Perfect example to explain why we need #systematicreviews & not narrative reviews! The author isn't even a mask expert! Narrative reviews can be biased by selecting the evidence that supports the hypothesis of authors, ignoring quality & other evidence!https://www.nature.com/articles/d41586-020-02801-8?fbclid=IwAR3OJHss9MsOINcegBj8NIUWyf9GlDHBBc_1njkOL0_SV_-gGb58hJImBTs …
Isn’t the mentioned systematic review and meta-analysis quite compelling?https://www.sciencedirect.com/science/article/pii/S0140673620311429?via%3Dihub …
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1/6 Yes, but the data were mainly coming from health care seeting, using medical masks, based on viruses other than SARS-CoV-2 (only 4), and were of v bad low quality- as authors conclude! Also, studies in non health care seetings were not community/SARS-CoV-2.
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Completely agree, but seems to be the best evidence so far.
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2/6 To simplify- have u read these two papers? V bad quality as studies in the meta-analysis of Lancet. Meta-analyse such studies and you find strong significant results. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2770872 … https://jamanetwork.com/journals/jama/fullarticle/2768533 …
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3/6 the question I have: Do we make obligatory an intervention based on very low quality studies? This paper shows that the agreement between meta-analysis and RCTs addressing same question is 0.35 (0.06-0.67)- low!https://www.nejm.org/doi/10.1056/NEJM199708213370806?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov …
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4/6 On the other hand, Meta analyses of RCTs show "Compared to no masks there was no reduction of influenza-like illness"https://www.medrxiv.org/content/10.1101/2020.03.30.20047217v2 …
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5/6 Also, Clinical trial results caution against the use of cloth masks, which are used in community! Is anyone investigating how community is using the masks? There are people keeping masks for days, and one study showed cloth masks release fibers!https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/ …
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6/6 Last, let's see real world data: Spain and France, the countries with highest adherence to masks since June, are having for some days the highest numbers of infections in Europe! There are challenges in applying mask use in community, which is not a health care setting
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I quote: “Correlation is far from causation, and correlation cannot drive decision, but help generate ideas to test further!”
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Right, but I think the point was on the Nature article itself as "meta–meta-analysis".
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Yes, but we need to do high quality meta-analysis as well. Is it worthy meta-analyzing studies as this one https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2770872 … ? It's better to say there is no evidence, than say there is some evidence!
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