7 ms·

The pro-HCQ people are very clear in saying it needs to be administered early before symptoms are severe and with zinc and azithromycin. When 1/4 of your study

The pro-HCQ people are very clear in saying it needs to be administered early before symptoms are severe and with zinc and azithromycin. When 1/4 of your study population is dying then you are obviously not following the protocol advocated for since you've selected extremely sick people. I'm undecided on whether HCQ is effective or not, but attempting to discredit it with shitty science is a large part of why people don't "believe science".

peter422 6y ago
Multiple RCTs have been done where HCQ was given as a post exposure prophylaxis. Didn’t do anything significant in terms of reducing infection. It’s not just about doses or timing. It doesn’t work.
- jeffreyrogers 6y ago
  I wasn't referring to any of those studies. I was referring to this one, which is obviously poorly designed if it's attempting to test the efficacy of HCQ treatment as it is actually proposed. This being shitty science has no bearing on whether HCQ works on not, but does relate to why people distrust the medical research establishment.
  - peter422 6y ago
    It’s a shitty study because after we all know the results you are post facto complaining that they studied the wrong thing?
    - ColanR 6y ago
      The parameters within which HCQ is thought to work have been clearly stated. If a study is attempting to evaluate HCQ without following those parameters, then the study is badly designed regardless of when it's being discussed.
      - peter422 6y ago
        You came up with those parameters conveniently after the study was published. The people who created and executed these studies wanted to save lives. They created a method they thought would be most likely to work, and time and time again they didn’t. Different dosages, different timing, different places. No benefit. The fact that people aren’t running more studies is not because there is a global conspiracy. It’s because the drug doesn’t do anything and researchers don’t want to waste their time and their patients lives satisfying critics who don’t care about the science. Does HCQ work if you have some magic combination of zinc? Maybe. Is that more likely than another treatment given that HCQ has been heavily studied and shown no benefit and zinc had been heavily studied for a lot of things and shown no magical properties? Probably not. So researchers spend their time on things more likely to work.
        ColanR 6y ago
        It sounds like you're ignoring the other studies that did show benefit. The people who came up with those studies wanted to save lives, too, just like the people who still think that HCQ is being overlooked. > You came up with those parameters conveniently after the study was published. > The fact that people aren’t running more studies is not because there is a global conspiracy. > satisfying critics who don’t care about the science > magic combination...magical properties It seems like you've suddenly made a sharp u-turn from a good-faith discussion into crazy town. I thought we were hashing out differences, and now you're suddenly accusing me of making up excuses, believing in a global conspiracy, being anti-science, and thinking zinc is somehow a miracle drug. I think I should end the conversation here.
        peter422 6y ago
        Please link me to a single RCT that shows HCQ as having a significant benefit. I also apologize if you felt I was maligning you, I’m not. However I am maligning the belief that a drug works when it’s been proven time and again to show it doesn’t.
        jeffreyrogers 6y ago
  - lvs 6y ago
    Please see the part of the study where your objection was actually addressed regarding dosage time from symptom onset. There is no difference. I'm not sure why you would call something "shitty science" without actually looking at the science in the paper. https://www.nejm.org/na101/home/literatum/publisher/mms/journals/content/nejm/0/nejm.ahead-of-print/nejmoa2022926/20201008/images/img_xlarge/nejmoa2022926_f3.jpeg https://www.nejm.org/na101/home/literatum/publisher/mms/jour...
landryraccoon 6y ago
> The pro-HCQ This term alone makes me highly skeptical. Honest researchers shouldn't be "pro" or "anti" anything. Coronavirus doesn't have an opinion on HCQ. It is a virus that either responds biologically to HCQ in vivo or it doesn't. Pro or anti are political terms that change the conversation from scientific to propaganda based. If the research indicates that HCQ has a powerful prophylactic effect against Coronavirus in a double blind study, then let the data speak for itself. However saying that you're "pro-HCQ" or "anti-HCQ" immediately discredits you in my eyes because viral pandemics don't have emotions and therefore can't care whether you are pro or anti anything.
- jeffreyrogers 6y ago
  Any clinical intervention is going to have advocates. Same as any non-generic drug trial. It's a complete distortion of how science and medical research actually works to suggest people don't have a hoped for outcome. The French scientist who is one of the main proponents of HCQ obviously wants it to succeed. The American media establishment and some of its scientific community obviously want it to fail. To pretend like they do otherwise is to engage in a different form of bias that attempts to conceal itself by denying its existence.
  - landryraccoon 6y ago
    > Any clinical intervention is going to have advocates. Honestly I don't really get this at all. Not even a little bit. Why? Anyone who actually has a motive (like a company trying to make money) should be kept far away from the regulators that oversee the study, and the whole point of double blind trials is to keep self interested bias away from the result of a study where lives are literally at stake. Isn't the point of a clinical intervention to save lives? Either the intervention saves lives or it doesn't. The researchers should be selected from people who can maintain a neutral viewpoint. If that is impossible their neutrality should still be maximized and biases should be eliminated as much as humanly possible. Simply accepting that bias as a matter of course is imo the worst way to approach it.
    - 6y ago
fabian2k 6y ago
It's rather telling that these criteria only came up after the first negative trials of HCQ. The study that arguably kicked off the whole debated from Didier Raoult does not meet your criteria. It does include azithromycin, but it is on already hospizalized patients and doesn't include zinc. There are also quite a lot of other HCQ studies, many with azithromycin and some also given very early before significant symptoms appeared (see one example here: https://www.nejm.org/doi/full/10.1056/NEJMoa2016638 https://www.nejm.org/doi/full/10.1056/NEJMoa2016638). They also didn't find any benefit to HCQ. The insistence on these very specific criteria is just blatantly moving the goalposts. There simply isn't enough indications that HCQ works, and plenty of evidence that it doesn't to justify even more large studies than it already got. This is arguably a huge misallocation of resources based on very flimsy initial evidence.
- lvs 6y ago
  There's No True Scotsman.
- deleted 6y ago
  [deleted]
lvs 6y ago
The study itself shows there was no stratification of effect on the basis of days since symptom onset. Patients <7 days into symptoms fared no better with the drug than people >7 days. https://www.nejm.org/na101/home/literatum/publisher/mms/journals/content/nejm/0/nejm.ahead-of-print/nejmoa2022926/20201008/images/img_xlarge/nejmoa2022926_f3.jpeg https://www.nejm.org/na101/home/literatum/publisher/mms/jour...
sorokod 6y ago
> very clear Politicians completely ruined this particular word combination for me. My reflexive interpretation is that things were exactly the opposite of clear and the speaker is likely to be lying.
downrightmike 6y ago
Doesn't help the case, along with the deaths, that a snake oil conman loves it, loves it, loves it; unless he's being treated for covid.
DanBC 6y ago
> The pro-HCQ people are very clear in saying it needs to be administered early before symptoms are severe a Doctors are very clear that HCQ is too dangerous to give to people unless those people are very ill. You not understanding this balance between risk vs reward doesn't make the science shitty.
- alea_iacta_est 6y ago
  You don't know what you're talking about. HCQ has been used for 60 years for malaria, lupus and autoimmune diseases.
  - rsynnott 6y ago
    Sure; HCQ is effective against some strains of malaria, and if you're going to a region where the strain isn't vulnerable to anything else, or if there are contraindications for everything else, or if you're in a health system where the cost is relevant, the doctor may prescribe you HCQ, after warning you about it. Its side effects are generally safer than having malaria. Of course, lots of things are safer than having malaria, so this is hardly a great endorsement.
    - alea_iacta_est 6y ago
      You too are talking out of your bottom. HCQ is given in prevention to millions on people every year, used as cure for many sicknesses, here in the US and all over the world. In 60 years, it's been given to more than a billion people. Please, stick to what you know and leave medicine to specialists. Wikipedia doesn't make you a doctor.
      - tatersolid 6y ago
        > Wikipedia doesn't make you a doctor. I will be stealing this line. Honestly I could use “Wikipedia doesn’t make you a lawyer” even more frequently.
  - deleted 6y ago
    [deleted]
deleted 6y ago
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peter422 6y ago

Multiple RCTs have been done where HCQ was given as a post exposure prophylaxis. Didn’t do anything significant in terms of reducing infection. It’s not just about doses or timing. It doesn’t work.

jeffreyrogers 6y ago
I wasn't referring to any of those studies. I was referring to this one, which is obviously poorly designed if it's attempting to test the efficacy of HCQ treatment as it is actually proposed. This being shitty science has no bearing on whether HCQ works on not, but does relate to why people distrust the medical research establishment.
- peter422 6y ago
  It’s a shitty study because after we all know the results you are post facto complaining that they studied the wrong thing?
  - ColanR 6y ago
    The parameters within which HCQ is thought to work have been clearly stated. If a study is attempting to evaluate HCQ without following those parameters, then the study is badly designed regardless of when it's being discussed.
    - peter422 6y ago
      You came up with those parameters conveniently after the study was published. The people who created and executed these studies wanted to save lives. They created a method they thought would be most likely to work, and time and time again they didn’t. Different dosages, different timing, different places. No benefit. The fact that people aren’t running more studies is not because there is a global conspiracy. It’s because the drug doesn’t do anything and researchers don’t want to waste their time and their patients lives satisfying critics who don’t care about the science. Does HCQ work if you have some magic combination of zinc? Maybe. Is that more likely than another treatment given that HCQ has been heavily studied and shown no benefit and zinc had been heavily studied for a lot of things and shown no magical properties? Probably not. So researchers spend their time on things more likely to work.
      - ColanR 6y ago
        It sounds like you're ignoring the other studies that did show benefit. The people who came up with those studies wanted to save lives, too, just like the people who still think that HCQ is being overlooked. > You came up with those parameters conveniently after the study was published. > The fact that people aren’t running more studies is not because there is a global conspiracy. > satisfying critics who don’t care about the science > magic combination...magical properties It seems like you've suddenly made a sharp u-turn from a good-faith discussion into crazy town. I thought we were hashing out differences, and now you're suddenly accusing me of making up excuses, believing in a global conspiracy, being anti-science, and thinking zinc is somehow a miracle drug. I think I should end the conversation here.
        peter422 6y ago
        Please link me to a single RCT that shows HCQ as having a significant benefit. I also apologize if you felt I was maligning you, I’m not. However I am maligning the belief that a drug works when it’s been proven time and again to show it doesn’t.
      - jeffreyrogers 6y ago
- lvs 6y ago
  Please see the part of the study where your objection was actually addressed regarding dosage time from symptom onset. There is no difference. I'm not sure why you would call something "shitty science" without actually looking at the science in the paper. https://www.nejm.org/na101/home/literatum/publisher/mms/journals/content/nejm/0/nejm.ahead-of-print/nejmoa2022926/20201008/images/img_xlarge/nejmoa2022926_f3.jpeg https://www.nejm.org/na101/home/literatum/publisher/mms/jour...

landryraccoon 6y ago

> The pro-HCQ This term alone makes me highly skeptical. Honest researchers shouldn't be "pro" or "anti" anything. Coronavirus doesn't have an opinion on HCQ. It is a virus that either responds biologically to HCQ in vivo or it doesn't. Pro or anti are political terms that change the conversation from scientific to propaganda based. If the research indicates that HCQ has a powerful prophylactic effect against Coronavirus in a double blind study, then let the data speak for itself. However saying that you're "pro-HCQ" or "anti-HCQ" immediately discredits you in my eyes because viral pandemics don't have emotions and therefore can't care whether you are pro or anti anything.

jeffreyrogers 6y ago
Any clinical intervention is going to have advocates. Same as any non-generic drug trial. It's a complete distortion of how science and medical research actually works to suggest people don't have a hoped for outcome. The French scientist who is one of the main proponents of HCQ obviously wants it to succeed. The American media establishment and some of its scientific community obviously want it to fail. To pretend like they do otherwise is to engage in a different form of bias that attempts to conceal itself by denying its existence.
- landryraccoon 6y ago
  > Any clinical intervention is going to have advocates. Honestly I don't really get this at all. Not even a little bit. Why? Anyone who actually has a motive (like a company trying to make money) should be kept far away from the regulators that oversee the study, and the whole point of double blind trials is to keep self interested bias away from the result of a study where lives are literally at stake. Isn't the point of a clinical intervention to save lives? Either the intervention saves lives or it doesn't. The researchers should be selected from people who can maintain a neutral viewpoint. If that is impossible their neutrality should still be maximized and biases should be eliminated as much as humanly possible. Simply accepting that bias as a matter of course is imo the worst way to approach it.
  - 6y ago

fabian2k 6y ago

It's rather telling that these criteria only came up after the first negative trials of HCQ. The study that arguably kicked off the whole debated from Didier Raoult does not meet your criteria. It does include azithromycin, but it is on already hospizalized patients and doesn't include zinc. There are also quite a lot of other HCQ studies, many with azithromycin and some also given very early before significant symptoms appeared (see one example here: https://www.nejm.org/doi/full/10.1056/NEJMoa2016638 https://www.nejm.org/doi/full/10.1056/NEJMoa2016638). They also didn't find any benefit to HCQ. The insistence on these very specific criteria is just blatantly moving the goalposts. There simply isn't enough indications that HCQ works, and plenty of evidence that it doesn't to justify even more large studies than it already got. This is arguably a huge misallocation of resources based on very flimsy initial evidence.

lvs 6y ago
There's No True Scotsman.
deleted 6y ago
[deleted]

lvs 6y ago

The study itself shows there was no stratification of effect on the basis of days since symptom onset. Patients <7 days into symptoms fared no better with the drug than people >7 days. https://www.nejm.org/na101/home/literatum/publisher/mms/journals/content/nejm/0/nejm.ahead-of-print/nejmoa2022926/20201008/images/img_xlarge/nejmoa2022926_f3.jpeg https://www.nejm.org/na101/home/literatum/publisher/mms/jour...

sorokod 6y ago

> very clear Politicians completely ruined this particular word combination for me. My reflexive interpretation is that things were exactly the opposite of clear and the speaker is likely to be lying.

downrightmike 6y ago

Doesn't help the case, along with the deaths, that a snake oil conman loves it, loves it, loves it; unless he's being treated for covid.

DanBC 6y ago

> The pro-HCQ people are very clear in saying it needs to be administered early before symptoms are severe a Doctors are very clear that HCQ is too dangerous to give to people unless those people are very ill. You not understanding this balance between risk vs reward doesn't make the science shitty.

alea_iacta_est 6y ago
You don't know what you're talking about. HCQ has been used for 60 years for malaria, lupus and autoimmune diseases.
- rsynnott 6y ago
  Sure; HCQ is effective against some strains of malaria, and if you're going to a region where the strain isn't vulnerable to anything else, or if there are contraindications for everything else, or if you're in a health system where the cost is relevant, the doctor may prescribe you HCQ, after warning you about it. Its side effects are generally safer than having malaria. Of course, lots of things are safer than having malaria, so this is hardly a great endorsement.
  - alea_iacta_est 6y ago
    You too are talking out of your bottom. HCQ is given in prevention to millions on people every year, used as cure for many sicknesses, here in the US and all over the world. In 60 years, it's been given to more than a billion people. Please, stick to what you know and leave medicine to specialists. Wikipedia doesn't make you a doctor.
    - tatersolid 6y ago
      > Wikipedia doesn't make you a doctor. I will be stealing this line. Honestly I could use “Wikipedia doesn’t make you a lawyer” even more frequently.
- deleted 6y ago
  [deleted]

deleted 6y ago

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