Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Hydroxychloroquine Probably Isn’t the Answer

acsh.org

Post reply on HN
Print view View original

91–100 of 115 posts

Re: Hydroxychloroquine Probably Isn’t the Answer

#91

Post by downerending »

nradov wrote: post #84
downerending wrote: post #80

Earlier quoted context omitted.

I'm guessing it's because the organization has been praised by a number of well-known people on the right (e.g., Steve Forbes, Ben Carson). And because the question of whether or not this drug works, or even should be used at all, seems to have become highly politicized. I think I read that at least one US governor threatened to pull the medical license of any doctor that used it. I don't have any idea whether this d…

US state governors don't have the authority to pull medical licenses.

Perhaps. I believe that doctors are licensed at the state level, and if I were a doctor, I wouldn't care to cross a governor making such a statement.

Re: Hydroxychloroquine Probably Isn’t the Answer

#92

Post by cma »

jojo2000 wrote: post #74
cma wrote: post #57

Earlier quoted context omitted.

Does Marseille test more than France? It is expected no one is hitting a 9.5% death rate unless they quit testing almost all but the severe or dead.

It's the most heavily tested area of the world [0], and also the only place where everyone who is positive gets a treatment (hydroxychloroquine + azithromycine). Other protocols are listed here [1] Regarding status, it seems the peak is being reached there [2] [0] https://twitter.com/raoult_didier/status/1245978149206228992... [1] https://twitter.com/raoult_didier/status/1242808646997880832... [1] https://twitter.com…

1% is about expected at that point, since there is a 14 day lag on average and CFR can only go up over time after new cases trail off, it should end up higher. Look how South Korea eventually rose from .7% to 1.8% (somewhat biased by lots of young people infected early, but most of the rise at least from 1% to 1.8% was just due to the lags involved).

Maybe it is still a good number for their population age demographics and the treatment helps a lot, but it doesn't seem to be showing it to be anything like a game changer.

Re: Hydroxychloroquine Probably Isn’t the Answer

#93

Post by Dylan16807 »

h_r wrote: post #68
Dylan16807 wrote: post #55

Earlier quoted context omitted.

It's not begging the question at all! The entire point is that you can have compelling evidence without a randomized controlled trial.

Again, this is the very thing that needs to be shown. You're simply repeating the same mistake. The post I was responding to really had no _point_, per se. It merely asserted that it's ridiculous to require such experiments because... miracle drug !

> Again, this is the very thing that needs to be shown. You're simply repeating the same mistake.

"This" being the idea that "compelling evidence" and "evidence from randomized controlled trials" are not the same thing? That has been shown. The cliche example is parachutes. We have compelling evidence that they save lives, even though nobody has ever done a proper trial.

Experiments don't have to be perfect to provide valid data. And there are things you can learn from observation even without an explicit experiment.

Nobody is suggesting that we would take an unknown drug and call it a miracle drug without evidence. When someone has a miracle drug in a hypothetical, pretend they're holding a bottle of penicillin and they've gone to a country where nobody has ever heard of penicillin. How should that country react when it immediately cures almost everyone with a certain disease? Do they really need a randomized trial to be confident it works?

Re: Hydroxychloroquine Probably Isn’t the Answer

#94

Post by Dylan16807 »

gus_massa wrote: post #89
Dylan16807 wrote: post #62

Earlier quoted context omitted.

So you have a cancer that normally has a 90% fatality rate after a year. Someone gives you evidence that they gave this drug to everyone with this cancer in their hospital, and 70/73 survived for a year. Not properly randomized, not properly controlled. Would you really reject their data and find it unconvincing?

If the results are so good it would be impressive. But it will be necessary to take a look at the data. Dollar to doughnuts they have a horrible methodological mistake, like a bad classification of the patients, or using a weird definition of cure [1], or cherrypicking the patients that get cured. [1] We have a big announcement of a miracle cure in Argentina in 1986. It was crotoxina [links bellow] that is a part of…

Valid issues, but you can have all of those problems in a randomized controlled trial too. That's not a very compelling argument that the non-random poorly-controlled version is any worse in this hypothetical.

Re: Hydroxychloroquine Probably Isn’t the Answer

#95

Post by miked85 »

justin66 wrote: post #83
miked85 wrote: post #77

Earlier quoted context omitted.

A fair amount of doctors tend to believe it is promising [1]. If I was in the hospital, of course I would want to take it regardless of how anecdotal the evidence is. [1] https://www.washingtontimes.com/news/2020/apr/2/hydroxychlor...

> A fair amount of doctors tend to believe it is promising There are a couple of red flags about that article. No peer-reviewed (or otherwise) papers are mentioned and no clinical trials are discussed. The article does not even attempt to evaluate the truth of whether it's an effective therapy. Even judged on its own terms, the article is a weak. After looking at that survey they're flogging, it'd be pretty interesti…

> "Of course?" I hope you would at least consider the opinion of the physician treating you.

Sure. But if I was dying, "of course" I would want to try something with even anecdotal evidence of efficacy.

Re: Hydroxychloroquine Probably Isn’t the Answer

#96

Post by af33 »

> There is absolutely no evidence that HCQ or HCQ/azithromycin would have any effect on seriously ill patients with viral pneumonia

It's supposed to be taken BEFORE you become seriously ill and develop ARDS.

In fact, many elites are put on a short course of HCQ/Z-Pak as soon as they show symptoms, even before the results of their tests come back (which can take days).

> https://www.cbsnews.com/news/coronavirus-treatment-drug-hydr...

Re: Hydroxychloroquine Probably Isn’t the Answer

#98

Post by stewbrew »

hexl wrote: post #87
stewbrew wrote: post #51

Earlier quoted context omitted.

Unless you did such a trial, you cannot be sure it actually was the drug that helped. But if everyone gets cured, such a trial should be easy to set up. Unfortunately, things are not that easy in real life. There is no miracle drug.

But you already have a control which is a statistic called "survival rate after x years". If you beat it with a large enough treatment group, then you can prove it works.

Selection bias?

If you don't control who gets the treatment, who gets a placebo, and who gets the current state of the art treatment, you cannot really exclude your results are biased. There are some ideas about how to reason with observational data but your conclusion are still weaker as with experimental data.

Re: Hydroxychloroquine Probably Isn’t the Answer

#99

Post by pseudalopex »

cjhopman wrote: post #65
tgafpc2 wrote: post #34

This site also has an article wistfully praising Remdesivir, a proprietary drug with far less evidence than HCQ. I think money might be talking here.

A proprietary drug whose maker has said they will donate all 1.5 million doses that they currently have. That's more than they'll be able to produce over the next year (1 million) even after greatly increasing that production capacity.

The goal is more than 1 million treatment courses (10 million doses) by the end of this year.

https://www.gilead.com/stories/articles/an-update-on-covid-1...

Re: Hydroxychloroquine Probably Isn’t the Answer

#100

Post by pbreit »

xtof wrote: post #75
pbreit wrote: post #70

Earlier quoted context omitted.

It's very clear that the resistance to these drugs is an intense case of Trump Derangement Syndrome. There's an almost perfect correlation between reaction to these drugs and Trump support.

It's resistance to people who are clearly out of their lane. He is not a medical doctor, yet he's recommending people take it. It's unremarkable that he's incompetent to give this advice, because most people are incompetent to give such advice. I am incompetent to give such advice. What is remarkable is he clearly thinks he's competent to give such advice, and that it's appropriate for him to give it without any qual…

Trump mentioning a drug in a press conference is now "giving [medical] advice"? Please.
Post reply on HN