Non-Political Coronavirus Thread

[plama]

Not to belabor, but he says "There is no mention of how long the 50% of each group of patients were on HQC and/AZT prior to starting the study, since they don't tell us." They do tell us, specifically. None of the patients were on it more than 24 hours.

Where's it say that?

"Use of trial medication was defined as the use of hydroxychloroquine or azithromycin during the 24-hour period before randomization."

 

[plama]

It's a facebook messenger exchange between cousins filled with typos, or me writing typos while typing, re: frame of reference on the "No one in medicine would use AZT" type comments. Re: other comments, Up to 14 days and half within 7 days are semantic arguments.

 

[Rafi]

Where's it say that?

"Use of trial medication was defined as the use of hydroxychloroquine or azithromycin during the 24-hour period before randomization."

These are some of the exclusion criteria: "previous use of chloroquine, hydroxychloroquine, azithromycin, or any other macrolide for more than 24 hours before enrollment (and since the onset of symptoms)"

 

[Rafi]

It's a facebook messenger exchange between cousins filled with typos, or me writing typos while typing, re: frame of reference on the "No one in medicine would use AZT" type comments. Re: other comments, Up to 14 days and half within 7 days are semantic arguments.

Not really. If 90% were enrolled on day 13 and 14, that would be a lot different than a median of 7 days.

 

[plama]

Not really. If 90% were enrolled on day 13 and 14, that would be a lot different than a median of 7 days.

Well certainly a semantic argument in the sense of arguing with someone whose point is "The Yale guy and everyone else told us before March that we needed to start treatment within 4 days. This has been further qualified to 24-48, with the recommendation to start treatment immediately/less than 24 hour from symptoms. "

But yeah I see where he's off on the exclusion criteria.

I'm personally interested in this one because I don't really watch fox news but I did in early march to see what the crazies were saying. I've maybe seen 3-5 episodes of Ingraham in my life, but I saw the one where she had the doc on saying HCQ was a game changer, then I heard 2-3 days later Trump start hyping it. the insanity to me on this one isn't that trump started touting it, is that he clearly got it from the fucking Ingraham angle. He never seemed to answer to me well enough why with so much at stake there won't eventually be a good study showing the positive effects. You'd think a republican super PAC would be funding it by now. Although the Yale doc is referencing some that will be forthcoming. Politically speaking, if there ever is a study that's early enough and able to withstand peer review, it'll be one of the more interesting results out there especially now that Trump and Navarro are digging in on it again. *Michael Jackson Popcorn gif*

 

[Louis Gossett Jr]

Medically speaking getting someone on treatment within 24 hours of symptoms is next to impossible outside of a tightly controlled trial and then makes any findings pointless. This is especially true when testing results take up to a week to return. Throw in initial symptoms for the virus cover a huge range and looks like if you go to the doctor any time in the future you would be prescribed HCQ. Despite what people might think doctors aren't too keen on prescribing unnecessary drugs. If anything a prophylaxis study would be more beneficial, pick a MAGA town and enough of them would more than willing to gobble down some drugs in the name of dear leader.

 

[Rafi]

Medically speaking getting someone on treatment within 24 hours of symptoms is next to impossible outside of a tightly controlled trial and then makes any findings pointless. This is especially true when testing results take up to a week to return. Throw in initial symptoms for the virus cover a huge range and looks like if you go to the doctor any time in the future you would be prescribed HCQ. Despite what people might think doctors aren't too keen on prescribing unnecessary drugs. If anything a prophylaxis study would be more beneficial, pick a MAGA town and enough of them would more than willing to gobble down some drugs in the name of dear leader.

A prophylactic study of HCQ has already been done and published in NEJM. It showed no benefit https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

 

[Tobacco Road]

Anyone think you can have an honest and substantive "non-political" discussion about coronavirus?
While we wait for a vaccine (or better treatments), this is primarily a political and "freedom!" issue. We know what we should be doing right now.

 

[ConnorEl]

Man, fuckin' Herman Cain. That's a huge bummer.

At Trump rally 9 days before testing positive.

 

[ConnorEl]

I have no problem with running trials trying to answer the question. IMO, one of the (many) big failures of our government response to COVID has been the lack of central coordination of well designed clinical trials. Even though we have had way more cases than anywhere else, the lack of data is pretty shocking. A place like the UK has done a much better job of putting a huge percentage of their patients on study, which is why we have gotten the answers we have on Dex (it works!) and on HCQ (it doesn't, at least in hospitalized patients). The problem with just prescribing random drugs before the data is available is not just the potential harm it could do to patients, and the wasted money, but it makes it harder to do the research needed to know whether you are actually helping or not.

That said, there are a finite numbers of patients and dollars that are available for clinical research, even if things were better organized. So far, a hugely disproportionate amount of those dollars and patients have gone into HCQ studies. Given that the available evidence suggests it is highly unlikely to be helpful, I think it makes more sense to divert those patients and dollars to testing other options with a higher pretest probability of success.

Yep

Well said.

 

[ConnorEl]

Yikes. Lots wrong here. The idea of shitting on a randomized study because it's open label, and then hyping non-randomized data later on is LOL bad. The 50% of patients thing is not close to accurate. But even it were, it comes no where close to the amount of bias introduced in the non randomized studies. Like the Henry Ford study he references is laughably bad. "Not purely randomized.." It was a retrospective cohort study that wasn't even well matched (the group that got HCQ was 5 years younger on average; steroids, which we now know do save lifes, were given to 80% of the patients who got HCQ and only 35% of the group that didn't)!


He seems to be...not well informed.

Again...yep.

 

[ConnorEl]

Thx to Rafi and Tilt...I have neither the time or patience.

 

[birdman]

Related thought. It's wild to me that basically every high school kid ends up taking algebra 2 and trig, and many end up taking calculus. An pretty much nobody uses that stuff in real life. But did anyone actually take stats in high school? It wasn't even an option for me. Seems way more useful, no?

I have long said this is a massive problem in America. Hell, I got a Biology degree from Wake and only took one stats class.

Also, p-values and significance testing should go by the wayside. p<0.05 is an arbitrary standard set up arbitrarily in the 1940's. We should be looking a effect sizes and confidence interval overlap.

 

[Louis Gossett Jr]

Yeah you know how I feel about confidence intervals, the forgotten measurement in so many graphs because those overlapping tails at 90-95% confidence really illustrate what shit your data is. It’s interesting too with a lot of advanced modeling even when there are very complicated statistical interpretations to be used it requires best guess or biological fit, it’s a problem machine learning runs into time and time again because mathematically it checks out but biologically it fails.

 

[Wakeforest22890]

stats was only taught as an AP class at my high school

I'm not quite rj or dv7 level good, but I find most math pretty intuitive and took higher level courses most of my (filthy public) education -- much of stats, however, is very much not intuitive to me and I always have to refresh my memory on the most basic elements of it

Interesting - I’m the complete opposite. Fine math-wise up to algebra 2 but pre-cal and calculus was basically another language. Took AP stats my junior year and it was the easiest math class I ever took - thought the AP exam was a breeze.

Definitely agree with us needing more stats in high school especially now.

 

[Grabs Turds Bare]

I have a hard science BS. Multiple semesters of calculus, O/P Chem, etc. Nothing was as fundamentally hard as calculus. I would be hard pressed to differentiate between the first and second semesters of calculus. Organic Chemistry was one of those gut-check classes that culled a huge number of people from the sciences, but Calculus was like the fucking civil war - just blood everywhere. So many Johnny's coming home from the calculus wars saying, "I just really got interested in Psychology; the human mind is fascinating. I couldn't help changing my major, mom."

 

[tagsfan]

Back in the day, the 5 hour freshman calculus class was what caused many engineering students to say their major was pre-Business.

 

[JuiceCrewAllStar]

I used calculus once a few years ago

had to google and messed up a few times, but I used it

 

[ConnorEl]

I got used by it a few times.

 

[BarcaDeac]

have never taken a calc class, which I'm ok with.