How is uncovering a trial that probably didnt happen a bad thing?
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I'm not sure, although Dr Cadegiani made similar criticisms to me privately when I spoke to him before I went public. I explained to him that I am not "attempting to discredit" anything, I apply the same tests to all RCTs and observational studies over a certain size.
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Also, I certainly don't spend "all" my time doing this. It is entirely unpaid work that takes up evenings and weekends, I honestly don't know how much longer I can devote to it
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Replying to @GidMK @K_Sheldrick and
I reckon there are quite a few fraudulent studies that we'll never know are fake because no one is actually incentivised to do this work and the only payment you get is hate mail, death threats, and internet randoms accusing you of working for the pharmaceutical industry
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Interesting, I havent gotten death threats but I am apparently going to be sentenced at the next Nuremberg trial for promoting experimental gene therapy. But also im going to jail bc Ive discussed that i believe ivermectin will ultimately be shown 2 have a + effect size in covid
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Replying to @EdoajoEric @GidMK and
It doesnt matter that mRNA doesnt interact with the genome and represents the safest vaccine vector, or that low certainty data and clinician judgement routinely guide practice.
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I think a worthwhile point to make there though is whether low quality data *should* guide clinical practice. For every success story there are half a dozen treatments proven ultimately ineffective
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The best evidence available should guide practice.
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And if the best evidence available cannot exclude serious harm from the treatment?
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Then it comes down to a risk of serious harm vs a risk of serious benefit. E.g. many treatment options for some cancers are known to definitely cause harm, but the groups are small enough we can't be certain of benefit.
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But surely in that context a treatment should only be used within a pretty structured modality, with explicit consent etc? As a patient I'd be really worried if I was at potential harm and it wasn't clearly outlined
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Oh yeah I completely agree with that, can't pretend to be more certain than you are, can't hide potential harm, can't override autonomy. That being said... 1/
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Replying to @K_Sheldrick @GidMK and
If point estimate for drug x for covid is 20% relative reduction in mortality, but 95% CI crosses 1, and we decline to prescribed. Then with more studies the CI tightens and point estimate doesn't change. Now clear it works 100 million patients not treated. 2/
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