4 ms·

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

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.
dariusj18 6y ago
This is one of the reasons politicians shouldn't wade into these decisions. They raise the stakes and create opposing incentives.
dboreham 6y ago
>We still have no idea whether hydroxychloroquine works or not for COVID19 Don't we know to a first approximation that it doesn't work? This because it has been widely tried and there wasn't an "Awakenings" experience where the patients obviously got better. So if it works at all, it only does so at the margin. So hard to tell that it's necessary to gather a large statistical sample to know one way or the other.
- fabian2k 6y ago
  I personally think it is unlikely to work, and at best might have a marginal effect. That is mostly because most of these early results don't pan out, so that is a reasonably safe bet in any case. And as you said, a very strong effect would likely have been shown by now, with all the attention and the large number of people getting the drug. I was trying to keep objective when writing that, there simply wasn't any really well-designed trial yet. Though from what I read just an hour ago or so there is a new trial that is said to be randomized and well-designed that hasn't found an effect, but I haven't looked beyond the headlines there yet.
  - SomeoneFromCA 6y ago
    One of the potential reasons that ex-USSR has quite low death rate (even if we consider that numbers are forged, and actualy 5x (!) bigger than in reality is that all of these countries actively use antimalarial drugs.
    - zoomablemind 6y ago
      Where does this claim come from? Ex-USSR sounds too broad. Any sources on the 'active use'?
      - SomeoneFromCA 6y ago
        Russia does according to various circumstantial pieces of evidence - keep in mind, being Russia, lot of this info is not public. All of ex-USSR shared similar medical system previously, and many (except for Baltic countries probably) tend to follow the advice of Russian doctors. I cannot give you some "hard evidence", only probably for Russia, yet the death rate and speed of infection spread is clearly lower in these countries.
retox 6y ago
Some people hate the US president so much they don't care if people die because of their reporting.

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.

dariusj18 6y ago

This is one of the reasons politicians shouldn't wade into these decisions. They raise the stakes and create opposing incentives.

dboreham 6y ago

>We still have no idea whether hydroxychloroquine works or not for COVID19 Don't we know to a first approximation that it doesn't work? This because it has been widely tried and there wasn't an "Awakenings" experience where the patients obviously got better. So if it works at all, it only does so at the margin. So hard to tell that it's necessary to gather a large statistical sample to know one way or the other.

fabian2k 6y ago
I personally think it is unlikely to work, and at best might have a marginal effect. That is mostly because most of these early results don't pan out, so that is a reasonably safe bet in any case. And as you said, a very strong effect would likely have been shown by now, with all the attention and the large number of people getting the drug. I was trying to keep objective when writing that, there simply wasn't any really well-designed trial yet. Though from what I read just an hour ago or so there is a new trial that is said to be randomized and well-designed that hasn't found an effect, but I haven't looked beyond the headlines there yet.
- SomeoneFromCA 6y ago
  One of the potential reasons that ex-USSR has quite low death rate (even if we consider that numbers are forged, and actualy 5x (!) bigger than in reality is that all of these countries actively use antimalarial drugs.
  - zoomablemind 6y ago
    Where does this claim come from? Ex-USSR sounds too broad. Any sources on the 'active use'?
    - SomeoneFromCA 6y ago
      Russia does according to various circumstantial pieces of evidence - keep in mind, being Russia, lot of this info is not public. All of ex-USSR shared similar medical system previously, and many (except for Baltic countries probably) tend to follow the advice of Russian doctors. I cannot give you some "hard evidence", only probably for Russia, yet the death rate and speed of infection spread is clearly lower in these countries.

retox 6y ago

Some people hate the US president so much they don't care if people die because of their reporting.