11/n There is no attempt to actually assess HCQ usage, despite this being SOMETHING YOU COULD DO You could look at HCQ doses given/purchases made in countries by date, for example Instead, the authors reference tweetspic.twitter.com/1QATjL1c0m
Epidemiologist. Writer (Guardian, Observer etc). "Well known research trouble-maker". PhDing at @UoW Host of @senscipod Email gidmk.healthnerd@gmail.com he/him
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11/n There is no attempt to actually assess HCQ usage, despite this being SOMETHING YOU COULD DO You could look at HCQ doses given/purchases made in countries by date, for example Instead, the authors reference tweetspic.twitter.com/1QATjL1c0m
12/n So right off the bat, any analysis is meaningless. We have no idea whatsoever whether people in the 'intervention' group ACTUALLY RECEIVED HCQ, making the calculations largely a waste of time But that's just the start of the errors here
13/n Next, we can look at the analysis itself Or, rather, we can't, because the authors don't describe what they did, only giving relative risks and p-values
14/n Without any description of the analysis whatsoever, we cannot trust a single number that is portrayed on this site, because the stats could be simply incorrect Impossible to know!
15/n The authors then report using "controls" to adjust the estimates, but these controls are again incredibly misleading For example, country-level obesity ratespic.twitter.com/HGHc9md58T
16/n The obesity rates are referenced to the CIA world factbook Problem is, this data was last entered in 2016, and often is cited to sources up to a decade old So it's really very out of date!
17/n But forgetting that, this is a classic example of the ecological fallacy You CANNOT assume that country-level obesity rates apply to the people who got COVID-19 - if you don't check that this is true, whatever you produce is basically nonsensicalhttps://medium.com/@gidmk/why-you-might-be-wrong-about-covid-19-the-ecological-fallacy-e8a47a030902 …
18/n On top of this, the outcome measure is terrible. There is no attempt to clarify whether the reported deaths from Our World In Data are correct for the country, simply the assumption that Algeria and France have comparable death reporting systems
19/n The ecological fallacy is at play in terms of death rates as well - deaths/million is a meaningless measure if you don't take infections into account!
It's not a limitation, it's a fundamental flaw. India, for example, is still increasing rapidly in terms of cases and deaths. If you only look at deaths/million, you completely ignore the nature of the epidemic itself
The seroprevalence data for India, thus far, is extremely problematic (very biased samples). But that was just one example - Algeria is increasing in deaths and cases. Comparing them to France, which is stable, on deaths/mil makes no sense
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