10/n In contrast, here is ALL OF THE INFORMATION from Elgazzar and Niaee on randomization, allocation concealment, etcpic.twitter.com/VcjWJPXVET
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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10/n In contrast, here is ALL OF THE INFORMATION from Elgazzar and Niaee on randomization, allocation concealment, etcpic.twitter.com/VcjWJPXVET
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
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
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 …
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
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
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
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
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 
I see they didn't include the largest placebo controlled trial on this to date which found no significant result? https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06348-5 … Perhaps it was too new?
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