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GidMK's profile
Health Nerd
Health Nerd
Health Nerd
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@GidMK

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Health NerdVerified account

@GidMK

Epidemiologist. Writer (Guardian, Observer etc). "Well known research trouble-maker". PhDing at @UoW Host of @senscipod Email gidmk.healthnerd@gmail.com he/him

Sydney, New South Wales
theguardian.com/profile/gideon…
Joined November 2015

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    1. Health Nerd‏Verified account @GidMK Jul 6

      Health Nerd Retweeted Health Nerd

      3/n In fact, it is amazingly similar to the other systematic review that I looked at recently, down to THE SAME DETAILS THAT ARE WEIRD This whole thing feels like some bizarre deja-vuhttps://twitter.com/GidMK/status/1407140602009985025?s=20 …

      Health Nerd added,

      Health NerdVerified account @GidMK
      This new systematic review/meta-analysis of ivermectin for COVID-19 has come out, and everyone's asking me to review it My take - decent study, but the devil's in the details 1/n pic.twitter.com/RB0dfYe5vr
      Show this thread
      1 reply 5 retweets 51 likes
      Show this thread
    2. Health Nerd‏Verified account @GidMK Jul 6

      4/n Skipping over the other methodological stuff (which was VERY similar), there is still a worry about publication bias in this newer review. Potentially an issue, hard to exclude as a problempic.twitter.com/Sa3NBfx5em

      1 reply 5 retweets 44 likes
      Show this thread
    3. Health Nerd‏Verified account @GidMK Jul 6

      5/n The authors did attempt to test for this (good!) and found no strong evidence for publication bias So some improvement there

      1 reply 3 retweets 41 likes
      Show this thread
    4. Health Nerd‏Verified account @GidMK Jul 6

      6/n But, as before, the devil really is in the details This review included those same two studies that I mentioned before - Elgazzar and Niaee This time, however, they were rated as at LOW risk of bias (i.e. high quality)pic.twitter.com/5cFzdHiGde

      2 replies 7 retweets 51 likes
      Show this thread
    5. Health Nerd‏Verified account @GidMK Jul 6

      7/n Now, it's perhaps debatable whether these have some concerns or are at very high risk of bias. I think the latter. But I genuinely cannot see how anyone who read the studies could think that they were at low risk of bias

      1 reply 3 retweets 47 likes
      Show this thread
    6. Health Nerd‏Verified account @GidMK Jul 6

      8/n Let's compare to another paper - Mahmud (2020) is a study that everyone would agree is at low risk of bias. It is just incredibly well done Also, it found a benefit for ivermectinhttps://journals.sagepub.com/doi/10.1177/03000605211013550?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed …

      3 replies 7 retweets 50 likes
      Show this thread
    7. Health Nerd‏Verified account @GidMK Jul 6

      9/n Here's how Mahmud describes randomization. It is incredibly detailed, including descriptions of exactly how allocation was concealed, and even descriptions of the placebo meds to ensure that blinding was maintainedpic.twitter.com/a4XfWsPN74

      1 reply 4 retweets 44 likes
      Show this thread
    8. Health Nerd‏Verified account @GidMK Jul 6

      10/n In contrast, here is ALL OF THE INFORMATION from Elgazzar and Niaee on randomization, allocation concealment, etcpic.twitter.com/VcjWJPXVET

      1 reply 5 retweets 44 likes
      Show this thread
    9. Health Nerd‏Verified account @GidMK Jul 6

      11/n Elgazzar simply does not have enough information to make a reasonable assessment (this would usually be high risk of bias for me). Niaee is clearly better, but the information is still not nearly as detailed as the Mahmud study

      1 reply 3 retweets 41 likes
      Show this thread
    10. Health Nerd‏Verified account @GidMK Jul 6

      12/n And as I pointed out in my other thread, Niaee had ~enormous~ differences between groups at baseline, which should automatically put it at high risk of bias in the field of randomizationpic.twitter.com/tBrjnqyg2P

      1 reply 4 retweets 48 likes
      Show this thread
      Health Nerd‏Verified account @GidMK Jul 6

      13/n I could go on, but suffice to say that I genuinely do not understand how anyone could read these studies and consider them at a low risk of bias. Have a look for yourself, there are innumerable issues: https://www.researchsquare.com/article/rs-109670/v1 …https://www.researchsquare.com/article/rs-100956/v3 …

      9:53 PM - 6 Jul 2021
      • 5 Retweets
      • 46 Likes
      • Truite D'Amour, Anti-Racist Csdk 🌊🎼🎾🐊 (((Jabb3r0cky))) Impeach his ass James Igoe Tara Zarry MIGUEL♊🔥💚💙💜❤️ Steeven Yeh InCytometry - Graham Bottley
      3 replies 5 retweets 46 likes
        1. New conversation
        2. Health Nerd‏Verified account @GidMK Jul 6

          14/n And guess what happens if you exclude these two studies from the mortality meta-analysis (RE/IV model in Stata) in this particular study? Suddenly, ivermectin has NO BENEFIT Againpic.twitter.com/OHjEaqYrEF

          4 replies 25 retweets 100 likes
          Show this thread
        3. Health Nerd‏Verified account @GidMK Jul 6

          15/n Indeed, the entirety of the ivermectin benefit across all of the literature appears to come down entirely to these two pretty low-quality pieces of researchpic.twitter.com/C5q5Kqtlwm

          2 replies 38 retweets 110 likes
          Show this thread
        4. Health Nerd‏Verified account @GidMK Jul 6

          16/n Now look, take this all with a pinch of salt, rating of bias is an inherently subjective thing and I might not be right That being said, it is extremely concerning that all of the benefit seen for ivermectin seems to come from just 2 studies

          1 reply 9 retweets 70 likes
          Show this thread
        5. Health Nerd‏Verified account @GidMK Jul 6

          17/n It is not a coincidence that out of the three (!) ivermectin meta-analyses to be published in the last 14 days, the two that included these studies found a benefit and the one that excluded Elgazzar did not

          4 replies 10 retweets 77 likes
          Show this thread
        6. Health Nerd‏Verified account @GidMK Jul 6

          18/n In the absence of new evidence (this meta-analysis doesn't really count), I reckon that the only reasonable stance is that we don't really know if ivermectin works, and probably should not be using it outside of clinical trials 🤷‍♂️

          10 replies 19 retweets 129 likes
          Show this thread
        7. End of conversation
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