Another day, another systematic review and meta-analysis of the same ivermectin research published This one is positive. I don't think it should be 1/npic.twitter.com/f9k8hfvidy
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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Another day, another systematic review and meta-analysis of the same ivermectin research published This one is positive. I don't think it should be 1/npic.twitter.com/f9k8hfvidy
2/n Study is here, and generally it looks fine - search strategy was decent, they followed most guidelines (I.e. PRISMA), and overall the methodology was pretty reasonable for the stated purposehttps://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofab358/6316214#.YORtErIpyh8.twitter …
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,
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
5/n The authors did attempt to test for this (good!) and found no strong evidence for publication bias So some improvement there
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
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
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 …
If mahmud's study was well done + showed benefit, and only 16% of professional medical societal treatment guidelines in infectious diseases are based on even one single RCT (https://pubmed.ncbi.nlm.nih.gov/20946067/ ) then why, in a pandemic, are we applying an unpredented data hurdle to a safe rx?
There are two better trials that show no benefit at all. If you pick and choose your evidence, you can come to whatever conclusion you want
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