14/n The primary results are presented in this forest plot There are a number of issues herepic.twitter.com/eySEa84CWw
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25/n It's also worth noting that several of these retrospective clinical audits were from the same places at overlapping times, and so probably included some of the same patients anyway
26/n There are, somehow, even more issues to examine here For one thing, the review protocol was poorly described and hard to followpic.twitter.com/AVrJ50Kx6s
27/n Remember; this is the pre-proof version of the study In other words, the final, slightly unedited, publishable version In that context, this methodology is FAR too opaque
28/n The results show you what I'm talking about There is NO WAY that searching with those search terms gets you only 23 studies Even just plugging in the search terms to PubMed gives you >100 studiespic.twitter.com/73Qn7v1x9u
29/n It took me less than 5 minutes to find a study that matches the inclusion criteria but was not included That's...worrying
30/n On top of that, in some cases the authors have included older versions of the included studies That's less than ideal (newer versions CORRECT mistakes!)
31/n There is so much more I could look at here, but honestly you have to stop somewhere This study is riddled with flaws and almost certainly does not present an accurate estimate of the effect of HCQ or CQ
32/n If you want a decent summation of the evidence for/against HCQ, a good source is CEBM: "Current data do not support the use of hydroxychloroquine for prophylaxis or treatment of COVID-19"https://www.cebm.net/covid-19/hydroxychloroquine-for-covid-19-what-do-the-clinical-trials-tell-us/ …
33/n I forgot to mention, the paper was received, revised, and accepted within a month While not unheard of, that's very quick for academic publishing!pic.twitter.com/UgR3WO2BPB
34/n In summation, the paper: - inadequately rates risk of bias - inappropriately combines estimates... - ...that may have been miscalculated It is hard to know what to make of this, except to say that the paper itself is not very useful in any way
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