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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 16

      7/n Step 2: remove only Elgazzar Immediately, the difference is notable. The primary benefit goes from 60% to 44%, is only marginally statistically significant, and there's no benefit in either Mild or Severe subgroupspic.twitter.com/QHjWGPXLOn

      4 replies 6 retweets 49 likes
      Show this thread
    2. Health Nerd‏Verified account @GidMK Jul 16

      8/n Ok, so that's an issue. What were extremely strong results are now statistically very weak and not beneficial in the major subgroups But there's a bigger issue here

      2 replies 6 retweets 44 likes
      Show this thread
    3. Health Nerd‏Verified account @GidMK Jul 16

      9/n Step 3: add in new research This study was published shortly after Bryant et al came out. It would certainly have been included in the analysis if it was already out (no fault to the authors of course) so let's add it inpic.twitter.com/Wc8I7Qmf4d

      2 replies 6 retweets 40 likes
      Show this thread
    4. Health Nerd‏Verified account @GidMK Jul 16

      10/n The significance of the model entirely disappears. Now ivermectin shows no benefit for mortality at all, even in the overall analysispic.twitter.com/QH8tdyXi7U

      1 reply 7 retweets 55 likes
      Show this thread
    5. Health Nerd‏Verified account @GidMK Jul 16

      11/n But wait, there's more! If you go back to that graph excluding Elgazzar, there's something odd. You see only one study finding a significant benefit for ivermectinpic.twitter.com/2VZvGDOetB

      1 reply 7 retweets 43 likes
      Show this thread
    6. Health Nerd‏Verified account @GidMK Jul 16

      12/n In fact, it seems like the entire mortality benefit for ivermectin, once Elgazzar is excluded, comes down to this one study: Niaee et al

      1 reply 7 retweets 45 likes
      Show this thread
    7. Health Nerd‏Verified account @GidMK Jul 16

      13/n If you look at the Niaee et al preprint, there are quite a number of issues. In fact, @K_Sheldrick noted that the results are worrying, and that the study "should not be included in meta-analyses" 👀👀👀pic.twitter.com/mWV8BvccnJ

      3 replies 10 retweets 63 likes
      Show this thread
    8. Health Nerd‏Verified account @GidMK Jul 16

      14/n So, Step 4: Sensitivity Analysis Rerunning the original model excluding both Elgazzar and Niaee gives you this result Absolutely no benefit for ivermectin on mortality. CIs include both large benefit and large detrimentpic.twitter.com/tVKlmxJgpp

      3 replies 9 retweets 59 likes
      Show this thread
    9. Health Nerd‏Verified account @GidMK Jul 16

      15/n Worth noting that removing these two studies from the analysis takes the I squared statistic down to 0% - in other words, the remaining studies are all statistically consistent with each other

      1 reply 7 retweets 49 likes
      Show this thread
    10. Health Nerd‏Verified account @GidMK Jul 16

      16/n What does this all mean? In short - once Elgazzar is excluded, the results are incredibly uncertain, and any potential benefit rests entirely on the Niaee study, which at least one expert has argued should never be included in meta-analyses

      1 reply 7 retweets 54 likes
      Show this thread
      Health Nerd‏Verified account @GidMK Jul 16

      17/n Moreover, because the result is so marginally significant, including a ~single~ new piece of evidence also results in the benefit disappearing even if you still include Niaee in the model

      11:57 PM - 16 Jul 2021
      • 6 Retweets
      • 42 Likes
      • Stan Pennington Skippy the Vaccinated Kangaroo Holli Jo Dieter Blomme Mariet Meyer Fahmi Hassan RPh Stephen Griffin Persephones_Pomegranites AN, an anti-speciesist
      1 reply 6 retweets 42 likes
        1. New conversation
        2. Health Nerd‏Verified account @GidMK Jul 16

          18/n Therefore, in my opinion, this means that excluding Elgazzar removes any certainty and a lot of significance from this analysis

          2 replies 6 retweets 42 likes
          Show this thread
        3. Health Nerd‏Verified account @GidMK Jul 16

          19/n In other words the conclusion - that moderate-certainty evidence found large reductions in death using ivermectin - is entirely reversed. The certainty is gone, and the reduction in death is likely to be very substantially smaller

          2 replies 8 retweets 49 likes
          Show this thread
        4. Health Nerd‏Verified account @GidMK Jul 16

          20/n Indeed, since the benefit now appears to rest entirely on one very worrisome trial, it is hard to see how we can justify any argument other than that we do not have sufficient information to make a conclusion about ivermectin at this pointpic.twitter.com/39xLhAewpi

          2 replies 5 retweets 69 likes
          Show this thread
        5. Health Nerd‏Verified account @GidMK Jul 16

          21/n I remain optimistic that ivermectin will indeed prove to be a "wonder drug" as Elgazzar claimed, but I simply don't think the evidence to date supports that assertion 🤷‍♂️

          6 replies 9 retweets 61 likes
          Show this thread
        6. Health Nerd‏Verified account @GidMK Jul 17

          22/n With large randomized trials ongoing, we can only wait for them to finish before making a strong judgement as to whether ivermectin is beneficial It may yet turn out to be fantastic. We simply do not know

          11 replies 9 retweets 76 likes
          Show this thread
        7. End of conversation

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