So, one of the biggest studies to date on ivermectin for COVID-19 has issues significant enough that, if not fraud, are so serious that it invalidates the study without further explanation I promised a thread Here we go 1/nhttps://twitter.com/GidMK/status/1415764372362649601 …
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3/n The basic story is pretty astonishing. I've previously written about this study, Elgazzar et al, and why there are some indications that it's low-quality and potentially very unreliablehttps://twitter.com/GidMK/status/1407140636281638912?s=20 …
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4/n But
@JackMLawrence noticed something weirder when he read the paper It appears that pretty much the entire introduction is plagiarized That's...not great Left is Elgazzar et al, right another study published 3 months beforepic.twitter.com/yVg4WrR6CG
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5/n But that's just the start of this wild story You see, the authors had shared their data online They locked it, but our tenacious hero
@JackMLawrence figured out the password - 1234pic.twitter.com/E2Wc2O9wU0Show this thread -
6/n To cut a very long story short, the file uploaded by the authors as the data for the study is filled with errors, and certainly not data collected from real patients in a real study
@sTeamTraen with the in-depth analysis here: https://steamtraen.blogspot.com/2021/07/Some-problems-with-the-data-from-a-Covid-study.html …Show this thread -
7/n One tiny example of the issues with the data - most of the patients in one of the control groups are clones of each other, with very minor changes This is a very common feature of scientific fraudpic.twitter.com/8VlPC5nkJP
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8/n Moreover, the study is meant to have started on the 8th of June according to the authors Of the people who died, fully 1/3 had been hospitalized and died BEFORE this date That's...badpic.twitter.com/3HPbTViNTD
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9/n You can actually download the file yourself to check, although the website is a morass of malware so it's a bit dicey
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10/n So is this the data file used in this study? Well...we don't know. Maybepic.twitter.com/DIMyycE2zN
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11/n It's certainly what the authors uploaded, and in many ways matches their results, but it is also inconsistent in some other ways that make the whole thing extraordinarily confusing
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12/n Problem is, even if this ISN'T the data that the authors actually collected (assuming they collected any data at all), there are still issues in the study For example, they used the wrong statistical tests several timespic.twitter.com/zURo3fpP0g
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13/n Their statistical methodology is...frankly really bizarre They had SPSS but looked up p-values by hand in paper tables? Wildpic.twitter.com/JSA6NMy2Hy
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14/n And let's not forget, pretty much the entire introduction WAS PLAGIARIZED Not good. Not good at all
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14.5/n Is the study fraud? We may never know. It is really, really hard to prove anything in cases like these, and unless the authors go public we might never know what actually happened beyond the issues that we've seen so far
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15/n What does this mean more broadly? Well, here's where the story gets both more interesting and somewhat darker This is currently THE BIGGEST RCT of ivermectin. It shows a mortality benefit of 90% That's huge
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16/n Being such a big study, it has been included in multiple meta-analyses. With such a vast benefit, it has a very large influence on the meta-analytic resultspic.twitter.com/hkaBoyN0Dq
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17/n Indeed, removing ~just this single piece of research~ from recent meta-analyses either mostly or entirely overturns the positive results that they found for ivermectin


pic.twitter.com/Bgw7fGOFyL
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18/n Worse still, the paper has been viewed over 130,000 times, and the comments are filled with medical doctors praising the authors and recommending ivermectin based on their results
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19/n In other words, this single study has drive ivermectin as a treatment to thousands, perhaps millions, of people And it is either so flawed as to be totally unreliable, or potentially outright fraud
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20/n But the story doesn't stop there. Remember, several meta-analyses have included this study in their results. Why would they do that? Well, they thought it was at LOW risk of bias (i.e. high-quality)pic.twitter.com/OG79Rv9MML
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21/n The pretty obvious issue we now have is that this study is clearly filled with problems, yet it's been included in meta-analyses that considered it to be a piece of top-quality research
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22/n At the absolute minimum, studies including this paper should revise their main analysis to exclude it until we have a reasonable explanation for all these issues
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23/n But we're left with the depressing realization that somehow EVERYONE MISSED THIS I reviewed the study. While I noted concerns with the way it was reported, I never even checked to see if it was fraud
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24/n How can it be that a study this problematic was used as evidence to treat 1,000s of people since November 2020, and no one noticed? No one cared?
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25/n Anyway, the TL:DR is that the largest study to date of ivermectin for COVID-19, which found a HUGE benefit for the drug, has just been retracted amid very serious concerns about plagiarism and fraud This will echo in the scientific community for years to come
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26/n While it is still certainly possible that ivermectin works for COVID-19, this has made a huge dent in that possibility. I await the large studies that are currently being conducted, because we really have no good evidence to rely on
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End of conversation
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