9 ms·

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

by 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.
- deleted 6y ago
  [deleted]
- eric_b 6y ago
  > This is a responsibility for which journal reviewers can only ever take partial responsibility for both practical and intrinsic reasons. So what you're saying is we should never fully trust these journals? We should always be skeptical? That's what I'm saying too...
  - macintux 6y ago
    No, you said you wouldn’t trust it at all and that it was 100% political. HN isn’t the ideal venue for hyperbole.
  - seesawtron 6y ago
    But you argued as if you were always trustworthy of these Journals before but from now on, you plan to be skeptical. Your future intentions are similar but for the wrong reasons. One should always be skeptical of research and have dicsussions on the reported data and to what extent and in what context it makes sense. The media outlets summarizing the research papers very often fail to do that so as to skip the details and keep the readers happy because they assume "readers just want to know the superficial abstract knowledge, they can't possibly be interested in the critical analysis of the figures and the numbers so let's exclude that".
ufo 6y ago
> 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. COVID patients are different from the patients that normally receive chloroquine and the chloroquine doses used for COVID are also higher. There is also the issue of how chloroquine interacts with other drugs such as azythromycin. This particular study has its problems but other studies on chloroquine were also starting to suggest that chloroquine could have dangerous side effects. https://blogs.sciencemag.org/pipeline/archives/2020/05/04/hydroxychloroquine-update-may-4 https://blogs.sciencemag.org/pipeline/archives/2020/05/04/hy...
v77 6y ago
A lot of people on this forum have been aware with the issues in social science and medical research for a long time, it's only under real stress that it's become an issue that will get wide coverage. The next fiasco-in-the-making to watch is the 'evidence-based' criminal justice reform sure to come to a lot more American cities soon.
throwaway5752 6y ago
We don't know as much about the safety profile of the drug in patients with COVID-19. Aspirin has a long track record and well understood safety profile, but it can still cause life threatening complications like Reye syndrome in certain viral infections.
truebeliefs 6y ago
It was interesting to see Facui so quickly endorse remdesivir but perhaps he did so because it's safer than choloroquine. It is convienent that remdesivir costs $1000 to 4000 per patient, whereas choloroquine is basically free compared to that. And this: "Before the Covid outbreak, remdesivir was a drug for which Gilead had failed to find a use." (Barrons 6/2/2020)
- garraeth 6y ago
  fyi: https://www.barrons.com/articles/coronavirus-news-updates-51591192554 https://www.barrons.com/articles/coronavirus-news-updates-51...
PiggySpeed 6y ago
> To think that all of a sudden it became more dangerous was silly and unreasonable. This is a dangerous view and not a fair take. Drugs CAN become more dangerous when used in a different context. The sheer permutation of prior/current medical conditions, interacting drugs, demographics, genetics, medical procedures, and a bunch of other factors all play into the equation that determines a drug's safety and efficacy profile. This is why we continue to do research. This is why guidelines are constantly shifting. This is why medicine requires years of study. > The media was so quick to champion it everywhere though. I definitely agree with this point. The media has caused harm to the population by taking the results of a single observational study, and parading it around like it was some new concrete medical certainty. This is not how professionals operate. We don't flip our practice on the whims of a single OBSERVATIONAL study. And I emphasize OBSERVATIONAL because most people here don't understand what that entails. Most people here who comment on clinical trials are not even trained to interpret them. Is it randomized/non-randomized? Double-blinded? What did data collection look like? How were results analyzed? What was the patient population? Timelines? Control arm? Placebos? Previous findings? Primary/secondary endpoint? Do you know the difference between a meta-analysis and a systematic review? NNT? Hazards ratios? Odds ratios? Too many people outside of medicine think they know how to interpret a study, when in reality they have no idea what they're looking at and cherry-pick the interesting sentences that they're looking for. > I know I'm not going to trust the Lancet or the NEJM ever again. This is not a fair take. The journals are responsible for reviewing and publishing the most influential clinical research in the world. Occasionally a bad study makes its way in due to falsified data or other illegitimate factors. Health care professionals are well-aware of this, which is why we are trained to interpret studies, and be conservative in the face of radical findings like this. If anyone has a problem with the Lancet or NEJM, they should see some of the mess found in lower-impact journals.
- pacala 6y ago
  Sadly, some of us are aware of the mess found in lower impact journals. It doesn't help with the trust issue. At all.
- lbeltrame 6y ago
  I did not agree with the conclusions of the paper, but I fell prey of the same bias that many others had: it was "published in Lancet" and "those journals have strict peer review". The lesson I learned is that I will always scrutinize papers I read with a more critical eye, regardless of where they were published in.
phkahler 6y ago
>> 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. That's true. There are people who want to discredit science as a whole. Reality tends to get in the way of most hidden agendas - that's why they're hidden.
everdrive 6y ago
> I know I'm not going to trust the Lancet or the NEJM ever again. It's all political now. Who can you trust these days?
- raphlinus 6y ago
  This may have been asked rhetorically, but I will answer it seriously. First, there are some really good science reporters out there, doing excellent work. I recommend Ed Yong at the Atlantic, Helen Branswell of STAT News, Jon Cohen at Science, Amy Maxmen at Nature. There are others (it's a team effort and those are all great publications), but if you just read all of the articles under their bylines, you will get a good overview of what's going on. They will not let you down. If you have a little bit more time and energy for this stuff (as I do), then there are many experts on Twitter who freely share their analysis, and among them are some excellent communicators. When controversial stuff comes out, you can get a good sense very quickly what the flaws are and what seems to be the consensus. If you want to dip your toes into these waters, I recommend Angela Rasmussen, Trevor Bedford, and Marc Lipsitch. For critical analysis of bullshit published by seemingly reputable academics, I highly recommend Carl Bergstrom (his takedowns are highly entertaining as well as informative). It's frustrating for me to see such pearls of knowledge and expertise so freely available, yet the vast majority of people snarfing down huge quantities of information swill.
- scottlocklin 6y ago
  Named editors. Peer review is recent, and has mostly proved itself a bad idea. Editors who have a personal reputation to maintain will do a better job, just as they did back in the day when, you know, guys like Einstein walked the earth.
- snowwrestler 6y ago
  Personally I do not think of trust as binary. If I ruled out every journal, publisher, or news property that published something that turned out to be wrong, I would read nothing at all and wallow in blissful ignorance. Actually that sounds kind of nice right now...
mc32 6y ago
The really odd thing is the media were highlighting risks... but not giving them context. Aspirin is risky, but millions take it too, over the counter. I’m all for being skeptical, but I think they went overboard, especially given the alternative of having no medicine.
takeda 6y ago
Every medication has a side effects and you balance if the benefits are better than the side effects it causes. Chloroquine has tons of side effects[1] though (including things like causing trouble with breathing). It might still be worth it if you have Lupus. When an existing drug is intended to treat some new disease it needs to be reevaluated for that disease again, because even if it can save lives for one disease it can be deadly for another. So the fact that it is given to thousands or millions does not mean much in this context. [1] https://www.drugs.com/sfx/chloroquine-side-effects.html https://www.drugs.com/sfx/chloroquine-side-effects.html
haltingproblem 6y ago
HCQ and its derivatives were given not to thousands or millions but tens of millions sometimes for years on end. In tropical countries like Nigeria it is customary for visitors and residents alike to be on long term HCQ dosages. I was quite surprised at the newfound fatality. Given that it was the Lancet, I took it at face value. Their political biases made them overlook the sheer flimsiness of the study. Rather than a mess, it is showing us the messy humans behind the veil of "science". There is no platonic scientist - just humans doing imperfect science.
snowwrestler 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. Aspirin is one of the most widely used drugs and generally considered safe. But you should never give it to a kid with chickenpox, because doing so is a risk factor for developing Reye's Syndrome, a serious and potentially fatal disease. It's not that aspirin "becomes more dangerous" in general, but it is more dangerous for those particular patients. And we don't really know why, either; but the data is clear on the correlation. We don't yet know all the ways that the novel coronavirus makes people sick. Heck we don't even have a reliable inventory of possible symptoms yet. So it's really not fair to pretend that it would be silly or unreasonable to suspect the possibility of some sort of negative correlation with a particular drug or class of drugs. This sort of thing happens all the time in medicine.
throwaway_pdp09 6y ago
> was silly and unreasonable / This study always smelled bad / The whole thing is disgusting / "science"[0] / I know I'm not going to trust the Lancet or the NEJM ever again / What a mess You're throwing around an awful lot of poo. Nothing concrete at all but all in very emotive terms. Not constructive - but was that the point? [0] (note scare quotes)
sparrc 6y ago
> I know I'm not going to trust the Lancet or the NEJM ever again. Wait, what?? The fact that the lancet was able to determine that there were validity concerns with the data and issue an expression of concern in less than 2 weeks is proof that the system works. Science is never 100% certain. The media has never been a good source of scientific information and probably never will be. edit: also, if you "don't trust the Lancet or NEJM" then you don't trust a huge number of the treatments available to you at the hospital. These are two of the most important and eminent medical journals in the world and many life-saving treatments began as articles in these journals.
- cm2187 6y ago
  It is proof that the peer review failed, on a topic that the Lancet couldn't ignore was high profile. I have no idea what the motivation of the reviewers were, but given how political this molecule has become, I can't help having a terrible doubt.
  - pavon 6y ago
    Peer review is never intended to be an independent audit of the data for any journal. Reviewers check the methodology, look for obvious mistakes or oversights, provide suggestions for clarification or improvement in the text and for high-demand journals, weigh in on their opinion of the importance of the study. All of the feedback is based on the paper itself, so outright fraud usually is not caught at this stage unless the malicious author is exceptionally sloppy. It is later when other scientists start working to replicate or expand on the study that they request access to the data, and dig into the details. This is when most instances of scientific misconduct are found, and this paper is no exception. In science, publication is the start of the peer review process, not the end.
gameswithgo 6y ago
>Why might that be I wonder? Because our president was idiotically and irresponsibly championing a drug for which there was no good evidence of efficacy at all.
emmelaich 6y ago
Philip Greenspun had some good articles on this. See below. He also quotes the CDC website saying it is quite safe. > “CDC has no limits on the use of hydroxychloroquine for the prevention of malaria. When hydroxychloroquine is used at higher doses for many years, a rare eye condition called retinopathy has occurred. People who take hydroxychloroquine for more than five years should get regular eye exams.” https://philip.greenspun.com/blog/2020/04/23/the-disappointing-results-of-hydroxychloroquine-for-covid-19-patients/ https://philip.greenspun.com/blog/2020/04/23/the-disappointi... https://philip.greenspun.com/blog/2020/05/21/hydroxychloroquine-from-innocuous-travel-drug-to-dangerous-poison/ https://philip.greenspun.com/blog/2020/05/21/hydroxychloroqu...
aksss 6y ago
Couldn't agree more. People lament the attack on "experts", but when they are transparently lying to the people [0], you can forgive the breakdown of trust. [0] human-to-human transmission doesn't happen; masks are ineffective; HCQ is horribly risky; a vaccine is coming;

by eric_b 6y ago

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.

deleted 6y ago
[deleted]
eric_b 6y ago
> This is a responsibility for which journal reviewers can only ever take partial responsibility for both practical and intrinsic reasons. So what you're saying is we should never fully trust these journals? We should always be skeptical? That's what I'm saying too...
- macintux 6y ago
  No, you said you wouldn’t trust it at all and that it was 100% political. HN isn’t the ideal venue for hyperbole.
- seesawtron 6y ago
  But you argued as if you were always trustworthy of these Journals before but from now on, you plan to be skeptical. Your future intentions are similar but for the wrong reasons. One should always be skeptical of research and have dicsussions on the reported data and to what extent and in what context it makes sense. The media outlets summarizing the research papers very often fail to do that so as to skip the details and keep the readers happy because they assume "readers just want to know the superficial abstract knowledge, they can't possibly be interested in the critical analysis of the figures and the numbers so let's exclude that".

ufo 6y ago

> 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. COVID patients are different from the patients that normally receive chloroquine and the chloroquine doses used for COVID are also higher. There is also the issue of how chloroquine interacts with other drugs such as azythromycin. This particular study has its problems but other studies on chloroquine were also starting to suggest that chloroquine could have dangerous side effects. https://blogs.sciencemag.org/pipeline/archives/2020/05/04/hydroxychloroquine-update-may-4 https://blogs.sciencemag.org/pipeline/archives/2020/05/04/hy...

v77 6y ago

A lot of people on this forum have been aware with the issues in social science and medical research for a long time, it's only under real stress that it's become an issue that will get wide coverage. The next fiasco-in-the-making to watch is the 'evidence-based' criminal justice reform sure to come to a lot more American cities soon.

throwaway5752 6y ago

We don't know as much about the safety profile of the drug in patients with COVID-19. Aspirin has a long track record and well understood safety profile, but it can still cause life threatening complications like Reye syndrome in certain viral infections.

truebeliefs 6y ago

It was interesting to see Facui so quickly endorse remdesivir but perhaps he did so because it's safer than choloroquine. It is convienent that remdesivir costs $1000 to 4000 per patient, whereas choloroquine is basically free compared to that. And this: "Before the Covid outbreak, remdesivir was a drug for which Gilead had failed to find a use." (Barrons 6/2/2020)

garraeth 6y ago
fyi: https://www.barrons.com/articles/coronavirus-news-updates-51591192554 https://www.barrons.com/articles/coronavirus-news-updates-51...

PiggySpeed 6y ago

> To think that all of a sudden it became more dangerous was silly and unreasonable. This is a dangerous view and not a fair take. Drugs CAN become more dangerous when used in a different context. The sheer permutation of prior/current medical conditions, interacting drugs, demographics, genetics, medical procedures, and a bunch of other factors all play into the equation that determines a drug's safety and efficacy profile. This is why we continue to do research. This is why guidelines are constantly shifting. This is why medicine requires years of study. > The media was so quick to champion it everywhere though. I definitely agree with this point. The media has caused harm to the population by taking the results of a single observational study, and parading it around like it was some new concrete medical certainty. This is not how professionals operate. We don't flip our practice on the whims of a single OBSERVATIONAL study. And I emphasize OBSERVATIONAL because most people here don't understand what that entails. Most people here who comment on clinical trials are not even trained to interpret them. Is it randomized/non-randomized? Double-blinded? What did data collection look like? How were results analyzed? What was the patient population? Timelines? Control arm? Placebos? Previous findings? Primary/secondary endpoint? Do you know the difference between a meta-analysis and a systematic review? NNT? Hazards ratios? Odds ratios? Too many people outside of medicine think they know how to interpret a study, when in reality they have no idea what they're looking at and cherry-pick the interesting sentences that they're looking for. > I know I'm not going to trust the Lancet or the NEJM ever again. This is not a fair take. The journals are responsible for reviewing and publishing the most influential clinical research in the world. Occasionally a bad study makes its way in due to falsified data or other illegitimate factors. Health care professionals are well-aware of this, which is why we are trained to interpret studies, and be conservative in the face of radical findings like this. If anyone has a problem with the Lancet or NEJM, they should see some of the mess found in lower-impact journals.

pacala 6y ago
Sadly, some of us are aware of the mess found in lower impact journals. It doesn't help with the trust issue. At all.
lbeltrame 6y ago
I did not agree with the conclusions of the paper, but I fell prey of the same bias that many others had: it was "published in Lancet" and "those journals have strict peer review". The lesson I learned is that I will always scrutinize papers I read with a more critical eye, regardless of where they were published in.

phkahler 6y ago

>> 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. That's true. There are people who want to discredit science as a whole. Reality tends to get in the way of most hidden agendas - that's why they're hidden.

everdrive 6y ago

> I know I'm not going to trust the Lancet or the NEJM ever again. It's all political now. Who can you trust these days?

raphlinus 6y ago
This may have been asked rhetorically, but I will answer it seriously. First, there are some really good science reporters out there, doing excellent work. I recommend Ed Yong at the Atlantic, Helen Branswell of STAT News, Jon Cohen at Science, Amy Maxmen at Nature. There are others (it's a team effort and those are all great publications), but if you just read all of the articles under their bylines, you will get a good overview of what's going on. They will not let you down. If you have a little bit more time and energy for this stuff (as I do), then there are many experts on Twitter who freely share their analysis, and among them are some excellent communicators. When controversial stuff comes out, you can get a good sense very quickly what the flaws are and what seems to be the consensus. If you want to dip your toes into these waters, I recommend Angela Rasmussen, Trevor Bedford, and Marc Lipsitch. For critical analysis of bullshit published by seemingly reputable academics, I highly recommend Carl Bergstrom (his takedowns are highly entertaining as well as informative). It's frustrating for me to see such pearls of knowledge and expertise so freely available, yet the vast majority of people snarfing down huge quantities of information swill.
scottlocklin 6y ago
Named editors. Peer review is recent, and has mostly proved itself a bad idea. Editors who have a personal reputation to maintain will do a better job, just as they did back in the day when, you know, guys like Einstein walked the earth.
snowwrestler 6y ago
Personally I do not think of trust as binary. If I ruled out every journal, publisher, or news property that published something that turned out to be wrong, I would read nothing at all and wallow in blissful ignorance. Actually that sounds kind of nice right now...

mc32 6y ago

The really odd thing is the media were highlighting risks... but not giving them context. Aspirin is risky, but millions take it too, over the counter. I’m all for being skeptical, but I think they went overboard, especially given the alternative of having no medicine.

takeda 6y ago

Every medication has a side effects and you balance if the benefits are better than the side effects it causes. Chloroquine has tons of side effects[1] though (including things like causing trouble with breathing). It might still be worth it if you have Lupus. When an existing drug is intended to treat some new disease it needs to be reevaluated for that disease again, because even if it can save lives for one disease it can be deadly for another. So the fact that it is given to thousands or millions does not mean much in this context. [1] https://www.drugs.com/sfx/chloroquine-side-effects.html https://www.drugs.com/sfx/chloroquine-side-effects.html

haltingproblem 6y ago

HCQ and its derivatives were given not to thousands or millions but tens of millions sometimes for years on end. In tropical countries like Nigeria it is customary for visitors and residents alike to be on long term HCQ dosages. I was quite surprised at the newfound fatality. Given that it was the Lancet, I took it at face value. Their political biases made them overlook the sheer flimsiness of the study. Rather than a mess, it is showing us the messy humans behind the veil of "science". There is no platonic scientist - just humans doing imperfect science.

snowwrestler 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. Aspirin is one of the most widely used drugs and generally considered safe. But you should never give it to a kid with chickenpox, because doing so is a risk factor for developing Reye's Syndrome, a serious and potentially fatal disease. It's not that aspirin "becomes more dangerous" in general, but it is more dangerous for those particular patients. And we don't really know why, either; but the data is clear on the correlation. We don't yet know all the ways that the novel coronavirus makes people sick. Heck we don't even have a reliable inventory of possible symptoms yet. So it's really not fair to pretend that it would be silly or unreasonable to suspect the possibility of some sort of negative correlation with a particular drug or class of drugs. This sort of thing happens all the time in medicine.

throwaway_pdp09 6y ago

> was silly and unreasonable / This study always smelled bad / The whole thing is disgusting / "science"[0] / I know I'm not going to trust the Lancet or the NEJM ever again / What a mess You're throwing around an awful lot of poo. Nothing concrete at all but all in very emotive terms. Not constructive - but was that the point? [0] (note scare quotes)

sparrc 6y ago

> I know I'm not going to trust the Lancet or the NEJM ever again. Wait, what?? The fact that the lancet was able to determine that there were validity concerns with the data and issue an expression of concern in less than 2 weeks is proof that the system works. Science is never 100% certain. The media has never been a good source of scientific information and probably never will be. edit: also, if you "don't trust the Lancet or NEJM" then you don't trust a huge number of the treatments available to you at the hospital. These are two of the most important and eminent medical journals in the world and many life-saving treatments began as articles in these journals.

cm2187 6y ago
It is proof that the peer review failed, on a topic that the Lancet couldn't ignore was high profile. I have no idea what the motivation of the reviewers were, but given how political this molecule has become, I can't help having a terrible doubt.
- pavon 6y ago
  Peer review is never intended to be an independent audit of the data for any journal. Reviewers check the methodology, look for obvious mistakes or oversights, provide suggestions for clarification or improvement in the text and for high-demand journals, weigh in on their opinion of the importance of the study. All of the feedback is based on the paper itself, so outright fraud usually is not caught at this stage unless the malicious author is exceptionally sloppy. It is later when other scientists start working to replicate or expand on the study that they request access to the data, and dig into the details. This is when most instances of scientific misconduct are found, and this paper is no exception. In science, publication is the start of the peer review process, not the end.

gameswithgo 6y ago

>Why might that be I wonder? Because our president was idiotically and irresponsibly championing a drug for which there was no good evidence of efficacy at all.

emmelaich 6y ago

Philip Greenspun had some good articles on this. See below. He also quotes the CDC website saying it is quite safe. > “CDC has no limits on the use of hydroxychloroquine for the prevention of malaria. When hydroxychloroquine is used at higher doses for many years, a rare eye condition called retinopathy has occurred. People who take hydroxychloroquine for more than five years should get regular eye exams.” https://philip.greenspun.com/blog/2020/04/23/the-disappointing-results-of-hydroxychloroquine-for-covid-19-patients/ https://philip.greenspun.com/blog/2020/04/23/the-disappointi... https://philip.greenspun.com/blog/2020/05/21/hydroxychloroquine-from-innocuous-travel-drug-to-dangerous-poison/ https://philip.greenspun.com/blog/2020/05/21/hydroxychloroqu...

aksss 6y ago

Couldn't agree more. People lament the attack on "experts", but when they are transparently lying to the people [0], you can forgive the breakdown of trust. [0] human-to-human transmission doesn't happen; masks are ineffective; HCQ is horribly risky; a vaccine is coming;