Re: #COVID19 / #Hydroxychloroquine - single arm phase 2 data is the scientific equivalent of a hypothesis - don’t confuse larger number of uncontrolled patients as evidence - it is only the volume with which you are yelling. Proof requires randomized studies @VPrasadMDMPH
Sometimes uncontrolled ph2 studies show “preliminary findings” that in the judgement of experts render the “hypothesis” compelling or encouraging, but you still cannot argue that it is proof something works. And yes - the therapy “can still hurt” @realDonaldTrump
Sometimes uncontrolled ph2 studies are even good enough to get a new cancer therapy approved #ibrutinib in cll/mcl but the burden of evidence remains on the Pharma company to perform the correct study and create proof.
Watch for upcoming reports with a multitude of novel approaches for #COVID19 to show “efficacy” but pay careful attention to study design - and interpret with caution.
From a treatment perspective we will be a lot better when we have:
1) anti-viral to lessen viremia
2) rescue drug to lessen impact of inflammation
3) vaccine to prevent illness in first place
4) testing for prior exposure and active infection
1) anti-viral to lessen viremia
2) rescue drug to lessen impact of inflammation
3) vaccine to prevent illness in first place
4) testing for prior exposure and active infection
Think of each piece as a leg of a table
All that being said: I have a hypothesis....
