It's pretty complex, but basically once you're into the single digits it's hard to draw much meaning from logistic models i.e.https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-016-0267-3#Sec12 …
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They discuss overestimation of covariate-outcome relation. In our case where the covariates are the risk factors, it means the effect of VitD is actually larger. In any case, even if you assume only people with hypertension go to ICU, the result is significant (see our analysis).
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Replying to @Rootclaim @saarwilf
I mean, that's not true and it mostly misses the point so...I disagree. It really comes back to the fact that a tiny pilot study doesn't form a strong basis for decision-making
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Replying to @GidMK @Rootclaim
You need to think risk/reward. What is the probability that the study is completely wrong, what is the risk of treatment, and weigh those to make a decision with positive expected impact on patient health.
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Replying to @saarwilf @Rootclaim
I always find that attitude striking. HCQ was recommended on the same basis, and with arguably much better evidence, and now we know it doesn't work at all and we've wasted vast sums and potentially harmed millions. It is not such an easy either/or, I think
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Replying to @GidMK @Rootclaim
HCQ was exactly how not to do science. No RCT, no history of effectiveness against respiratory viruses, no multiple correlation studies, no causal models, no clear mechanism of action. It's like rejecting vaccines, because doctors once used leeches and it failed.
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Replying to @saarwilf @Rootclaim
The HCQ proponents would argue precisely the opposite. And vitamin D has a long, long history of being touted as a cure for every disease under the sun and failing to show a benefit in rigorous RCTs
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In fact, taking the most robust evidence from a large systematic review of thousands of patients on vitamin D prior to the pandemic, there is a modest reduction in the rate of respiratory infections with vit D supplementation, but no benefit to any hard outcomes like death
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But, and this is crucial, I don't think we can take it as writ that evidence applying to RTIs, which are caused by a plethora of viruses, will be true for COVID-19. So we need evidence - GOOD evidence - or we're mostly just flying blind
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Replying to @GidMK @Rootclaim
Of course, this is just part of the puzzle. Please read through the summary I sent you. There is nothing remotely close to that on HCQ.
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There are literally dozens of websites that look exactly the same for HCQ. I'm not saying that the two treatments are the same - I'm saying a lack of evidence doesn't allow for good decision-making no matter how many inconclusive studies you link to
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