Gideon is being modest here: this is MASSIVE. A single RCT, which has caused 2 meta-analyses to show benefit of ivermectin, is almost certainly FRAUD. Remove that study, and both meta-analyses (Lawrie and Hill) show NO benefit. Astonishing story.https://twitter.com/GidMK/status/1415764372362649601 …
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Replying to @AlastairMcA30
@AlastairMcA30, you're making unsupported claims again. the Hill review included leave-one-out sensitivity analysis, and still found significance with this study's omission.3 replies 0 retweets 4 likes -
Replying to @NeilTStacey
Alastair McAlpine, MD Retweeted Health Nerd
Not really: all benefit rests with essentially 2 studies: Elgazzar and Niaee. One of which is fraud and the other is dodgy. Dr Hill has responded to me that he’s already re-running his meta-analysis. So… very supported.https://twitter.com/gidmk/status/1415906647185125377?s=21 …
Alastair McAlpine, MD added,
Health NerdVerified account @GidMKReplying to @AlastairMcA30 @pash22 @DrAndrewHillYep. It's also worth noting that once you exclude Elgazzar, any potential benefit entirely rests on another very high-risk study Niaee et al, which has some extremely worrying aspects H/T@K_Sheldrick pic.twitter.com/nu7qwQh3wl2 replies 1 retweet 9 likes -
Replying to @AlastairMcA30 @NeilTStacey
Also worth noting that the Hill meta-analysis didn't entirely exclude Elgazzar - the leave-one-out approach excluded either of the estimates (mild/severe) from the paper, but not the entire studypic.twitter.com/aI3LPHnKBW
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Here's what I get when I run the standard inverse variance random-effects model in Stata 15 using the metan command. Left including, right excluding Elgazzarpic.twitter.com/mWKmIgI1Z5
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Replying to @GidMK @AlastairMcA30
Thanks for the analysis! A modest benefit remains here, so it's unlikely the issue will be entirely put to bed until findings from PRINCIPLE, but the notion of IVM as magic bullet should die here. PRINCIPLE may well show something along these lines (~20% mortality reduction) /1
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Replying to @NeilTStacey @AlastairMcA30
If you exclude both Elgazzar and Niaee the confidence interval goes from ~0.6-1.25. That's a pretty solid null finding imo
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Replying to @GidMK @NeilTStacey
Null hypothesis has an excellent chance of standing, unless some very compelling new data comes along.
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I'm waiting for the bigger trials, but I think we can say quite comfortably that at this point in time the best-quality evidence does not support the use of ivermectin for COVID-19 outside of clinical trials
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