Questions raised by Australian infectious disease researchers over Hydroxychloroquine study which caused WHO to halt trials for Covid-19

You can’t get a better study than the President of The United States of America.

The data relied upon by researchers to draw their conclusions in Lancet is not readily available in Australian clinical databases, leading many to ask where it came from.

I'm betting it was someplace dark and stinky...

The Lancet is the very same publication which recently urged American voters to vote President Trump out of office.

RE: The Lancet is the very same publication which recently urged American voters to vote President Trump out of office.

What the heck does a medical publication have to do with elections?

what subjects are needed for forensic anthropology

Bookmark.

Old saying:
In theory, theory and practice are the same thing, but in practice, they are different.

In theory, I like science just fine: I am not a science denier, but when I see how it is practiced, I have very little respect for what passes for science these days.

[[What the heck does a medical publication have to do with elections?]]

People with the incurable TDS can’t help themselves from injecting politics into everything

I was asking myself that same question when the Lancet was saying we murdered 100K civilians in Iraq back in 2003.

The world health organization has lost all 100% of its credibility during this latest coronavirus crisis

they will never recover

and if we were smart we will never give them another dime

The study (not a trial) article in the Lancet states:

"a cause-and-effect relationship between drug therapy and survival should not be inferred"

So, the authors themselves state at the end of the article that nothing they've found should be interpreted that the quinolone treatments increase death.

Article is utter nonsense. Shocking that the Lancet published it. And the conflict of interest statement should not be overlooked:

"MRM reports personal fees from Abbott, Medtronic, Janssen, Mesoblast, Portola, Bayer, Baim Institute for Clinical Research, NupulseCV, FineHeart, Leviticus, Roivant, and Triple Gene. SSD is the founder of Surgisphere Corporation. FR has been paid for time spent as a committee member for clinical trials, advisory boards, other forms of consulting, and lectures or presentations;"

Link to the article Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis

And in America using our veterans!!!

Sacrificing US Veterans To Own Trump: The Hydroxychloroquine Hit Job

Here is a test. Infect Fauci with the coronavirus and see if he waits for a vaccine or takes the hydroxy cocktail. That ought to cut through all the political posturing.

Actually for the vaccine, I’d like Bill Gates to take it first. Put your body where you mouth is ( like Trump did with Hydroxychloroquine ).

Now it appears the Lancet has been cheapened into a tabloid that’s not worth reading.

This has become ENTIRELY political - specifically, about bashing Trump. I have reached the point where I refuse to listen to anything that WHO says, and I’m pretty damned close to doing the same with the (very political) CDC. Damn, the CDC said NOT to wear masks...then they said to do so. Now evidence is out there that wearing a mask when you’re healthy is actually dangerous - so perhaps their original advice was correct...which means that they don’t know WTF they are talking about, or (more likely) that they are acting in a political manner.

Sorry for the rant, but I was spoiled, having grown up in an era when doctors only cared about their patients, and listening to my MD grandfather, who ONLY cared about the health of his patients and did not give a tinker’s damn what their politics were. He would be utterly appalled - and probably prescribing HCQ, z-packs and zinc - if he were alive and practicing today.

As an aside, I once asked my GF about the secret to long life; the short answer was “stay away from doctors and stay away from hospitals.” The longer answer was that God gave us a magnificent machine that’s very capable of self-repair and of fighting off infections galore - you only need to give it modest care in the form of eating right, getting some exercise, getting enough sleep and looking both ways when you cross the street to live to about 85 years of age. When he told me that, I said that I could have gotten that advice from the Old Farmers Almanac - and, with a glint in his eye, he said, “Shhh, don’t tell the AMA that I told you.” :>) That’s why I KNOW that he’d be appalled at the CDC and other bureaucratic health agencies - he despised them, and that was over 40 years ago.

“Actually for the vaccine, I’d like Bill Gates to take it first. Put your body where you mouth is ( like Trump did with Hydroxychloroquine ).”

He’d be as likely to get a saline injection as the actual “vaccine” that will come out someday. I don’t trust the elites - not for quite a number of decades now, once I learned how they lie to us for their own benefit. I will NOT take any Wuhan virus vaccine and, now having heard that the flu vaccine increases the chance of getting cancer (I still have to check that out to be more certain), I won’t be taking that, either. As it is, I only get the flu vaccine about once every 2 years, mainly when the wife nags the crap out of me about it. Well, no more - now it’ll be up to lots of Vitamin D, zinc, Vitamin C and Quercetin to aid my immune system.

25 May: Stat Modeling (Columbia Uni): This controversial hydroxychloroquine paper: What’s Lancet gonna do about it?
Posted by Andrew
Lancet
A recent paper published in the famous/notorious medical journal Lancet reports that hydroxychloroquine and chloroquine increased the risk of in-hospital death by 30% to 40% and increased arrhythmia by a factor of 2 to 5. The study hit the news with the headline, “Antimalarial drug touted by President Trump is linked to increased risk of death in coronavirus patients, study says.” (Meanwhile, Trump says that Columbia is “a liberal, disgraceful institution.” Good thing we still employ Dr. Oz!)…

All this politics . . . in the meantime, this Lancet study has been criticized; see here and here. I have not read the article in detail so I’m not quite sure what to make of the criticisms; I linked to them on Pubpeer in the hope that some experts can join in...

Almost all the press coverage of this study seemed to be taking the Lancet label as a sign of quality...READ ON

FIRST COMMENT:
25 May: ETH: One additional important development: The WHO announced today that they would be temporarily pausing their trial of hydroxychloroquine, citing the results of The Lancet paper.
SECOND COMMENT:
26 May: Zach: It looks like they’ve already restarted it
https://statmodeling.stat.columbia.edu/2020/05/25/this-controversial-hydroxychloroquine-paper-whats-lancet-gonna-do-about-it/

26 May: RecoveryTrial.net: Recruitment to the RECOVERY trial continues as planned
Prof Peter Horby and Prof Martin Landray, Chief Investigators of the RECOVERY trial, said ‘We have been working over the weekend to understand the implications of the Mehra paper for the safety and welfare of patients randomised to hydroxychloroquine.
‘On Saturday 23 May, the independent Data Monitoring Committee conducted an urgent review of the data that we have collected so far on the effects of hydroxychloroquine on mortality among patients admitted to hospital with COVID-19. The Committee concluded that there is “no cogent reason to suspend recruitment for safety reasons.”

‘The Committee found that the effects of hydroxychloroquine on mortality reported in the analysis by Mehra were not consistent with those observed in the RECOVERY trial. The Committee therefore recommended that the trial continue recruitment without interruption, a recommendation that was endorsed on Sunday by the MHRA.

‘The conclusion of the Mehra paper is that “Randomised clinical trials will be required before any conclusion can be reached regarding benefit or harm of these agents in COVID-19 patients.” The RECOVERY trial is currently the largest randomised controlled trial of hydroxychloroquine and other potential treatments for COVID-19. Enrolment in this trial is the best way to provide definitive evidence on these drugs.’
https://www.recoverytrial.net/news/recruitment-to-the-recovery-trial-continues-as-planned

25 May: StatModeling: Hydroxychloroquine update
Posted by Andrew
The study only has 4 authors which is weird for a global study in 96,000 patients (and no acknowledgements at the end of the paper). Studies like this in medicine usually would have 50-100 authors (often in some kind of collaborative group). The data come from the “Surgical Outcomes Collaborative”, which is in fact a company. The CEO (Sapan Desai) is the second author. One of the comments on the blog post is “I was surprised to see that the data have not been analyzed using a hierarchical model”. But not only do they not use hierarchical modelling and they do not appear to be adjusting by hospital/country, they also give almost no information about the different hospitals: which countries (just continent level), how the treated vs not treated are distributed across hospitals etc. A previous paper by the same group in NEJM says that they use data from UK hospitals (no private hospitals are treating COVID so must be from the NHS). Who is allowing some random company to use NHS data and publish with no acknowledgments. Another interesting sentence is about patient consent and ethical approval:

We emailed them to ask for the data, in particular to look at the dose effect which I think is key in understanding the results. They got back to us very quickly and said

“Thanks for your email inquiry. Our data sharing agreements with the various governments, countries and hospitals do not allow us to share data unfortunately. I do wish you all the very best as you continue to perform trials since that is the stance we advocate. All we have said is to cease and desist the off label and unmonitored and uncontrolled use of such therapy in hospitalized patients.”

So unavailable data from unknown origins . . .

Another rather remarkable aspect is how beautifully uniform the aggregated data are across continents: ...
https://statmodeling.stat.columbia.edu/2020/05/25/hydroxychloroquine-update/

22 May: PubPeer: Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis
The Lancet(2020) - 11 Comments
https://pubpeer.com/publications/71DA593B9943638F1ADE6F80696914#1

The Lancet: Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis
Mandeep R Mehra, Sapan S Desai, Frank Ruschitzka, Amit N Patel
Declaration of interests
MRM reports personal fees from Abbott, Medtronic, Janssen, Mesoblast, Portola, Bayer, Baim Institute for Clinical Research, NupulseCV, FineHeart, Leviticus, Roivant, and Triple Gene. SSD is the founder of Surgisphere Corporation. FR has been paid for time spent as a committee member for clinical trials, advisory boards, other forms of consulting, and lectures or presentations; these payments were made directly to the University of Zurich and no personal payments were received in relation to these trials or other activities...
Research in context
Evidence before this study
We searched MEDLINE (via PubMed) for articles published up to April 21, 2020, using the key words “novel coronavirus”, “2019-nCoV”, “COVID-19”, “SARS-CoV-2”, “therapy”, “hydroxychloroquine”, “chloroquine”, and “macrolide”. Moreover, we screened preprint servers, such as Medrxiv, for relevant articles and consulted the web pages of organisations such as the US National Institutes of Health and WHO...
Acknowledgments
The development and maintenance of the Surgical Outcomes Collaborative database was funded by Surgisphere Corporation (Chicago, IL, USA). This study was supported by the William Harvey Distinguished Chair in Advanced Cardiovascular Medicine at Brigham and Women’s Hospital (Boston, MA, USA). We acknowledge Jide Olayinka (Surgisphere) for their helpful statistical review of the manuscript...

https://www.lindependant.fr/2020/05/25/coronavirus-hommes-politiques-medias-etude-foireuse-sur-la-chloroquine-le-professeur-didier-raoult-regle-ses-comptes,8902250.php

In the link above Didier Raoult addresses the Lancet article and also defends what they are doing in Marseille. It is in French so you can use google translate to read it. Some comments are negative saying in effect that he inflates the denominator by adding patients who would get well anyway. About that I don’t know, but Dr. Zelenko doesn’t inflate the denominator since he breaks patients into high risk and low risk groups, with symptoms, and then gives the meds to the high risk patients. And he says if someone is initially determined as a low risk patient, if symptoms worsen, he puts them into the high risk group and gives them the meds. So we know it works certainly from what Dr. Zelenko reports.

Zelenko’s presentation is essentially a report from an experimental group, in my mind, to be compared to the control group that consists of patients elsewhere who would have been assessed as high risk had Zelenko saw them. So we know what the general death rate is among those not getting Zelenko’s plan and the only question is what is the death rate of patients following Zelenko’s plan and it is immediately obvious that his plan is effective. Enough is determined that his strategy of early intervention should be applied at the lowest level of medicine, which is on an outpatient basis.

With respect to Lancet one commenter said the following (translated from French)

A shocking admission by the publisher of The Lancet, the world’s most esteemed medical journal, has been largely overlooked by mainstream and mainstream media. Dr. Richard Horton, editor of The Lancet, recently made an announcement saying that an outrageous number of study publications are at best, unreliable, if not completely false, in addition to fraudulent.

Horton said:

“A large part of the scientific literature, probably half, could be simply false. Afflicted with studies with reduced samples, tiny effects, invalid preliminary analyzes, and flagrant conflicts of interest, with the obsession to follow trends of dubious importance in fashion, science has taken the wrong turning to darkness. Putting it differently, Horton bluntly says that the big pharmaceutical companies are falsifying or faking tests on the health, safety and efficacy of their various drugs, taking samples too small to be statistically significant, or else, to the trials, hire laboratories or scientists with flagrant conflicts of interest, they must please the pharmaceutical company to obtain other subsidies. At least half of all these tests are worthless or are ...