the ability to 1) understand any kind of complex systems, 2) read, understand, contextualize and retain data, and maintain any rigorous logical thinking structure (e.g., keeping previously eliminated options eliminated) declines rapidly.

The result is that, despite having absolute record numbers and percentages of people educated with college degrees, we have massive anti-science movements that are literally killing thousands of people daily, by ape-ing scientific-sounding terms & distorting concepts & data in order to more effectively broadcast disinformation - and hordes lap it up.

We even have nurses and healthcare workers, who supposedly have been taught and passed tests on basic germ theory, actively resisting and campaigning against safe and effective public health measures.

A related phenomenon is that college degrees are systematically being degraded. I personally know someone who was a visiting professor at a US State University, teaching introductory economics. He found that many of the students didn't even have the math skills (or motivation) to understand and wield the basic concepts on assignments, classroom discussion, and tests, and of course he was recommending them to remedial options and failing them. He was explicitly ordered by the administration to pass them or quit. He quit.

Sadly, it is looking more and more like this great experiment in college for all is not working out as hoped. Instead of a culture of wisdom, we have a culture of sophomores - literally wise fools, who know very little, but think they know it all, and therefore don't have to listen to any expert who actually has real knowledge.

It is considered obvious that at 5'6"/168cm, I was not born with the attributes necessary to engage in a professional basketball career. Yet the same kind of sorting based on intelligence is considered something to not discuss, perhaps getting too close to eugenics.

I strongly believe that the opportunity should exist for any person to get whatever level education they want, without financial or other obstacles. But, with the caveat that it cannot be dumbed-down - either you can understand and do the work and pass, or you do not. The practices seen above, and grade inflation in general need to be reset. The problem is that failing your students is bad for business, so unlikely that most colleges will reform.

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

#90

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…

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 else sorts out what the data says.

But as you point out, there are two major flaws in the assumptions. First, that the scientific procedure is sound. Secondly, that the data is handled properly, and thus you can take the summary and back out the underlying data.

Unfortunately trying to fix the first is really, really hard.

The second is somewhat mitigatable. As the Nature article suggests, you could publish the underlying data (anonymized of course). This would help in two ways. First, the meta-analysis could check for confounding variables to control across all of the data. The second major one is it would help people spot fraudulent data.

However, as anyone who handles datasets knows, publishing and wrangling data into a useable state from multiple sources is a serious pain in the neck. Plus a lot of concerns about how de-anonymized the data would be. As we've known, with enough metadata it can be used to identify individuals. And publicly publishing dais data would definitely allow for some serious sleuthing work to be done.

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