30 ms·

A mysterious company’s Covid-19 papers in top medical journals may be unraveling

325 points by onemoresoop 6y ago

seesawtron 6y ago
This guy [0] did some good analysis of the "mysterious company". [0] https://news.ycombinator.com/item?id=23394357 https://news.ycombinator.com/item?id=23394357
- joncrane 6y ago
  Linking directly to the article here: https://www.medicineuncensored.com/a-study-out-of-thin-air https://www.medicineuncensored.com/a-study-out-of-thin-air It reads like a Muddy Waters (famous stock shorter) screed. Good stuff. Fair to say the data is made up. The question is, who would be incentivized to do such a thing? Things that make you go hmmm....
  - seesawtron 6y ago
    When such a large study is published in a big Journal, claiming that a drug might have a negative impact on lives of people in the trials, the authorities will be considered stupid not to pay attention to it at all and continue the trials. That is exactly what they did: They paused their trials temporarily to look at the evidence of this study, examined it and found that it was indeed controversial and lacked solid data. Now they have resumed the trials again. The media sells it as a clickbait story "All trials STOPPED because of a flawed study" implying they were stopped PERMANENTLY to excite the general audience. For them it is entirely something that brings them huge revenue from ads when they write such "emotinally driven" stories, they do not care about the effects it has on the public in the long term by reducing faith in world health organizations.
- raphlinus 6y ago
  James Todaro is not an honest scientist. I couldn't find any A-grade sources on him, but here's an interesting Wired piece: https://www.wired.com/story/an-old-malaria-drug-may-fight-covid-19-and-silicon-valleys-into-it/ https://www.wired.com/story/an-old-malaria-drug-may-fight-co... If people don't know this story, Todaro and Rigano published what looked like an academic paper as a Google doc, with academic qualifications that verge on fraudulent, if not crossing the line. The original Google doc has been taken down for TOS violation, but it is still accessible on archive.org [1]. To be clear, I decry the fact that HCQ has become a political soccer match (with apparently bad behavior on both sides), where what we really need is something that at least approximates an impartial, objective search for truth. The fact that people are getting their information from this guy (even though he's actually right about the Lancet study being flawed) is strong evidence that we're living in a dystopian information nightmare. [1]: https://web.archive.org/web/20200315004631/https://docs.google.com/document/d/e/2PACX-1vTi-g18ftNZUMRAj2SwRPodtscFio7bJ7GdNgbJAGbdfF67WuRJB3ZsidgpidB2eocFHAVjIL-7deJ7/pub https://web.archive.org/web/20200315004631/https://docs.goog...
drocer88 6y ago
A lot of people got hung up in the politics of this issue. A prominent politician endorsed using hydroxycholoroquine. Bill Maher recently made a good point: "Liberals are falling into lionizing someone because because they are the anti-Trump. Even before the virus America had a far too chronically sick population which is one reason we've lost so many now. We need to demand something better than how the entrenched medical establishment manages symptoms but cures and heals far too little". I guess pushing "the narrative" was more important than the science.
- jtbayly 6y ago
  This. People are so desperate to attack Trump that they're willing to accept any result that paints him as doing something stupid. And if they can blame him for people dying, all the better. In the meantime, ignoring the science and falling for the politics means that people may well die since the science may not be able to happen now.
  - belltaco 6y ago
    Why is a politician endorsing an unproven drug? Oh it's because he's "getting great calls about it" from Fox News personas who are not doctors themselves, and instead fell for bad studies from a questionable French doctor.
    - notaharvardmba 6y ago
      Also insider trading
      - javagram 6y ago
        The insider trading argument was proven to be nonsense. He had a <$5000 interest in a mutual fund that fractionally owns the drug manufacturer . For multi-millionaire to care about this would be like dumpster diving for pennies. If anything the drug magically curing coronavirus would make the entire stock market, and his re-election chances, go up dramatically, so there is no need to look for an insider trading argument when plain old wishful thinking/stupidity explains it all.
RcouF1uZ4gsC 6y ago
> Desai, through the spokesperson, also said of the company’s work with patient data: “We use a great deal of artificial intelligence and machine learning to automate this process as much as possible, which is the only way a task like this is even possible.” I wonder if we are heading for an AI winter soon. AI has been heavily hyped, but is having a lot of real world failures and is becoming associated with a bunch of fraud. At this time, I am less inclined and I believe a company if they invoke “AI” or “machine learning”. Sure, businesses will still use machine learning for problems where it makes sense, but the hype of AI will die down and funding will dry up.
- battery423 6y ago
  I think AI/Machine learning fits much better at the big big companies like google. You only need one or 2-3 competiting Neuronal Networks for cancer detection and if you look how expensive it is to train that stuff, not many can actually do it anyway. But what tripples down are pre learned networks you can easily reuse for your small use cases which are specific and have plenty of data and only need to outperform the existing solution.
  - tw000001 6y ago
    >You only need one or 2-3 competiting Neuronal Networks for cancer detection and if you look how expensive it is to train that stuff, not many can actually do it anyway. This is just wrong. You can train a cancer discriminator on a low end gpu on your desktop. The hard part is getting quality [often annotated] data - and thats why data brokers like Google are positioned to dominate.
    - battery423 6y ago
      So why are those papers with good results are not running on 'low end gpus'? I don't mean running them, i mean training them.
      - tw000001 6y ago
chrisbrandow 6y ago
Despite the helpfulness of quick exchange of laboratory results via preprint, peer review is clearly going to remain central to the scientific process.
- rootusrootus 6y ago
  I completely agree. It seems great now, because the situation is dire, to get preprints instantly as they become available. But people don't seem to realize just how much crap gets into preprints and ultimately fails during peer review. There's so much garbage out there now, and it can and will (and probably already is) be used as just more political fodder. I like reading preprints as much as the next geek, but I think we might ultimately be better served if the papers weren't released until after peer review.
  - James_Henry 6y ago
    Do you think that people will start to read preprints for what they really are? If that's the case then I think they'll never go away. Open review by peers before publication is incredibly useful compared to peer review. Imagine if these 3 papers could have been scrutinized before getting that Lancet peer review stamp that has led to bad policy decisions and research decisions by so many. People would have started questioning Surgisphere's data sooner and wouldn't have taken their results so seriously.
- James_Henry 6y ago
  I'm not sure I understand where this comment is coming from. The 3 Surgisphere papers were peer reviewed.
eric_b 6y ago
Chloroquine and its derivatives were given to thousands, if not millions, of people for years. We know and understand the safety profile of this drug well. To think that all of a sudden it became more dangerous was silly and unreasonable. This study always smelled bad. The media was so quick to champion it everywhere though. Why might that be I wonder? Where are the retractions now? The whole thing is disgusting. The media in the US is doing everyone a disservice. Because of this less people are going to believe "science" and more people are going to just retreat to their echo chambers and believe whatever they want. I know I'm not going to trust the Lancet or the NEJM ever again. It's all political now. What a mess.
- zpeti 6y ago
  What makes it even worse is that social media companies are now so paranoid about being labelled spreaders of misinformation, they are relying on sources who could easily be wrong about something as well (like in this case). I guess this way at least they can point the responsibility somewhere else, and say it's not their fault.
- ed25519FUUU 6y ago
  > Why might that be I wonder? Where are the retractions now? The whole thing is disgusting. It’s going to take a long time to recover from what the media has done here. HCQ isn’t even allowed as a treatment in a lot of places, or require hospitalization (funny for a drug on the market for 60 years and over the counter in some places). Other countries are ramping up production and we’re still dealing with the yet another casualty of culture war.
- sonicggg 6y ago
  Some media conglomerates, like CNN, were clearly using this study as a political attack. Not uncommon these days to cherry pick your favourite paper. On top of that, there is no patent money to be made by big pharmaceuticals on this drug. It makes me wonder where the funding really came from in this Lancet study.
- nathan_compton 6y ago
  "I know I'm not going to trust the Lancet or the NEJM ever again. It's all political now." This is an absurd reaction and I suspect you know it. There isn't a single scientific journal in the world not subject to some bias, trend, or failure of one form or another. To dismiss an entire platform because of an imperfect record amounts to an abdication of your own responsibility to form your own opinions about scientific matters. This is a responsibility for which journal reviewers can only ever take partial responsibility for both practical and intrinsic reasons. Peer review is not a rubber stamp which blesses anything which passes through it as "TRUTH." It is a minimal standard and subject, at any rate, to all the uncertainties and biases implicit in any human endeavor. It is entirely possible this paper represents a political bias. Almost everything does. It still falls to us to make reasonable judgments about science. What doesn't make sense is to reject the entire process because it fails to meet some unreachable expectation of perfection.
jakeogh 6y ago
More: https://news.ycombinator.com/item?id=23272222 https://news.ycombinator.com/item?id=23272222
ed25519FUUU 6y ago
> Antimalarial drugs touted by the White House as possible COVID-19 treatments looked to be not just ineffective, but downright deadly. Immediately when the long knives came out against HCQ I was cynical. A drug on the market for 60 years (and over the counter in many countries) is “extremely dangerous”? Or, more likely because it’s out of patent there’s a lot of money interested in exploring other things as a treatment.
- boomboomsubban 6y ago
  >A drug on the market for 60 years (and over the counter in many countries) is “extremely dangerous Tylenol has been on the market for a 60 years, often over the counter, but off label recommendations involving a high dose could be deadly. Drugs should always be considered "extremely dangerous."
  - emmelaich 6y ago
    Anything in high dose can be dangerous. So that's not helpful. Anything. For instance, water.
    - boomboomsubban 6y ago
      Yep, taking ~8 extra strength Tylenol twice a day is comparable to drinking however many gallons of water a day you would need to cause problems.
- tw000001 6y ago
  >more likely because it’s out of patent there’s a lot of money interested in exploring other things as a treatment HCQ was not even remotely controversial until Trump tweeted about it. Our institutions have lost their collective minds with their spiteful, childish hatred for a politician. Academia and news media have completely lost sight of objectivity.
  - programmarchy 6y ago
    People started hoarding HCQ in early February when the first Chinese studies were coming out. Didier Raoult's (crazy looking French doctor) reports in mid-March sparked the first controversies. I remember worrying at that point there'd be some big-pharma-backed media operation to discredit a cheap, patent-expired drug since there are trillions of dollars at stake. Trump tweet was in late March.
gator-io 6y ago
Fantastic analysis of the Lancet study's flaws: https://www.youtube.com/watch?v=IUD_wvkNhnk https://www.youtube.com/watch?v=IUD_wvkNhnk
- gamegod 6y ago
  This is a garbage analysis that ends up with a plug for vitamins and t-shirts. You don't write off a journal for making mistakes. Retraction is part of the scientific process. What this YouTuber failed to mention is that there were already a couple of other studies before this one that reached the same conclusion - that there was no evidence of it working for COVID-19, or that it potentially made things worse in the most sick patients. The retraction of a single paper doesn't invalidate the body of evidence (albeit small) provided by other papers prior to it.
  - gator-io 6y ago
    Don't get hung up on the how the channel survives. The channel, whose host has a Phd in pathology, has been focused on Covid issues for months, after being demonitized by YouTube.
    - gator-io 6y ago
      And from his experienced analysis, the study is clearly, obviously junk, and the Lancet should be held to account for publishing it.
    - ufo 6y ago
      If a channel advertises snake oil supplements and products then that should be a valid reason to criticize them.
      - gator-io 6y ago
        And just to be clear, the supplements are recommendations based on research, not advertisements. No commissions. Go back a few episodes and you'll see the rationale for them.
devit 6y ago
So they suspect that Surgisphere has manufactured or falsified the data?
- gator-io 6y ago
  Yup. More than suspicious.
fareesh 6y ago
The lengths to which the American media will go to score points against President Trump should worry any reasonable person. Sadly the filter bubbles of the Internet bury so many of the retractions and fact checks that favour Trump, so many of the aforementioned reasonable folks almost never see the whole story. The most egregious lie peddled by the media is the "Very Fine People" statement, which, is claimed to be a reference to white supremacists, when in fact in he clarifies in the very speech, "and I am not talking about the white supremacists, they should be condemned totally". Armed with those facts, the reader/viewer is free to draw their own conclusions with regard to the President's inner thoughts and hidden meanings, but the whole, unfiltered picture is almost never presented. An omission like this is what potentially amplifies racial tensions across the country. We are now seeing this type of narrative again with the Hydroxychloroquine charade. A number of scientists and academics in Brazil penned a great open letter on this topic (the media and HCQ) a few weeks ago, which I thought was a great read: https://conexaopolitica.com.br/ultimas/brazilian-scientists-and-academics-write-an-open-letter-on-the-science-of-the-coronavirus-pandemic/ https://conexaopolitica.com.br/ultimas/brazilian-scientists-...
- beepboopbeep 6y ago
  Donald Trump is a gibbering goblin of a human being. This is not the place to white Knight for him.
  - whatshisface 6y ago
    Even accepting the premise, surely if the Shire's media has painted Azog as a gibbering green goblin, while in reality he's only a gibbering goblin, you would want to hear about it.
  - fareesh 6y ago
    My point is proved, QED?
    - sjwright 6y ago
      If beepboopbeep is the entirety of the US media, then yes. Otherwise no, it’s just yet another comment by a single individual on the internet with no broader meaning, context or consequence.
mensetmanusman 6y ago
The best quote is at the end: “Here we are in the middle of a pandemic with hundreds of thousands of deaths, and the two most prestigious medical journals have failed us.” There should be prison time if an investigation determines that this was done to increase certain drug sales.
- tootie 6y ago
  There's absolutely no indication that would be true. This study in particular curtailed support for pharmaceutical treatment.
  - tlb 6y ago
    It reduced support for a particular cheap, off-patent medication that wasn't going to make anyone much money if it worked. Competing on-patent drugs, like Remdesivir, would make someone a great deal of money if they work better than HCQ.
    - deleted 6y ago
      [deleted]
- eric_b 6y ago
  I strongly believe there were people at the Lancet who wanted to believe the HCQ study, regardless of how well it was run. See, if you can skewer HCQ, that means you get to take a shot at a certain politician too. There were a number of researchers who criticized the study's structure and numbers from day 1. Over 100 researchers wrote an open letter about how skeptical they were. I understand journals make mistakes, but this was egregious and smells like agenda to me.
  - newacct583 6y ago
    > See, if you can skewer HCQ, that means you get to take a shot at a certain politician too. For clarity, and I'm sure you agree: Trump's boosting of this drug as a "miracle" and "greatest breakthrough" was absolutely irresponsible even if the drug actually works, for the simple reason that we didn't know if it did (frankly we still don't), and that it is known to have significant risks (it still does, even usingly only baseline data and ignoring this study). This was a bad study. It's possible that the editors at the Lancet hate Trump. But... you're simply reading too much here. Bad science gets published all the time. In particular, bad science gets published in circumstances like we have now where there is desperate need for "fast science". Not everything has to be an "agenda" by global elites to damage your favorite politician. But even granting your framing: why are you so concerned about the Lancet boosting bad data as an "agenda" but not with Trump doing exactly the same thing, with even less evidence? Why is it an "agenda" only when your enemies do it?
walterbell 6y ago
Media & select journals helped justify trillions of societal costs when many could be saved from death by early treatment with zinc + zinc ionophore (HCQ/quercetin) therapeutic that costs less than one dollar. Some poorly designed HCQ studies have used late treatment or omitted zinc, which is known not to work. Specific cohorts are also excluded, including cardiac patients with long QT interval and some malaria-prone populations with G6PD gene. Some US states have blocked pharmacies from filling doctor prescriptions for HCQ, instead of advocating for increased manufacturing capacity within US factories that make HCQ/ingredients. Meanwhile, we boosted ventilator production, where hospitals received $30K for each late-stage patient placed on ventilation, with only 20% chance of survival. We blocked early treatment that worked and we funded expensive late-stage equipment that did not work. All this with more global information sharing than ever before in the history of humanity. Since we were collectively unable to filter/parse data generated by wildly different economic incentives, where the consequences were DEATH, how can we design new systemic incentives to avoid repeating such mistakes? https://www.telegraph.co.uk/news/2020/06/02/prof-lockdown-neil-ferguson-admits-sweden-used-science-uk-has/ https://www.telegraph.co.uk/news/2020/06/02/prof-lockdown-ne... > Neil Ferguson, who became known as “professor lockdown” after convincing Boris Johnson to radically curtail everyday freedoms, acknowledged that, despite relying on “quite similar science”, the Swedish authorities had “got a long way to the same effect” without a full lockdown.
- andreilys 6y ago
  “ how can we design new systemic incentives to avoid repeating such mistakes?” I don’t think you’ll like the answer here. Financial incentives have been known to cause perverse outcomes where moral hazards occur more often than not. I think financial incentives work well in a lot of cases, but healthcare and media have been so perverted by financial interests it’s become untenable.
- ceejayoz 6y ago
  > Some US states have blocked pharmacies from filling doctor prescriptions for HCQ... Good. Patients with lupus and other diseases were experiencing shortages of what for them is demonstrably life-saving medication. There's not an infinite supply, and there are folks who need it for more than speculation and self-administered home prophylaxis. https://jamanetwork.com/channels/health-forum/fullarticle/2764607 https://jamanetwork.com/channels/health-forum/fullarticle/27...
ddrt 6y ago
Can anyone explain why there’s a new trend I. Saying a negative, then saying “but” and stating another negative. Like... “He was a dishonest man. But, he cheated on his wife” “He had a nut allergy. But, he had a dairy allergy.” It’s like they’re saying: “he’s a good father. However, he had a dark side.” But they’re really not. Also, at the beginning they say “it may be unraveling” and begin to show how it never had any legs to stand on. Just confusing communication for an article.
- wyldfire 6y ago
  Titles are the copy that are the most critical to driving eyeballs to your content. I suppose "mysterious company ... may be unraveling" sounds like an engaging mystery for the reader to enjoy.
- dec0dedab0de 6y ago
  Antimalarial drugs touted by the White House as possible COVID-19 treatments looked to be not just ineffective, but downright deadly. I think the quote above is what you're referring to. If so, the structure "Not only {small_point}, but {large_point}" is extremely common and used both with negatives and positives.
Gatsky 6y ago
I gave up reading The Lancet some time ago. They have a poor record frankly with this kind of thing, Andrew Wakefield et al chief among them. They should have been cancelled over that one. Anyway, the larger point is that these established journals have failed us. Their added value, already low, has dropped below zero in this pandemic. They are slow, opaque, rent seeking parasitic entities seemingly run by individuals who don’t grasp basic statistics. The combination of preprint servers + twitter has proven far more effective in looking after humanity’s best interests.
- jxy 6y ago
  It is exactly such kinds of ignorants of basic statistics, the faulty generalizations of the effectiveness of established journals, have failed the humanity.
  - cracker_jacks 6y ago
    Is there a statistical demonstration of the effectiveness of established journals? It seems like you would have to do some form of counterfactual study to prove/disprove this. As far as I know, the argument of the effectiveness of journals only stems from the survivorship bias (e.g. all things considered research until recently has been published by journals).
    - SiempreViernes 6y ago
      No, you can look at the stuff people put up on the preprints to see what would happen if there's basically no screening at all.
      - cracker_jacks 6y ago
        The preprint model has actually been wildly successful for many communities (https://arxiv.org/ https://arxiv.org/, https://www.biorxiv.org/ https://www.biorxiv.org/). I don't think anyone is arguing against peer review, but the idea of peer review and an established journal is being conflated. If anything, publishing established journals can create a level of implied authority that reduces much need scrutiny.
raverbashing 6y ago
It's amazing how big of a mess this is: - NEJM and the Lancet published (and "peer reviewed") this article, or apparently just rubber stamped it. - The company doesn't have any semblance of having the capability of doing the work it purports to do. - The article has severe inconsistencies, for example, do you really have data on 98k hospitalized patients? http://freerangestats.info/blog/2020/05/30/implausible-health-data-firm http://freerangestats.info/blog/2020/05/30/implausible-healt... - The company apparently was founded in 2008 but no data from them was used in any peer-reviewed journal until this year. https://www.theguardian.com/world/2020/jun/03/covid-19-surgisphere-who-world-health-organization-hydroxychloroquine https://www.theguardian.com/world/2020/jun/03/covid-19-surgi... And governments and the WHO bought this, hook line and sinker?
- javagram 6y ago
  Look at how easily the original flawed pro-HCQ paper was bought into (edit: removed my false statement it was retracted - I think it was criticized by the publishing society of the journal, but not retracted.). Many people were treated with HCQ across the world and so far there is no evidence it did anything to help them. An important lesson here about the limits of peer review and science. A lot depends on the original authors not being frauds or simply making mistakes as we’ve seen time and again with scandals.
  - raverbashing 6y ago
    Yeah the 1st study was deficient in several ways (low n, questionable criteria), which at one point, as a work in progress in an emergency situation was understandable, and was caught early by the community. Another very different thing is to misrepresent the source of the data, or worse.
  - lenkite 6y ago
    There is a truckload of evidence unless you have closed your eyes to it. Anyways many national medical boards of south-asia have adopted HCQ formally. https://www.newindianexpress.com/nation/2020/may/29/icmr-writes-to-who-disagreeing-with-hcq-assessment-officials-say-international-trial-dosage-four-ti-2149702.html https://www.newindianexpress.com/nation/2020/may/29/icmr-wri... https://timesofindia.indiatimes.com/india/hcq-and-ppe-used-together-cut-covid-risk-by-80-icmr/articleshow/76146220.cms https://timesofindia.indiatimes.com/india/hcq-and-ppe-used-t...
deleted 6y ago
[deleted]
tuna-piano 6y ago
Ugh. I'm so disappointed in this whole situation. Feels like Theranos. I want to cover my eyes and ears for the media and political shit show that's going to come from this. It's true that a certain politician shouldn't be trumpeting unproven treatments, but the media seemed to celebrate when that politician was "proven" wrong. Did we forget that we should all be rooting for treatments to work? I hoped during this pandemic science would move fast and sacrifice some accuracy for speed. But I didn't expect (a seemingly) complete fabrication could go so far with so many eyes. Now I worry the overreaction toward accuracy-over-speed will cause significant slowdowns in published data. We shouldn't over-punish honest mistakes when we value speed over accuracy... but this just feels awful. Would think prison is likely to come. A good read: http://freerangestats.info/blog/2020/05/30/implausible-health-data-firm http://freerangestats.info/blog/2020/05/30/implausible-healt...
- HideousKojima 6y ago
  >We shouldn't over-punish honest mistakes when we value speed over accuracy Looking at some of the specifics, these don't look like "honest" mistakes, and I'm doubting any integrity on the part of the peer reviewers and the Lancet too with how blatantly false some of their data are. It doesn't even pass the smell test: https://mobile.twitter.com/JamesTodaroMD/status/1266108861259210753 https://mobile.twitter.com/JamesTodaroMD/status/126610886125...
  - ImaCake 6y ago
    The blog post linked by the parent post very clearly argues the data is fake. So I think you are misinterpreting what the parent post is saying. But I totally agree with your sentiment that this is truly terrible and everyone involved should be more than a bit ashamed.
- lbeltrame 6y ago
  > We shouldn't over-punish honest mistakes when we value speed over accuracy... But we should still make sure these behaviors are not rewarded. Science was right when they called against "Pandemic Research Exceptionalism". I think at this point in time, where available knowledge has increased a little, we can afford to be stricter than before.
lenkite 6y ago
ICMR in India does not trust the Lancet study and have formally objected to it. https://www.thehindu.com/sci-tech/health/coronavirus-csir-chief-flays-hcq-trial-suspension/article31712065.ece https://www.thehindu.com/sci-tech/health/coronavirus-csir-ch... https://www.news18.com/news/india/icmr-says-hcq-reducing-risk-among-healthcare-workers-even-as-lancet-study-questions-drug-benefits-2647007.html https://www.news18.com/news/india/icmr-says-hcq-reducing-ris... https://theprint.in/talk-point/lancet-hcq-study-row-did-who-experts-rush-to-damn-the-drug-due-to-trump-modi-politics/434908/ https://theprint.in/talk-point/lancet-hcq-study-row-did-who-...
valarauko 6y ago
To the comments suggesting preprint servers as the solution, it's worth remembering that they are subject to much higher levels of noise, especially at high volume times like now. In early April, my co-authors and I were planning to submit a computational COVID manuscript (I was the first author). The journals were overrun with COVID submissions, and required preprint submission. This was a sticking point for my co-authors, who felt they had a much bigger paper on their hands given more time, and were opposed to a preprint submission. Personally, I was in favour of the preprint, since I felt we had hit the upper limit of what could be achieved with our collective resources. The other authors disagreed, and outvoted me to bring in a big name author who could steam roll his way into a reputable journal. The only way they could tempt a big name scientist would be to offer up the first author credit, so I bowed out. At the time, there were 4,500 preprints dealing with COVID, which just seems bonkers. Honestly, even most of the published work around COVID is of poor quality.
- SiempreViernes 6y ago
  What, they forced you out of a paper you did most of the work on?
  - valarauko 6y ago
    Honestly, it's not that straight forward, which is why I didn't mind leaving the manuscript in the end. I did much of the work bringing it to a workable manuscript, but I didn't originate the project. I was approached by the corresponding author, who had originated and done most of the initial work. This was just a data dump, and he felt he didn't have the time or the ability to polish it into a manuscript. My contribution was to analyse the data, and write most of the manuscript. However, it became clear that the two other authors were pushing a narrative which I felt wasn't well supported by the data we had. We discussed two possible options: bring in an immunologist to determine if our results make sense, which I voted for, or stick to our guns. The second option would have also required submitting to a preprint, which they were against. The corresponding author felt the claims were justified, and decided that a more forceful (and prestigeous) first author was what was needed instead, and I agreed. Since my contribution wasn't all that much (about a week of my time?), and I wasn't convinced by the findings, I didn't mind losing the authorship. This sort of negotiating happens all the time in academia, so it's unsurprising.
fabian2k 6y ago
Hydroxychloroquine is a really frustrating topic as there's so much bad science involved. The early studies were terrible and didn't give any useful information. And now we have more studies in prestigious journals that appear to be at least problematic, if not based on outright faked data. And on top of that are the politics, endorsing and promoting it before any substantial data could be collected. We still have no idea whether hydroxychloroquine works or not for COVID19. And the hype is rather harmful and misleading as even if it did work, it is exceedingly unlikely to be a game changer but a small incremental improvement. This is also certainly a failure of peer review. Though that has always been rather weak for cases of outright fraud and scientific misconduct, it still relies on the researchers to be honest about the data they represent.
- PiggySpeed 6y ago
  People are losing their heads out there because they don't understand how to interpret studies. The most infuriating offenders are the media, who have been irresponsible with the presentation of clinical study results. They'll take the results of an observational study and herald it as some revolutionary insight, when in reality the doctors, nurses, and pharmacists interpreting these results are saying "hmm okay, well let's be cautious in our approach and wait for other studies to be done". Clinical practice should never change, and has never changed (to my knowledge) from the whims of a single OBSERVATIONAL study. But outside medical circles, people will see the results they want to see, and never look past the first 10 words of a headline.
  - userbinator 6y ago
    They'll take the results of an observational study and herald it as some revolutionary insight That's been going on for a while, it reminds me of this: https://kill-or-cure.herokuapp.com/ https://kill-or-cure.herokuapp.com/
  - thu2111 6y ago
    A problem is that different fields that sound similar have very different standards. Epidemiologists appear to frequently take un-reviewed, un-published papers straight to the press and politicians specifically to change government policy. Actual doctors, not so much. What's the difference between an expert in infectious diseases and an expert in treatment of infectious diseases, to the layman? Hardly any. The media plays a part. Journalists routinely conflate doctors, academics and political activists under the rubric of "experts". Sometimes this is deliberate and overt. Guido Fawkes has had a long running campaign where they expose TV news presenting left-wing activists as neutral experts, without telling anyone about the interviewees backgrounds. As can be seen in this particular incident, that campaign has started to have a small effect, but some journalists don't like being exposed that way! https://order-order.com/2020/05/22/sky-news-gets-there-eventually/ https://order-order.com/2020/05/22/sky-news-gets-there-event... For people to get better at interpreting studies the first step must be to de-conflate different kinds of "expert". In particular academics need to be referred to as such and separated from the type of practical expert who practices their craft in the real world every day.
gator-io 6y ago
The corruption of science should be aggressively confronted. If you dig into Surgisphere, you will see they have significant consulting engagements with Johnson and Johnson. Not saying that's necessarily bad, but so much bad science about Covid and HCQ seems geared towards promoting high-priced treatments like Remdesivir, and not low-cost preventative measures like making sure you're not D deficient. All these studies need to be evaluated based on who's funding them or the political agenda behind them. HCQ seems like it's been targeted for destruction. Every study I've read on it shows you shouldn't use it in late stages of disease. Fair enough, but the theory of its effectiveness (as a Zinc ionophore) hasn't been fully studied, although there is a good amount of anecdotal and country-level evidence it works well if taken early (with Zinc). These garbage studies are dangerous and should be called out loudly.
- inasio 6y ago
  This is a pretty simplistic view, the article talks about a different Surgisphere study where the conclusion is that a cheap and widely available drug is effective against covid-19 (the study also has its problems though): "A third COVID-19 study using Surgisphere data has also drawn fire. In a preprint first posted in early April, Surgisphere founder and CEO Sapan Desai and co-authors conclude that ivermectin, an antiparasitic drug, dramatically reduced mortality in COVID-19 patients. In Latin America, where ivermectin is widely available, that study has led government officials to authorize the drug—although with precautions—creating a surge in demand in several countries."
  - gator-io 6y ago
    I pointed out the Johnson and Johnson relationship only to say motives should be examined. Surgisphere is producing studies based on data they don't actually have, according to researchers, Australian hospitals, etc. It could be for self-aggrandizement, or pay-for-publish or something else. I don't know, but it should not be tolerated for any reason.
- jbritton 6y ago
  I have been wondering why so many HCQ studies do not include Zinc. A couple months ago I watched a video that detailed how Zinc once inside a cell could block replication of coronaviruses. And that HCQ being a Zinc ionophore gets the Zinc into the cell. The relevant study was published approximately 10 years ago.
ucha 6y ago
For reference, this is the original study and HN comments: https://news.ycombinator.com/item?id=23273615 https://news.ycombinator.com/item?id=23273615
AlleyTrotter 6y ago
TDS at it's finest
InTheArena 6y ago
The lancet has really fscked up a number of elements in Covid19. Not only this, they also published a letter on March 11th saying that NSAIDS make COVID worst. This is a consistent problem with them recently. I'm more then willing to say that it's more due to error in judgement then malice, but the political ramifications are obvious.
gnusty_gnurc 6y ago
So much of the lockdown and gov't response around the world has been political. It fundamentally rests on virtue, not science. It's clearer with every passing day. There were legitimate concerns in the beginning, but by now it's bizarre to see when people decide to ignore lockdown with the right political justifications.
knzhou 6y ago
Whenever this kind of thing happens, you get a lot of people advocating for the abolition of peer review and its replacement with Twitter or something. I simply don't understand that. Normal peer review means "we showed our work to about 2 people who know what they're talking about and they thought it was okay." Preprints mean "nobody who knows what they're talking about has looked at this carefully yet, but we think it's okay." Viral Twitter threads mean "here's my opinion, which hasn't been shown to anybody who actually knows what they're talking about, but which has been selected for maximum public response." Of course, in all cases, real credibility only comes once a paper has been looked over by hundreds of people who know what they're talking about. Yes, showing something to only 2 experts (who themselves are very busy, and are powerless to directly verify many of the paper's claims) is not a perfect initial quality cut -- but no cut at all is worse. If you really believe in the power of Twitter, take a long, hard look at the sensational, outrageous tweets you've liked. Go look at a sample of 100 old threads and see how many actually held up. The accuracy rate will not even be comparable to the Lancet's.
- stephc_int13 6y ago
  The credibility problem has been partially solved with a PageRank type algorithm. (Sergei and Larry were actually inspired by the weighting system of research papers) Highly regarded scientific journals like the Lancet are used to accelerate this weighting process. The problem is that nowadays they seem kind of outdated, opaque and corrupt on many levels. Nobody wants to suppress peer-review, simply replace the journals mafia with something less corrupt.
  - knzhou 6y ago
    But this isn't a case of a journal acting like a "mafia". This is a case where something bad slipped past peer review, because of the inherent limitations of peer review. The reason is that expert time and attention is intrinsically scarce (if you double the number of experts, you double the number of papers produced, and hence double the amount of time that must be spent on peer review), and really properly vetting a paper takes a massive amount of time. This wouldn't be changed by system reform. In my opinion, the best option for everybody who's serious about this is to read a lot of papers, until you become "well-calibrated", i.e. when you have a good handle on the overall chances a preprint is true, vs. a Twitter thread, vs. a paper in a top-tier journal. This has to be learned from experience. Reform doesn't change the fact that you need to do this -- it just adds yet another venue, either more or less reliable than the previous ones, that you also need to become calibrated on.
deleted 6y ago
[deleted]
rdtsc 6y ago
> Chaccour says both NEJM and The Lancet should have scrutinized the provenance of Surgisphere’s data more closely before publishing the studies. “Here we are in the middle of a pandemic with hundreds of thousands of deaths, and the two most prestigious medical journals have failed us,” he says. Well maybe that's one positive thing here and people will be more skeptical about where this data is coming from > “We use a great deal of artificial intelligence and machine learning to automate this process as much as possible, which is the only way a task like this is even possible.” He meant it as a defense and to paint themselves as highly knowledgeable professionals using advanced technology, but I read it as "we used machine learning to generate this data".
Threeve303 6y ago
Perhaps this is the phenomenon behind fake news being applied to medical research?
mrfusion 6y ago
It feels like science is becoming more like religion every day.
tamaharbor 6y ago
How many more must die by Democrat hands and their hatred of Trump?
salimmadjd 6y ago
OT - lets face it. Half of the country wants to see Trump fail and another half want him to succeed. For covid we should hope 100% of country want to see him succeed. The problem is, part of that half is entire media enterprise (BTW, next adminstration will face the wrath of the other half of that enterprise) who have invested so much of their own credibility on Trump failing. As a result I have little confidence (just knowing how the CYA-mindset works inside any type of corporations) that we will ever hear a correction with (or nearly with) the same magnitude that will inform the public of the updates. It's unclear what data ultimately comes out of the Hydroxychloroquine research, maybe no update is needed. But I just don't have the confidence we'll get any mea culpa broadcasted across the airways. Nor will I expect much, if any, of my social media contacts who posted some of the articles to post the correction. Trump is a polarizing figure, but I don't understand (outside of increase ratings) why the media falls for his traps day after day. It's possible Trump might accidentally be right once (or not completely wrong), if the media can not remain objective, the entire nation will lose faith in the institution of journalism as a whole. Opening the doors for all types of conspiracies and people searching for alternative news sources. This will eventually lead to a showdown between Facebook and these media entities that Facebook should ban anything outside of the few established news outlets to prevent the spread of disinformation. Which is another bad policy, because people ultimately leave Facebook to other places to find these disinformation or alternate sources. Doing some basic fact checking on this company, before taking their research at face value, especially given there was so much red flags, is what should separate established media from someone writing a blog post in Romania. This is really a massive failure, given the vitality of information around COIVD.
BrandonMarc 6y ago
... and the W.H.O. based their decision making on this ... What exactly is surgisphere? Hackers that paid for illicit data feeds? A total fabrication? Chinese misinformation? Nothing makes any sense.
aksss 6y ago
I always think that you can tell when a 'narrative' is being pushed in the news when there's an obvious lack of dialectic examination of the issue at hand across multiple outlets (even better when the same keywords are used across publishers). This was observable during the WMD, Russiagate, and yeah, the HCQ stories, and many other issues. It's a pattern which, if you read many sources of news every day (thanks RSS), you can spot pretty quickly. The other thing is hyperbole, which may be a little harder to discern if you don't have direct experience with the subject. I used to take HCQ regularly so was pretty "read up" on the health impacts. The fear-mongering I was seeing in the news about the risks was a bit much. A common refrain about Trump is that if he publicly said cancer was bad, the media would advocate cancer for everyone. I don't know if it's better or worse that journalists wear their politics on their sleeves these days, but the one person out there who still regards journalists as competent objective reporters should probably read the mess they make of science and legal reporting and then realize the same level of competence is applied to domestic and foreign affairs reporting.
Ghostt8117 6y ago
There are a lot of comments questioning the political motives of publishing this research quickly. In medicine, if there is even a hint of increased risk of death, then studies are stopped. It happens a lot. In two weeks the journals published statements and corrections. Imagine if this same article was posted that said the drug was killing patients for two weeks, and the journals withheld the research because it was politically sensitive. This was a mistake, and human error and bias may have come into play, but it was a mistake that erred on the side of caution. Unfortunately, if the drug does prevent deaths, then it could also be just as bad an error. Hindsight is 20/20. I wish politics never entered this equation, and I blame the president for pushing politics into medicine during a pandemic. It was dangerous and these are the issues we are now facing.
tamaharbor 6y ago
Is everything a lie these days?
throwawy8429 6y ago
How much of this coordinated FUDDing of HCQ was knee-jerk because Trump touted it, and how much of it was because progressives (the rich ones, especially) wanted a higher death toll, longer lockdowns, and more overall suffering to blame on Trump? If they willingly buried a viable, cheap, unpatented, easy to produce therapy, then they have blood on their hands.

325 points by onemoresoop 6y ago

This guy [0] did some good analysis of the "mysterious company". [0] https://news.ycombinator.com/item?id=23394357 https://news.ycombinator.com/item?id=23394357

joncrane 6y ago
Linking directly to the article here: https://www.medicineuncensored.com/a-study-out-of-thin-air https://www.medicineuncensored.com/a-study-out-of-thin-air It reads like a Muddy Waters (famous stock shorter) screed. Good stuff. Fair to say the data is made up. The question is, who would be incentivized to do such a thing? Things that make you go hmmm....
- seesawtron 6y ago
  When such a large study is published in a big Journal, claiming that a drug might have a negative impact on lives of people in the trials, the authorities will be considered stupid not to pay attention to it at all and continue the trials. That is exactly what they did: They paused their trials temporarily to look at the evidence of this study, examined it and found that it was indeed controversial and lacked solid data. Now they have resumed the trials again. The media sells it as a clickbait story "All trials STOPPED because of a flawed study" implying they were stopped PERMANENTLY to excite the general audience. For them it is entirely something that brings them huge revenue from ads when they write such "emotinally driven" stories, they do not care about the effects it has on the public in the long term by reducing faith in world health organizations.
raphlinus 6y ago
James Todaro is not an honest scientist. I couldn't find any A-grade sources on him, but here's an interesting Wired piece: https://www.wired.com/story/an-old-malaria-drug-may-fight-covid-19-and-silicon-valleys-into-it/ https://www.wired.com/story/an-old-malaria-drug-may-fight-co... If people don't know this story, Todaro and Rigano published what looked like an academic paper as a Google doc, with academic qualifications that verge on fraudulent, if not crossing the line. The original Google doc has been taken down for TOS violation, but it is still accessible on archive.org [1]. To be clear, I decry the fact that HCQ has become a political soccer match (with apparently bad behavior on both sides), where what we really need is something that at least approximates an impartial, objective search for truth. The fact that people are getting their information from this guy (even though he's actually right about the Lancet study being flawed) is strong evidence that we're living in a dystopian information nightmare. [1]: https://web.archive.org/web/20200315004631/https://docs.google.com/document/d/e/2PACX-1vTi-g18ftNZUMRAj2SwRPodtscFio7bJ7GdNgbJAGbdfF67WuRJB3ZsidgpidB2eocFHAVjIL-7deJ7/pub https://web.archive.org/web/20200315004631/https://docs.goog...

drocer88 6y ago

A lot of people got hung up in the politics of this issue. A prominent politician endorsed using hydroxycholoroquine. Bill Maher recently made a good point: "Liberals are falling into lionizing someone because because they are the anti-Trump. Even before the virus America had a far too chronically sick population which is one reason we've lost so many now. We need to demand something better than how the entrenched medical establishment manages symptoms but cures and heals far too little". I guess pushing "the narrative" was more important than the science.

jtbayly 6y ago
This. People are so desperate to attack Trump that they're willing to accept any result that paints him as doing something stupid. And if they can blame him for people dying, all the better. In the meantime, ignoring the science and falling for the politics means that people may well die since the science may not be able to happen now.
- belltaco 6y ago
  Why is a politician endorsing an unproven drug? Oh it's because he's "getting great calls about it" from Fox News personas who are not doctors themselves, and instead fell for bad studies from a questionable French doctor.
  - notaharvardmba 6y ago
    Also insider trading
    - javagram 6y ago
      The insider trading argument was proven to be nonsense. He had a <$5000 interest in a mutual fund that fractionally owns the drug manufacturer . For multi-millionaire to care about this would be like dumpster diving for pennies. If anything the drug magically curing coronavirus would make the entire stock market, and his re-election chances, go up dramatically, so there is no need to look for an insider trading argument when plain old wishful thinking/stupidity explains it all.

RcouF1uZ4gsC 6y ago

> Desai, through the spokesperson, also said of the company’s work with patient data: “We use a great deal of artificial intelligence and machine learning to automate this process as much as possible, which is the only way a task like this is even possible.” I wonder if we are heading for an AI winter soon. AI has been heavily hyped, but is having a lot of real world failures and is becoming associated with a bunch of fraud. At this time, I am less inclined and I believe a company if they invoke “AI” or “machine learning”. Sure, businesses will still use machine learning for problems where it makes sense, but the hype of AI will die down and funding will dry up.

battery423 6y ago
I think AI/Machine learning fits much better at the big big companies like google. You only need one or 2-3 competiting Neuronal Networks for cancer detection and if you look how expensive it is to train that stuff, not many can actually do it anyway. But what tripples down are pre learned networks you can easily reuse for your small use cases which are specific and have plenty of data and only need to outperform the existing solution.
- tw000001 6y ago
  >You only need one or 2-3 competiting Neuronal Networks for cancer detection and if you look how expensive it is to train that stuff, not many can actually do it anyway. This is just wrong. You can train a cancer discriminator on a low end gpu on your desktop. The hard part is getting quality [often annotated] data - and thats why data brokers like Google are positioned to dominate.
  - battery423 6y ago
    So why are those papers with good results are not running on 'low end gpus'? I don't mean running them, i mean training them.
    - tw000001 6y ago

chrisbrandow 6y ago

Despite the helpfulness of quick exchange of laboratory results via preprint, peer review is clearly going to remain central to the scientific process.

rootusrootus 6y ago
I completely agree. It seems great now, because the situation is dire, to get preprints instantly as they become available. But people don't seem to realize just how much crap gets into preprints and ultimately fails during peer review. There's so much garbage out there now, and it can and will (and probably already is) be used as just more political fodder. I like reading preprints as much as the next geek, but I think we might ultimately be better served if the papers weren't released until after peer review.
- James_Henry 6y ago
  Do you think that people will start to read preprints for what they really are? If that's the case then I think they'll never go away. Open review by peers before publication is incredibly useful compared to peer review. Imagine if these 3 papers could have been scrutinized before getting that Lancet peer review stamp that has led to bad policy decisions and research decisions by so many. People would have started questioning Surgisphere's data sooner and wouldn't have taken their results so seriously.
James_Henry 6y ago
I'm not sure I understand where this comment is coming from. The 3 Surgisphere papers were peer reviewed.

eric_b 6y ago

Chloroquine and its derivatives were given to thousands, if not millions, of people for years. We know and understand the safety profile of this drug well. To think that all of a sudden it became more dangerous was silly and unreasonable. This study always smelled bad. The media was so quick to champion it everywhere though. Why might that be I wonder? Where are the retractions now? The whole thing is disgusting. The media in the US is doing everyone a disservice. Because of this less people are going to believe "science" and more people are going to just retreat to their echo chambers and believe whatever they want. I know I'm not going to trust the Lancet or the NEJM ever again. It's all political now. What a mess.

zpeti 6y ago
What makes it even worse is that social media companies are now so paranoid about being labelled spreaders of misinformation, they are relying on sources who could easily be wrong about something as well (like in this case). I guess this way at least they can point the responsibility somewhere else, and say it's not their fault.
ed25519FUUU 6y ago
> Why might that be I wonder? Where are the retractions now? The whole thing is disgusting. It’s going to take a long time to recover from what the media has done here. HCQ isn’t even allowed as a treatment in a lot of places, or require hospitalization (funny for a drug on the market for 60 years and over the counter in some places). Other countries are ramping up production and we’re still dealing with the yet another casualty of culture war.
sonicggg 6y ago
Some media conglomerates, like CNN, were clearly using this study as a political attack. Not uncommon these days to cherry pick your favourite paper. On top of that, there is no patent money to be made by big pharmaceuticals on this drug. It makes me wonder where the funding really came from in this Lancet study.
nathan_compton 6y ago
"I know I'm not going to trust the Lancet or the NEJM ever again. It's all political now." This is an absurd reaction and I suspect you know it. There isn't a single scientific journal in the world not subject to some bias, trend, or failure of one form or another. To dismiss an entire platform because of an imperfect record amounts to an abdication of your own responsibility to form your own opinions about scientific matters. This is a responsibility for which journal reviewers can only ever take partial responsibility for both practical and intrinsic reasons. Peer review is not a rubber stamp which blesses anything which passes through it as "TRUTH." It is a minimal standard and subject, at any rate, to all the uncertainties and biases implicit in any human endeavor. It is entirely possible this paper represents a political bias. Almost everything does. It still falls to us to make reasonable judgments about science. What doesn't make sense is to reject the entire process because it fails to meet some unreachable expectation of perfection.

jakeogh 6y ago

More: https://news.ycombinator.com/item?id=23272222 https://news.ycombinator.com/item?id=23272222

ed25519FUUU 6y ago

> Antimalarial drugs touted by the White House as possible COVID-19 treatments looked to be not just ineffective, but downright deadly. Immediately when the long knives came out against HCQ I was cynical. A drug on the market for 60 years (and over the counter in many countries) is “extremely dangerous”? Or, more likely because it’s out of patent there’s a lot of money interested in exploring other things as a treatment.

boomboomsubban 6y ago
>A drug on the market for 60 years (and over the counter in many countries) is “extremely dangerous Tylenol has been on the market for a 60 years, often over the counter, but off label recommendations involving a high dose could be deadly. Drugs should always be considered "extremely dangerous."
- emmelaich 6y ago
  Anything in high dose can be dangerous. So that's not helpful. Anything. For instance, water.
  - boomboomsubban 6y ago
    Yep, taking ~8 extra strength Tylenol twice a day is comparable to drinking however many gallons of water a day you would need to cause problems.
tw000001 6y ago
>more likely because it’s out of patent there’s a lot of money interested in exploring other things as a treatment HCQ was not even remotely controversial until Trump tweeted about it. Our institutions have lost their collective minds with their spiteful, childish hatred for a politician. Academia and news media have completely lost sight of objectivity.
- programmarchy 6y ago
  People started hoarding HCQ in early February when the first Chinese studies were coming out. Didier Raoult's (crazy looking French doctor) reports in mid-March sparked the first controversies. I remember worrying at that point there'd be some big-pharma-backed media operation to discredit a cheap, patent-expired drug since there are trillions of dollars at stake. Trump tweet was in late March.

gator-io 6y ago

Fantastic analysis of the Lancet study's flaws: https://www.youtube.com/watch?v=IUD_wvkNhnk https://www.youtube.com/watch?v=IUD_wvkNhnk

gamegod 6y ago
This is a garbage analysis that ends up with a plug for vitamins and t-shirts. You don't write off a journal for making mistakes. Retraction is part of the scientific process. What this YouTuber failed to mention is that there were already a couple of other studies before this one that reached the same conclusion - that there was no evidence of it working for COVID-19, or that it potentially made things worse in the most sick patients. The retraction of a single paper doesn't invalidate the body of evidence (albeit small) provided by other papers prior to it.
- gator-io 6y ago
  Don't get hung up on the how the channel survives. The channel, whose host has a Phd in pathology, has been focused on Covid issues for months, after being demonitized by YouTube.
  - gator-io 6y ago
    And from his experienced analysis, the study is clearly, obviously junk, and the Lancet should be held to account for publishing it.
  - ufo 6y ago
    If a channel advertises snake oil supplements and products then that should be a valid reason to criticize them.
    - gator-io 6y ago
      And just to be clear, the supplements are recommendations based on research, not advertisements. No commissions. Go back a few episodes and you'll see the rationale for them.

devit 6y ago

So they suspect that Surgisphere has manufactured or falsified the data?

gator-io 6y ago
Yup. More than suspicious.

fareesh 6y ago

The lengths to which the American media will go to score points against President Trump should worry any reasonable person. Sadly the filter bubbles of the Internet bury so many of the retractions and fact checks that favour Trump, so many of the aforementioned reasonable folks almost never see the whole story. The most egregious lie peddled by the media is the "Very Fine People" statement, which, is claimed to be a reference to white supremacists, when in fact in he clarifies in the very speech, "and I am not talking about the white supremacists, they should be condemned totally". Armed with those facts, the reader/viewer is free to draw their own conclusions with regard to the President's inner thoughts and hidden meanings, but the whole, unfiltered picture is almost never presented. An omission like this is what potentially amplifies racial tensions across the country. We are now seeing this type of narrative again with the Hydroxychloroquine charade. A number of scientists and academics in Brazil penned a great open letter on this topic (the media and HCQ) a few weeks ago, which I thought was a great read: https://conexaopolitica.com.br/ultimas/brazilian-scientists-and-academics-write-an-open-letter-on-the-science-of-the-coronavirus-pandemic/ https://conexaopolitica.com.br/ultimas/brazilian-scientists-...

beepboopbeep 6y ago
Donald Trump is a gibbering goblin of a human being. This is not the place to white Knight for him.
- whatshisface 6y ago
  Even accepting the premise, surely if the Shire's media has painted Azog as a gibbering green goblin, while in reality he's only a gibbering goblin, you would want to hear about it.
- fareesh 6y ago
  My point is proved, QED?
  - sjwright 6y ago
    If beepboopbeep is the entirety of the US media, then yes. Otherwise no, it’s just yet another comment by a single individual on the internet with no broader meaning, context or consequence.

mensetmanusman 6y ago

The best quote is at the end: “Here we are in the middle of a pandemic with hundreds of thousands of deaths, and the two most prestigious medical journals have failed us.” There should be prison time if an investigation determines that this was done to increase certain drug sales.

tootie 6y ago
There's absolutely no indication that would be true. This study in particular curtailed support for pharmaceutical treatment.
- tlb 6y ago
  It reduced support for a particular cheap, off-patent medication that wasn't going to make anyone much money if it worked. Competing on-patent drugs, like Remdesivir, would make someone a great deal of money if they work better than HCQ.
  - deleted 6y ago
    [deleted]
eric_b 6y ago
I strongly believe there were people at the Lancet who wanted to believe the HCQ study, regardless of how well it was run. See, if you can skewer HCQ, that means you get to take a shot at a certain politician too. There were a number of researchers who criticized the study's structure and numbers from day 1. Over 100 researchers wrote an open letter about how skeptical they were. I understand journals make mistakes, but this was egregious and smells like agenda to me.
- newacct583 6y ago
  > See, if you can skewer HCQ, that means you get to take a shot at a certain politician too. For clarity, and I'm sure you agree: Trump's boosting of this drug as a "miracle" and "greatest breakthrough" was absolutely irresponsible even if the drug actually works, for the simple reason that we didn't know if it did (frankly we still don't), and that it is known to have significant risks (it still does, even usingly only baseline data and ignoring this study). This was a bad study. It's possible that the editors at the Lancet hate Trump. But... you're simply reading too much here. Bad science gets published all the time. In particular, bad science gets published in circumstances like we have now where there is desperate need for "fast science". Not everything has to be an "agenda" by global elites to damage your favorite politician. But even granting your framing: why are you so concerned about the Lancet boosting bad data as an "agenda" but not with Trump doing exactly the same thing, with even less evidence? Why is it an "agenda" only when your enemies do it?

walterbell 6y ago

Media & select journals helped justify trillions of societal costs when many could be saved from death by early treatment with zinc + zinc ionophore (HCQ/quercetin) therapeutic that costs less than one dollar. Some poorly designed HCQ studies have used late treatment or omitted zinc, which is known not to work. Specific cohorts are also excluded, including cardiac patients with long QT interval and some malaria-prone populations with G6PD gene. Some US states have blocked pharmacies from filling doctor prescriptions for HCQ, instead of advocating for increased manufacturing capacity within US factories that make HCQ/ingredients. Meanwhile, we boosted ventilator production, where hospitals received $30K for each late-stage patient placed on ventilation, with only 20% chance of survival. We blocked early treatment that worked and we funded expensive late-stage equipment that did not work. All this with more global information sharing than ever before in the history of humanity. Since we were collectively unable to filter/parse data generated by wildly different economic incentives, where the consequences were DEATH, how can we design new systemic incentives to avoid repeating such mistakes? https://www.telegraph.co.uk/news/2020/06/02/prof-lockdown-neil-ferguson-admits-sweden-used-science-uk-has/ https://www.telegraph.co.uk/news/2020/06/02/prof-lockdown-ne... > Neil Ferguson, who became known as “professor lockdown” after convincing Boris Johnson to radically curtail everyday freedoms, acknowledged that, despite relying on “quite similar science”, the Swedish authorities had “got a long way to the same effect” without a full lockdown.

andreilys 6y ago
“ how can we design new systemic incentives to avoid repeating such mistakes?” I don’t think you’ll like the answer here. Financial incentives have been known to cause perverse outcomes where moral hazards occur more often than not. I think financial incentives work well in a lot of cases, but healthcare and media have been so perverted by financial interests it’s become untenable.
ceejayoz 6y ago
> Some US states have blocked pharmacies from filling doctor prescriptions for HCQ... Good. Patients with lupus and other diseases were experiencing shortages of what for them is demonstrably life-saving medication. There's not an infinite supply, and there are folks who need it for more than speculation and self-administered home prophylaxis. https://jamanetwork.com/channels/health-forum/fullarticle/2764607 https://jamanetwork.com/channels/health-forum/fullarticle/27...

ddrt 6y ago

Can anyone explain why there’s a new trend I. Saying a negative, then saying “but” and stating another negative. Like... “He was a dishonest man. But, he cheated on his wife” “He had a nut allergy. But, he had a dairy allergy.” It’s like they’re saying: “he’s a good father. However, he had a dark side.” But they’re really not. Also, at the beginning they say “it may be unraveling” and begin to show how it never had any legs to stand on. Just confusing communication for an article.

wyldfire 6y ago
Titles are the copy that are the most critical to driving eyeballs to your content. I suppose "mysterious company ... may be unraveling" sounds like an engaging mystery for the reader to enjoy.
dec0dedab0de 6y ago
Antimalarial drugs touted by the White House as possible COVID-19 treatments looked to be not just ineffective, but downright deadly. I think the quote above is what you're referring to. If so, the structure "Not only {small_point}, but {large_point}" is extremely common and used both with negatives and positives.

Gatsky 6y ago

I gave up reading The Lancet some time ago. They have a poor record frankly with this kind of thing, Andrew Wakefield et al chief among them. They should have been cancelled over that one. Anyway, the larger point is that these established journals have failed us. Their added value, already low, has dropped below zero in this pandemic. They are slow, opaque, rent seeking parasitic entities seemingly run by individuals who don’t grasp basic statistics. The combination of preprint servers + twitter has proven far more effective in looking after humanity’s best interests.

jxy 6y ago
It is exactly such kinds of ignorants of basic statistics, the faulty generalizations of the effectiveness of established journals, have failed the humanity.
- cracker_jacks 6y ago
  Is there a statistical demonstration of the effectiveness of established journals? It seems like you would have to do some form of counterfactual study to prove/disprove this. As far as I know, the argument of the effectiveness of journals only stems from the survivorship bias (e.g. all things considered research until recently has been published by journals).
  - SiempreViernes 6y ago
    No, you can look at the stuff people put up on the preprints to see what would happen if there's basically no screening at all.
    - cracker_jacks 6y ago
      The preprint model has actually been wildly successful for many communities (https://arxiv.org/ https://arxiv.org/, https://www.biorxiv.org/ https://www.biorxiv.org/). I don't think anyone is arguing against peer review, but the idea of peer review and an established journal is being conflated. If anything, publishing established journals can create a level of implied authority that reduces much need scrutiny.

raverbashing 6y ago

It's amazing how big of a mess this is: - NEJM and the Lancet published (and "peer reviewed") this article, or apparently just rubber stamped it. - The company doesn't have any semblance of having the capability of doing the work it purports to do. - The article has severe inconsistencies, for example, do you really have data on 98k hospitalized patients? http://freerangestats.info/blog/2020/05/30/implausible-health-data-firm http://freerangestats.info/blog/2020/05/30/implausible-healt... - The company apparently was founded in 2008 but no data from them was used in any peer-reviewed journal until this year. https://www.theguardian.com/world/2020/jun/03/covid-19-surgisphere-who-world-health-organization-hydroxychloroquine https://www.theguardian.com/world/2020/jun/03/covid-19-surgi... And governments and the WHO bought this, hook line and sinker?

javagram 6y ago
Look at how easily the original flawed pro-HCQ paper was bought into (edit: removed my false statement it was retracted - I think it was criticized by the publishing society of the journal, but not retracted.). Many people were treated with HCQ across the world and so far there is no evidence it did anything to help them. An important lesson here about the limits of peer review and science. A lot depends on the original authors not being frauds or simply making mistakes as we’ve seen time and again with scandals.
- raverbashing 6y ago
  Yeah the 1st study was deficient in several ways (low n, questionable criteria), which at one point, as a work in progress in an emergency situation was understandable, and was caught early by the community. Another very different thing is to misrepresent the source of the data, or worse.
- lenkite 6y ago
  There is a truckload of evidence unless you have closed your eyes to it. Anyways many national medical boards of south-asia have adopted HCQ formally. https://www.newindianexpress.com/nation/2020/may/29/icmr-writes-to-who-disagreeing-with-hcq-assessment-officials-say-international-trial-dosage-four-ti-2149702.html https://www.newindianexpress.com/nation/2020/may/29/icmr-wri... https://timesofindia.indiatimes.com/india/hcq-and-ppe-used-together-cut-covid-risk-by-80-icmr/articleshow/76146220.cms https://timesofindia.indiatimes.com/india/hcq-and-ppe-used-t...

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tuna-piano 6y ago

Ugh. I'm so disappointed in this whole situation. Feels like Theranos. I want to cover my eyes and ears for the media and political shit show that's going to come from this. It's true that a certain politician shouldn't be trumpeting unproven treatments, but the media seemed to celebrate when that politician was "proven" wrong. Did we forget that we should all be rooting for treatments to work? I hoped during this pandemic science would move fast and sacrifice some accuracy for speed. But I didn't expect (a seemingly) complete fabrication could go so far with so many eyes. Now I worry the overreaction toward accuracy-over-speed will cause significant slowdowns in published data. We shouldn't over-punish honest mistakes when we value speed over accuracy... but this just feels awful. Would think prison is likely to come. A good read: http://freerangestats.info/blog/2020/05/30/implausible-health-data-firm http://freerangestats.info/blog/2020/05/30/implausible-healt...

HideousKojima 6y ago
>We shouldn't over-punish honest mistakes when we value speed over accuracy Looking at some of the specifics, these don't look like "honest" mistakes, and I'm doubting any integrity on the part of the peer reviewers and the Lancet too with how blatantly false some of their data are. It doesn't even pass the smell test: https://mobile.twitter.com/JamesTodaroMD/status/1266108861259210753 https://mobile.twitter.com/JamesTodaroMD/status/126610886125...
- ImaCake 6y ago
  The blog post linked by the parent post very clearly argues the data is fake. So I think you are misinterpreting what the parent post is saying. But I totally agree with your sentiment that this is truly terrible and everyone involved should be more than a bit ashamed.
lbeltrame 6y ago
> We shouldn't over-punish honest mistakes when we value speed over accuracy... But we should still make sure these behaviors are not rewarded. Science was right when they called against "Pandemic Research Exceptionalism". I think at this point in time, where available knowledge has increased a little, we can afford to be stricter than before.

lenkite 6y ago

ICMR in India does not trust the Lancet study and have formally objected to it. https://www.thehindu.com/sci-tech/health/coronavirus-csir-chief-flays-hcq-trial-suspension/article31712065.ece https://www.thehindu.com/sci-tech/health/coronavirus-csir-ch... https://www.news18.com/news/india/icmr-says-hcq-reducing-risk-among-healthcare-workers-even-as-lancet-study-questions-drug-benefits-2647007.html https://www.news18.com/news/india/icmr-says-hcq-reducing-ris... https://theprint.in/talk-point/lancet-hcq-study-row-did-who-experts-rush-to-damn-the-drug-due-to-trump-modi-politics/434908/ https://theprint.in/talk-point/lancet-hcq-study-row-did-who-...

valarauko 6y ago

To the comments suggesting preprint servers as the solution, it's worth remembering that they are subject to much higher levels of noise, especially at high volume times like now. In early April, my co-authors and I were planning to submit a computational COVID manuscript (I was the first author). The journals were overrun with COVID submissions, and required preprint submission. This was a sticking point for my co-authors, who felt they had a much bigger paper on their hands given more time, and were opposed to a preprint submission. Personally, I was in favour of the preprint, since I felt we had hit the upper limit of what could be achieved with our collective resources. The other authors disagreed, and outvoted me to bring in a big name author who could steam roll his way into a reputable journal. The only way they could tempt a big name scientist would be to offer up the first author credit, so I bowed out. At the time, there were 4,500 preprints dealing with COVID, which just seems bonkers. Honestly, even most of the published work around COVID is of poor quality.

SiempreViernes 6y ago
What, they forced you out of a paper you did most of the work on?
- valarauko 6y ago
  Honestly, it's not that straight forward, which is why I didn't mind leaving the manuscript in the end. I did much of the work bringing it to a workable manuscript, but I didn't originate the project. I was approached by the corresponding author, who had originated and done most of the initial work. This was just a data dump, and he felt he didn't have the time or the ability to polish it into a manuscript. My contribution was to analyse the data, and write most of the manuscript. However, it became clear that the two other authors were pushing a narrative which I felt wasn't well supported by the data we had. We discussed two possible options: bring in an immunologist to determine if our results make sense, which I voted for, or stick to our guns. The second option would have also required submitting to a preprint, which they were against. The corresponding author felt the claims were justified, and decided that a more forceful (and prestigeous) first author was what was needed instead, and I agreed. Since my contribution wasn't all that much (about a week of my time?), and I wasn't convinced by the findings, I didn't mind losing the authorship. This sort of negotiating happens all the time in academia, so it's unsurprising.

fabian2k 6y ago

Hydroxychloroquine is a really frustrating topic as there's so much bad science involved. The early studies were terrible and didn't give any useful information. And now we have more studies in prestigious journals that appear to be at least problematic, if not based on outright faked data. And on top of that are the politics, endorsing and promoting it before any substantial data could be collected. We still have no idea whether hydroxychloroquine works or not for COVID19. And the hype is rather harmful and misleading as even if it did work, it is exceedingly unlikely to be a game changer but a small incremental improvement. This is also certainly a failure of peer review. Though that has always been rather weak for cases of outright fraud and scientific misconduct, it still relies on the researchers to be honest about the data they represent.

PiggySpeed 6y ago
People are losing their heads out there because they don't understand how to interpret studies. The most infuriating offenders are the media, who have been irresponsible with the presentation of clinical study results. They'll take the results of an observational study and herald it as some revolutionary insight, when in reality the doctors, nurses, and pharmacists interpreting these results are saying "hmm okay, well let's be cautious in our approach and wait for other studies to be done". Clinical practice should never change, and has never changed (to my knowledge) from the whims of a single OBSERVATIONAL study. But outside medical circles, people will see the results they want to see, and never look past the first 10 words of a headline.
- userbinator 6y ago
  They'll take the results of an observational study and herald it as some revolutionary insight That's been going on for a while, it reminds me of this: https://kill-or-cure.herokuapp.com/ https://kill-or-cure.herokuapp.com/
- thu2111 6y ago
  A problem is that different fields that sound similar have very different standards. Epidemiologists appear to frequently take un-reviewed, un-published papers straight to the press and politicians specifically to change government policy. Actual doctors, not so much. What's the difference between an expert in infectious diseases and an expert in treatment of infectious diseases, to the layman? Hardly any. The media plays a part. Journalists routinely conflate doctors, academics and political activists under the rubric of "experts". Sometimes this is deliberate and overt. Guido Fawkes has had a long running campaign where they expose TV news presenting left-wing activists as neutral experts, without telling anyone about the interviewees backgrounds. As can be seen in this particular incident, that campaign has started to have a small effect, but some journalists don't like being exposed that way! https://order-order.com/2020/05/22/sky-news-gets-there-eventually/ https://order-order.com/2020/05/22/sky-news-gets-there-event... For people to get better at interpreting studies the first step must be to de-conflate different kinds of "expert". In particular academics need to be referred to as such and separated from the type of practical expert who practices their craft in the real world every day.

gator-io 6y ago

The corruption of science should be aggressively confronted. If you dig into Surgisphere, you will see they have significant consulting engagements with Johnson and Johnson. Not saying that's necessarily bad, but so much bad science about Covid and HCQ seems geared towards promoting high-priced treatments like Remdesivir, and not low-cost preventative measures like making sure you're not D deficient. All these studies need to be evaluated based on who's funding them or the political agenda behind them. HCQ seems like it's been targeted for destruction. Every study I've read on it shows you shouldn't use it in late stages of disease. Fair enough, but the theory of its effectiveness (as a Zinc ionophore) hasn't been fully studied, although there is a good amount of anecdotal and country-level evidence it works well if taken early (with Zinc). These garbage studies are dangerous and should be called out loudly.

inasio 6y ago
This is a pretty simplistic view, the article talks about a different Surgisphere study where the conclusion is that a cheap and widely available drug is effective against covid-19 (the study also has its problems though): "A third COVID-19 study using Surgisphere data has also drawn fire. In a preprint first posted in early April, Surgisphere founder and CEO Sapan Desai and co-authors conclude that ivermectin, an antiparasitic drug, dramatically reduced mortality in COVID-19 patients. In Latin America, where ivermectin is widely available, that study has led government officials to authorize the drug—although with precautions—creating a surge in demand in several countries."
- gator-io 6y ago
  I pointed out the Johnson and Johnson relationship only to say motives should be examined. Surgisphere is producing studies based on data they don't actually have, according to researchers, Australian hospitals, etc. It could be for self-aggrandizement, or pay-for-publish or something else. I don't know, but it should not be tolerated for any reason.
jbritton 6y ago
I have been wondering why so many HCQ studies do not include Zinc. A couple months ago I watched a video that detailed how Zinc once inside a cell could block replication of coronaviruses. And that HCQ being a Zinc ionophore gets the Zinc into the cell. The relevant study was published approximately 10 years ago.

ucha 6y ago

For reference, this is the original study and HN comments: https://news.ycombinator.com/item?id=23273615 https://news.ycombinator.com/item?id=23273615

AlleyTrotter 6y ago

TDS at it's finest

InTheArena 6y ago

The lancet has really fscked up a number of elements in Covid19. Not only this, they also published a letter on March 11th saying that NSAIDS make COVID worst. This is a consistent problem with them recently. I'm more then willing to say that it's more due to error in judgement then malice, but the political ramifications are obvious.

gnusty_gnurc 6y ago

So much of the lockdown and gov't response around the world has been political. It fundamentally rests on virtue, not science. It's clearer with every passing day. There were legitimate concerns in the beginning, but by now it's bizarre to see when people decide to ignore lockdown with the right political justifications.

knzhou 6y ago

Whenever this kind of thing happens, you get a lot of people advocating for the abolition of peer review and its replacement with Twitter or something. I simply don't understand that. Normal peer review means "we showed our work to about 2 people who know what they're talking about and they thought it was okay." Preprints mean "nobody who knows what they're talking about has looked at this carefully yet, but we think it's okay." Viral Twitter threads mean "here's my opinion, which hasn't been shown to anybody who actually knows what they're talking about, but which has been selected for maximum public response." Of course, in all cases, real credibility only comes once a paper has been looked over by hundreds of people who know what they're talking about. Yes, showing something to only 2 experts (who themselves are very busy, and are powerless to directly verify many of the paper's claims) is not a perfect initial quality cut -- but no cut at all is worse. If you really believe in the power of Twitter, take a long, hard look at the sensational, outrageous tweets you've liked. Go look at a sample of 100 old threads and see how many actually held up. The accuracy rate will not even be comparable to the Lancet's.

stephc_int13 6y ago
The credibility problem has been partially solved with a PageRank type algorithm. (Sergei and Larry were actually inspired by the weighting system of research papers) Highly regarded scientific journals like the Lancet are used to accelerate this weighting process. The problem is that nowadays they seem kind of outdated, opaque and corrupt on many levels. Nobody wants to suppress peer-review, simply replace the journals mafia with something less corrupt.
- knzhou 6y ago
  But this isn't a case of a journal acting like a "mafia". This is a case where something bad slipped past peer review, because of the inherent limitations of peer review. The reason is that expert time and attention is intrinsically scarce (if you double the number of experts, you double the number of papers produced, and hence double the amount of time that must be spent on peer review), and really properly vetting a paper takes a massive amount of time. This wouldn't be changed by system reform. In my opinion, the best option for everybody who's serious about this is to read a lot of papers, until you become "well-calibrated", i.e. when you have a good handle on the overall chances a preprint is true, vs. a Twitter thread, vs. a paper in a top-tier journal. This has to be learned from experience. Reform doesn't change the fact that you need to do this -- it just adds yet another venue, either more or less reliable than the previous ones, that you also need to become calibrated on.

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rdtsc 6y ago

> Chaccour says both NEJM and The Lancet should have scrutinized the provenance of Surgisphere’s data more closely before publishing the studies. “Here we are in the middle of a pandemic with hundreds of thousands of deaths, and the two most prestigious medical journals have failed us,” he says. Well maybe that's one positive thing here and people will be more skeptical about where this data is coming from > “We use a great deal of artificial intelligence and machine learning to automate this process as much as possible, which is the only way a task like this is even possible.” He meant it as a defense and to paint themselves as highly knowledgeable professionals using advanced technology, but I read it as "we used machine learning to generate this data".

Threeve303 6y ago

Perhaps this is the phenomenon behind fake news being applied to medical research?

mrfusion 6y ago

It feels like science is becoming more like religion every day.

tamaharbor 6y ago

How many more must die by Democrat hands and their hatred of Trump?

salimmadjd 6y ago

OT - lets face it. Half of the country wants to see Trump fail and another half want him to succeed. For covid we should hope 100% of country want to see him succeed. The problem is, part of that half is entire media enterprise (BTW, next adminstration will face the wrath of the other half of that enterprise) who have invested so much of their own credibility on Trump failing. As a result I have little confidence (just knowing how the CYA-mindset works inside any type of corporations) that we will ever hear a correction with (or nearly with) the same magnitude that will inform the public of the updates. It's unclear what data ultimately comes out of the Hydroxychloroquine research, maybe no update is needed. But I just don't have the confidence we'll get any mea culpa broadcasted across the airways. Nor will I expect much, if any, of my social media contacts who posted some of the articles to post the correction. Trump is a polarizing figure, but I don't understand (outside of increase ratings) why the media falls for his traps day after day. It's possible Trump might accidentally be right once (or not completely wrong), if the media can not remain objective, the entire nation will lose faith in the institution of journalism as a whole. Opening the doors for all types of conspiracies and people searching for alternative news sources. This will eventually lead to a showdown between Facebook and these media entities that Facebook should ban anything outside of the few established news outlets to prevent the spread of disinformation. Which is another bad policy, because people ultimately leave Facebook to other places to find these disinformation or alternate sources. Doing some basic fact checking on this company, before taking their research at face value, especially given there was so much red flags, is what should separate established media from someone writing a blog post in Romania. This is really a massive failure, given the vitality of information around COIVD.

BrandonMarc 6y ago

... and the W.H.O. based their decision making on this ... What exactly is surgisphere? Hackers that paid for illicit data feeds? A total fabrication? Chinese misinformation? Nothing makes any sense.

aksss 6y ago

I always think that you can tell when a 'narrative' is being pushed in the news when there's an obvious lack of dialectic examination of the issue at hand across multiple outlets (even better when the same keywords are used across publishers). This was observable during the WMD, Russiagate, and yeah, the HCQ stories, and many other issues. It's a pattern which, if you read many sources of news every day (thanks RSS), you can spot pretty quickly. The other thing is hyperbole, which may be a little harder to discern if you don't have direct experience with the subject. I used to take HCQ regularly so was pretty "read up" on the health impacts. The fear-mongering I was seeing in the news about the risks was a bit much. A common refrain about Trump is that if he publicly said cancer was bad, the media would advocate cancer for everyone. I don't know if it's better or worse that journalists wear their politics on their sleeves these days, but the one person out there who still regards journalists as competent objective reporters should probably read the mess they make of science and legal reporting and then realize the same level of competence is applied to domestic and foreign affairs reporting.

Ghostt8117 6y ago

There are a lot of comments questioning the political motives of publishing this research quickly. In medicine, if there is even a hint of increased risk of death, then studies are stopped. It happens a lot. In two weeks the journals published statements and corrections. Imagine if this same article was posted that said the drug was killing patients for two weeks, and the journals withheld the research because it was politically sensitive. This was a mistake, and human error and bias may have come into play, but it was a mistake that erred on the side of caution. Unfortunately, if the drug does prevent deaths, then it could also be just as bad an error. Hindsight is 20/20. I wish politics never entered this equation, and I blame the president for pushing politics into medicine during a pandemic. It was dangerous and these are the issues we are now facing.

tamaharbor 6y ago

Is everything a lie these days?

throwawy8429 6y ago

How much of this coordinated FUDDing of HCQ was knee-jerk because Trump touted it, and how much of it was because progressives (the rich ones, especially) wanted a higher death toll, longer lockdowns, and more overall suffering to blame on Trump? If they willingly buried a viable, cheap, unpatented, easy to produce therapy, then they have blood on their hands.