The Lancet has issued an expression of concern regarding the study that was posted here.
https://www.thelancet.com/lancet/art...40673620312903
The Lancet has issued an expression of concern regarding the study that was posted here.
https://www.thelancet.com/lancet/art...40673620312903
Our 1000-bed field hospital that was set up in a convention center for the surge discharged its last 2 patients today. Treated ~700 patients total over the past couple months.
Pretty sobering stats considering our city has some of the best hospitals/medical staff in the world. "Only" 400 in ICU with COVID now, down from ~1000 in mid April. Several hospitals are still using surge capacity.
The trends in hospitalizations and new cases in many states in the South and Midwest which haven't even hit their peak yet three months after lockdown frankly scare the fuck out of me (especially with these protests happening).
Wasn't someone here blasting the Lancet for stuff like this a few pages ago?Originally Posted by MickAK
It's not just The Lancet.
https://www.sciencemag.org/news/2020...-be-unravelingToday, The Lancet issued an Expression of Concern (EOC) saying “important scientific questions have been raised about data” in the paper and noting that “an independent audit of the provenance and validity of the data has been commissioned by the authors not affiliated with Surgisphere and is ongoing, with results expected very shortly.”
Hours earlier, The New England Journal of Medicine (NEJM) issued its own EOC about a second study using Surgisphere data, published on 1 May. The paper reported that taking certain blood pressure drugs including angiotensin-converting enzyme (ACE) inhibitors didn’t appear to increase the risk of death among COVID-19 patients, as some researchers had suggested. (Several studies analyzing other groups of COVID-19 patients support the NEJM results.) “Recently, substantive concerns have been raised about the quality of the information in that database,” an NEJM statement noted. “We have asked the authors to provide evidence that the data are reliable.”
A third COVID-19 study using Surgisphere data has also drawn fire. In a preprint first posted in early April, Surgisphere founder and CEO Sapan Desai and co-authors conclude that ivermectin, an antiparasitic drug, dramatically reduced mortality in COVID-19 patients. In Latin America, where ivermectin is widely available, that study has led government officials to authorize the drug—although with precautions—creating a surge in demand in several countries.
My surprised face.
Good for NIH for continuing with their RCT despite all of the hysteria and spastic moves around the covid.
From a linked article above:
Desai expressed confidence. “The real question is: With data like this, do we even need a randomized controlled trial?" he said
The answer is a resounding yes. We need a bunch of various trials. If you are debating this point, your days of being a credible source are done. They may be done anyway.
Doesn't read posts longer than two paragraphs.
Yes, but he did not have sufficient credentials to understand what he understood so it was very important for him to go sit in the corner while the adults talked.
I can't remember if it was here or somewhere else, but I read an analogy not too long ago about how under normal circumstances, average people wouldn't take much interest in mountaineering nor could they be relied upon to make any decisions about rope descent from a glacier, but if we all somehow found ourselves stranded on a mountain, not only is it reasonable for average people to suddenly take an interest in abseiling techniques, but that's also really valuable. They don't become mountaineers just because they started focusing on this problem, and you can't compare their ideas to those of professional climbers, but that doesn't mean you shouldn't be paying attention to their critiques of what the mountaineers are suggesting.
Definitely good to listen to the professional mountaineers in the group and I would primarily take instruction from them...but if there's a smart guy on hand with a bit of sailing experience who says there's a problem with the rope, telling him to sit down and be quiet because you have mountaineers on hand is not my idea of a smart move, even though that is EXACTLY what the mountaineers will expect. And there will be a whole bunch of people screaming "why are you anti-mountaineer" if you want input from an outside source.
Expertise is valuable, but all advanced training sharpens the mind by narrowing it. People who are deeply invested in a particular type of thinking become incredibly skilled at dismissing information which does not fit with their preconceptions.
Listen to the mountaineers, but don't let them decide too much for you. They are also prone to serious mistakes - just of a different sort - and they can get you killed just as dead. That's not anti-mountaineer talk, it's recognition of the inherent fallibility of humans.
This is a thread where I built a boat I designed and which I very occasionally update with accounts of using it, which is really fun as long as I'm not driving over logs and blowing up the outboard.
https://pistol-forum.com/showthread....ilding-a-skiff
First manager at a new job (many years ago) would regularly ask me for my feedback on the way he ran his business. He was very up front about wanting any constructive input on any aspect of the job, mine, his or other. His phrase was, "New guy, new eye." Words to live by. They have proven useful as well as prevented much embarrassment over the years.
"No free man shall ever be debarred the use of arms." - Thomas Jefferson, Virginia Constitution, Draft 1, 1776
I think this analogy is somewhat imperfect, for the following reasons:
1. This Lancet paper and its authors represent a very small (but of course, for a time, reasonably influential) slice of the COVID 19 research sphere, so the impact of this paper on our long-horizon ability to get our arms around the disease is fairly minimal. Remember, we are only 3 months into this pandemic... it took us decades to really get a handle of treatment and detection of HIV, as a counter example.
2. I assume that part of successful mountaineering involves not making mistakes (i.e. the rope in your analogy) or controversial decisions. In the research world, human error, controversy and debate are the engine of productivity. The recognition of flaws in the Surgisphere dataset is not evidence of dysfunction or failure, but rather evidence of the success of the scientific community.
The recognition of fatal flaws within this data set a. removes it as a source of misinformation in the public sphere, and b. increases the level of scrutiny placed on other, similar research articles in the near future. To revisit your analogy, it is great that we found problems with this rope, because it means we will make better rope in the future, and apply more focused scrutiny to these new ropes as they are made.
3. Unlike, say, someone with sailing experience, it is very, very hard for a non-expert to apply their expertise to critically examine clinical literature, and even harder for them to critique the raw data used in their analysis.
For example, despite both MD and PhD training with a specific focus on ARDS, my ability to dive into the nitty gritty of their regression analysis is pretty limited. My ability to read and critique their raw data set is almost none, as I do not have the software or skills to access and critically examine it. Similarly, someone with a PhD in biostatistics who can read and interpret the dataset may not understand the clinical context of the data or be able to recognize issues with the way specific data are encoded. For a layperson who has, at best, a couple college level math or science classes under their belt, this is basically impossible.
To be clear: not arguing that biomedical research is flawless. Far from it. I could write an entire book about the problems I see with the American biomedical research sphere, both public and private. However, the controversy over this Lancet publication is really not the best example, as, to me, the critique it has drawn is precisely a sign of the healthy function of the scientific community. It is the papers that have NOT drawn controversy and gone on to inform clinical standard of care that are truly problematic, and almost by definition these issues rarely if ever reach the public sphere.
Last edited by Nephrology; 06-03-2020 at 11:16 AM.
Except the poster in question was "smelling horse shit" less on any ability to suss out errors in data collection and interpretation methods, but by vaguely implying a conspiracy in the medical-industrial complex to suppress HCL as a COVID-19 treatment. Right for the wrong reasons doesn't quite cut it.
Hain’t we got all the fools in town on our side? And ain’t that a big enough majority in any town?
Missed this point.
Yes. To be clear: if you're going to engage in a debate about content and/or conclusions of medical/scientific literature, you need to understand it first. You need to have an argument grounded in what you understand about the article. To say you "smell horseshit" without substantiation is magical thinking: "I think, therefore, I'm right". I do not have patience or respect for magical thinking. I never have and never will.
That said, substantiation does not mean world class expertise. You do not need a scientific background to read a research article. This will, however, deeply limit your ability to understand it, and it would be advisable to maintain an according degree of circumspection about the conclusions you draw.
You also don't need an investing background to read Barron's. I read Barrons just about every day. Would you bet your retirement portfolio on my investment advice? No? I wonder why.
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