Ivermectin: balance of evidence shows no benefit against Covid-19

[quovadis]

Nope

I think you miss the point @Nerfherder was making and that by their own admission the quality of evidence provided as part of the study is poor thus that needs to be considered when interpreting the outcome/result/conclusion. Nothing confusing there. Ideally you don't want weak or moderate evidence at all. In terms of studies the gold standard is high. Anything less there is pretty much no confidence in the data.

 

[Geoff.D]

The question is if all doctors are complying with the requirements under section 21 including registration/application etc.

There is a list of approved products for use specifically under this S21 authorisation.

I’m not sure anyone lost anything - the S21 process is nothing new.

Their problem if they don't. And yes SAHPRA lost big time because it exposed their own deficiencies and understanding of the Act that governs them.

 

[Geoff.D]

You might want to preface that this is a review and not a study. Cherry picking from such and presenting as fact rather than hypothesis is problematic.

That is for those that read it to find out. And no was not cherry picking just highlighting some points. Read the article and you decide.

 

[quovadis]

Their problem if they don't. And yes SAHPRA lost big time because it exposed their own deficiencies and understanding of the Act that governs them.

Lol. If you say so. The biggest issue? It is my understanding that no drug manufacturer had wanted approval for Ivermectin in SA in the first place. That created the "deficiency" as you put it.

 

[Geoff.D]

explain what you understand section 21 to be.

Been there done that in another thread, long before the court case. The Act BTW is an example of how legally complicated some of legislation is. It is a patchwork mess.

 

[buka001]

I think you miss the point @Nerfherder was making and that by their own admission the quality of evidence provided as part of the study is poor thus that needs to be considered when interpreting the outcome/result/conclusion. Nothing confusing there. Ideally you don't want weak or moderate evidence at all. In terms of studies the gold standard is high. Anything less there is pretty much no confidence in the data.

This demonstrates the concept quite well -

https://twitter.com/i/web/status/1436267068257669120

 

[quovadis]

That is for those that read it to find out. And no was not cherry picking just highlighting some points. Read the article and you decide.

You're highlighting references to studies that are of poor quality referenced in a review written by a student?

 

[Geoff.D]

Nope. It's pretty confusing interpreting these studies sometimes. Results in clinical studies always include primary outcome measures and secondary outcome measures. The secondary outcome looks at use of ivermectin for more serious cases of covid-19 and when people are at the point of requiring mechanical ventilation. There is poor evidence to show ivermectin is beneficial past early stages... This Table 4 only refers to the information provided from 2 studies that were analysed for secondary outcomes.

For primary outcome (death from covid-19) measures, the 15 included clinical trials found that "ivermectin reduced the risk of death by an average of 62% compared with no ivermectin treatment ".
The evidence of this data was judged as MODERATE.

Evidence when grading quality of research is put into 4 standard categories. 'Moderate' being second after 'high'. Moderate definition means they believe that the true effect is probably close to the estimated effect.

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Spot on correct. And that is where casual skim reading gets many into deep water. Including the likes of the Cochrane analysts. They very often miss out on what really matters.

 

[quovadis]

They very often miss out on what really matters.

Studies of qualitative depth beyond reproach?

 

[JohnStarr]

5.56 Billion shots have already been administered in what is arguably the most hyper-analysed vaccine roll-out in human history.

No reporting on new infections, hospitalisations or deaths that I've seen have given me a moment's pause about my decision to jump in the queue for those Pfizer shots just as soon as I could.

Geoff helps people get the vaccination...and therein lies the irony!

 

[JohnStarr]

Hearsay and an urban legend at best. JS? Is he questioning the integrity of the health profession or what?

Lol...like you attacking the specialist doctor at Groote Schuur? Like questioning that integrity?

 

[Geoff.D]

The problem of poor quality trials is decades old and the reports that come out of them, so poor goes way beyond just this pandemic. The issue is years old.

 

[Sensorei]

I think you miss the point @Nerfherder was making and that by their own admission the quality of evidence provided as part of the study is poor thus that needs to be considered when interpreting the outcome/result/conclusion. Nothing confusing there. Ideally you don't want weak or moderate evidence at all. In terms of studies the gold standard is high. Anything less there is pretty much no confidence in the data.

No, I missed nothing. His point was misguided as I clearly explained. You don't really understand how statistical analysis works when doing a meta-analysis of studies. The reports are done with each study expected to have some degree of error. Moderately graded evidence is never discarded us unreliable.

Your layman's interpretation is not useful here. In layman's terms it mean's that the truth is probably close to what the data suggests but more research is required to establish certainty.

Read my explanation of what secondary outcome means in the setting of a study. Only secondary outcome evidence was poor. Nobody is claiming ivermectin is useful for patients with severe covid-19 illness or on a ventilator. That's what they refer to by secondary.

With science the devil is in the details, and unfortunately most people can't see or understand the details. They can only see a yes or a no as you've shown.

 

[Cosmik Debris]

Spot on correct. And that is where casual skim reading gets many into deep water. Including the likes of the Cochrane analysts. They very often miss out on what really matters.

And you're capable of in depth reading and understanding of medical research? When are you going to help me understand post # 4901?

 

[Stonemason]

I don't know what such behaviour is called but on a serious thread like this, it is just unacceptable!

I did not know this was a serious thread. I come here once a week for light entertainment whenever I feel a little blue. It is always good for a laugh.

 

[Sensorei]

It is always good for a laugh.

Coz discussing possible treatments to try stop people from dying is very funny.

 

[Geoff.D]

The reports are done with each study expected to have some degree of error. Moderately graded evidence is never discarded us unreliable.

This!

In layman's terms it mean's that the truth is probably close to what the data suggests but more research is required to establish certainty.

And this!

Nobody is claiming ivermectin is useful for patients with severe covid-19 illness or on a ventilator. That's what they refer to by secondary.

And double this!!!!

devil is in the details, and unfortunately most people can't see or understand the details. They can only see a yes or a no as you've shown.

And this in buckets full.

There are no perfect clear cut answers in this game. There are only better or poor probabilities with many confounding factors researchers cannot allow for and maybe don't even know they should allow for.

Stats is about using imperfect information coming out of a very confusing and complicated environment, analyzing it and providing direction for the way forward. It is hardly ever about perfection and being 100% spot-on correct. It is about getting as close to an answer so that progress can be made in a positive direction, NOT about 100% guarantees that sometimes some aspects will not be wrong.

It is also about deciding when enough information is available to allow progress.

To illustrate, 62% is considered not good enough to use IVM in a treatment plan for Covid 19, BUT at the same time, everyone is happy (the WHO gods have decreed it so) that 50% efficacy is "good enough" to allow the use of a vaccine for Covid 19?

 

[JohnStarr]

but more research is required to establish certainty.

When I was suggesting this in February holy crap did that irk Geoff. Apparently the only studies that were worth following or believing were the ones showing that it worked. nothing else. Never say IVM needs more studies here...you're going to get shot down.

 

[Stonemason]

Coz discussing possible treatments to try stop people from dying is very funny.

It is funny when people people regard IVM as a treatment when most health authorities in the world advises against it. That makes one laugh at the stupidity of mankind.

 

[Cosmik Debris]

Coz discussing useless possible treatments to try stop people from dying is very funny.

FTFY