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Thread: CDC: "This is the time to open up your pandemic plans"

  1. #361
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    Good medicine in bad places

  2. #362
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    Thank You,

  3. #363
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    Thanks Fidel
    Greater love hath no man than this, That a man lay down his life for a friend.
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  4. #364
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    Hydroxychloroquine working in Bahrain;

    https://twitter.com/NedJohnson45/sta...45674670473216

  5. #365

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    Yes, thank you!
    Making good people helpless, doesn't make bad people harmless!

  6. #366
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    Quote Originally Posted by bambam View Post
    Hydroxychloroquine working in Bahrain;

    https://twitter.com/NedJohnson45/sta...45674670473216
    There's a huge disconnect regarding "anecdotal evidence".

    The average person hears that phrase and immediately thinks of "well my sons' coach said his sister's husband's aunt's car mechanic's piano tuner said they tried it and it worked..."

    Here's the thing...

    To get medical establishment to endorse/approve a treatment and insurance to pay for a certain treatment, it has to be proven both safe and effective. The standards for that high standard are very stringent and take repeatable, clinical studies involving people who got the treatment AND control groups that didn't to compare and analyze and produce analytical, standardized and repeatable results.

    For the record, a doctor coming out of the "hot zone" who treated 500 patients of a deadly disease with a certain medication with 499 amazing complete recoveries qualifies as "anecdotal evidence" and a clinical double-blind placebo study taking 5 years which shows 65% of 10,000 people responded in a mostly positive fashion is "clinically proven".

    Nobody with a reputation wants to stake it on something that seemed promising initially due to a statistical anomaly or flawed study methodology.

    But you would think there should be a line between "that's a nasty little rash you've got" where there are treatments with proven track records, vs a novel, highly fatal disease with no documented treatments at all. As a doctor, are you really going to stand by and watch people die by the dozens for 2 years because you are afraid to believe the evidence of your own eyes and experience and the reasoning of your mind? So that you can wait until your actions are unreproachable? If that's the kind of medical system we've forced doctors into, we need to re-examine that whole system.

    Now... you tell me where you're going to find a group of 100 CV19 people who are sick enough to require hospitalization who will sign up for a study where they know they have a 50% chance of getting the "do-nothing" placebo while the other group gets the "maybe" miracle cure? I don't know about you but if those are the options I would say no-thanks to the study, get the "maybe" miracle wonder drug by hook or by crook, and take my chances... my mind, effort and intuition has got to beat a coin flip any day.
    Last edited by bruss01; 03-28-2020 at 01:48 AM.
    "The thing about smart people is they seem like crazy people to dumb people" - Stephen Hawking

  7. #367
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    You make a very valid point Bruss. That is exactly how our medical system is now, and that is the position our doctors are in. If a doctor goes out on a limb to give that treatment to a patient but they still die then they are going to get sued. Our medical system’s hands are now tied by our government and by the patients themselves in most cases.
    Prepare for the worst, hope for the best

  8. #368
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    Quote Originally Posted by bruss01 View Post
    There's a huge disconnect regarding "anecdotal evidence".

    The average person hears that phrase and immediately thinks of "well my sons' coach said his sister's husband's aunt's car mechanic's piano tuner said they tried it and it worked..."

    Here's the thing...

    To get medical establishment to endorse/approve a treatment and insurance to pay for a certain treatment, it has to be proven both safe and effective. The standards for that high standard are very stringent and take repeatable, clinical studies involving people who got the treatment AND control groups that didn't to compare and analyze and produce analytical, standardized and repeatable results.

    For the record, a doctor coming out of the "hot zone" who treated 500 patients of a deadly disease with a certain medication with 499 amazing complete recoveries qualifies as "anecdotal evidence" and a clinical double-blind placebo study taking 5 years which shows 65% of 10,000 people responded in a mostly positive fashion is "clinically proven".

    Nobody with a reputation wants to stake it on something that seemed promising initially due to a statistical anomaly or flawed study methodology.

    But you would think there should be a line between "that's a nasty little rash you've got" where there are treatments with proven track records, vs a novel, highly fatal disease with no documented treatments at all. As a doctor, are you really going to stand by and watch people die by the dozens for 2 years because you are afraid to believe the evidence of your own eyes and experience and the reasoning of your mind? So that you can wait until your actions are unreproachable? If that's the kind of medical system we've forced doctors into, we need to re-examine that whole system.

    Now... you tell me where you're going to find a group of 100 CV19 people who are sick enough to require hospitalization who will sign up for a study where they know they have a 50% chance of getting the "do-nothing" placebo while the other group gets the "maybe" miracle cure? I don't know about you but if those are the options I would say no-thanks to the study, get the "maybe" miracle wonder drug by hook or by crook, and take my chances... my mind, effort and intuition has got to beat a coin flip any day.
    All correct.

    Medical evidence is tiered. The very best is a multi-institution, double-blinded, controlled study involving 10,000 or more patients in each 'arm' - control and treatment These take years to run, and cost tens of millions of dollars. They should be multi-institution to get a wide variety of testers experiences, double blind so the testers don't inadvertently bias the results (observers bias), and involve a LOT of people...

    The very worst is an anecdote: "Hmm, I tried this once, and the patient didn't die." Anecdote is not a synonym for proof: Nor is it an antonym.

    In between there is a case report (one patient but written up), a case series (a few patients written up), case control studies, cohort studies, and then RCT's Randomized control studies). When you have a number of RCT's you can do a meta analysis but they have the potential for injecting error back into the mix

    Right now, we have gone from anecdote to small case studies and a few small cohorts. The original French study was terrible - 40 people total, divided into 2 arms (control which gets normal treatment and treatment which got HQ), and then they kicked 15% of the treatment arm out...VERY suspicious...

    A better study was published yesterday, and while still small shows better results and better structure of the report. Of interest to me is that the dose of HQ administered was 3x larger than normal...

    https://www.mediterranee-infection.c...ID-IHU-2-1.pdf
    Good medicine in bad places

  9. #369
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    Thanks for the info, Fidel. Keep us posted as you can.
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  10. #370
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