7 ms·

Widely disseminated hydroxychlroquine study retracted by authors

51 points by ed25519FUUU 6y ago

RcouF1uZ4gsC 6y ago
I wonder if the news that talked about the study so much when it was first published will spend as much time talking about the retraction.
- jeffmcmahan 6y ago
  FWIW, that never occurs. EDIT: Although it is currently being mentioned on the front pages of NYT, WaPo, and WSJ.
  - stcredzero 6y ago
    Aw hell, for the past several years, they're just fine with editing their posts and hoping their error falls down the digital "memory hole." https://en.wikipedia.org/wiki/Memory_hole https://en.wikipedia.org/wiki/Memory_hole
  - MaxBarraclough 6y ago
    Retractions are troublesome even if published prominently. https://en.wikipedia.org/wiki/Confirmation_bias#backfire_effect https://en.wikipedia.org/wiki/Confirmation_bias#backfire_eff...
  - jansan 6y ago
    Oh, it happened in Germany in 1983 when the media realized that Hitler's diaries were fake. But that was one media outlet, who had purchased all the rights of the fake diaries, against all others. https://en.wikipedia.org/wiki/Hitler_Diaries https://en.wikipedia.org/wiki/Hitler_Diaries
- jberryman 6y ago
  It's front page on the Washington Post right now. I haven't been on HN regularly in years; is promotion by the HN and silicon valley dabblers-and-blowhards crowd the reason the drug (one of dozens being tried) become so talked about? Did Elon Musk spend an hour browsing the preprints and tweet it to the world or something? I'm confused
  - javagram 6y ago
    Trump promoted it in a press conference, which prompted world-wide interest. Elon Musk also promoted it https://twitter.com/elonmusk/status/1239650597906898947?s=20 https://twitter.com/elonmusk/status/1239650597906898947?s=20 Background: * https://www.nytimes.com/2020/04/17/health/trump-hydroxychloroquine-coronavirus.html https://www.nytimes.com/2020/04/17/health/trump-hydroxychlor... “ Trump Calls This Drug a ‘Game Changer.’ Doctors Aren’t So Sure: The malaria drug hydroxychloroquine has become a political litmus test. But doctors on the front lines of coronavirus say it’s just another tool in desperate times.” * https://www.nytimes.com/2020/04/25/us/coronavirus-trump-chloroquine-hydroxychloroquine.html https://www.nytimes.com/2020/04/25/us/coronavirus-trump-chlo... “ Prescriptions Surged as Trump Praised Drugs in Coronavirus Fight: Prescriptions for two antimalarial drugs jumped by 46 times the average when the president promoted them on TV. There’s no proof they work against Covid-19.”
deleted 6y ago
[deleted]
chrisco255 6y ago
What troubles me is that people politicized a potentially life-saving treatment. That's how dangerous our political climate has gotten. Orange man says HCQ good, but orange man bad therefore HCQ bad.
- criddell 6y ago
  Calling the President orange man makes you part of the problem, no?
  - throwaway9482 6y ago
    Not OP but I don’t think so. He’s remarking on the phenomenon on how there’s a few people who have a strong bias against Trump and anything he touches
    - SpicyLemonZest 6y ago
      Sure, but he's doing it in a very inflammatory way. There are many alternative phrases which would have expressed the same idea without making it look like he's picking a fight.
  - eplanit 6y ago
    "Orange man bad" is a meme or just shorthand to refer to anti-Trump bias. It's meant to be dismissive of it and is rather widely circulated.
- javagram 6y ago
  The issue was also that “orange man” was not basing his statements on any convincing evidence. However people across the world associate the prestige and respects of the POTUS office as conferring authority on his statements. They think he has access to sources of info they may not (His HCQ boosterism seems to have been based on tweets and watching Fox News cable hosts though, no inside info).
  - foolfoolz 6y ago
throwaway9482 6y ago
So if I’m reading this right, the authors retracted the study because they weren’t able to get more details about the anonymous data they used, as the org who provided the anonymous data refuses to share more details about it on account of patient confidentiality agreements Edit: I think I found the statement from the org who has the sensitive data ... https://surgisphere.com/2020/05/29/response-to-widespread-reaction-to-recent-lancet-article-on-hydroxychloroquine/ https://surgisphere.com/2020/05/29/response-to-widespread-re... It includes: > We also take data privacy very seriously. Our registry is an aggregation of customers who use our QuartzClinical data platform. Our strong privacy standards are a major reason that hospitals trust Surgisphere and we have been able to collect data from over 1,200 institutions across 46 countries. While our data use agreements with these institutions prevents us from sharing patient level data or customer names, we are able to complete appropriate analyses and share aggregate findings to the wider scientific community. And... > We believe that an independent academic audit that validates those three functions as it relates to our papers in the New England Journal of Medicine and The Lancet will bring further transparency to our work, further highlight the quality of our work, and also continue to deserve the confidence of our work by our colleagues. > > This process will follow strict boundaries as it relates to our data use agreements, among other considerations. We are pursuing such an independent audit with all due haste while ensuring compliance with various legal and regulatory concerns. [my emphasis]
- boredumb 6y ago
  Science!
- hirundo 6y ago
  > these institutions prevents us from sharing patient level data ... They are prevented from sharing the data, not just with the public, but with three of the authors of the paper! That's pretty tight security. I wonder if any of the other authors have seen it.
  - elliekelly 6y ago
    One of the authors of the paper is the founder/CEO of Surgisphere so presumably he has permission to see the "data" (assuming it exists) and has convinced his co-authors to take his word for it.
boomboomsubban 6y ago
Haven't there been several other studies showing it has largely been ineffective? There was a completely unrelated one yesterday about how it didn't seem to help prevent catching the virus. https://www.nejm.org/doi/full/10.1056/NEJMe2020388 https://www.nejm.org/doi/full/10.1056/NEJMe2020388
- lbeltrame 6y ago
  Indeed, it doesn't help post exposure. UMN is doing two other trials, one for pre exposure and one for treatment. IIRC, all of them do not use zinc or macrolides. (Some patients of the post exposure prophylaxis trial used zinc, but there's no statistical difference without, although the authors warn about confounding factors). Some important limitations of the study, results notwithstanding: - There were basically no PCR-confirmed tests, due to lack of testing materials, and patients reported symptoms themselves - The whole thing (reporting) was done via email or telephone, no in person checks (even HCQ or placebo was shipped to the participants) David Boulware (the study's PI) on Twitter, a couple of weeks ago, complained that he sought funding from the NIH for this trial, but he got none. I thought it was all said and done for post exposure prophylaxis, but at least NEJM's editor is not of the same opinion, and mentions that even in this field of application there are still unknowns[1]. There are larger trials going on, like UK's RECOVERY, which will likely give firmer answers. [1] https://www.nejm.org/doi/full/10.1056/NEJMe2020388 https://www.nejm.org/doi/full/10.1056/NEJMe2020388
stcredzero 6y ago
There's even more going on here. Take a look at the studies and note 1) the timing and 2) the lack of zinc. We've already had statistically significant results, where zinc is a significant factor with HCQ. Also the timing doesn't make sense. Wait 4 days after they show up so the virus can replicate, then give them a viral replication inhibitor? Huh? Check out Dr. Martensen's videos. He's called this stuff earlier than anyone I'm aware of: https://www.youtube.com/watch?v=IUD_wvkNhnk https://www.youtube.com/watch?v=IUD_wvkNhnk Also, compare and contrast what the news media was saying at the time. Then, compare and contrast with this: (WHO report which also shows how safe HCQ is) https://www.who.int/malaria/mpac/mpac-mar2017-erg-cardiotoxicity-report-session2.pdf https://www.who.int/malaria/mpac/mpac-mar2017-erg-cardiotoxi...
- ejstronge 6y ago
  I’ve never seen a published report on zinc and chloroquine, and this combination seems to only appear in YouTube videos. Do you have any links to clinical studies?
  - stcredzero 6y ago
    There's a study referenced here. The p-value for Zinc vs. No Zinc is 0.003. https://youtu.be/IH2UoBUcW2I?t=1289 https://youtu.be/IH2UoBUcW2I?t=1289 The study title, and authors are here: https://youtu.be/IH2UoBUcW2I?t=1008 https://youtu.be/IH2UoBUcW2I?t=1008
mturmon 6y ago
Submitting this as a tweet in isolation is teeing up for a flamey exchange in the comments here.
programmarchy 6y ago
Thankfully, this was discovered by some tenacious independent researchers. Does anyone have the scoop on who sounded the alarm how they were able to bring the issue to light? Edit: So apparently this study was just a preprint and not even peer reviewed yet. I don't see why it carried so much weight in the media and WHO decision if that's the case. I think it's probably a good thing that it was scrutinized before it even hit peer review. Found a pretty good writeup here: https://statmodeling.stat.columbia.edu/2020/05/25/this-controversial-hydroxychloroquine-paper-whats-lancet-gonna-do-about-it/ https://statmodeling.stat.columbia.edu/2020/05/25/this-contr...
- dwaltrip 6y ago
  The media does not usually know how to report on scientific research. Unfortunately, the increase of pre-prints seems to have magnified this problem. Taking a step back, scientific progress is poorly understood in general, even by many smart and inquisitive folks. In fact, I think no one really has a good concise, thorough description for how science unfolds. The reality of it is incredibly complex and messy (but nonetheless unbelievably effective). Even something as seemingly basic as the “scientific method” as it is taught in schools and seen in popular discussion is pretty misleading. It is not a great model of how science is done. Another concrete example of the confusion is the debates commonly seen about the definition of supposedly official scientific terms such as “law”, “theory” and “hypothesis ”. Sean Carroll has a great episode on his Mindscape podcast that touches on this a bit and provides a decent if not fully satisfactory answer to the question of how science actually works. As a heads up, they spend a good chunk of time talking about the concept of truth and some related philosophy :) I found it interesting and useful, but I can guess not everyone will appreciate it. https://www.preposterousuniverse.com/podcast/2020/05/04/95-liam-kofi-bright-on-knowledge-truth-and-science/ https://www.preposterousuniverse.com/podcast/2020/05/04/95-l...

51 points by ed25519FUUU 6y ago

I wonder if the news that talked about the study so much when it was first published will spend as much time talking about the retraction.

jeffmcmahan 6y ago
FWIW, that never occurs. EDIT: Although it is currently being mentioned on the front pages of NYT, WaPo, and WSJ.
- stcredzero 6y ago
  Aw hell, for the past several years, they're just fine with editing their posts and hoping their error falls down the digital "memory hole." https://en.wikipedia.org/wiki/Memory_hole https://en.wikipedia.org/wiki/Memory_hole
- MaxBarraclough 6y ago
  Retractions are troublesome even if published prominently. https://en.wikipedia.org/wiki/Confirmation_bias#backfire_effect https://en.wikipedia.org/wiki/Confirmation_bias#backfire_eff...
- jansan 6y ago
  Oh, it happened in Germany in 1983 when the media realized that Hitler's diaries were fake. But that was one media outlet, who had purchased all the rights of the fake diaries, against all others. https://en.wikipedia.org/wiki/Hitler_Diaries https://en.wikipedia.org/wiki/Hitler_Diaries
jberryman 6y ago
It's front page on the Washington Post right now. I haven't been on HN regularly in years; is promotion by the HN and silicon valley dabblers-and-blowhards crowd the reason the drug (one of dozens being tried) become so talked about? Did Elon Musk spend an hour browsing the preprints and tweet it to the world or something? I'm confused
- javagram 6y ago
  Trump promoted it in a press conference, which prompted world-wide interest. Elon Musk also promoted it https://twitter.com/elonmusk/status/1239650597906898947?s=20 https://twitter.com/elonmusk/status/1239650597906898947?s=20 Background: * https://www.nytimes.com/2020/04/17/health/trump-hydroxychloroquine-coronavirus.html https://www.nytimes.com/2020/04/17/health/trump-hydroxychlor... “ Trump Calls This Drug a ‘Game Changer.’ Doctors Aren’t So Sure: The malaria drug hydroxychloroquine has become a political litmus test. But doctors on the front lines of coronavirus say it’s just another tool in desperate times.” * https://www.nytimes.com/2020/04/25/us/coronavirus-trump-chloroquine-hydroxychloroquine.html https://www.nytimes.com/2020/04/25/us/coronavirus-trump-chlo... “ Prescriptions Surged as Trump Praised Drugs in Coronavirus Fight: Prescriptions for two antimalarial drugs jumped by 46 times the average when the president promoted them on TV. There’s no proof they work against Covid-19.”

deleted 6y ago

[deleted]

chrisco255 6y ago

What troubles me is that people politicized a potentially life-saving treatment. That's how dangerous our political climate has gotten. Orange man says HCQ good, but orange man bad therefore HCQ bad.

criddell 6y ago
Calling the President orange man makes you part of the problem, no?
- throwaway9482 6y ago
  Not OP but I don’t think so. He’s remarking on the phenomenon on how there’s a few people who have a strong bias against Trump and anything he touches
  - SpicyLemonZest 6y ago
    Sure, but he's doing it in a very inflammatory way. There are many alternative phrases which would have expressed the same idea without making it look like he's picking a fight.
- eplanit 6y ago
  "Orange man bad" is a meme or just shorthand to refer to anti-Trump bias. It's meant to be dismissive of it and is rather widely circulated.
javagram 6y ago
The issue was also that “orange man” was not basing his statements on any convincing evidence. However people across the world associate the prestige and respects of the POTUS office as conferring authority on his statements. They think he has access to sources of info they may not (His HCQ boosterism seems to have been based on tweets and watching Fox News cable hosts though, no inside info).
- foolfoolz 6y ago

throwaway9482 6y ago

So if I’m reading this right, the authors retracted the study because they weren’t able to get more details about the anonymous data they used, as the org who provided the anonymous data refuses to share more details about it on account of patient confidentiality agreements Edit: I think I found the statement from the org who has the sensitive data ... https://surgisphere.com/2020/05/29/response-to-widespread-reaction-to-recent-lancet-article-on-hydroxychloroquine/ https://surgisphere.com/2020/05/29/response-to-widespread-re... It includes: > We also take data privacy very seriously. Our registry is an aggregation of customers who use our QuartzClinical data platform. Our strong privacy standards are a major reason that hospitals trust Surgisphere and we have been able to collect data from over 1,200 institutions across 46 countries. While our data use agreements with these institutions prevents us from sharing patient level data or customer names, we are able to complete appropriate analyses and share aggregate findings to the wider scientific community. And... > We believe that an independent academic audit that validates those three functions as it relates to our papers in the New England Journal of Medicine and The Lancet will bring further transparency to our work, further highlight the quality of our work, and also continue to deserve the confidence of our work by our colleagues. > > This process will follow strict boundaries as it relates to our data use agreements, among other considerations. We are pursuing such an independent audit with all due haste while ensuring compliance with various legal and regulatory concerns. [my emphasis]

boredumb 6y ago
Science!
hirundo 6y ago
> these institutions prevents us from sharing patient level data ... They are prevented from sharing the data, not just with the public, but with three of the authors of the paper! That's pretty tight security. I wonder if any of the other authors have seen it.
- elliekelly 6y ago
  One of the authors of the paper is the founder/CEO of Surgisphere so presumably he has permission to see the "data" (assuming it exists) and has convinced his co-authors to take his word for it.

boomboomsubban 6y ago

Haven't there been several other studies showing it has largely been ineffective? There was a completely unrelated one yesterday about how it didn't seem to help prevent catching the virus. https://www.nejm.org/doi/full/10.1056/NEJMe2020388 https://www.nejm.org/doi/full/10.1056/NEJMe2020388

lbeltrame 6y ago
Indeed, it doesn't help post exposure. UMN is doing two other trials, one for pre exposure and one for treatment. IIRC, all of them do not use zinc or macrolides. (Some patients of the post exposure prophylaxis trial used zinc, but there's no statistical difference without, although the authors warn about confounding factors). Some important limitations of the study, results notwithstanding: - There were basically no PCR-confirmed tests, due to lack of testing materials, and patients reported symptoms themselves - The whole thing (reporting) was done via email or telephone, no in person checks (even HCQ or placebo was shipped to the participants) David Boulware (the study's PI) on Twitter, a couple of weeks ago, complained that he sought funding from the NIH for this trial, but he got none. I thought it was all said and done for post exposure prophylaxis, but at least NEJM's editor is not of the same opinion, and mentions that even in this field of application there are still unknowns[1]. There are larger trials going on, like UK's RECOVERY, which will likely give firmer answers. [1] https://www.nejm.org/doi/full/10.1056/NEJMe2020388 https://www.nejm.org/doi/full/10.1056/NEJMe2020388

stcredzero 6y ago

There's even more going on here. Take a look at the studies and note 1) the timing and 2) the lack of zinc. We've already had statistically significant results, where zinc is a significant factor with HCQ. Also the timing doesn't make sense. Wait 4 days after they show up so the virus can replicate, then give them a viral replication inhibitor? Huh? Check out Dr. Martensen's videos. He's called this stuff earlier than anyone I'm aware of: https://www.youtube.com/watch?v=IUD_wvkNhnk https://www.youtube.com/watch?v=IUD_wvkNhnk Also, compare and contrast what the news media was saying at the time. Then, compare and contrast with this: (WHO report which also shows how safe HCQ is) https://www.who.int/malaria/mpac/mpac-mar2017-erg-cardiotoxicity-report-session2.pdf https://www.who.int/malaria/mpac/mpac-mar2017-erg-cardiotoxi...

ejstronge 6y ago
I’ve never seen a published report on zinc and chloroquine, and this combination seems to only appear in YouTube videos. Do you have any links to clinical studies?
- stcredzero 6y ago
  There's a study referenced here. The p-value for Zinc vs. No Zinc is 0.003. https://youtu.be/IH2UoBUcW2I?t=1289 https://youtu.be/IH2UoBUcW2I?t=1289 The study title, and authors are here: https://youtu.be/IH2UoBUcW2I?t=1008 https://youtu.be/IH2UoBUcW2I?t=1008

mturmon 6y ago

Submitting this as a tweet in isolation is teeing up for a flamey exchange in the comments here.

programmarchy 6y ago

Thankfully, this was discovered by some tenacious independent researchers. Does anyone have the scoop on who sounded the alarm how they were able to bring the issue to light? Edit: So apparently this study was just a preprint and not even peer reviewed yet. I don't see why it carried so much weight in the media and WHO decision if that's the case. I think it's probably a good thing that it was scrutinized before it even hit peer review. Found a pretty good writeup here: https://statmodeling.stat.columbia.edu/2020/05/25/this-controversial-hydroxychloroquine-paper-whats-lancet-gonna-do-about-it/ https://statmodeling.stat.columbia.edu/2020/05/25/this-contr...

dwaltrip 6y ago
The media does not usually know how to report on scientific research. Unfortunately, the increase of pre-prints seems to have magnified this problem. Taking a step back, scientific progress is poorly understood in general, even by many smart and inquisitive folks. In fact, I think no one really has a good concise, thorough description for how science unfolds. The reality of it is incredibly complex and messy (but nonetheless unbelievably effective). Even something as seemingly basic as the “scientific method” as it is taught in schools and seen in popular discussion is pretty misleading. It is not a great model of how science is done. Another concrete example of the confusion is the debates commonly seen about the definition of supposedly official scientific terms such as “law”, “theory” and “hypothesis ”. Sean Carroll has a great episode on his Mindscape podcast that touches on this a bit and provides a decent if not fully satisfactory answer to the question of how science actually works. As a heads up, they spend a good chunk of time talking about the concept of truth and some related philosophy :) I found it interesting and useful, but I can guess not everyone will appreciate it. https://www.preposterousuniverse.com/podcast/2020/05/04/95-liam-kofi-bright-on-knowledge-truth-and-science/ https://www.preposterousuniverse.com/podcast/2020/05/04/95-l...