13 ms·

Three authors retract study on hydroxychloroquine and chloroquine

296 points by marvin 6y ago

stephc_int13 6y ago
In the best scenario, this whole story is an illustration of incompetence, in the worst case, this is a sign of corruption. In both, more scrutiny is needed.
deleted 6y ago
[deleted]
hartator 6y ago
> "can no longer vouch for the veracity of the primary data sources." It's a little understatement when the accusations are they made up the data.
- groby_b 6y ago
  You're conflating many "they" here. The retraction is by the study authors. The data is from a company that's entirely different, and that company claims their data is "proprietary" and they can't share it. There's strong suspicion that that proprietary data is in fact made up, but the study authors cannot prove it. And you really don't want to retract a study by making unproven allegations. "We can't vouch for the veracity" is all they can truthfully say. For the full statement: "“Our independent peer reviewers informed us that Surgisphere would not transfer the full dataset, client contracts, and the full ISO audit report to their servers for analysis as such transfer would violate client agreements and confidentiality requirements. As such, our reviewers were not able to conduct an independent and private peer review and therefore notified us of their withdrawal from the peer-review process.”[1] The authors tried for an independent audit. Surgisphere failed to cooperate. Given the history of its principal, not a surprise. [1] https://www.theguardian.com/world/2020/jun/04/covid-19-lancet-retracts-paper-that-halted-hydroxychloroquine-trials https://www.theguardian.com/world/2020/jun/04/covid-19-lance...
  - himinlomax 6y ago
    The CEO of said company is one of the authors. In any case, even if he wasn't, the other three dunces should never have trusted such dubious data.
bsaul 6y ago
now will there be a next step ? This looks like fraud, and my hope now is that there is a police investigation, because it may very well be guided by economical interest. No conspiracy theory here, there's nothing sure, but we can't rule it out completely either.
- csunbird 6y ago
  Also, when you think about it, they put a lot of lives at risk by publishing, seemingly, false information in a critical time.
- tunesmith 6y ago
  What's the economic interest of claiming the medication doesn't work?
  - pdog 6y ago
    There a huge battle going on between hydroxychloroquine (the Republican therapy of choice when combined with a zinc supplement) and remdesivir (the antiviral drug by Gilead that's preferred by anti-Trump liberals). To answer your question, there can be an economic interest in claiming a competitor treatment (which is generic and manufactured cheaply) doesn't work.
  - saas_sam 6y ago
    To prop up a competing medication.
  - rlp 6y ago
    Increased sales of a competing medication, like Remdesivir.
  - comicjk 6y ago
    The company that provided the data, Surgisphere, might have been trying to raise their profile by getting a big publication. They're a bit shady. https://blogs.sciencemag.org/pipeline/archives/2020/06/02/surgisphere-and-their-data https://blogs.sciencemag.org/pipeline/archives/2020/06/02/su...
walterbell 6y ago
How about thanking or crediting the many independent doctors and scientists (https://zenodo.org/record/3873178 https://zenodo.org/record/3873178) who identified the issues in Lancet's publication? Even Apple credits/pays independent researchers for finding weaknesses in Apple code. Will countries now revert national health policy changes that were based on this questionable study? What about the families of patients who were denied early HCQ treatment based on this study? Who is liable for their denial of treatment? James Todaro, May 29th, https://www.medicineuncensored.com/a-study-out-of-thin-air https://www.medicineuncensored.com/a-study-out-of-thin-air > Misinformation is bad. Misinformation in medicine is worse. Misinformation from a prestigious medical journal is the worst. Herein is a detailed look at the controversial Lancet study that resulted in the World Health Organization ending worldwide clinical trials on hydroxychloroquine in order to focus on patented therapeutics. Guardian, June 3rd, 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... > The very serious concerns being raised about the validity of the papers by Mehra et al need to be recognised and actioned urgently, and ought to bring about serious reflection on whether the quality of editorial and peer review during the pandemic has been adequate. Scientific publication must above all be rigorous and honest. In an emergency, these values are needed more than ever. James Todaro helped to bring this questionable study to light—his website (https://www.medicineuncensored.com/ https://www.medicineuncensored.com/) and compilation of HCQ studies (https://docs.google.com/document/d/1O6Cls-Oz2ZAgJuyDbnICEGjMvQPEyM-aaXARUomR9Ww/ https://docs.google.com/document/d/1O6Cls-Oz2ZAgJuyDbnICEGjM...) may be of interest.
- terio 6y ago
  The WHO already restarted studies involving hydroxychloroquine. >> Who is liable for their denial of treatment? Doctors base their treatments on the best information they have at hand. In many cases, that information turns out to be faulty. This retraction does not mean the HCQ works against COVID-19, only that this particular study is no proof that it does not work.
  - tjenkinsqs 6y ago
    Hydroxychloroquine does not repair damaged cells, but it does stop the virus from replicating (especially when used with Zinc) There are five scientific studies demonstrating this for outpatient use. https://academic.oup.com/aje/advance-article/doi/10.1093/aje/kwaa093/5847586?fbclid=IwAR1uM2zcTs_UpRT4hKcf2Vm4gHDHI8wWflHEArys-Dax4vRPcTYoZCgLi9Q https://academic.oup.com/aje/advance-article/doi/10.1093/aje...
gotoeleven 6y ago
If it gets trump run it!
- Fellshard 6y ago
  You are going to get votebombed for phrasing it like, but I do think a serious look needs to be made based on this on whether political outcomes have motivated individuals and organizations to discard their normal vetting process, because if nothing else, the appearance of corrupted credibility runs very high with this.
  - bsaul 6y ago
    yeah. the "anti-conspiracy theory" reflex is starting to become just stupid. We do live in a world where people struggle for power, influence and money. It's just as silly pretending everything is due to people plotting as it is to pretend everyone always has pure intentions.
  - zests 6y ago
    Yeah, that's a shame. Vote bombed in what looks like under 20 minutes. How many upvote points do I need before I can read [flagged] posts? edit: Found showdead, thanks everyone. Probably makes sense to get votebombed because its low effort. I retract my comment.
    - walterbell 6y ago
      Click the time stamp ("N minutes ago").
    - slig 6y ago
      Go to your profile and change "showdead" to true.
    - fourthark 6y ago
      Set showdead true in your profile.
ardy42 6y ago
Influential Lancet hydroxychloroquine study retracted by 3 authors (https://www.cbc.ca/news/health/hydroxychloroquine-covid-lancet-1.5598761 https://www.cbc.ca/news/health/hydroxychloroquine-covid-lanc...) > Three of the authors of an influential article that found hydroxychloroquine increased the risk of death in COVID-19 patients retracted the study on concerns about the quality of the data.... > Results of a [different] high-quality randomized, placebo-control trial also published yesterday in the New England Journal of Medicine from U.S. and Canadian researchers showed hydroxychloroquine was no better than placebo pills at preventing illness from the coronavirus.
elihu 6y ago
What did the retracted study say about hydroxychloroquine and chloroquine? Did it claim they were efficacious versus COVID-19, or that they weren't? Or was it something else?
- moultano 6y ago
  It claimed that they significantly increased the chances of death.
  - w_t_payne 6y ago
    Since I take it daily for my Rheumatoid Arthritis -- a source of more than a small amount of concern.
    - kgwgk 6y ago
      You're probably not in intensive care with a life threatening viral infection, so even if there is an increase in mortality in that group you may not need to be concerned.
    - newacct583 6y ago
      IIRC the doses used as an antiviral are quite a big higher than those for an immunosuppressor. Everyone is piling on, but in fact the drug was known to have side effects from decades of use, and the hypothesis that it would hurt more than it helps was absolutely not unfounded. It was wrong (or at least, still unsupported), but it wasn't insane.
- Sharlin 6y ago
  The study claimed to have found evidence that hydroxychloroquine/chloroquine use is correlated with increased COVID-19 mortality.
- djannzjkzxn 6y ago
  This was the original report: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext?utm_source=AusSMC+mailing+list&utm_campaign=a5c0a299a0-EMAIL_CAMPAIGN_2020_05_26_03_00&utm_medium=email&utm_term=0_90d9431cd5-a5c0a299a0-126967137 https://www.thelancet.com/journals/lancet/article/PIIS0140-6... They claimed that hydroxychloroquine and chloroquine both caused more deaths. The study claimed a huge effect size (~20% increase in death rate) and a giant sample (14888 treated, 81144 control across 671 hospitals). Despite not being a proper blinded trial, this still appeared to be strong evidence and sufficient to stop any reasonable doctor who heard of this study from giving these drugs to patients. If the evidence was fabricated, that’s a big deal.
MilnerRoute 6y ago
The study's three authors retracted their study on June 4th, "because independent peer reviewers could not access the data used for the analysis," reports The Hill. "The source of the data was Surgisphere Corporation, which told peer reviewers it would not transfer the full dataset used for the study because it would violate client agreements and confidentiality requirements." However, the same day the New England Journal of Medicine published results from a new double-blind randomized, placebo-controlled trial which found hydroxychloroquine didn't help prevent people exposed to others with Covid-19 from developing the disease. One of the study's co-authors said that as a preventative agent, "It doesn't seem to work." https://science.slashdot.org/story/20/05/23/0140202/study-of-96000-covid-19-patients-finds-hydroxychloroquine-increased-their-risk-of-dying https://science.slashdot.org/story/20/05/23/0140202/study-of...
- mxcrossb 6y ago
  This should terrify any researcher working with a private company’s data. I think top journals need to change their policy here ably data availability, especially when private companies get involved.
  - WalterBright 6y ago
    > private companies Government entities hardly exempt from self-serving bias and manipulation.
- triyambakam 6y ago
  Important distinction though - preventative vs curative
Alex3917 6y ago
Headline is wrong. Lancet didn't retract the study, three of the four authors did.
- dang 6y ago
  Ok, we've put three authors in the HN title to reflect that.
thrown2020 6y ago
Fuck Fauci and fuck all you socialists!
pen2l 6y ago
A lot of the controversy surrounding this Lancet paper was about the data being used, which was provided by a firm named Surgisphere [1]. One of the co-authors of the Lancet paper is Sapan Desai, he is incidentally also the chief executive of this firm. The lone one who chose not to retract the paper was him. I recommend this twitter thread that explains the thrust of the issue: https://twitter.com/reverendofdoubt/status/1266902969045463041 https://twitter.com/reverendofdoubt/status/12669029690454630... Essentially, doubt began swirling around when this company claimed to acquire in a very short time massive amounts of EHR (Electronic Health Record, basically large datasets showing how patients are doing, how they're responding to medication, etc.). When Sapan Desai was pressed on by the other three authors of this very paper, he refused to cooperate, invoking a somewhat shoddy defense of not being at liberty to reveal sensitive information. Surgisphere refuses to say which hospitals chose to give it the EHR. The thing is, this EHR data is a big deal. Pharma companies give _big_ money to hospitals for this data. One of the key questions has been how this newcomer company managed to acquire these EHR deals with such a large number of hospitals. Since the scrutiny, NEJM has also chosen to retract a Covid-19-related paper which sourced data from this company: https://www.nejm.org/doi/full/10.1056/NEJMoa2007621 https://www.nejm.org/doi/full/10.1056/NEJMoa2007621 [1]: The company is choosing to stand behind the 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...
- taurath 6y ago
  It feels like a large part of the value of a journal like the Lancet is that they DON'T do stuff like this. That one of the authors is ceo of the company that owns the data behind the study should be a glaring red flag. What value does the Lancet still have? Note - I edited this post because it was much more crass and reactionary, and realized its not at all my domain, so I rephrased.
  - knzhou 6y ago
    The value is that even given this, they're much more reliable than preprints, and much much more reliable than sensational Twitter threads or public forums. They manage to filter out a tremendous amount of crap, but a sufficiently crafty and dishonest author can still sometimes slip past -- as is possible in any system.
stephc_int13 6y ago
I hope this will lead to more public scrutiny about the practices of the leading scientific journals.
emtel 6y ago
As I understand it, the WHO changed policy on HCQ because of this study. So, if you had posted a YouTube video criticizing this study and the WHO decision, Google may have taken that video down in accordance with their policy to delete videos the are counter to WHO policy. That didn't actually happen, to my knowledge. But it would have been Google policy if it did. That is what is wrong with platforms like Google and Facebook adopting the role of fact-checkers.
- matthewmarkus 6y ago
  This comment cannot be upvoted enough IMHO. This scandal is the medical science equivalent of Enron, and it could've easily been covered up in a world where a oligopoly determines the truth. I think the even bigger danger here is when people want to point out flaws in policies like Section 230 and Net Neutrality. The incentives are huge for these companies to either bury or suppress dissenting views that impact their bottom lines.
  - Natsu 6y ago
    The Lancet basically created modern anti-vaxxers with the Wakefield fiasco, too, lest we forget.
  - knzhou 6y ago
    The Enron scandal lasted for 10 years and was only exposed by outsiders. This paper was questioned by other scientists from the very first day, and now has been retracted by the authors themselves after barely lasting 10 days. It's not at all comparable.
- adventured 6y ago
  > That is what is wrong with platforms like Google and Facebook adopting the role of fact-checkers. Along with that little problem of Google and Facebook being aggressive monopolies capable of wiping you off the Internet as a presence to an extent that whatever you're trying to publish will barely exist online (G search, gone; YouTube, gone; FB, gone; Instagram, gone; WhatsApp, gone). Five monopoly positions on critical speech platforms between the two of them. Those two monopolies have more totalitarian speech restriction capabilities than the US Government does by a dramatic margin. They should be broken up and regulated accordingly, due to their monopoly positions de facto putting them into the role of censor.
staycoolboy 6y ago
Here is a great example of why I keep pointing out how difficult it is to be a critical thinker. There isn't a single source to go to that gives the current status of HCQ + COVID, and there are dozens of links to journals in this thread that are making my head spin. So when people ask my opinion on HCQ, my answer is now: "I don't know, we don't have enough data that has been studied and approved by multiple peer-reviewed journals, because one isn't enough." This doesn't shake my attitude toward science in the slightest, but it does leave me feeling very uninformed. But maybe, just maybe, that is the correct phase-state to be in given the data? Or have I been zone-flooded?
- iagovar 6y ago
  The reality is that although we've improved, we're still slow getting data reliably, analyzing and understanding it. Science is actually a very manual labor.
  - asdff 6y ago
    Not to mention the difficulties with the i/o. next generation sequencing files, depending on the analysis done and the state in the pipeline, are just plain text files (sometimes binary for efficiency) but like 5-100s of GB in size per sample. If you maybe have a thousand samples, good for statistical power, you need terabytes of storage available, a lot of memory, and a lot of fast cores, so the natural answer is to use a compute cluster and some universities have them for their researchers. Not everyone has access to $100k of parallel computing power, however.
- deelowe 6y ago
  My answer is "we don't know but there seems to be little harm in trying it." This is what's happening right now. Sure, it's a bit of a shotgun approach, but again, if Drs want to used an already fda approved drug and try various approaches to see if it helps, I see no issue. Honestly, I don't get all the politics around this.
  - pkilgore 6y ago
mhandley 6y ago
Well done to the three authors who launched an independent peer review of the dataset, and when those reviewers couldn't verify it, asked for the paper to be withdrawn. I'm sure they will always regret they didn't ask more questions earlier, but once discrepancies emerged, they seem to have acted with integrity.
- mindfulhack 6y ago
  However, it reminds me how many believe in scientific studies - i.e. individual scientific studies - almost like a religion - holding up one study and result like it's the bible. Instead, we need to attach our primal emotions to the scientific process. Work should be done in the media and popular science to educate the public to make them learn to latch on to the process...and much less abuse of science may take place. Would anyone else agree?
  - mhandley 6y ago
    I would definitely agree; even when we're trying our absolute best to get to the bottom of a phenomenon (and from some people's publication counts, it's clear not everyone does that), it's still possible to delude ourselves and often then also the reviewers. Over time consensus is achieved, but it's rare any scientist trusts a single study or paper. A problem then arises when you really need results fast, as with COVID-19, because good science isn't fast.
  - banads 6y ago
    Indeed, "I believe in Science" is an all to common phrase these days
mrosett 6y ago
The medical profession needs to have a serious discussion about whether or not the Lancet should still be treated as a top journal. In addition to this retraction, 3 of the top 10 most cited retracted papers of all time were published in the Lancet. [0] This includes the infamous Wakefield "vaccines cause autism" paper which is probably the most damaging scientific fraud of the last several decades. On the editorial side, they've become quite outspoken on political matters [1], publishing one piece calling for the ban of tobacco, a letter expressing strong opinions on the Israel/Palestine conflict, and a piece just a couple weeks ago calling for Americans to vote Trump out of office. The also published a rather controversial study that provided very high estimates of the civilian death toll of the Iraq War. I'm inclined to agree with their position on some issues and disagree with it on others, but either way they seem to court controversy. All of this has been under the same editor, Richard Horton (who is himself quite outspoken.) Put it all together, and the picture that emerges is a publication that values making a splash (whether by publishing shocking results or by taking a position on political issues) over getting things correct. That's irritating behavior in a tabloid. In a prestigious journal, it's horrifyingly irresponsible. [0] https://retractionwatch.com/the-retraction-watch-leaderboard/top-10-most-highly-cited-retracted-papers/ https://retractionwatch.com/the-retraction-watch-leaderboard... [1] https://en.wikipedia.org/wiki/The_Lancet#Controversies https://en.wikipedia.org/wiki/The_Lancet#Controversies
buboard 6y ago
Another study that was using the same data was retracted from NE Journal of Medicine: https://www.nejm.org/doi/full/10.1056/NEJMc2021225 https://www.nejm.org/doi/full/10.1056/NEJMc2021225
tjenkinsqs 6y ago
Regarding HCQ safety: This is from the CDC web site: safe for young, old and pregnant: https://www.cdc.gov/malaria/resources/pdf/fsp/drugs/hydroxychloroquine.pdf https://www.cdc.gov/malaria/resources/pdf/fsp/drugs/hydroxyc...
- mafuy 6y ago
  Is this the same as what is applied for covid patients? Elsewhere it was stated that for covid, the dosis is increased 14x.
dang 6y ago
See also https://news.ycombinator.com/item?id=23420774 https://news.ycombinator.com/item?id=23420774
- jakeogh 6y ago
  And the original: https://news.ycombinator.com/item?id=23272222 https://news.ycombinator.com/item?id=23272222
asdff 6y ago
The lancet is a good journal, but how did this study as well as that retracted study on vaccines and autism end up in this journal and not JAMA or NEJM? At this point, I'm a little suspicious of their peer review process if these contrarian papers that turn out to be wrong in the end aren't being properly scrutinized at the peer review level, and will spend much more time in methods sections of striking lancet papers.
tjenkinsqs 6y ago
Five studies show effectiveness of Hydroxychloroquine for outpatients https://academic.oup.com/aje/advance-article/doi/10.1093/aje/kwaa093/5847586?fbclid=IwAR2x3eEIuV9EbOmtAN7U35eZsmMNsohWXrh-RIwxTIei5KhHa5iKsk2YE2o https://academic.oup.com/aje/advance-article/doi/10.1093/aje...
- abbracadabbra 6y ago
  Since this is being repeated multiple times, quoting benmaraschino: One of these "studies" is a 2-page Google Doc with no real data. Another is the discredited Raoult study, which is under investigation by the journal [1]. Another study cited is also by Raoult's team. The Brazil study (ref. 29) doesn't seem to have passed peer review (yet?) and has severe methodological flaws. Like the Raoult studies, the Brazil study was not randomized, but makes no attempt to control for confounding by indication or self-selection, such as with propensity score matching or similar methods commonly used in observational studies. The last study cited isn't a study, but an article from a local news station.
tartoran 6y ago
Such a poop-show. This is going to hurt the public trust in science, let’s hope this is short term because what is the alternative?
jussij 6y ago
Back in 1998 Andrew Wakefield duped Lancet with a concocted MMR autism study and the consequence of that study still haunt us to this day. Now it appears this has happened again.
- knzhou 6y ago
  The MMR study took 12 years from publication to retraction. This one took 12 days.
  - marvin 6y ago
    That's certainly an improvement, but even if health authorities and researchers quickly adapt their knowledge to reflect the retraction of this paper, the wide media circulation of "HCQ will kill you" has permanently poisoned the well of test patients for future research. Even though the retraction was quick, the damage to future research is permanent. If this was in fact a propaganda operation rather than just incompetence, pride and an unethical career gambit, it was an incredibly successful one. When someone fakes data to this degree, in a case that has this level of immediate real-world impact, one has to question the motivation behind it. Hope this gets illuminated during the investigation, but I'm not holding my breath.
wyck 6y ago
The media really went to town on this one, the reports that you might die using it lacked some real common sense, all of a sudden a drug that was approved in 1955, considered extremely safe (listed as an essential medicine by WHO) , and used on millions of people... is suddenly not safe.
- mafuy 6y ago
  Isn't the problem that it was so far used in a quite different dosis? The covid applications seems to increase the limit 14x. That's reason enough not to carry over the established safety status.
hkai 6y ago
So then should we also retract the continuous media message that we've heard for days, claiming that chloroquine kills people? It was on the front page of every media outlet.
- newacct583 6y ago
  No, we should cover the retraction. And we are, that's what the linked article is. I genuinely don't understand the need on some people's part to impart an "agenda" here. The president of the united states made this front page news by boosting the drug in a context where there was minimal evidence that it helped. That's newsworthy. It just is. The same principle that gets his statements on the front page gets refutations there too. It's news if he's right. It's news if he's wrong. I mean... what would your preferred action be? Not cover newsworthy science? Not cover the statements of the president? Or do you just not want them to cover stuff you personally disagree with? In reality: they covered the president, they covered the result, and they covered the retraction. All with pretty solid reach, frankly. We're literally yelling about it right now.

296 points by marvin 6y ago

In the best scenario, this whole story is an illustration of incompetence, in the worst case, this is a sign of corruption. In both, more scrutiny is needed.

deleted 6y ago

[deleted]

hartator 6y ago

> "can no longer vouch for the veracity of the primary data sources." It's a little understatement when the accusations are they made up the data.

groby_b 6y ago
You're conflating many "they" here. The retraction is by the study authors. The data is from a company that's entirely different, and that company claims their data is "proprietary" and they can't share it. There's strong suspicion that that proprietary data is in fact made up, but the study authors cannot prove it. And you really don't want to retract a study by making unproven allegations. "We can't vouch for the veracity" is all they can truthfully say. For the full statement: "“Our independent peer reviewers informed us that Surgisphere would not transfer the full dataset, client contracts, and the full ISO audit report to their servers for analysis as such transfer would violate client agreements and confidentiality requirements. As such, our reviewers were not able to conduct an independent and private peer review and therefore notified us of their withdrawal from the peer-review process.”[1] The authors tried for an independent audit. Surgisphere failed to cooperate. Given the history of its principal, not a surprise. [1] https://www.theguardian.com/world/2020/jun/04/covid-19-lancet-retracts-paper-that-halted-hydroxychloroquine-trials https://www.theguardian.com/world/2020/jun/04/covid-19-lance...
- himinlomax 6y ago
  The CEO of said company is one of the authors. In any case, even if he wasn't, the other three dunces should never have trusted such dubious data.

bsaul 6y ago

now will there be a next step ? This looks like fraud, and my hope now is that there is a police investigation, because it may very well be guided by economical interest. No conspiracy theory here, there's nothing sure, but we can't rule it out completely either.

csunbird 6y ago
Also, when you think about it, they put a lot of lives at risk by publishing, seemingly, false information in a critical time.
tunesmith 6y ago
What's the economic interest of claiming the medication doesn't work?
- pdog 6y ago
  There a huge battle going on between hydroxychloroquine (the Republican therapy of choice when combined with a zinc supplement) and remdesivir (the antiviral drug by Gilead that's preferred by anti-Trump liberals). To answer your question, there can be an economic interest in claiming a competitor treatment (which is generic and manufactured cheaply) doesn't work.
- saas_sam 6y ago
  To prop up a competing medication.
- rlp 6y ago
  Increased sales of a competing medication, like Remdesivir.
- comicjk 6y ago
  The company that provided the data, Surgisphere, might have been trying to raise their profile by getting a big publication. They're a bit shady. https://blogs.sciencemag.org/pipeline/archives/2020/06/02/surgisphere-and-their-data https://blogs.sciencemag.org/pipeline/archives/2020/06/02/su...

walterbell 6y ago

How about thanking or crediting the many independent doctors and scientists (https://zenodo.org/record/3873178 https://zenodo.org/record/3873178) who identified the issues in Lancet's publication? Even Apple credits/pays independent researchers for finding weaknesses in Apple code. Will countries now revert national health policy changes that were based on this questionable study? What about the families of patients who were denied early HCQ treatment based on this study? Who is liable for their denial of treatment? James Todaro, May 29th, https://www.medicineuncensored.com/a-study-out-of-thin-air https://www.medicineuncensored.com/a-study-out-of-thin-air > Misinformation is bad. Misinformation in medicine is worse. Misinformation from a prestigious medical journal is the worst. Herein is a detailed look at the controversial Lancet study that resulted in the World Health Organization ending worldwide clinical trials on hydroxychloroquine in order to focus on patented therapeutics. Guardian, June 3rd, 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... > The very serious concerns being raised about the validity of the papers by Mehra et al need to be recognised and actioned urgently, and ought to bring about serious reflection on whether the quality of editorial and peer review during the pandemic has been adequate. Scientific publication must above all be rigorous and honest. In an emergency, these values are needed more than ever. James Todaro helped to bring this questionable study to light—his website (https://www.medicineuncensored.com/ https://www.medicineuncensored.com/) and compilation of HCQ studies (https://docs.google.com/document/d/1O6Cls-Oz2ZAgJuyDbnICEGjMvQPEyM-aaXARUomR9Ww/ https://docs.google.com/document/d/1O6Cls-Oz2ZAgJuyDbnICEGjM...) may be of interest.

terio 6y ago
The WHO already restarted studies involving hydroxychloroquine. >> Who is liable for their denial of treatment? Doctors base their treatments on the best information they have at hand. In many cases, that information turns out to be faulty. This retraction does not mean the HCQ works against COVID-19, only that this particular study is no proof that it does not work.
- tjenkinsqs 6y ago
  Hydroxychloroquine does not repair damaged cells, but it does stop the virus from replicating (especially when used with Zinc) There are five scientific studies demonstrating this for outpatient use. https://academic.oup.com/aje/advance-article/doi/10.1093/aje/kwaa093/5847586?fbclid=IwAR1uM2zcTs_UpRT4hKcf2Vm4gHDHI8wWflHEArys-Dax4vRPcTYoZCgLi9Q https://academic.oup.com/aje/advance-article/doi/10.1093/aje...

gotoeleven 6y ago

If it gets trump run it!

Fellshard 6y ago
You are going to get votebombed for phrasing it like, but I do think a serious look needs to be made based on this on whether political outcomes have motivated individuals and organizations to discard their normal vetting process, because if nothing else, the appearance of corrupted credibility runs very high with this.
- bsaul 6y ago
  yeah. the "anti-conspiracy theory" reflex is starting to become just stupid. We do live in a world where people struggle for power, influence and money. It's just as silly pretending everything is due to people plotting as it is to pretend everyone always has pure intentions.
- zests 6y ago
  Yeah, that's a shame. Vote bombed in what looks like under 20 minutes. How many upvote points do I need before I can read [flagged] posts? edit: Found showdead, thanks everyone. Probably makes sense to get votebombed because its low effort. I retract my comment.
  - walterbell 6y ago
    Click the time stamp ("N minutes ago").
  - slig 6y ago
    Go to your profile and change "showdead" to true.
  - fourthark 6y ago
    Set showdead true in your profile.

ardy42 6y ago

Influential Lancet hydroxychloroquine study retracted by 3 authors (https://www.cbc.ca/news/health/hydroxychloroquine-covid-lancet-1.5598761 https://www.cbc.ca/news/health/hydroxychloroquine-covid-lanc...) > Three of the authors of an influential article that found hydroxychloroquine increased the risk of death in COVID-19 patients retracted the study on concerns about the quality of the data.... > Results of a [different] high-quality randomized, placebo-control trial also published yesterday in the New England Journal of Medicine from U.S. and Canadian researchers showed hydroxychloroquine was no better than placebo pills at preventing illness from the coronavirus.

elihu 6y ago

What did the retracted study say about hydroxychloroquine and chloroquine? Did it claim they were efficacious versus COVID-19, or that they weren't? Or was it something else?

moultano 6y ago
It claimed that they significantly increased the chances of death.
- w_t_payne 6y ago
  Since I take it daily for my Rheumatoid Arthritis -- a source of more than a small amount of concern.
  - kgwgk 6y ago
    You're probably not in intensive care with a life threatening viral infection, so even if there is an increase in mortality in that group you may not need to be concerned.
  - newacct583 6y ago
    IIRC the doses used as an antiviral are quite a big higher than those for an immunosuppressor. Everyone is piling on, but in fact the drug was known to have side effects from decades of use, and the hypothesis that it would hurt more than it helps was absolutely not unfounded. It was wrong (or at least, still unsupported), but it wasn't insane.
Sharlin 6y ago
The study claimed to have found evidence that hydroxychloroquine/chloroquine use is correlated with increased COVID-19 mortality.
djannzjkzxn 6y ago
This was the original report: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext?utm_source=AusSMC+mailing+list&utm_campaign=a5c0a299a0-EMAIL_CAMPAIGN_2020_05_26_03_00&utm_medium=email&utm_term=0_90d9431cd5-a5c0a299a0-126967137 https://www.thelancet.com/journals/lancet/article/PIIS0140-6... They claimed that hydroxychloroquine and chloroquine both caused more deaths. The study claimed a huge effect size (~20% increase in death rate) and a giant sample (14888 treated, 81144 control across 671 hospitals). Despite not being a proper blinded trial, this still appeared to be strong evidence and sufficient to stop any reasonable doctor who heard of this study from giving these drugs to patients. If the evidence was fabricated, that’s a big deal.

MilnerRoute 6y ago

The study's three authors retracted their study on June 4th, "because independent peer reviewers could not access the data used for the analysis," reports The Hill. "The source of the data was Surgisphere Corporation, which told peer reviewers it would not transfer the full dataset used for the study because it would violate client agreements and confidentiality requirements." However, the same day the New England Journal of Medicine published results from a new double-blind randomized, placebo-controlled trial which found hydroxychloroquine didn't help prevent people exposed to others with Covid-19 from developing the disease. One of the study's co-authors said that as a preventative agent, "It doesn't seem to work." https://science.slashdot.org/story/20/05/23/0140202/study-of-96000-covid-19-patients-finds-hydroxychloroquine-increased-their-risk-of-dying https://science.slashdot.org/story/20/05/23/0140202/study-of...

mxcrossb 6y ago
This should terrify any researcher working with a private company’s data. I think top journals need to change their policy here ably data availability, especially when private companies get involved.
- WalterBright 6y ago
  > private companies Government entities hardly exempt from self-serving bias and manipulation.
triyambakam 6y ago
Important distinction though - preventative vs curative

Alex3917 6y ago

Headline is wrong. Lancet didn't retract the study, three of the four authors did.

dang 6y ago
Ok, we've put three authors in the HN title to reflect that.

thrown2020 6y ago

Fuck Fauci and fuck all you socialists!

pen2l 6y ago

A lot of the controversy surrounding this Lancet paper was about the data being used, which was provided by a firm named Surgisphere [1]. One of the co-authors of the Lancet paper is Sapan Desai, he is incidentally also the chief executive of this firm. The lone one who chose not to retract the paper was him. I recommend this twitter thread that explains the thrust of the issue: https://twitter.com/reverendofdoubt/status/1266902969045463041 https://twitter.com/reverendofdoubt/status/12669029690454630... Essentially, doubt began swirling around when this company claimed to acquire in a very short time massive amounts of EHR (Electronic Health Record, basically large datasets showing how patients are doing, how they're responding to medication, etc.). When Sapan Desai was pressed on by the other three authors of this very paper, he refused to cooperate, invoking a somewhat shoddy defense of not being at liberty to reveal sensitive information. Surgisphere refuses to say which hospitals chose to give it the EHR. The thing is, this EHR data is a big deal. Pharma companies give _big_ money to hospitals for this data. One of the key questions has been how this newcomer company managed to acquire these EHR deals with such a large number of hospitals. Since the scrutiny, NEJM has also chosen to retract a Covid-19-related paper which sourced data from this company: https://www.nejm.org/doi/full/10.1056/NEJMoa2007621 https://www.nejm.org/doi/full/10.1056/NEJMoa2007621 [1]: The company is choosing to stand behind the 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...

taurath 6y ago
It feels like a large part of the value of a journal like the Lancet is that they DON'T do stuff like this. That one of the authors is ceo of the company that owns the data behind the study should be a glaring red flag. What value does the Lancet still have? Note - I edited this post because it was much more crass and reactionary, and realized its not at all my domain, so I rephrased.
- knzhou 6y ago
  The value is that even given this, they're much more reliable than preprints, and much much more reliable than sensational Twitter threads or public forums. They manage to filter out a tremendous amount of crap, but a sufficiently crafty and dishonest author can still sometimes slip past -- as is possible in any system.

stephc_int13 6y ago

I hope this will lead to more public scrutiny about the practices of the leading scientific journals.

emtel 6y ago

As I understand it, the WHO changed policy on HCQ because of this study. So, if you had posted a YouTube video criticizing this study and the WHO decision, Google may have taken that video down in accordance with their policy to delete videos the are counter to WHO policy. That didn't actually happen, to my knowledge. But it would have been Google policy if it did. That is what is wrong with platforms like Google and Facebook adopting the role of fact-checkers.

matthewmarkus 6y ago
This comment cannot be upvoted enough IMHO. This scandal is the medical science equivalent of Enron, and it could've easily been covered up in a world where a oligopoly determines the truth. I think the even bigger danger here is when people want to point out flaws in policies like Section 230 and Net Neutrality. The incentives are huge for these companies to either bury or suppress dissenting views that impact their bottom lines.
- Natsu 6y ago
  The Lancet basically created modern anti-vaxxers with the Wakefield fiasco, too, lest we forget.
- knzhou 6y ago
  The Enron scandal lasted for 10 years and was only exposed by outsiders. This paper was questioned by other scientists from the very first day, and now has been retracted by the authors themselves after barely lasting 10 days. It's not at all comparable.
adventured 6y ago
> That is what is wrong with platforms like Google and Facebook adopting the role of fact-checkers. Along with that little problem of Google and Facebook being aggressive monopolies capable of wiping you off the Internet as a presence to an extent that whatever you're trying to publish will barely exist online (G search, gone; YouTube, gone; FB, gone; Instagram, gone; WhatsApp, gone). Five monopoly positions on critical speech platforms between the two of them. Those two monopolies have more totalitarian speech restriction capabilities than the US Government does by a dramatic margin. They should be broken up and regulated accordingly, due to their monopoly positions de facto putting them into the role of censor.

staycoolboy 6y ago

Here is a great example of why I keep pointing out how difficult it is to be a critical thinker. There isn't a single source to go to that gives the current status of HCQ + COVID, and there are dozens of links to journals in this thread that are making my head spin. So when people ask my opinion on HCQ, my answer is now: "I don't know, we don't have enough data that has been studied and approved by multiple peer-reviewed journals, because one isn't enough." This doesn't shake my attitude toward science in the slightest, but it does leave me feeling very uninformed. But maybe, just maybe, that is the correct phase-state to be in given the data? Or have I been zone-flooded?

iagovar 6y ago
The reality is that although we've improved, we're still slow getting data reliably, analyzing and understanding it. Science is actually a very manual labor.
- asdff 6y ago
  Not to mention the difficulties with the i/o. next generation sequencing files, depending on the analysis done and the state in the pipeline, are just plain text files (sometimes binary for efficiency) but like 5-100s of GB in size per sample. If you maybe have a thousand samples, good for statistical power, you need terabytes of storage available, a lot of memory, and a lot of fast cores, so the natural answer is to use a compute cluster and some universities have them for their researchers. Not everyone has access to $100k of parallel computing power, however.
deelowe 6y ago
My answer is "we don't know but there seems to be little harm in trying it." This is what's happening right now. Sure, it's a bit of a shotgun approach, but again, if Drs want to used an already fda approved drug and try various approaches to see if it helps, I see no issue. Honestly, I don't get all the politics around this.
- pkilgore 6y ago

mhandley 6y ago

Well done to the three authors who launched an independent peer review of the dataset, and when those reviewers couldn't verify it, asked for the paper to be withdrawn. I'm sure they will always regret they didn't ask more questions earlier, but once discrepancies emerged, they seem to have acted with integrity.

mindfulhack 6y ago
However, it reminds me how many believe in scientific studies - i.e. individual scientific studies - almost like a religion - holding up one study and result like it's the bible. Instead, we need to attach our primal emotions to the scientific process. Work should be done in the media and popular science to educate the public to make them learn to latch on to the process...and much less abuse of science may take place. Would anyone else agree?
- mhandley 6y ago
  I would definitely agree; even when we're trying our absolute best to get to the bottom of a phenomenon (and from some people's publication counts, it's clear not everyone does that), it's still possible to delude ourselves and often then also the reviewers. Over time consensus is achieved, but it's rare any scientist trusts a single study or paper. A problem then arises when you really need results fast, as with COVID-19, because good science isn't fast.
- banads 6y ago
  Indeed, "I believe in Science" is an all to common phrase these days

mrosett 6y ago

The medical profession needs to have a serious discussion about whether or not the Lancet should still be treated as a top journal. In addition to this retraction, 3 of the top 10 most cited retracted papers of all time were published in the Lancet. [0] This includes the infamous Wakefield "vaccines cause autism" paper which is probably the most damaging scientific fraud of the last several decades. On the editorial side, they've become quite outspoken on political matters [1], publishing one piece calling for the ban of tobacco, a letter expressing strong opinions on the Israel/Palestine conflict, and a piece just a couple weeks ago calling for Americans to vote Trump out of office. The also published a rather controversial study that provided very high estimates of the civilian death toll of the Iraq War. I'm inclined to agree with their position on some issues and disagree with it on others, but either way they seem to court controversy. All of this has been under the same editor, Richard Horton (who is himself quite outspoken.) Put it all together, and the picture that emerges is a publication that values making a splash (whether by publishing shocking results or by taking a position on political issues) over getting things correct. That's irritating behavior in a tabloid. In a prestigious journal, it's horrifyingly irresponsible. [0] https://retractionwatch.com/the-retraction-watch-leaderboard/top-10-most-highly-cited-retracted-papers/ https://retractionwatch.com/the-retraction-watch-leaderboard... [1] https://en.wikipedia.org/wiki/The_Lancet#Controversies https://en.wikipedia.org/wiki/The_Lancet#Controversies

buboard 6y ago

Another study that was using the same data was retracted from NE Journal of Medicine: https://www.nejm.org/doi/full/10.1056/NEJMc2021225 https://www.nejm.org/doi/full/10.1056/NEJMc2021225

tjenkinsqs 6y ago

Regarding HCQ safety: This is from the CDC web site: safe for young, old and pregnant: https://www.cdc.gov/malaria/resources/pdf/fsp/drugs/hydroxychloroquine.pdf https://www.cdc.gov/malaria/resources/pdf/fsp/drugs/hydroxyc...

mafuy 6y ago
Is this the same as what is applied for covid patients? Elsewhere it was stated that for covid, the dosis is increased 14x.

dang 6y ago

See also https://news.ycombinator.com/item?id=23420774 https://news.ycombinator.com/item?id=23420774

jakeogh 6y ago
And the original: https://news.ycombinator.com/item?id=23272222 https://news.ycombinator.com/item?id=23272222

asdff 6y ago

The lancet is a good journal, but how did this study as well as that retracted study on vaccines and autism end up in this journal and not JAMA or NEJM? At this point, I'm a little suspicious of their peer review process if these contrarian papers that turn out to be wrong in the end aren't being properly scrutinized at the peer review level, and will spend much more time in methods sections of striking lancet papers.

tjenkinsqs 6y ago

Five studies show effectiveness of Hydroxychloroquine for outpatients https://academic.oup.com/aje/advance-article/doi/10.1093/aje/kwaa093/5847586?fbclid=IwAR2x3eEIuV9EbOmtAN7U35eZsmMNsohWXrh-RIwxTIei5KhHa5iKsk2YE2o https://academic.oup.com/aje/advance-article/doi/10.1093/aje...

abbracadabbra 6y ago
Since this is being repeated multiple times, quoting benmaraschino: One of these "studies" is a 2-page Google Doc with no real data. Another is the discredited Raoult study, which is under investigation by the journal [1]. Another study cited is also by Raoult's team. The Brazil study (ref. 29) doesn't seem to have passed peer review (yet?) and has severe methodological flaws. Like the Raoult studies, the Brazil study was not randomized, but makes no attempt to control for confounding by indication or self-selection, such as with propensity score matching or similar methods commonly used in observational studies. The last study cited isn't a study, but an article from a local news station.

tartoran 6y ago

Such a poop-show. This is going to hurt the public trust in science, let’s hope this is short term because what is the alternative?

jussij 6y ago

Back in 1998 Andrew Wakefield duped Lancet with a concocted MMR autism study and the consequence of that study still haunt us to this day. Now it appears this has happened again.

knzhou 6y ago
The MMR study took 12 years from publication to retraction. This one took 12 days.
- marvin 6y ago
  That's certainly an improvement, but even if health authorities and researchers quickly adapt their knowledge to reflect the retraction of this paper, the wide media circulation of "HCQ will kill you" has permanently poisoned the well of test patients for future research. Even though the retraction was quick, the damage to future research is permanent. If this was in fact a propaganda operation rather than just incompetence, pride and an unethical career gambit, it was an incredibly successful one. When someone fakes data to this degree, in a case that has this level of immediate real-world impact, one has to question the motivation behind it. Hope this gets illuminated during the investigation, but I'm not holding my breath.

wyck 6y ago

The media really went to town on this one, the reports that you might die using it lacked some real common sense, all of a sudden a drug that was approved in 1955, considered extremely safe (listed as an essential medicine by WHO) , and used on millions of people... is suddenly not safe.

mafuy 6y ago
Isn't the problem that it was so far used in a quite different dosis? The covid applications seems to increase the limit 14x. That's reason enough not to carry over the established safety status.

hkai 6y ago

So then should we also retract the continuous media message that we've heard for days, claiming that chloroquine kills people? It was on the front page of every media outlet.

newacct583 6y ago
No, we should cover the retraction. And we are, that's what the linked article is. I genuinely don't understand the need on some people's part to impart an "agenda" here. The president of the united states made this front page news by boosting the drug in a context where there was minimal evidence that it helped. That's newsworthy. It just is. The same principle that gets his statements on the front page gets refutations there too. It's news if he's right. It's news if he's wrong. I mean... what would your preferred action be? Not cover newsworthy science? Not cover the statements of the president? Or do you just not want them to cover stuff you personally disagree with? In reality: they covered the president, they covered the result, and they covered the retraction. All with pretty solid reach, frankly. We're literally yelling about it right now.