Some VA studyNawlinsAg01 said:Wendy 1990 said:
Laura Ingraham is ripping this study. The drug was given to very ill patients in the cytokine storm in this study. The control group was given the Z pack!
Which study are you referencing?
Hydroxychloroquine...........
337,521 Views |
1854 Replies |
Last: 11 mo ago by Jabin
Holy cow, seems like there are so many obviously flawed studies out there, including the Stanford study. Hard to know what to believe these days. Makes you wonder if it is this bad on other subjects? The science is definitely not settled!
barnyard1996 said:Some VA studyNawlinsAg01 said:Wendy 1990 said:
Laura Ingraham is ripping this study. The drug was given to very ill patients in the cytokine storm in this study. The control group was given the Z pack!
Which study are you referencing?
I don't think Laura understands what's a control. Just look at the headers for table 1 or 2, they describe each study arm: https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf
Remember, the aim of these studies is to assess hospitalized patients and not the use for less severe symptoms. I hope the newest data coming from the 1,600 member cohort in NY breaks it down by number of days post symptom onset that it was given but that is unlikely. Likely to see little to no effect in very sick people. Too far gone. May skew the data quite a bit.
The hope with this med combo was to keep moderately sick people from advancing to critical care. Delays in testing and treatment may make these retrospective studies skewed toward more advanced/sicker cases.
The data I'm really waiting to see is the Minnesota and Duke studies exploring post-exposure prophylaxis and early treatment.
The hope with this med combo was to keep moderately sick people from advancing to critical care. Delays in testing and treatment may make these retrospective studies skewed toward more advanced/sicker cases.
The data I'm really waiting to see is the Minnesota and Duke studies exploring post-exposure prophylaxis and early treatment.
Wendy 1990 said:
Laura Ingraham...
Dug up the segment you mentioned...wow ...so bad, so wrong, I couldn't watch the whole thing. Yes, there are limitations to the study that are actually described fairly well in the paper itself. I could go point by point and counter the BS she spewed but will just comment on the message you took from the segment:
- we know nothing about the level of cytokines or inflammation in the study subjects. We do know that most patients were never intubated (13.3% of the HC group, 6.9% HC + AZ, and 14.1 in the no-HC group required MV.) So no, they weren't only treating those already on death's door.
- Yes, some (32%) of the patients who never received HC did receive azithromycin as part of SOC (likely to prevent secondary bacterial infection.) There will be many interventions not specifically reported on: other antibiotics, antivirals, IL-6 inhibitors, pressors, anticoagulants, fluids, respiratory support strategy, use of ECMO. I don't see the conspiracy here?
Its was segment designed to provide political cover.2PacShakur said:barnyard1996 said:Some VA studyNawlinsAg01 said:Wendy 1990 said:
Laura Ingraham is ripping this study. The drug was given to very ill patients in the cytokine storm in this study. The control group was given the Z pack!
Which study are you referencing?
I don't think Laura understands what's a control. Just look at the headers for table 1 or 2, they describe each study arm: https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf
What is Dr. Raoult's motive?barnyard1996 said:Its was segment designed to provide political cover.2PacShakur said:barnyard1996 said:Some VA studyNawlinsAg01 said:Wendy 1990 said:
Laura Ingraham is ripping this study. The drug was given to very ill patients in the cytokine storm in this study. The control group was given the Z pack!
Which study are you referencing?
I don't think Laura understands what's a control. Just look at the headers for table 1 or 2, they describe each study arm: https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf
https://www.mediterranee-infection.com/wp-content/uploads/2020/04/Response-to-Magagnoli.pdf
Never met him.rayneag said:What is Dr. Raoult's motive?barnyard1996 said:Its was segment designed to provide political cover.2PacShakur said:barnyard1996 said:Some VA studyNawlinsAg01 said:Wendy 1990 said:
Laura Ingraham is ripping this study. The drug was given to very ill patients in the cytokine storm in this study. The control group was given the Z pack!
Which study are you referencing?
I don't think Laura understands what's a control. Just look at the headers for table 1 or 2, they describe each study arm: https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf
https://www.mediterranee-infection.com/wp-content/uploads/2020/04/Response-to-Magagnoli.pdf
Sad that now even medications have become a political football.
Pretty much symbolizes everything wrong with our response to this.
Pretty much symbolizes everything wrong with our response to this.
Thank you for posting.
Good read.
(Edit - I am sure the French Dr. does not give two ****s about US Politics. Unlike the supposed science facts only posters here.)
Good read.
(Edit - I am sure the French Dr. does not give two ****s about US Politics. Unlike the supposed science facts only posters here.)
Hooper Drives the Boat
Are there any other studies pending completion that are worth following?
Exactly. It is his observations. Dismissing his report speaks more to having political motivations.Matt Hooper said:
Thank you for posting.
Good read.
(Edit - I am sure the French Dr. does not give two ****s about US Politics. Unlike the supposed science facts only posters here.)
RESULTS:
Of the 636 symptomatic outpatients, 412 started treatment with hydroxychloroquine and azithromycin and 224 refused medications (control group). Need for hospitalization was 1.9% in the treatment group and 5.4% in the control group (2.8 times greater) and number needed to treat was 28 (NNT = 28).
In those who started treatment before versus after the seventh day of symptoms, the need for hospitalization was 1.17% and 3.2%, respectively.
CONCLUSION:
Empirical treatment with hydroxychloroquine associated with azithromycin for suspected cases of COVID-19 infection reduces the need for hospitalization (p< 0.001).
https://static.poder360.com.br/2020/04/2020.04.15-journal-manuscript-final.pdf
Of the 636 symptomatic outpatients, 412 started treatment with hydroxychloroquine and azithromycin and 224 refused medications (control group). Need for hospitalization was 1.9% in the treatment group and 5.4% in the control group (2.8 times greater) and number needed to treat was 28 (NNT = 28).
In those who started treatment before versus after the seventh day of symptoms, the need for hospitalization was 1.17% and 3.2%, respectively.
CONCLUSION:
Empirical treatment with hydroxychloroquine associated with azithromycin for suspected cases of COVID-19 infection reduces the need for hospitalization (p< 0.001).
https://static.poder360.com.br/2020/04/2020.04.15-journal-manuscript-final.pdf
that's a pretty good little study
especially liked the telemedicine diagnostic approach. curious how and when they got the imaging results to conclude COVID probable.
still it does seem to bolster the early use helps reduce severity anecdotes
especially liked the telemedicine diagnostic approach. curious how and when they got the imaging results to conclude COVID probable.
still it does seem to bolster the early use helps reduce severity anecdotes
From a trial design perspective, that is interesting how they define the control group since it's not randomizes.
In other words - what drives people to decline?
Is it such old age and poor health that they don't want tot ale what they perceive to be a risky drug? This would advantage the HQC takers in the results.
Is it that they didn't feel bad symptoms and thought they'd be fine? This would make the results even more telling.
In other words - what drives people to decline?
Is it such old age and poor health that they don't want tot ale what they perceive to be a risky drug? This would advantage the HQC takers in the results.
Is it that they didn't feel bad symptoms and thought they'd be fine? This would make the results even more telling.
DadHammer said:
RESULTS:
Of the 636 symptomatic outpatients, 412 started treatment with hydroxychloroquine and azithromycin and 224 refused medications (control group). Need for hospitalization was 1.9% in the treatment group and 5.4% in the control group (2.8 times greater) and number needed to treat was 28 (NNT = 28).
In those who started treatment before versus after the seventh day of symptoms, the need for hospitalization was 1.17% and 3.2%, respectively.
CONCLUSION:
Empirical treatment with hydroxychloroquine associated with azithromycin for suspected cases of COVID-19 infection reduces the need for hospitalization (p< 0.001).
https://static.poder360.com.br/2020/04/2020.04.15-journal-manuscript-final.pdf
That looks good, no?
FrioAg 00 said:
From a trial design perspective, that is interesting how they define the control group since it's not randomizes.
In other words - what drives people to decline?
Is it such old age and poor health that they don't want tot ale what they perceive to be a risky drug? This would advantage the HQC takers in the results.
Is it that they didn't feel bad symptoms and thought they'd be fine? This would make the results even more telling.
It seems like in this case the control group actually seemed healthier with less symptoms.
[url=https://ibb.co/4YKC3sG]
[/url]The treatment cohort was older, had more comorbidities and far more symptomatic
Exsurge Domine said:DadHammer said:
RESULTS:
Of the 636 symptomatic outpatients, 412 started treatment with hydroxychloroquine and azithromycin and 224 refused medications (control group). Need for hospitalization was 1.9% in the treatment group and 5.4% in the control group (2.8 times greater) and number needed to treat was 28 (NNT = 28).
In those who started treatment before versus after the seventh day of symptoms, the need for hospitalization was 1.17% and 3.2%, respectively.
CONCLUSION:
Empirical treatment with hydroxychloroquine associated with azithromycin for suspected cases of COVID-19 infection reduces the need for hospitalization (p< 0.001).
https://static.poder360.com.br/2020/04/2020.04.15-journal-manuscript-final.pdf
That looks good, no?
If this was for a drug that extended life for 3 weeks in people with self-inflicted, terminal lung cancer, it would be worth hundreds of millions of $$.
cone said:
that's a pretty good little study
especially liked the telemedicine diagnostic approach. curious how and when they got the imaging results to conclude COVID probable.
still it does seem to bolster the early use helps reduce severity anecdotes
They didn't confirm with an actual test. That seems a big problem. Even in NY the rate of people presenting for testing going positive is in the 10 percent range.
culdeus said:cone said:
that's a pretty good little study
especially liked the telemedicine diagnostic approach. curious how and when they got the imaging results to conclude COVID probable.
still it does seem to bolster the early use helps reduce severity anecdotes
They didn't confirm with an actual test. That seems a big problem. Even in NY the rate of people presenting for testing going positive is in the 10 percent range.
That's a problem, but the fact that the treatment group actually was more symptomatic when the protocol was started could actually mean the true efficacy was better than it looked.
of course that's a problem
but the tests are also unreliable
and CT seems to be the actual way to get a definitive "you have COVID" diagnosis
but the tests are also unreliable
and CT seems to be the actual way to get a definitive "you have COVID" diagnosis
I'm not a doctor, I find the above statement sketchy. I feel like 80-90% of patients would not show on a CT scan at any point.cone said:
of course that's a problem
but the tests are also unreliable
and CT seems to be the actual way to get a definitive "you have COVID" diagnosis
The CT was for those that went to the hospital. The idea here was to keep lightly symptomatic people away from the hospital altogether.
I would hesitate to use this information for anything, Brazil has a low case count. You need to do science with the right conditions in mind. If anything you could probably use this to say a medicine route prevents hospital visits, and subsequent infections of non-impacted people.
Other than that the setup of the study isn't really viable and there's a reason it has been more or less buried for two weeks (on dropbox).
I suppose it's good news to the state of Utah who is desperate to get rid of piles and piles of this stuff..
culdeus said:I'm not a doctor, I find the above statement sketchy. I feel like 80-90% of patients would not show on a CT scan at any point.cone said:
of course that's a problem
but the tests are also unreliable
and CT seems to be the actual way to get a definitive "you have COVID" diagnosis
The CT was for those that went to the hospital. The idea here was to keep lightly symptomatic people away from the hospital altogether.
I would hesitate to use this information for anything, Brazil has a low case count. You need to do science with the right conditions in mind. If anything you could probably use this to say a medicine route prevents hospital visits, and subsequent infections of non-impacted people.
Other than that the setup of the study isn't really viable and there's a reason it has been more or less buried for two weeks (on dropbox).
I suppose it's good news to the state of Utah who is desperate to get rid of piles and piles of this stuff..
Look up University of Michigan study on using CT scans for COVID19. They said COVID19 in the lungs look like broken glass. Later in the week I saw a CT scan and it did look like broken glass
Infectious disease expert slams study that panned hydroxychloroquine as COVID-19 treatment: 'It's a sham'
https://www.foxnews.com/media/dr-stephen-smith-study-hydroxychloroquine-coronavirus-treatment
It's a shame the way this is being handled. Why can't we just get some honest people and do real trials? We could have done this a month ago. Unbelievable.
My Dr. says it's working and he will prescribe it to anyone he thinks it will help. I am going with on the ground results from a real Dr. in the field. To heck with the rest of them.
https://www.foxnews.com/media/dr-stephen-smith-study-hydroxychloroquine-coronavirus-treatment
It's a shame the way this is being handled. Why can't we just get some honest people and do real trials? We could have done this a month ago. Unbelievable.
My Dr. says it's working and he will prescribe it to anyone he thinks it will help. I am going with on the ground results from a real Dr. in the field. To heck with the rest of them.
Ok, that has nothing to do with my comment.FCBlitz said:culdeus said:I'm not a doctor, I find the above statement sketchy. I feel like 80-90% of patients would not show on a CT scan at any point.cone said:
of course that's a problem
but the tests are also unreliable
and CT seems to be the actual way to get a definitive "you have COVID" diagnosis
The CT was for those that went to the hospital. The idea here was to keep lightly symptomatic people away from the hospital altogether.
I would hesitate to use this information for anything, Brazil has a low case count. You need to do science with the right conditions in mind. If anything you could probably use this to say a medicine route prevents hospital visits, and subsequent infections of non-impacted people.
Other than that the setup of the study isn't really viable and there's a reason it has been more or less buried for two weeks (on dropbox).
I suppose it's good news to the state of Utah who is desperate to get rid of piles and piles of this stuff..
Look up University of Michigan study on using CT scans for COVID19. They said COVID19 in the lungs look like broken glass. Later in the week I saw a CT scan and it did look like broken glass
80-90% of COVID patients?Quote:
I feel like 80-90% of patients would not show on a CT scan at any point.
even asymptomatic people are showing GGO
I saw her interview with Dr. Smith last night. He said he had never seen a "study" in which the dosages given to patients was not published as was the case in this one. He and Laura also said they had tried to contact the authors of the study but did not receive return calls. Dr. Smith also noted that neither of the authors had actually seen a Covid patient.DadHammer said:
Infectious disease expert slams study that panned hydroxychloroquine as COVID-19 treatment: 'It's a sham'
https://www.foxnews.com/media/dr-stephen-smith-study-hydroxychloroquine-coronavirus-treatment
It's a shame the way this is being handled. Why can't we just get some honest people and do real trials? We could have done this a month ago. Unbelievable.
My Dr. says it's working and he will prescribe it to anyone he thinks it will help. I am going with on the ground results from a real Dr. in the field. To heck with the rest of them.
What are the motives of people criticizing Laura for questioning the study? My guess is the document was not really intended to represent a study, it was just a compilation of statistics. Then someone fed it to the press because they knew it would be used to make Trump look bad.
As noted on here, it was a retrospective study. For all of the hand wringing saying doctors should "DO SOMETHING!!" and prescribe a medicine, you have the exact same time pressure for people trying to figure out if the "something" is working. If we're going to (rightly) give docs a pass for taking a swing at a treatment in the midst of a pandemic, we should give researchers the same pass for measuring as best they can.
Is it perfect? No - there's no control group, we don't know if the docs were prescribing all the same, treating all the same, whatever. But the truth is that there's a pretty typical dosage for both HCL and AZ, and it's probably unlikely any of those docs were deviating too far.
It is what it is... a limited study. It found only one statistically relevant finding, and that was that <<in this study>> people who were on HCL only had a higher risk of mortality for all causes. That's it. That's all we can say.
The politicization of this topic on both sides is completely asinine.
Is it perfect? No - there's no control group, we don't know if the docs were prescribing all the same, treating all the same, whatever. But the truth is that there's a pretty typical dosage for both HCL and AZ, and it's probably unlikely any of those docs were deviating too far.
It is what it is... a limited study. It found only one statistically relevant finding, and that was that <<in this study>> people who were on HCL only had a higher risk of mortality for all causes. That's it. That's all we can say.
The politicization of this topic on both sides is completely asinine.
Would that really be a good reason for not including that information in the "study"? I would think that if I were a doctor (as Dr. Smith is), that would be pretty interesting information.Quote:
But the truth is that there's a pretty typical dosage for both HCL and AZ, and it's probably unlikely any of those docs were deviating too far.
I don't understand the question. The most likely reason they didn't include that information is because they don't have it. They write in the paper they're grouping patients based on any record of dispensed drug during hospitalization in the data file they have.
I don't get the quotes around study. It was a retrospective study, they did statistical analysis on records available. What it wasn't was a controlled trial.
And they know the limitations of the findings - they write
They also note:
It's just information. That's all it is.
I don't get the quotes around study. It was a retrospective study, they did statistical analysis on records available. What it wasn't was a controlled trial.
And they know the limitations of the findings - they write
Quote:
Multiple prospective, randomized trials of hydroxychloroquine are now underway and will, in due course, provide valuable information about safety and efficacy. However, given its increasingly widespread use, not only as therapy but also as prophylaxis for Covid-19, there is a great and immediate need to obtain insights into the clinical outcomes among patients currently treated with hydroxychloroquine, particularly because of the non-negligible toxicities associated with its use.
Therefore, we conducted a retrospective analysis of patients hospitalized with Covid-19 in all the Veterans Health Administration medical centers across the United States to analyze the associations between hydroxychloroquine and azithromycin use and clinical outcomes. The findings of this nationwide study of one of the most complete national datasets in the United States can accelerate our understanding of the outcomes of these drugs in Covid-19 while we await the results of the ongoing prospective trials.
....
Our study has certain limitations including those inherent to all retrospective analyses such as non-randomization of treatments. We did, however adjust for a large number of Covid19-relevant confounders including comorbidities, medications, clinical and laboratory abnormalities. Despite propensity score adjustment for a large number of relevant confounders, we cannot rule out the possibility of selection bias or residual confounding. Our study cohort comprised only men whose median age was over 65 years. Therefore, the results may not necessarily reflect outcomes in women or in younger hospitalized populations, nor can they be extrapolated to pediatric patients.
Our findings may also be influenced by the demographic composition of patients in our cohort, the majority of whom were black. Disproportionately higher rates of Covid-19-related hospitalization among the black population have also been reported in the United States as a whole.
Our study also has certain strengths. Because we studied data from a comprehensive electronic medical record rather than from an administrative health insurance claims database, we used rigorously identified covariates and outcomes. We studied patients in an integrated national healthcare system; therefore, the data are less susceptible to biases of single-center or regional studies. Data from ongoing, randomized controlled studies will prove informative when they emerge. Until then, the findings from this retrospective study suggest caution in using hydroxychloroquine in hospitalized Covid-19 patients, particularly when not combined with azithromycin
They also note:
Quote:
...hydroxychloroquine, with or without azithromycin, was more likely to be prescribed to patients with more severe disease, as assessed by baseline ventilatory status and metabolic and hematologic parameters. Thus, as expected, increased mortality was observed in patients treated with hydroxychloroquine, both with and without azithromycin. Nevertheless, the increased risk of overall mortality in the hydroxychloroquine-only group persisted after adjusting for the propensity of being treated with the drug. That there was no increased risk of ventilation in the hydroxychloroquine-only group suggests that mortality in this group might be attributable to drug effects on or dysfunction in non-respiratory vital organ systems.
It's just information. That's all it is.
All I'm saying is the doctor I saw interviewed last night seemed to have a lot of experience in this, and he said he had never seen a study in which the dosage information for the drug used was not given. Like I said, I'm not sure whether this would be properly classified as a study or maybe just a compilation of data. But you said it was a retrospective study. I can get that.
I found interesting the previous reply that said since there was a standard dosage, it wouldn't need to have been documented by the study. Does this highly controversial drug, for which not a single clinical study has been completed for treatment for Covid-19, really have a standard dosage established by the medical profession?
I found interesting the previous reply that said since there was a standard dosage, it wouldn't need to have been documented by the study. Does this highly controversial drug, for which not a single clinical study has been completed for treatment for Covid-19, really have a standard dosage established by the medical profession?
You'd never see a clinical trial done like that because you want to avoid any and all possible sources of error. Variance in dosage clearly could be that. But, this was not a clinical trial, it was a review. There are *lots* of possible sources of bias or error. Dosing variance is one of them.
HCL is prescribed routinely for patients for immunotherapy and as a prophylactic for malaria. You can see dosing guidelines here. Obviously we have no idea what the docs were prescribing, but seeing as this isn't a new drug, they were all probably within a "normal" range.
But that's just my assumption, and obviously it's a source for error in the analysis. What are they supposed to do though? I mean, we need some evidence that this works. We have some equally or worse flawed studies being promoted by the same people who are butthurt about this one.
It's not a perfect study, but perfect studies take time. You're damned if you do, damned if you don't - when it comes to politics.
HCL is prescribed routinely for patients for immunotherapy and as a prophylactic for malaria. You can see dosing guidelines here. Obviously we have no idea what the docs were prescribing, but seeing as this isn't a new drug, they were all probably within a "normal" range.
But that's just my assumption, and obviously it's a source for error in the analysis. What are they supposed to do though? I mean, we need some evidence that this works. We have some equally or worse flawed studies being promoted by the same people who are butthurt about this one.
It's not a perfect study, but perfect studies take time. You're damned if you do, damned if you don't - when it comes to politics.
That's amazing. Trump has completely broken these people.