Posted on 04/21/2020 10:57:21 AM PDT by TECTopcat
...more...
One thing I noticed about the mechanism of action of Plaquenil that I had been previously unaware of, it interferes with vesicle uptake formation. So that may seem to be an explanation for why patients get psychological side effects. Specifically “psychotic delusions” and suicide. Then it hit me, “What neurotransmitter systems use presynaptic uptake of neurotransmitter to control the synaptic presence of the transmitter?”
Dopamine. My Cooper, Bloom, and Roth is a first edition so you have better info than I on this. But it occurs to me this drug could, perhaps in some subset of people, actually have a mechanism similar to Cocaine. Which might explain why some 93 year olds seem to “Bounce out of their death beds like Lazarus.” All conjecture, of course.
Can you provide the link because the twitter did not show up, at least for me. Thanks in advance. 8>)
Yes, plus the results are valid for veterans only. Not everybody served.
There is another aspect to retrospective studies that has not been addressed.
How was it decided which patients were given HCQ?
This study included all patients who had positive tests for COVID over a certain time period if the chart included body mas, vital signs and discharge information.
That is a very misleading way to design a study. Isn’t it very likely that the sicker patients would have had a trial of HCQ rather than a random distribution? The more severe disease in that cohort treated w/ HCQ would be expected to have yielded worse outcome data.
There was either a bias being fulfilled or a disingenuity concerning what could be ascertained using the study parameters in view of the lack of adequate study design.
https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf
If you read through the data, the labs and all, they petty fairly matched the groups. So your criticism is addressed in the study. Sure, it’s your criticism and you’re welcome to it but it isn’t a “valid” criticism.
Yeah they are a joke. I figure it is a mix of several things: 1) they have their partisan bias 2) they are under pressure to publish quickly 3) they want “clicks” (money) so they want controversial headlines 4) they are lazy SOBs who won’t do basic research 5) they are ignorant of or defiant to many topics that are peripheral or related to their thesis (e.g. civics, republican form of government etc) 6) they have a psychological disorder that causes them to be reflexively contrarian.
Probably other issues, but off the top of my head. There is no excuse to make an error like confusing two different drugs (they are analogous, but not analogues). There is no excuse to omit key details like which subgroups were being studied or when in the disease cycle they were administered, what underlying diseases the subgroup had etc. All of this and more is very important to understanding the study and the results. But it seems like they want the drug to fail, so they gravitate to stories that poopoo the potential. And they don’t want Trump to ever be right so they are thrilled at any hint of information they can use against him.
Notice the article starts out mentioning “the drug touted by Trump”? - so it’s not really about the drug or the study, is it? Political hit by the “chief medical correspondent”. Sorry there is no room for politics or ego or sloppy data mining in the sciences.
If democrats are involved with any part of this= very good chance it’s rigged/a lie.
UAB infectious disease doctor and recovering COVID-19 patient Dr. Michael Saag said he felt “a little bit unhappy with myself,” after trying a largely untested treatment for the new coronavirus during his illness.
“I survived, but I can’t tell you that it worked,” Saag said. “What we need are randomized, controlled clinical studies.”
Hmm. I didn’t know that was the main reason. I thought it had more to do with trying to get more oxygen to the patient. Which as I said would be futile if the lungs can’t deliver oxygen to the blood via ventilation.
No money in the malaria drug. Big Pharma needs a big money maker.
I did read through the study design looking for that point exactly.
I do not believe that aspect was adequately addressed.
I should think that our prior experience with model failures would have led you to be less eager to give a pass to this very derivative assessment of patient selection using propensity scores.
https://anesthesiology.pubs.asahq.org/article.aspx?articleid=1932162
January 2008
Liars, Damn Liars, and Propensity Scores
Gregory A. Nuttall, M.D.; Timothy T. Houle, Ph.D.
It’s pretty much axiomatic that the sooner you medically intervene against a disease, the better the outcome.
Now this was a relatively small study afaik, apx 350 patients. I didn’t read the study details just what I heard on TV. So a couple “more” deaths on the drug arm could just be outlier data or abberational data. And certainly incomplete. Of the survivors did they recover faster? Produce antibodies faster? Slow viral load build? Yeah, death is one outcome to look at but it’s not the only one to look at; and there could be other causes (the headline suggests the drug caused the deaths, which seems very unlikely).
As noted, what was the median age of the patients, how far along the disease cycle did they progress before administration of the drug, was it drug monotherapy or did they add AZ and or Zinc? What was the dosing? What underlying risk factors did they have? Among those who passed, other than CV19, what was the cause-in-fact (heart failure? pneumonia? Stroke?). What other medications were they on?
Actually, in a “retrospective study” don’t you sort of have to take what you are given? The people who didn’t get the drug have already not gotten the drug. Kind of hard to “randomly assign” them to a group. Maybe that’s what “Fine and Gray” is all about. You got me.
So now you consider a comparison to outside "similar" groups as a controlled study?
You can do that with any study then, the French study the Rockland Cty. study, etc.
Please read the actuall pdf study before you get back to me. Please?
Has anyone done a rigorous experiment on this?
All their experts are ex-spurts.
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