This to me is also an indictment of the meta analysis field. If only one study completely skews your analysis and you don't know it, then it's just bad statistics on those authors' part too.
I'm not sure if the author considered that even if this study was completely bogus, Ivermectin can still be a positive part of covid treatment. I have heard many good things about Ivermectin from several different countries including Africa, but had not heard about this study.
Your argument sounds like: even if the only scientific study that supports its use is fraudulent and wrong, we should look at some cherry picked anecdotes to confirm our preconceived belief that this drug is helpful to patients.
Sorry but this demonstrates a severe misunderstanding of the way medical studies are performed and used in clinical practice. The only way you know a drug is beneficial is to do the study and get the data.
Where is the "television" here? This article simply reports on the fraudulent paper, which casts doubt on the use of ivermectin which has been recently touted in right wing circles. There is no other evidence to support its use. Hopefully, one's doctor would be aware of the current best scientific analysis.
The comment I replied to was pointing out how this article is cherry-picking a single study to argue with, and I agreed... There is quite a bit of other evidence to support its use, such as [1].
I think it's pretty well summarized by MedpageToday: "Findings are positive, but critics still want a large randomized controlled trial" [2]
About [1]: It's not a randomized controlled trial.
For example if a patient arrives to the hospital and s/he is so ill that must be intubated immediately and can't sign the paperwork for the study or can't take oral pill [X] then s/he go to the no-ivermectin group. Does this increase the chances of death in the no-ivermectin group?
Another example, if someone takes ivermectin and recovers, but is readmitted later, then s/he is excluded [Y]. Does this increase or decrease How does this increase the chances of death in the no-ivermectin group?
About the first question: probably yes, but you may disagree.
About the second: I have no idea, perhaps it artificially decrease the death rate in the no-ivermectin group, I have no idea.
So, it's very difficult to be sure that you are comparing the outcomes correctly without a randomized controlled trial.
About [2]:
> Hill and colleagues assessed 24 randomized trials totaling 3,328 patients that involved some type of control, whether it was standard of care or another therapy. Sample sizes ranged from 24 to 400 participants. Eight of the studies had been published, nine were preprints, six were unpublished results shared for the analysis, and one was reported on a trial registry website.
I think that now there are like ~34 trials. If you look at them, most of them are small and no statistically significant. The problem is reporting and publication bias. Studies with a good/favorable outcome are published. Studies with a bad outcome are uninteresting and discarded.
From an interview I listened to of Pulmonologist at a small well respected private hospital in Johannesburg:
He would use anything that worked to save lives but Ivermectin just doesn't work. On one day he personally admitted 22 people to the hospital with Covid and 14 of those had been taking Ivermectin. 10 of them ended up in ICU and some of them had passed away a few days later when the interview was held.
Part of the problem seems to be that it masks a lot of the early symptoms of covid so the patients don't get prescribed things like corticosteroids that do help until much later than normal.
14 admitted out of population size of how many IVM users please? (Consider those who get the shots also get C19, though at a much lower rate vs not having C19 before nor shots; I'd like to compare the 2 rates.)
Is 'masking' ~= slowing down disease & symptoms?
BTW, the MD who testified before US Congress to research about IVM more (Dr Pierre Kory) also testified a few months prior to use corticosteroids for C19. They reccomend both & many other things (like Zinc, VitD) as part of their protocol.
> 14 admitted out of population size of how many IVM users please?
Completely agree. That's the correct question. Is the number higher or lower than the people that is not taking IVM, proportionally? The problem is that to have the correct answer you must do a randomized controlled trial (double blind to avoid other differences in the treatment and bias) (large to avoid flukes).
The comments on the top story, getting 300+ votes, are also a sight to behold: ‘I truly hope in the coming years the censorship of this topic will be the catalyst for allowing free speech to prevail on social media.“ (https://news.ycombinator.com/item?id=27562412). Also: “Please do not spread fake news. All current vaccines are less than 1% effective.”
Let’s see if the people who read those stories get a chance to see the correction, as well.
- Nature paper is from 2017
- paper makes zero claims about 2020 or 2021
- paper describes work that was awarded a Nobel prize
> Let's see if the people who read those stories get a chance to see the correction
If you would be so kind as to identify anything in the 2017 Nature paper that was corrected by a 2021 "blog post" or any other literature, that would be helpful.
The Nobel prize for Ivermectin has not been retracted. The 2017 paper preceded therapeutic debates of 2020 or 2021.
CLICKBAIT sponsored by Big Pharma who sells $$$ thousands of dollar treatments of questionable efficacy. Ivermectin costs pennies.
Hey Gideon, how much $$$ did Big Pharma pay you off to write this "hit piece" ?
The core of this story is based on ONE research study in Egypt.
Ivermectin has been proven effective against covid19 in numerous double blind controlled studies.
Could 10 well published American and European specialist doctors with decades of experience be in a conspiracy ? I doubt it.
27 controlled trials, including a total of 6,612 patients have been completed using well-matched control groups•
16 trials,including over 2,500 patients,a reprospective,randomized,controlled studies•
11 of the 27 trials have been published in peer-reviewed journals,3,900 patients,remainder are in pre-print
Full article is worth reading, but the TL;DR is that one of the key studies in the Ivermectin COVID-19 narrative is full of glaring issues that suggest some or all of the data was fabricated. When this potentially fraudulent study is removed from meta-analyses, the statistical significance of Ivermectin in treating COVID-19 disappears.
Meanwhile, Ivermectin has become deeply intertwined with conspiracy theory circles who have come to believe that Ivermectin is a magic bullet against COVID-19. They can't understand why governments aren't deploying Ivermectin to end the pandemic, which has spawned numerous waves of misinformation and conspiracy theories that pharmaceutical companies and/or governments are acting to cover up what they believe is a miracle cure.
If you want a peak into some of the conspiratorial thinking around Ivermectin, look at the top posts on the /r/ivermectin sub on Reddit: https://www.reddit.com/r/ivermectin/top/?t=month The topic has spread to popular outlets like the Joe Rogan podcast and Fox News, as well as become a meme in conspiracy and anti-vax circles.
It's still possible that Ivermectin might have some small modulating effect on COVID-19, but there's no real evidence that it's actually a miracle cure. We've also known for a long time that Ivermectin can cause serious adverse neurological events in certain populations: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5929173/
I'm pretty sure 'spam network' is a ad hominem logical fallacy, & perhaps your link is a appeal to authority.
There is sufficient proofs pro-IVM. Yes there is anti-proofs, I'm sure there are valid concerns there also. But consider how much $$$ exchanges hands with vaccines, which the emergency authorization of may not have happened if IVM was fully recognized treatment for C19. Not only the profits of the shots is more, but said companies already spend much $$$ on advertising on news channels & web, cloud compute time on major platforms (MicroSoft, Google, Amazon), research funding, etc... (I'm NOT saying the billion$ is proof of bias, but something to consider.)
IIUC it's a gene that we share with dogs and many (all?) animals. For example here is a paper about mutations in the human version https://pubmed.ncbi.nlm.nih.gov/11990778/
Perhaps we don't have the same mutations, but it's totally possible.
I haven't seen Joe Rogan, and I don't get what's going on there. As far as I can tell, it seems his big win is that he gets on both big-name celebrities and crackpots. I've seen him called a very good interviewer, but I honestly don't know exactly what that means, and how it's different from just getting guests who speak well.
The impression I get is that he seems even-handed to a certain stripe of people who think that playing to their bias and/or giving unquestioning air time to contrarians is what constitutes even-handedness.
Am I even vaguely on track here? I don't have much interest in interview shows in general; the format just isn't terribly interesting to me. The few I do listen to are those that invite relatively obscure scientists to explain their work -- the Ologies podcast and the BBC's Life Scientific. I dislike politics, after decades of watching it become worse. But I feel like I should have an inkling of what it's about.
A "good interviewer" is one who can ask "the right questions" when they've got a guest who may have something worth saying. A really good interviewer can tease information out of a guest during an interview that they likely might not otherwise have said aloud in a public venue.
Is Joe Rogan a "good interviewer"? I haven't watched enough of him to have much of an opinion, but what little I have watched, his guests seem pretty comfortable talking to him.
Not an expert, but for me it looks more like confirmation bias contaminating meta-analysis. Covid-19 has a lethality around 2%, so a huge fraction of infected people can be cured using any placebo. This very low lethality makes data with a bigger number of deaths very easily skewed or noisy.
So, it is very hard to derive any efficacy data except in cases where the improvement is significant, like in the cases of current vaccines.
If a placebo reduces lethality from 2% to 1% that may sound like a 50% reduction, but actually it is just a 1% improvement. This can only be ruled out with higher p-values which demand bigger samples.
There are hundreds of teams in the world right now trying many different drugs to treat Covid-19. It possible to use a meta analysis approach and carefully select works where statistics were favorable by mere chance. This is rare, but considering the enormous number of works, it is possible to find them.
A more trustworthy meta analysis can be derived if peer-reviewed published papers are also chosen randomly. But of course, such meta analysis will also be biased by the kinds of papers that are likely to be published after peer review.
If even half of what is alleged in the linked article is true it’s quite clearly scientific fraud and not anything that could be explained away by “confirmation bias”.
Yes. I just want to comment that meta analysis is not a panacea. In brazil, where these drugs and treatment became polarized and politicized, some people has been using meta analysis to prove that even cloroquine works against covid.
> Well, you just described how the C19 vax say how they improve survival rates.
In brazil, coronavac has 100% efficacy against death cases during the test phase. Reducing lethality from 3% to 0% is very different than reducing from 2% to 1%.
1) Isn't the default answer to a question headline supposed to be "No"?
2) How is one supposed to sift the wheat from the chaff these days? Everyone uses terms like "scientists agree that" and "here's a list of studies supporting my point of view". I took Ivermectin seriously because of Brett W etc (and perhaps I still should) but as humans we need heuristics, people who we can trust to give us well researched info, otherwise each and everyone of us needs to be an experienced researcher in every field to have any confidence of the "facts". I don't have time for that - I have a living to make, kids to spend time with, sleep to have....where are the smart people that we can trust?
Sorry Dang, I know this is kinda off topic but....kinda not?
The unfortunate reality is that you can't sift wheat from chaff as casual layperson reading a paper here and there.
You don't necessarily need to be one of the anointed, but you do need to read a lot of papers in a particular field critically. You need to read and understand enough papers in a field that you can tell the difference between a normal paper and a completely bonkers one, to tell which have novel methodology and which methods are less rigorous; you need to read enough to understand the context of each paper in the broader body of research. What other research has been done in a similar vein, which papers agree with each other, which are incompatible. Whether the data in one paper can be accounted for by the hypotheses in another.
Any individual paper can be flawed, unlucky or outright fraudulent. When you just grab a paper or two at random, you're engaging in a dangerous sampling problem. When the papers aren't grabbed at random, it's even worse.
> When you just grab a paper or two at random, you're engaging in a dangerous sampling problem. When the papers aren't grabbed at random, it's even worse.
I think you summarized the current situation perfectly.
It's an inverse Russian roulette of knowledge where only one of the bullets is missing :
hospitalized, gave grandma covid, no go into malls and trains in France, "nudged" into vaccination, dead, perfectly healthy with no adverse or long term effect from anything
If the journalism on this subject from someone (not myself) who is a lead author of a paper in "Nature" (albeit, > 20 years ago), PhD in Pathology from Duke University, former pharma exec, and currently, journalist and not-well-known media personality, might interest you, check these links:
https://osf.io/wx3zn/ ( Paper from the expert panel called the Front Line COVID-19 Critical Care Alliance (FLCCC), created and led by Professor Paul E. Marik ; articles in the blog linked below cover the failure-by-omission of the hcq studies cited here).
tldr; While the exposure that the Gideon M-K article does is fascinating and seems to expose a large fraud, there's a lot more evidence for ivermectin's purported efficacy.
Yeah, while it's disheartening to see that this research may have been fabricated a sizable amount, it also appears that places that may have leant on this information to justify using ivermectin look to now have a strong correlation between its rollout time and a reduction in cases and deaths from covid19.
Use the principle of charity - if you were a doctor who believed the data supporting ivermectin use against covid, as both treatment and preventive measure, and believed that the data suggested covid could be eradicated if the whole world went on it for 30 days, would you not also be yelling "hey, everybody, I think there's something important here!?"
The link you provided says this website lists some studies which don't meet its methodological standards. I understand that can be problematic, but that doesn't make them 'spam' sites.
I'd wager the people downvoting me didn't even look at the material you reference, nor the studies in the meta-analysis I posted.
Welcome to the suck. Most don't. It's less of a dopamine hit if before posting anything you take 2-3 hours to go through at least 1 or 2 papers in detail.
Then again, if you' want to show equanimity during a controversy, you'd have to go read what is said on the "other side" of any such debate.
IMHO, most people don't want to be "nuance"-pilled either way on any subject, much less in regards to the Covid situation. Going straight to the jugular in a comment is easier.
It's more that this website doesn't follow any methodological standards:
> Different websites (such as https://ivmmeta.com/, https://c19ivermectin.com/, https://tratamientotemprano.org/estudios-ivermectina/, among others) have conducted meta-analyses with ivermectin studies, showing unpublished colourful forest plots which rapidly gained public acknowledgement and were disseminated via social media, without following any methodological or report guidelines. These websites do not include protocol registration with methods, search strategies, inclusion criteria, quality assessment of the included studies nor the certainty of the evidence of the pooled estimates. Prospective registration of systematic reviews with or without meta-analysis protocols is a key feature for providing transparency in the review process and ensuring protection against reporting biases, by revealing differences between the methods or outcomes reported in the published review and those planned in the registered protocol. These websites show pooled estimates suggesting significant benefits with ivermectin, which has resulted in confusion for clinicians, patients and even decision-makers. This is usually a problem when performing meta-analyses which are not based in rigorous systematic reviews, often leading to spread spurious or fallacious findings.
People seem to be assuming, since there are flaws in the meta analysis, that means there must be flaws in all of the underlying research, which doesn't appear to be the case when looking at the publications.
The evidence is unambiguously clear. The "but there's no double blind randomly selected placebo controlled trial" line is becoming tiresome. There is sufficient data for prophylactic efficacy to justify widespread preventive dosing. There is sufficient data to justify use in treatment at all stages after infection. There is 4 decades worth of data on widespread use with billions of human doses to demonstrate its safety, with both accute and chronic use, saving countless lives.
The mental contortions and ethical gymnastics people are displaying in opposition to ivermectin even being discussed is pretty impressive.
There's a lot of heat and not much light from the folks hurling the conspiracy theory epithets. Disregard the arguments and noise and acquire the data for yourselves - tens of millions have already been treated, and hundreds of thousands of lives saved by countries that have deployed ivermectin. It appears to be as effective on novel variants and seems to be as good or better than vaccinations in preventing infection. Figure out the he said she said nonsense later.
I don't know how you call this evidence, it's a bunch of un-sourced charts (the "sources" link to random data dumps on government websites and there's no indication of how the "analyst" constructed charts from them)
He's not some internet rando. He's an academic, a PhD out of university EAFIT in Colombia. It looks like he's currently working as a data analyst doing postdoc work at Cambridge?
Anyway, if you make the hop to his papers and preprints, they look proper and describe the methodology. The paper is linked above is by all appearances well and thoroughly sourced and annotated, and is the source for some of the charts and data on the layman friendly site.
In good faith, what else would you think good measures to determine the legitimacy of the information being presented?
There's his Twitter, with lots of links and references and conversations with other doctors and researchers. Even being super skeptical, it doesn't look like he's a sock puppet or a deluded nutjob.
His twitter is completely unhinged trying to attribute any change in a covid cases/deaths chart somehow to starting/stopping interest in IVM. No thanks!
54 comments
[ 2.7 ms ] story [ 119 ms ] threadSorry but this demonstrates a severe misunderstanding of the way medical studies are performed and used in clinical practice. The only way you know a drug is beneficial is to do the study and get the data.
[1] https://journal.chestnet.org/article/S0012-3692(20)34898-4/f... [2] https://www.medpagetoday.com/special-reports/exclusives/9348...
For example if a patient arrives to the hospital and s/he is so ill that must be intubated immediately and can't sign the paperwork for the study or can't take oral pill [X] then s/he go to the no-ivermectin group. Does this increase the chances of death in the no-ivermectin group?
Another example, if someone takes ivermectin and recovers, but is readmitted later, then s/he is excluded [Y]. Does this increase or decrease How does this increase the chances of death in the no-ivermectin group?
About the first question: probably yes, but you may disagree.
About the second: I have no idea, perhaps it artificially decrease the death rate in the no-ivermectin group, I have no idea.
So, it's very difficult to be sure that you are comparing the outcomes correctly without a randomized controlled trial.
About [2]:
> Hill and colleagues assessed 24 randomized trials totaling 3,328 patients that involved some type of control, whether it was standard of care or another therapy. Sample sizes ranged from 24 to 400 participants. Eight of the studies had been published, nine were preprints, six were unpublished results shared for the analysis, and one was reported on a trial registry website.
I think that now there are like ~34 trials. If you look at them, most of them are small and no statistically significant. The problem is reporting and publication bias. Studies with a good/favorable outcome are published. Studies with a bad outcome are uninteresting and discarded.
For example https://c19ivermectin.com/chowdhury.html compares Ivermectin and Hydroxychloroquine. It is listed as a success in the https://ivmmeta.com/#fig_fpr but it's not listed a failure in the https://hcqmeta.com/#fcite_rct site.
[X] From the study:
> Patients in the ivermectin group received at least one oral dose of ivermectin at 200 μg/kg in addition to usual clinical care.
[Y] From the study:
> Patients who had at least two separate admissions placing them in both groups also were excluded.
He would use anything that worked to save lives but Ivermectin just doesn't work. On one day he personally admitted 22 people to the hospital with Covid and 14 of those had been taking Ivermectin. 10 of them ended up in ICU and some of them had passed away a few days later when the interview was held.
Part of the problem seems to be that it masks a lot of the early symptoms of covid so the patients don't get prescribed things like corticosteroids that do help until much later than normal.
14 admitted out of population size of how many IVM users please? (Consider those who get the shots also get C19, though at a much lower rate vs not having C19 before nor shots; I'd like to compare the 2 rates.)
Is 'masking' ~= slowing down disease & symptoms?
BTW, the MD who testified before US Congress to research about IVM more (Dr Pierre Kory) also testified a few months prior to use corticosteroids for C19. They reccomend both & many other things (like Zinc, VitD) as part of their protocol.
https://covid19criticalcare.com/ivermectin-in-covid-19/
Completely agree. That's the correct question. Is the number higher or lower than the people that is not taking IVM, proportionally? The problem is that to have the correct answer you must do a randomized controlled trial (double blind to avoid other differences in the treatment and bias) (large to avoid flukes).
The comments on the top story, getting 300+ votes, are also a sight to behold: ‘I truly hope in the coming years the censorship of this topic will be the catalyst for allowing free speech to prevail on social media.“ (https://news.ycombinator.com/item?id=27562412). Also: “Please do not spread fake news. All current vaccines are less than 1% effective.”
Let’s see if the people who read those stories get a chance to see the correction, as well.
Those who read the above story would know:
> Let's see if the people who read those stories get a chance to see the correctionIf you would be so kind as to identify anything in the 2017 Nature paper that was corrected by a 2021 "blog post" or any other literature, that would be helpful.
The Nobel prize for Ivermectin has not been retracted. The 2017 paper preceded therapeutic debates of 2020 or 2021.
uhhh. bud. have i got some extremely depressing reading for you...
I think invermectin doesn't sound promising at all, but there are some real atrocities in the literature, lemme tell ya...
Hey Gideon, how much $$$ did Big Pharma pay you off to write this "hit piece" ?
The core of this story is based on ONE research study in Egypt. Ivermectin has been proven effective against covid19 in numerous double blind controlled studies.
Could 10 well published American and European specialist doctors with decades of experience be in a conspiracy ? I doubt it.
https://covid19criticalcare.com/about
https://covid19criticalcare.com/about/flccc-alliance-contrib...
27 controlled trials, including a total of 6,612 patients have been completed using well-matched control groups• 16 trials,including over 2,500 patients,a reprospective,randomized,controlled studies• 11 of the 27 trials have been published in peer-reviewed journals,3,900 patients,remainder are in pre-print
More recent studies also fail to show statistical significance for Ivermectin in COVID-19: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s128... There are further Ivermectin trials ongoing.
Meanwhile, Ivermectin has become deeply intertwined with conspiracy theory circles who have come to believe that Ivermectin is a magic bullet against COVID-19. They can't understand why governments aren't deploying Ivermectin to end the pandemic, which has spawned numerous waves of misinformation and conspiracy theories that pharmaceutical companies and/or governments are acting to cover up what they believe is a miracle cure.
If you want a peak into some of the conspiratorial thinking around Ivermectin, look at the top posts on the /r/ivermectin sub on Reddit: https://www.reddit.com/r/ivermectin/top/?t=month The topic has spread to popular outlets like the Joe Rogan podcast and Fox News, as well as become a meme in conspiracy and anti-vax circles.
It's still possible that Ivermectin might have some small modulating effect on COVID-19, but there's no real evidence that it's actually a miracle cure. We've also known for a long time that Ivermectin can cause serious adverse neurological events in certain populations: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5929173/
https://roundingtheearth.substack.com/p/the-meta-analytical-...
There is sufficient proofs pro-IVM. Yes there is anti-proofs, I'm sure there are valid concerns there also. But consider how much $$$ exchanges hands with vaccines, which the emergency authorization of may not have happened if IVM was fully recognized treatment for C19. Not only the profits of the shots is more, but said companies already spend much $$$ on advertising on news channels & web, cloud compute time on major platforms (MicroSoft, Google, Amazon), research funding, etc... (I'm NOT saying the billion$ is proof of bias, but something to consider.)
https://covid19criticalcare.com/wp-content/uploads/2020/11/F...
Wonder if some people have a similar mutation?
Perhaps we don't have the same mutations, but it's totally possible.
A relevant paper that compares human and dog versions: https://pubmed.ncbi.nlm.nih.gov/16686372/
The impression I get is that he seems even-handed to a certain stripe of people who think that playing to their bias and/or giving unquestioning air time to contrarians is what constitutes even-handedness.
Am I even vaguely on track here? I don't have much interest in interview shows in general; the format just isn't terribly interesting to me. The few I do listen to are those that invite relatively obscure scientists to explain their work -- the Ologies podcast and the BBC's Life Scientific. I dislike politics, after decades of watching it become worse. But I feel like I should have an inkling of what it's about.
Is Joe Rogan a "good interviewer"? I haven't watched enough of him to have much of an opinion, but what little I have watched, his guests seem pretty comfortable talking to him.
So, it is very hard to derive any efficacy data except in cases where the improvement is significant, like in the cases of current vaccines.
If a placebo reduces lethality from 2% to 1% that may sound like a 50% reduction, but actually it is just a 1% improvement. This can only be ruled out with higher p-values which demand bigger samples.
There are hundreds of teams in the world right now trying many different drugs to treat Covid-19. It possible to use a meta analysis approach and carefully select works where statistics were favorable by mere chance. This is rare, but considering the enormous number of works, it is possible to find them.
A more trustworthy meta analysis can be derived if peer-reviewed published papers are also chosen randomly. But of course, such meta analysis will also be biased by the kinds of papers that are likely to be published after peer review.
?!? I thought it was 0.3%? Citation? Anyhow, all those stats are askew; not everyone who got C19 got tested, but most who died (from any cause) did.
> that may sound like a 50% reduction, but actually it is just a 1% improvement
Well, you just described how the C19 vax say how they improve survival rates.
https://youtu.be/Jkwn5I8tLmE?list=PL2S-_LNXy9Vx24_o9zSTF6MAD...
At least in brazil, lethality is under 3% ( https://ourworldindata.org/coronavirus/country/brazil ). Considering under reporting, you're right, this number can be even lower.
> Well, you just described how the C19 vax say how they improve survival rates.
In brazil, coronavac has 100% efficacy against death cases during the test phase. Reducing lethality from 3% to 0% is very different than reducing from 2% to 1%.
1) Isn't the default answer to a question headline supposed to be "No"?
2) How is one supposed to sift the wheat from the chaff these days? Everyone uses terms like "scientists agree that" and "here's a list of studies supporting my point of view". I took Ivermectin seriously because of Brett W etc (and perhaps I still should) but as humans we need heuristics, people who we can trust to give us well researched info, otherwise each and everyone of us needs to be an experienced researcher in every field to have any confidence of the "facts". I don't have time for that - I have a living to make, kids to spend time with, sleep to have....where are the smart people that we can trust?
Sorry Dang, I know this is kinda off topic but....kinda not?
You don't necessarily need to be one of the anointed, but you do need to read a lot of papers in a particular field critically. You need to read and understand enough papers in a field that you can tell the difference between a normal paper and a completely bonkers one, to tell which have novel methodology and which methods are less rigorous; you need to read enough to understand the context of each paper in the broader body of research. What other research has been done in a similar vein, which papers agree with each other, which are incompatible. Whether the data in one paper can be accounted for by the hypotheses in another.
Any individual paper can be flawed, unlucky or outright fraudulent. When you just grab a paper or two at random, you're engaging in a dangerous sampling problem. When the papers aren't grabbed at random, it's even worse.
I think you summarized the current situation perfectly.
It's an inverse Russian roulette of knowledge where only one of the bullets is missing :
hospitalized, gave grandma covid, no go into malls and trains in France, "nudged" into vaccination, dead, perfectly healthy with no adverse or long term effect from anything
https://osf.io/wx3zn/ ( Paper from the expert panel called the Front Line COVID-19 Critical Care Alliance (FLCCC), created and led by Professor Paul E. Marik ; articles in the blog linked below cover the failure-by-omission of the hcq studies cited here).
https://www.peakprosperity.com/shamefully-ignorant-journalis...
India Graph - https://covid19criticalcare.com/wp-content/uploads/2021/06/A...
Mexico Graph - https://covid19criticalcare.com/wp-content/uploads/2021/01/C...
Slovakia Graph - https://raw.githubusercontent.com/JQ-dev/FLCCC_charts/main/T...
Full link containing the above. https://covid19criticalcare.com/ivermectin-in-covid-19/epide...
https://ivmmeta.com/
I'd wager the people downvoting me didn't even look at the material you reference, nor the studies in the meta-analysis I posted.
Then again, if you' want to show equanimity during a controversy, you'd have to go read what is said on the "other side" of any such debate.
IMHO, most people don't want to be "nuance"-pilled either way on any subject, much less in regards to the Covid situation. Going straight to the jugular in a comment is easier.
> Different websites (such as https://ivmmeta.com/, https://c19ivermectin.com/, https://tratamientotemprano.org/estudios-ivermectina/, among others) have conducted meta-analyses with ivermectin studies, showing unpublished colourful forest plots which rapidly gained public acknowledgement and were disseminated via social media, without following any methodological or report guidelines. These websites do not include protocol registration with methods, search strategies, inclusion criteria, quality assessment of the included studies nor the certainty of the evidence of the pooled estimates. Prospective registration of systematic reviews with or without meta-analysis protocols is a key feature for providing transparency in the review process and ensuring protection against reporting biases, by revealing differences between the methods or outcomes reported in the published review and those planned in the registered protocol. These websites show pooled estimates suggesting significant benefits with ivermectin, which has resulted in confusion for clinicians, patients and even decision-makers. This is usually a problem when performing meta-analyses which are not based in rigorous systematic reviews, often leading to spread spurious or fallacious findings.
The evidence is unambiguously clear. The "but there's no double blind randomly selected placebo controlled trial" line is becoming tiresome. There is sufficient data for prophylactic efficacy to justify widespread preventive dosing. There is sufficient data to justify use in treatment at all stages after infection. There is 4 decades worth of data on widespread use with billions of human doses to demonstrate its safety, with both accute and chronic use, saving countless lives.
The mental contortions and ethical gymnastics people are displaying in opposition to ivermectin even being discussed is pretty impressive.
There's a lot of heat and not much light from the folks hurling the conspiracy theory epithets. Disregard the arguments and noise and acquire the data for yourselves - tens of millions have already been treated, and hundreds of thousands of lives saved by countries that have deployed ivermectin. It appears to be as effective on novel variants and seems to be as good or better than vaccinations in preventing infection. Figure out the he said she said nonsense later.
He's not some internet rando. He's an academic, a PhD out of university EAFIT in Colombia. It looks like he's currently working as a data analyst doing postdoc work at Cambridge?
Anyway, if you make the hop to his papers and preprints, they look proper and describe the methodology. The paper is linked above is by all appearances well and thoroughly sourced and annotated, and is the source for some of the charts and data on the layman friendly site.
In good faith, what else would you think good measures to determine the legitimacy of the information being presented?
There's his Twitter, with lots of links and references and conversations with other doctors and researchers. Even being super skeptical, it doesn't look like he's a sock puppet or a deluded nutjob.