"Urgent randomised trials are needed"
No.
And here is why : 🔽
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No.
And here is why : 🔽
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Thread end : ⏹️)
RCT have good internal validity. They are gold standard to prove "experimental efficacy" (= efficacy) of a drug.
RCT have poor external validity. They are bad at proving "real life efficacy" (= effectiveness) of a drug.
RCT have poor external validity. They are bad at proving "real life efficacy" (= effectiveness) of a drug.
A drug who have no efficacy can't have effectiveness.
A drug who have efficacy maybe have effectiveness, and maybe not.
What is important to know is effectiveness. Not efficacy.
A drug who have efficacy maybe have effectiveness, and maybe not.
What is important to know is effectiveness. Not efficacy.
We need RCT when we don't have patients treated by the treatment we want to study.
We don't need RCT when thousands of patients have already been treated all around the world by the treatment we want to study.
We don't need RCT when thousands of patients have already been treated all around the world by the treatment we want to study.
In a normal situation we would need RCT to test efficacy of hydroxychloroquine for Covid-19.
Because in a normal situation no one would have been treated with hydroxychloroquine outside of a RCT.
In a normal situation, thousands of patients all around the world whould not have been treated with a drug whose efficacy was not proven.
In a normal situation, thousands of patients all around the world whould not have been treated with a drug whose efficacy was not proven.
But we are in an abnormal situation where thousands of patients have been treated all around the world with a drug whose efficacy is not proven.
We don't need RCT because we have real life data of patients using hydroxychloroquine.
We therefore can study effectiveness.
And that's what has been done : comparative studies published in most prestigious medical journals have all the same conclusion : no efficacy of hydroxychloroquine.
And that's what has been done : comparative studies published in most prestigious medical journals have all the same conclusion : no efficacy of hydroxychloroquine.
Game over. ⏹️
