As a physician with MPH and MS degrees in evidence-based medicine, medical informatics, and biostatistics, I totally agree with you critique of other "expert" analyses in substack. As you suggested, I downloaded and read the study. This RCT was a poor quality study, IMHO, with 12 different treatment centers for the 679 patients who received IVM and with no analysis of secondary outcomes like adverse events or death. I am happy to see the breadth of your analytic critique. Your critique is very much on-point.
The value of RCTs are over-rated since they generally are restricted to early outcomes and do not evaluate late events like adverse events, long-COVID type of events, and events associated with vaccination, which was not even addressed in this RCT analysis. It is truly sad that so many people do not read these studies or have the expertise to critique them. Medicine is a very complex science that is often over-simplified in critiques I have read from others.
It's great hearing this coming from a physician. There's a lot wrong with the study but the overall argument here is that every study should be examined critically, even if it validates our assumptions- in fact, these are the studies we should be the most critical of.
RCTs are nothing more than heuristics. For the layperson if they don't see the phrase "RCT" somewhere in the paper they dismiss it because of course if it's not RCT it's not worth my time! Which is rather funny because I don't think these people would read these studies regardless.
Studies should always be evaluated based on their limitations which a lot of people tend not to do and would rather just say "this study clearly shows it works!" or "this study clearly shows it's ineffective!"
I also read a substack today where the author has previously expressed bias against IVM and clearly regurgitated something today that he read regarding this particular study. I’m not very good at data and statistics and I know people easily can use these to mislead people. In this particular study, the method seemed quite flawed for the reasons you stated. Also, as a provider, I don’t prescribe IVM without also making sure the patient is in zinc, and vitamin c and d3. Also, if they have Comorbid conditions, their prescribed dose is higher and generally IVM Is prescribed for 5 - 7 days, not three. IVM is also supposed to be taken with food. ( perhaps you mentioned this). It’s good to read and try to discern truth. I’m so skeptical about everything!
It's honestly funny seeing how many people would rather report on other people's reports than to actually look at the study themselves. The information is right there to be analyzed!
I never argue for or against a drug but I want to see what the methodology and limitations suggest and viewing studies within this context, but many people would rather want to find results rather than interpreting studies. Also, I am horrible with statistics! Which is unfortunate because the statistics can certainly mask a lot of faults within the methodology.
Thanks for providing your insight! Would you be able to clarify what you mean as a provider? don't worry if it provides too many personal information.
And yes, I mentioned that it was given on an empty stomach but forgot to mention that Ivermectin is fat soluble and should be taken with food! I'll add that information as well!
I’m a nurse practitioner in colorado. With the federal healthcare jab mandate, I’m in a no jab-no job situation. Of course there are exemptions available, but then you are required to undergo weekly or twice weekly testing -which is absolute nonsense. The requirement of Wearing a mask all day at work is entirely without reason. And frankly the culture in facilities at this time is very divisive and uncomfortable. There are not very many unjabbed in that environment. So Ive started my own business to provide early treatment as well as primary care services through the platform of Remote Health Solutions.
I'm sorry you were put into that situation. I feel the same way as you. I used to work in a lab and they mandated vaccine passports. I had a lot of reservations with the vaccines and was eventually let go in the fall of 2021 and ended up starting this Substack because the job market felt very uncertain. Also, I became very disillusioned with the science and medical field.
All in all it's nice to always hear of other people put into a similar situation and finding their way among the uncertainty. All the best to you and your business! We definitely need a lot more people taking a more proactive approach and not just waiting and seeing.
Your rant is completely judtified. I know this because I thought the exact same thing when I saw Berenson's bizarre post. He clearly hadn't read the thing in his rush to troll his own readers. He has a strange anti-ivm and anti-Robert Malone bent that undermines his credibility. His last anti-ivm post was actually embarrassing because the intro or abstract contradicted the actual contents of the paper, probably so it could get published. Even the lovely Jessica Rose was kind enough to try emailing to explain, but Alex is pervious to introspection. I cancelled by subscription. (I do understand these topics, being both an economist and a homemaker. 🙃)
My biggest issue is that he could at least put a little more effort in. I've been pondering what the new meta for Substack will be post all COVID talk, and I think in some regards Alex has paved a way for a more social media based approach to Substack that encourages shorter, low effort posts for some people.
And I meant no ill-will towards homemakers with my comment. It's more that people are quick to defend their ignorance because they are not formally trained, and I want to encourage and empower people to know that you can learn anything regardless of your starting point. It's only that those who have been formally trained just have a head-start compared to the rest of us. So hopefully my comment did not come off more crass than I intended.
We are fortunate in this day and age to have fairly easy access to studies and the ability to spend as much time as we need to review and think about them. Since COVID came to call, my time has been spent reading and researching as much as possible about the REAL science. Needless to say, I have few friends left and even though they know I was a scientist they ignore and cancel me. Now, some of my friends are victims of the jab. It is all so very sad. At least I know I'm in good and educated company here. Thank you for all your wonderful postings and for you caring rants. From an old broad, NEVER EVER apologize for giving a damn!!!!
What's strange is that I am noticing something similar. I'm seeing many people who believe what they are seeing is scientific, but won't engage in dialogue with me even though I have a background in Biochemistry. I think many people who are not versed in science may not want to have their ignorance be fully known and will rather outsource their intellect to authority figures. If people question these authority figures, they are question their intellect, which makes them very defensive. I hope it turns around soon but I definitely understand the frustrations when it's hard to reach out to people.
And thank you! It's always good to hear people enjoying my posts!
Apropos of your excellent rant, a life-simplification strategy of mine is to forever ignore anyone I discover lying to me. I also only consume news from unfamiliar sources by reading. I never watch or listen because it goes by too quickly for me to dependably catch initial lies upon which false conclusions would be based.
I've observed that most people who write lies will include many of them in the first paragraph or two, and this strategy means I can stop reading immediately thereafter. It's irrelevant to me if they write for a self-declared newspaper of record, work for a major university, or if they've won a Pulitzer or Nobel. If I catch them lying, I have carte blanche to ignore their entire life's work. It's better to be uninformed than misinformed, because it's far easier to be fooled than to accept that you had been fooled previously.
No lies is an exceptionally high bar, and the resulting rejection of most people allows me to focus my highest-quality energy, attention and loyalty only on truly good people. It also makes me a better person, since I strive--in interactions with good people--always to satisfy my own standard.
Maybe the best part is you are not reliant on "expert" advice from anyone else, not even to bootstrap your list of good people. You can build your own list one by one, as your growing experience soon makes the process easy and quick. You need only discover one lie from any given person to reject them, and every time you do that, it improves the efficiency, effectiveness, and enjoyment of your life.
Thank you for your insights. I wish more people were more critical in assuming that everything they see, even from independent sources, can be trusted. Being more skeptical and understanding that there may be people with intents to mislead should teach people to examine where biases may lie.
I will say that some people make mistakes- I certainly do! But the issue is whether people correct themselves or continuously mislead intentionally. For those who continue to lie or obfuscate the truth it's understandable to not trust these people. They certainly did not earn it/lost it if they never correct themselves.
This study is yet another study designed to fail. The dosage is less than recommended, for a shorter period of time than recommended starting later than recommended. A large number of participants being eliminated or not following up. Gee, what's not to like here?
Appreciate the comments on statistical significance vs clinical significance
Regardless of whether or not it was designed to fail, the important factor is determining what methodologies would lead to failure. You've stated a few factors but many times I think people just speculate that these studies have flawed methodologies without understanding what those flawed methodologies are which is the more important part.
I came across the clinical significance when researching another topic. I knew it was a concept but didn't know what the actual term was but you can easily determine who is focused solely on numbers and statistics and who else is focused on the patient and individual outcomes.
I'm mulling over intellectual laziness and contributing factors of perhaps gatekeeping and credentialism and an educational structure (indoctrination?) for many people that always had an authority figure who purportedly knew the answers, and applying that to other areas of life. I also wonder if for example right now you're 60ish, didn't get your degree in anywhere near the kinds of fields that have you reading research, having flagging energy levels, how driven and competent you feel to tackle digging into studies versus outsourcing conclusions to "trustworthy sources" (my SO's and my struggle to talk in any depth about these kinds of topics to our parents).
On the topic of double blind RCTs and statistical versus clinical significance, I'm glad to have gotten into nutrition as an interest. It became clear there have to be other ways to glean what might be impactful because you can't double blind and randomize people's medium and long term eating habits, and small sample sizes of people with certain chronic illnesses having vastly different results against what is well understood to be the baseline outcomes of that disease (QoL/functional disability, life expectancy, etc) shows the clinical versus statistical significance difference clearly.
Oh I am right there with you and mulling over all of this. Like Bret and Heather reiterate within their podcast (and which they did again yesterday) that there's a big difference between intelligence and education, and it is now that many people are realizing how many people conflate the two when there really should not be a conflation. I want to remove the illusion that you need to be properly educated in order to speak on any of these manners; it's far more important that someone spends time and continues to learn rather than go through university and believe that that somehow validates one's intelligence.
RCTs are the fallacy of heuristics. It's an easy shortcut that presumes that the evidence is valid without necessarily needing to look at the evidence. It's apparent that most people don't get past the abstract for many papers which is a serious fault of the scientific community.
“It is also wrong that the government, through main stream media is picking winners and losers, in terms of what science is deemed worthy or even allowed to be presented. The media now presents data and public health policies, which our government approves of as fait accompli. No scientific discussion or dissent allowed. This is not how good science works. Let me restate that. This is not how the scientific process works. This is how “totalitarism” works.”
While there may be problems in the pro-Ivermectin studies, in my opinion any mistakes made were not intentional and parts of many of those studies can still be used in a meta-analysis. By contrast, the anti-ivermectin studies were purposely designed to fail. It seems to me that there has been a concerted effort from the earliest days of the pandemic to deny that any early treatment options using re-purposed medications are effective. Look, for example, at the early hydroxychloroquine trials using near-lethal doses to convince the public that a 65 year-old drug with a proven track record wasn’t safe.
At this point, the American public has been told so many lies by the 3 letter govt agencies, the media and the medical establishment, I don’t think there is any trust at all in the COVID information published.
Consider this (these are CDC statistics): there are 258 Million people in this country over the age of 18. 88% of those people got an initial vaccination shot, but only 75% ended up becoming fully vaccinated. So there was a high level of trust when the govt first said the shots were “safe and effective” but a significant number of people (13%) already lost faith before they got their second shot.
Now, despite being urged to get boosters, only 94 Million of 18+ year-olds (36%) have gotten boosters. That tells me that 64% of the population no longer trusts their government or their doctors on this issue. I’m open to other interpretations of this data, but I don’t see any other logical explanation.
I will say that one of the biggest issues in medicine is compliance and having people get two shots may be seen as too burdensome- that's why people were encouraging the adenovirus vector vaccines and it was the actual tagline that people used.
But I do believe that constant pestering and reiteration of the need for your second, third, fourth booster is waking people up to the absurdities. I remember Scott Gotlieb speaking on NBC once saying that the lockdowns couldn't return not because they were not effective, not because of high vaccination rates, but because people would keep losing trust in the medical community if it persists. These people are far more concerned with saving face than attempting to conduct proper science.
Answer: generally, no, they don't, they only read headlines and, even if they do read studies, apparently the art of critical review is virtually lost, even, it sears me to say, among those *I trained in it!*
I think what's alarming is that if you look at this NBC article and look at the title on the page tab is starts with "Ivermectin is Useless", which makes me believe that the article started with a different title BEFORE it was edited and the tab could not be changed.
Appreciated the rant. Also just found this stack. I subscribe to Robert Malone who had some instructions in one of his stacks on how to read a study. The problem with education vs intelligence is language. Scientific language...words, sentence formation, acronyms ect. Someone with a significant science education can, if he chooses, read a study with a critical eye. Intelligent people have to acquire that ability and that takes time and significant self discipline, especially if someone's innate intelligence is more right brained. In any case that is why I subscribe to substack authors that can do some interpreting for me. I get a variety of different interpretations that I feel keep me honest. For example, you. I find you to be easy to understand and honest. I found Alex to have a great communication style but canceled because of his attacks on Robert Malone. The first time I wrote off as professional jealousy. Then he seemed to 'interpret' the ivermectin study with glee as it undermined the 'competition' and that was a bridge to far. I love reading Brian Mowry but am constantly asking for a translation and/or needing to read several times. I tend to side with Igor and bad cattude on oas but am open. 'Emperor' finds and publishes studies both pro and con the issue in spite of his personal bias and I respect that. Then there are the philosophers and the politicians. All over the world intelligent dialogue about the real world consequences of the abuse of science to undermine our liberties. I love substack. Bottom line...people have seen "the" science as objective and concrete. We were taught to trust that. But science is a journey more than a fact. Scientists are human beings with agendas, egos and bias. When people understand that, they will begin to use proper analysis. For huge numbers of people the door is now opened. The light is on and thanks to people like you the journey has begun.
Thanks for your remarks. Reading studies does take training and it's honestly one of those things you can never get down fully. There's still so much I need to figure out when reading papers especially when they are from different disciplines. There's jargon associated with different fields that don't overlap well with one another. There's also a large issue of how the public perceives scientific terminology or naming that the public may misinterpret or infer incorrectly.
The issue, as I would assume, is that Alex may have just latched onto what was reported by news outlets more than examine the study himself. I don't remember Alex being one that reads many studies and so likely relied on the interpretation of others which is an egregious error if that's the case.
Brian is great and I tend to agree with him on a lot of topics but he can be quite verbose and require rereading several times for me as well. I think he structures concepts in a very unique way that may sometimes not translate well into the public. Nonetheless, I think he's really trying to get to the bottom of a lot of this information and really appears to lean heavily into the science to do so, which unfortunately I would argue may not be occurring as often as it should on Substack.
Yupp, the concept and principles of science are things that we should ascribe to, but like with everything the human touch always makes its way into things and sometimes not for the best.
Thank you for this thoughtful analysis, this study is already making its way through casual conversations and is a helpful reference to share! This medication is a hot topic (everyone gets to have an opinion with limited information) and unfortunately bypasses the nuance of clinical care applied in nearly every appointment which weighs risk vs benefit for treatment (this medication reflects low risk, possible benefit) and cost of treatment (low cost ranks high!). I wish i could underline cost to emphasize this aspect but substack comment doesn't permit me to, sign...
Thank you! I was quite frustrated about IVM and honestly I just wanted to stop talking about it because it didn't seem much nuance was being used when talking about this topic. It's even more infuriating that in an era of open access studies people refer to reports in mainstream outlets, which of course means that one must consider the veracity and thoroughness that said mainstream reporting does. Of course, we should learn to be far more skeptical of such reporting by now.
I will say to be careful of interpreting too much from the study, but I don't think it's quite absolute in suggesting anything about IVM. I think the study is far too flawed which means that we should not look too deeply into the results.
This is not the first South American ivermectin trial that invited placebo deviation in advance (using the Table 3 value to infer deviation, not the Table 2 value), and then achieved apparent equal results on the other end, and also had to change the endpoint due to the first endpoint not panning out (the other being Lopez-Medina et al.). A "shame" since TOGETHER is designed to make innovative treatment research more robust, but the design still breaks apart as soon as they drive it off the lot. But also predictable. Sports and video games don't require trials to figure out how to optimize approach. Medicine shouldn't either. A scoring system and some crowdsourcing, done.
Still, it's interesting that there were such high rates of ER / hospitalization, assuming lots of the placebo group snuck in their own ivm as well. But maybe it should be compared to the more tightly-controlled Malaysia study, which had even higher rates, implying the real improvement was ~10%. What a mess, either way.
It's also fascinating that the researchers wanted a 1 day treatment option only, but "gave in" to the advocates and extended it by 3 days. Just seeing dialogue like that raises a lot of questions as to what they were hoping to achieve with their methodologies.
Also keep in mind that hospitalization was measured by clinical observation over 6 hours. Does that mean someone was hospitalized or was told to check in and wait to see how things go? If someone was perfectly fine and did not require oxygen or ventilation but stayed in a hospital is that still considered hospitalization?
I never looked deeply into the Malaysian study because I was just frustrated that very few people actually attempt to examine studies. I think in this instance I just was in a bad mindset and decided to rant this time around.
As a physician with MPH and MS degrees in evidence-based medicine, medical informatics, and biostatistics, I totally agree with you critique of other "expert" analyses in substack. As you suggested, I downloaded and read the study. This RCT was a poor quality study, IMHO, with 12 different treatment centers for the 679 patients who received IVM and with no analysis of secondary outcomes like adverse events or death. I am happy to see the breadth of your analytic critique. Your critique is very much on-point.
The value of RCTs are over-rated since they generally are restricted to early outcomes and do not evaluate late events like adverse events, long-COVID type of events, and events associated with vaccination, which was not even addressed in this RCT analysis. It is truly sad that so many people do not read these studies or have the expertise to critique them. Medicine is a very complex science that is often over-simplified in critiques I have read from others.
Thank your for your thoughtful input.
It's great hearing this coming from a physician. There's a lot wrong with the study but the overall argument here is that every study should be examined critically, even if it validates our assumptions- in fact, these are the studies we should be the most critical of.
RCTs are nothing more than heuristics. For the layperson if they don't see the phrase "RCT" somewhere in the paper they dismiss it because of course if it's not RCT it's not worth my time! Which is rather funny because I don't think these people would read these studies regardless.
Studies should always be evaluated based on their limitations which a lot of people tend not to do and would rather just say "this study clearly shows it works!" or "this study clearly shows it's ineffective!"
I also read a substack today where the author has previously expressed bias against IVM and clearly regurgitated something today that he read regarding this particular study. I’m not very good at data and statistics and I know people easily can use these to mislead people. In this particular study, the method seemed quite flawed for the reasons you stated. Also, as a provider, I don’t prescribe IVM without also making sure the patient is in zinc, and vitamin c and d3. Also, if they have Comorbid conditions, their prescribed dose is higher and generally IVM Is prescribed for 5 - 7 days, not three. IVM is also supposed to be taken with food. ( perhaps you mentioned this). It’s good to read and try to discern truth. I’m so skeptical about everything!
It's honestly funny seeing how many people would rather report on other people's reports than to actually look at the study themselves. The information is right there to be analyzed!
I never argue for or against a drug but I want to see what the methodology and limitations suggest and viewing studies within this context, but many people would rather want to find results rather than interpreting studies. Also, I am horrible with statistics! Which is unfortunate because the statistics can certainly mask a lot of faults within the methodology.
Thanks for providing your insight! Would you be able to clarify what you mean as a provider? don't worry if it provides too many personal information.
And yes, I mentioned that it was given on an empty stomach but forgot to mention that Ivermectin is fat soluble and should be taken with food! I'll add that information as well!
I’m a nurse practitioner in colorado. With the federal healthcare jab mandate, I’m in a no jab-no job situation. Of course there are exemptions available, but then you are required to undergo weekly or twice weekly testing -which is absolute nonsense. The requirement of Wearing a mask all day at work is entirely without reason. And frankly the culture in facilities at this time is very divisive and uncomfortable. There are not very many unjabbed in that environment. So Ive started my own business to provide early treatment as well as primary care services through the platform of Remote Health Solutions.
I'm sorry you were put into that situation. I feel the same way as you. I used to work in a lab and they mandated vaccine passports. I had a lot of reservations with the vaccines and was eventually let go in the fall of 2021 and ended up starting this Substack because the job market felt very uncertain. Also, I became very disillusioned with the science and medical field.
All in all it's nice to always hear of other people put into a similar situation and finding their way among the uncertainty. All the best to you and your business! We definitely need a lot more people taking a more proactive approach and not just waiting and seeing.
Your rant is completely judtified. I know this because I thought the exact same thing when I saw Berenson's bizarre post. He clearly hadn't read the thing in his rush to troll his own readers. He has a strange anti-ivm and anti-Robert Malone bent that undermines his credibility. His last anti-ivm post was actually embarrassing because the intro or abstract contradicted the actual contents of the paper, probably so it could get published. Even the lovely Jessica Rose was kind enough to try emailing to explain, but Alex is pervious to introspection. I cancelled by subscription. (I do understand these topics, being both an economist and a homemaker. 🙃)
My biggest issue is that he could at least put a little more effort in. I've been pondering what the new meta for Substack will be post all COVID talk, and I think in some regards Alex has paved a way for a more social media based approach to Substack that encourages shorter, low effort posts for some people.
And I meant no ill-will towards homemakers with my comment. It's more that people are quick to defend their ignorance because they are not formally trained, and I want to encourage and empower people to know that you can learn anything regardless of your starting point. It's only that those who have been formally trained just have a head-start compared to the rest of us. So hopefully my comment did not come off more crass than I intended.
We are fortunate in this day and age to have fairly easy access to studies and the ability to spend as much time as we need to review and think about them. Since COVID came to call, my time has been spent reading and researching as much as possible about the REAL science. Needless to say, I have few friends left and even though they know I was a scientist they ignore and cancel me. Now, some of my friends are victims of the jab. It is all so very sad. At least I know I'm in good and educated company here. Thank you for all your wonderful postings and for you caring rants. From an old broad, NEVER EVER apologize for giving a damn!!!!
What's strange is that I am noticing something similar. I'm seeing many people who believe what they are seeing is scientific, but won't engage in dialogue with me even though I have a background in Biochemistry. I think many people who are not versed in science may not want to have their ignorance be fully known and will rather outsource their intellect to authority figures. If people question these authority figures, they are question their intellect, which makes them very defensive. I hope it turns around soon but I definitely understand the frustrations when it's hard to reach out to people.
And thank you! It's always good to hear people enjoying my posts!
Apropos of your excellent rant, a life-simplification strategy of mine is to forever ignore anyone I discover lying to me. I also only consume news from unfamiliar sources by reading. I never watch or listen because it goes by too quickly for me to dependably catch initial lies upon which false conclusions would be based.
I've observed that most people who write lies will include many of them in the first paragraph or two, and this strategy means I can stop reading immediately thereafter. It's irrelevant to me if they write for a self-declared newspaper of record, work for a major university, or if they've won a Pulitzer or Nobel. If I catch them lying, I have carte blanche to ignore their entire life's work. It's better to be uninformed than misinformed, because it's far easier to be fooled than to accept that you had been fooled previously.
No lies is an exceptionally high bar, and the resulting rejection of most people allows me to focus my highest-quality energy, attention and loyalty only on truly good people. It also makes me a better person, since I strive--in interactions with good people--always to satisfy my own standard.
Maybe the best part is you are not reliant on "expert" advice from anyone else, not even to bootstrap your list of good people. You can build your own list one by one, as your growing experience soon makes the process easy and quick. You need only discover one lie from any given person to reject them, and every time you do that, it improves the efficiency, effectiveness, and enjoyment of your life.
Thanks, I love your work.
Thank you for your insights. I wish more people were more critical in assuming that everything they see, even from independent sources, can be trusted. Being more skeptical and understanding that there may be people with intents to mislead should teach people to examine where biases may lie.
I will say that some people make mistakes- I certainly do! But the issue is whether people correct themselves or continuously mislead intentionally. For those who continue to lie or obfuscate the truth it's understandable to not trust these people. They certainly did not earn it/lost it if they never correct themselves.
This study is yet another study designed to fail. The dosage is less than recommended, for a shorter period of time than recommended starting later than recommended. A large number of participants being eliminated or not following up. Gee, what's not to like here?
Appreciate the comments on statistical significance vs clinical significance
Regardless of whether or not it was designed to fail, the important factor is determining what methodologies would lead to failure. You've stated a few factors but many times I think people just speculate that these studies have flawed methodologies without understanding what those flawed methodologies are which is the more important part.
I came across the clinical significance when researching another topic. I knew it was a concept but didn't know what the actual term was but you can easily determine who is focused solely on numbers and statistics and who else is focused on the patient and individual outcomes.
I'm mulling over intellectual laziness and contributing factors of perhaps gatekeeping and credentialism and an educational structure (indoctrination?) for many people that always had an authority figure who purportedly knew the answers, and applying that to other areas of life. I also wonder if for example right now you're 60ish, didn't get your degree in anywhere near the kinds of fields that have you reading research, having flagging energy levels, how driven and competent you feel to tackle digging into studies versus outsourcing conclusions to "trustworthy sources" (my SO's and my struggle to talk in any depth about these kinds of topics to our parents).
On the topic of double blind RCTs and statistical versus clinical significance, I'm glad to have gotten into nutrition as an interest. It became clear there have to be other ways to glean what might be impactful because you can't double blind and randomize people's medium and long term eating habits, and small sample sizes of people with certain chronic illnesses having vastly different results against what is well understood to be the baseline outcomes of that disease (QoL/functional disability, life expectancy, etc) shows the clinical versus statistical significance difference clearly.
Oh I am right there with you and mulling over all of this. Like Bret and Heather reiterate within their podcast (and which they did again yesterday) that there's a big difference between intelligence and education, and it is now that many people are realizing how many people conflate the two when there really should not be a conflation. I want to remove the illusion that you need to be properly educated in order to speak on any of these manners; it's far more important that someone spends time and continues to learn rather than go through university and believe that that somehow validates one's intelligence.
RCTs are the fallacy of heuristics. It's an easy shortcut that presumes that the evidence is valid without necessarily needing to look at the evidence. It's apparent that most people don't get past the abstract for many papers which is a serious fault of the scientific community.
This is from Dr. Malone’s Substack column today:
“It is also wrong that the government, through main stream media is picking winners and losers, in terms of what science is deemed worthy or even allowed to be presented. The media now presents data and public health policies, which our government approves of as fait accompli. No scientific discussion or dissent allowed. This is not how good science works. Let me restate that. This is not how the scientific process works. This is how “totalitarism” works.”
While there may be problems in the pro-Ivermectin studies, in my opinion any mistakes made were not intentional and parts of many of those studies can still be used in a meta-analysis. By contrast, the anti-ivermectin studies were purposely designed to fail. It seems to me that there has been a concerted effort from the earliest days of the pandemic to deny that any early treatment options using re-purposed medications are effective. Look, for example, at the early hydroxychloroquine trials using near-lethal doses to convince the public that a 65 year-old drug with a proven track record wasn’t safe.
At this point, the American public has been told so many lies by the 3 letter govt agencies, the media and the medical establishment, I don’t think there is any trust at all in the COVID information published.
Consider this (these are CDC statistics): there are 258 Million people in this country over the age of 18. 88% of those people got an initial vaccination shot, but only 75% ended up becoming fully vaccinated. So there was a high level of trust when the govt first said the shots were “safe and effective” but a significant number of people (13%) already lost faith before they got their second shot.
Now, despite being urged to get boosters, only 94 Million of 18+ year-olds (36%) have gotten boosters. That tells me that 64% of the population no longer trusts their government or their doctors on this issue. I’m open to other interpretations of this data, but I don’t see any other logical explanation.
I will say that one of the biggest issues in medicine is compliance and having people get two shots may be seen as too burdensome- that's why people were encouraging the adenovirus vector vaccines and it was the actual tagline that people used.
But I do believe that constant pestering and reiteration of the need for your second, third, fourth booster is waking people up to the absurdities. I remember Scott Gotlieb speaking on NBC once saying that the lockdowns couldn't return not because they were not effective, not because of high vaccination rates, but because people would keep losing trust in the medical community if it persists. These people are far more concerned with saving face than attempting to conduct proper science.
Excellent writeup and opinion. Agree 100%.
Posted on Gab to my timeline:
https://gab.com/rebellium/posts/108057984620217956
Appreciate it Tab!
Answer: generally, no, they don't, they only read headlines and, even if they do read studies, apparently the art of critical review is virtually lost, even, it sears me to say, among those *I trained in it!*
I think what's alarming is that if you look at this NBC article and look at the title on the page tab is starts with "Ivermectin is Useless", which makes me believe that the article started with a different title BEFORE it was edited and the tab could not be changed.
https://www.nbcnewyork.com/news/coronavirus/study-ivermectin-does-not-reduce-hospitalization-from-covid-19-infection/3626431/
I do wish that, even among the Substack sphere, more people read past the headlines. Or even better, go directly to the actual study!
Appreciated the rant. Also just found this stack. I subscribe to Robert Malone who had some instructions in one of his stacks on how to read a study. The problem with education vs intelligence is language. Scientific language...words, sentence formation, acronyms ect. Someone with a significant science education can, if he chooses, read a study with a critical eye. Intelligent people have to acquire that ability and that takes time and significant self discipline, especially if someone's innate intelligence is more right brained. In any case that is why I subscribe to substack authors that can do some interpreting for me. I get a variety of different interpretations that I feel keep me honest. For example, you. I find you to be easy to understand and honest. I found Alex to have a great communication style but canceled because of his attacks on Robert Malone. The first time I wrote off as professional jealousy. Then he seemed to 'interpret' the ivermectin study with glee as it undermined the 'competition' and that was a bridge to far. I love reading Brian Mowry but am constantly asking for a translation and/or needing to read several times. I tend to side with Igor and bad cattude on oas but am open. 'Emperor' finds and publishes studies both pro and con the issue in spite of his personal bias and I respect that. Then there are the philosophers and the politicians. All over the world intelligent dialogue about the real world consequences of the abuse of science to undermine our liberties. I love substack. Bottom line...people have seen "the" science as objective and concrete. We were taught to trust that. But science is a journey more than a fact. Scientists are human beings with agendas, egos and bias. When people understand that, they will begin to use proper analysis. For huge numbers of people the door is now opened. The light is on and thanks to people like you the journey has begun.
Thanks for your remarks. Reading studies does take training and it's honestly one of those things you can never get down fully. There's still so much I need to figure out when reading papers especially when they are from different disciplines. There's jargon associated with different fields that don't overlap well with one another. There's also a large issue of how the public perceives scientific terminology or naming that the public may misinterpret or infer incorrectly.
The issue, as I would assume, is that Alex may have just latched onto what was reported by news outlets more than examine the study himself. I don't remember Alex being one that reads many studies and so likely relied on the interpretation of others which is an egregious error if that's the case.
Brian is great and I tend to agree with him on a lot of topics but he can be quite verbose and require rereading several times for me as well. I think he structures concepts in a very unique way that may sometimes not translate well into the public. Nonetheless, I think he's really trying to get to the bottom of a lot of this information and really appears to lean heavily into the science to do so, which unfortunately I would argue may not be occurring as often as it should on Substack.
Yupp, the concept and principles of science are things that we should ascribe to, but like with everything the human touch always makes its way into things and sometimes not for the best.
Thank you for this thoughtful analysis, this study is already making its way through casual conversations and is a helpful reference to share! This medication is a hot topic (everyone gets to have an opinion with limited information) and unfortunately bypasses the nuance of clinical care applied in nearly every appointment which weighs risk vs benefit for treatment (this medication reflects low risk, possible benefit) and cost of treatment (low cost ranks high!). I wish i could underline cost to emphasize this aspect but substack comment doesn't permit me to, sign...
Thank you! I was quite frustrated about IVM and honestly I just wanted to stop talking about it because it didn't seem much nuance was being used when talking about this topic. It's even more infuriating that in an era of open access studies people refer to reports in mainstream outlets, which of course means that one must consider the veracity and thoroughness that said mainstream reporting does. Of course, we should learn to be far more skeptical of such reporting by now.
I KNOW!!!!!
I note that in the figure (figure 2), every single confidence interval crosses 1! Nuff said?
I will say to be careful of interpreting too much from the study, but I don't think it's quite absolute in suggesting anything about IVM. I think the study is far too flawed which means that we should not look too deeply into the results.
This is not the first South American ivermectin trial that invited placebo deviation in advance (using the Table 3 value to infer deviation, not the Table 2 value), and then achieved apparent equal results on the other end, and also had to change the endpoint due to the first endpoint not panning out (the other being Lopez-Medina et al.). A "shame" since TOGETHER is designed to make innovative treatment research more robust, but the design still breaks apart as soon as they drive it off the lot. But also predictable. Sports and video games don't require trials to figure out how to optimize approach. Medicine shouldn't either. A scoring system and some crowdsourcing, done.
Still, it's interesting that there were such high rates of ER / hospitalization, assuming lots of the placebo group snuck in their own ivm as well. But maybe it should be compared to the more tightly-controlled Malaysia study, which had even higher rates, implying the real improvement was ~10%. What a mess, either way.
It's also fascinating that the researchers wanted a 1 day treatment option only, but "gave in" to the advocates and extended it by 3 days. Just seeing dialogue like that raises a lot of questions as to what they were hoping to achieve with their methodologies.
Also keep in mind that hospitalization was measured by clinical observation over 6 hours. Does that mean someone was hospitalized or was told to check in and wait to see how things go? If someone was perfectly fine and did not require oxygen or ventilation but stayed in a hospital is that still considered hospitalization?
I never looked deeply into the Malaysian study because I was just frustrated that very few people actually attempt to examine studies. I think in this instance I just was in a bad mindset and decided to rant this time around.