5 of the 11 included studies, covering 2582 of the 3409 patients included in the systematic review did not qualify for inclusion, based on a novel criterion used to exclude many other studies.
What you are missing is that nobody ever reads inclusion criteria of meta-analyses; including the authors themselves. It just so boring and dry, and then it actually requires you to do all this grunt work of collecting tidbits of information that cant readily be queried from a database. You just write the criteria so they sound reasonable and strict and sciency; and then you proceed to just cobble together a list of studies you actually liked.
This is unironically completely routine procedure. Move along people, nothing to see here.
If you haven't heard about the Roman et al. meta-analysis, it was amazing as well... They simply inverted or truncated about half of the results from the studies they included. These "errors" were clearly exposed by readers' comments under the preprint version, but it was nevertheless peer-reviewed and published with no correction.
I can't remember which one, but at least one Asian country withdrew ivermectin from its guidelines because of that meta-analysis.
If you can find more info on that, especially which country withdrew ivm, please let me know. I wrote this piece while looking into the broader question of meta-analyses of ivm, so it will come in handy when I continue. In general anything you have on insane meta-analyses :)
Sep 5, 2022·edited Sep 5, 2022Liked by Alexandros Marinos
What I remember is that through the "altmetric" tool attached to one of the versions of Roman's paper, I had found a link to the official page of a country's health authorities, stating that the guideline had been changed. Later, I never could find the link again. Today I searched again. I still couldn't find the link, but I found that other important authorities took Roman seriously:
- New Zealand's Ministry of Health, p.5: "Roman = good work; Bryant = bad work" (summary by myself :-) )
- Even in 2022, publications keep writing such things as : "Current evidence based on higher quality data suggests no benefit [of ivermectin] [[151], [152], [153]]."
I'm more appalled than shocked to see such a flawed review coming out of the Cochrane Collaboration. I used to be a huge fan of CC and relied heavily, and rather unquestioningly, on their reviews. That all stopped in 2020, after I discovered just how poor their 2018 review of the evidence for the HPV vaccine was. I still remember reading and rereading the 2018 BMJ article by Peter Gotzsche, Lars Jorgensen, and Tom Jefferson laying out the many serious problems with the review, including that the HPV vax review had missed *nearly half of the eligible trials* and was influenced by reporting bias and biased trial designs. And, Cochrane had failed to deal adequately (e.g. they didn't follow their own rules) with the conflicts of interest on the part of the lead author, among others. If folks want to read this critical piece they can check here. https://ebm.bmj.com/content/23/5/165.abstract. You could also read pp 146-150 (Section titled: "Cochrane review of the HPV vaccines was flawed and incomplete") in Gotzsche's 2020 book "Vaccines".
Also this from Gotzche's "Vaccines": "I found many other serious problems with the WHO report ["from 2014 that seems to have been carried out in response to [Peter] Aaby’s findings of increased mortality of the trivalent diphtheria, tetanus and pertussis (DTP) vaccine in Guinea-Bissau.7 It assessed the effect of three vaccines on total mortality in infants and children: BCG (Bacille Calmette-Guérin; against tuberculosis), DTP and measles."]. This is very surprising because two of the three authors of the WHO report are senior researchers in the Cochrane Collaboration. These two are the current editor-in-chief, Karla Soares-Weiser, and statistician Julian Higgins, who is editor of the Cochrane Handbook of 636 pages that describes how to do reliable systematic reviews. These researchers even used vote counting in the WHO report (how many studies are for and how many against?), which is a method recommended against in the Cochrane Handbook."
The original paper with the transposed numbers showed that Ivermectin was effective (Risk Reduction for all cause mortality), but not statistically significant. The conclusion was that Ivermectin was not effective.
However, after the transpose is corrected the results (if you run the numbers) become effective AND statistically significant. But, only the table listing the Niaee transpose was corrected. The table with the results of the meta-analysis was not updated. The most noteworthy point for me is that Roman did correct the table with the transposed Ivermectin arm and control arm, but did not correct the results. The paper still states that Ivermectin is not effective.
*The rebuttal was written by Dr. Tess Lawrie and LinkedIn censored her for posting a peer reviewed paper.
the reddit page is still up, but the embedded link on that page is now dead so I can't be sure, but I think it was her own Ivermectin meta-analysis that got her censored.
We should never throw out data on a whim. We will throw out data if we can demonstrate that it is somehow compromised or untrustworthy. Being a few days off in registration doesn’t look like a data compromise. It looks like selection of data to obtain a desired result. That’s untrustworthy.
Thank you for this substack and all the work that went into it. As a retired scientist I am saddened to see this coming from Cochrane and as a volunteer in their collaboration I am disgusted and will rethink giving any future time to their endeavours. Prior to this reading I had the highest respect and confidence in this group which is why I have given of my time to them. ( Head shaking......)
Last year, I did a deep dive into the 2021 Cochrane IVM meta-analysis. I noticed that Cochrane buried the results (in a tiny footnote in the summary, and in the Forrest plot at the end of the paper) of Shoumann's study of preventing Covid with IVM [NCT04422561]. Shoumann gave IVM to close contacts of infected patients. The results: RR 0.13 [0.08 , 0.21] i.e. 87% effective in prevention of Covid!
Hard to quibble much with the significance of that data, so Cochrane claimed high risk for “measurement of outcome” and then ignored it since it “reported results .. in a way [?] that we could not include in our analysis”. Whatever that means; perhaps because it doesn't support their anti-IVM narrative?
It's worth noting that Shoumann was one of the studies excluded from the 2022 revised Cochrane meta- analysis! In their revised edition (p.3), they state, “No trial investigated ivermectin to prevent SARS-CoV-2 infection”. Yeah, you threw it (and others) out!
If Alexandros gets some time, Cochrane's burial of a successful IVM prophalytic study might be worth investigating. Maybe even a follow-up Substack post?
P.S. I just noted that Cochrane 2021 mispelled the name; should be "Shouman" not "Shoumann" (IVMmeta had it right).
. . .
From my hi-lighted notes from the 2021 Cochrane IVM meta-analysis [pdf page #s]. I haven't looked at this in over a year, so I may have missed something in my quick review today):
p.4: Plain Language Summary: Preventing Covid-19: This study [Shoumann] reported results for development of COVID-19 symptoms (but not confirmed SARS-CoV-2 infection) and unwanted events, but in a way [?] that we could not include in our analyses
p.9: Summary of findings 3. Ivermectin compared to no treatment for prevention of SARS-CoV-2 infection … No study with low risk or some concerns of bias reported development of clinical COVID-2
p.10 [Tiny footnote] a.) No evidence available from studies with low risk or some concerns of bias. We included one study with high risk of bias in a secondary analysis (risk ratio (RR) 0.13, 95% CI
p.61-62: Brief summary of Shoumann 2021
p.136: Risk of Bias: Shoumann [given high risk for “measurement of the outcome”]
p. 152 – 153: Analysis 3.1. Comparison 3: Ivermectin compared to no treatment for prevention of SARS CoV-2 infection, Outcome 1: Development of clinical COVID-19 symptoms (secondary analysis) [Shoumann forest plot, buried at very end of paper!]
Just noted Comments about the Shouman study by Gideon Meyerowitz-Katz and one of the authors, Stephanie Weibe:
She wrote, "Dear Dr Meyerowitz-Katz, Thank you for your submitted comment. The review authors have written to the study authors of Shoumann 2021 to request for the study data prior to the breakdown in the randomization. If the trial authors send the randomized data set, the review author team will correct the data in the next Cochrane review update version. If the study authors do not clarify or send the data that relates to the study period prior to randomization breaking down, the review authors will exclude the study from the next Cochrane review update. ..."
So, Shouman may have been excluded for than reason and not for failure to register prior to patient enrollment.
Except in the most recent meta-analysis, they note that the TOGETHER team also didn't give them data, but that was apparently fine, even though they are also suspected (and IMO certainly) suffering from randomization failure due to offsetting of control/treatment group.
Spending way too much time today on this today! But, on p. 164, 2022 Popp says that Shouman's "Trial did not pass research integrity check*, due to wrong study design; direct contact with the author revealed that the study is not a RCT."
Here's Meyerowitz-Katz 11/21 comment to Cochrane:
... This study is reported as a randomized trial, and included in this review on the basis that it is an RCT ... however there are serious concerns about whether this randomization actually took place. In the methods section of the paper at the end of a paragraph the authors write:
“It was planned to include contacts of 50 RT-PCR confirmed COVID-19 patients in each arm. But during recruitment and as the trial was non-blinded, the high protective efficacy detected for ivermectin made the researchers to stop prematurely the non-intervention arm”
This seems to imply that the authors have stopped allocating patients into the control arm at some point in the study, and began giving all patients recruited ivermectin. ... This would appear to indicate that the authors did indeed cease allocation to the control group, while continuing to allocate patients to intervention, and thus this is not actually a randomized trial at all. ..."
One more point: From Popp 2022, p. 19: "One included trial from the previous review turned out to be a non-randomized trial (Shouman 2021). The authors described the method used for randomization via personal communication, which we then assessed as non-randomized alternate allocation; we excluded this trial from this review update."
The phrase, "... we then assessed....", seems to leave some wiggle-room to me. Was it, or wasn't it "alternate allocation"?
And, as noted above, Stephanie Weibel had written "If the trial authors send the randomized data set [prior to randomizaton breaking down], the review author team will correct the data in the next Cochrane review update version." I wonder if Shouman sent them that data? If so, perhaps Cochrane didn't like what they saw?
I can explain this in two words: Bill Gates. He started buying (tainting) the Cochran seal of approval in 2016, his restricted donations directed exactly where he wants. He corrupted Cochrane's evaluation of covid treatments so as to steer healthcare industry toward injections and novel treatments. In fact, we went upstream anf tainted original ivermectin studies (Andrew Hill ring a bell?) first, then tainted the systematic review of the ivermectin studies. This likely explains the inclusion criteria.
Gates started his meddling with the dirty HPV studies, along with the vaccine manufacturers and Remdesivir. Strategically buying influence throughout medical research has been great for his pHarma portfolio, but he would say this is purely coincidental.
I came across a book written if I understand correctly, by the founder of the Cochrane group, Peter Gotzsche, founded it some 20 years ago or more??? was forced out in the 2018 timeframe give or take?? including a Bill Gates putting his people in place for a takeover of the board??? .... Not sure if I have all of that exactly right ... just came across tidbits here and there. I bought the book and read parts of it ....it was published January 2013 ...... Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare by Peter C. Gøtzsche https://www.goodreads.com/book/show/18428805-deadly-medicines-and-organised-crime ................ one of my memorable takeaways from the book ..... SSRIs anti depressant class of drugs.... studies manipulated ... when someone in the study committed suicide they were removed from the study .... so the link between this class of drugs and suicides may be hidden ..... I was wondering if 2 charts ... one of the trajectory of use of SSRIs and one of the increases in suicides year by year .... wondering if the trajectories would be similar.
It is a tragedy to see formerly highly respectible institutions like Cochrane Collaboration, BMJ, NEJM etc ruin their reputation built up in increments over any years only to ruin it within just 2 years. A doubt they will ever regane that reputation. Mony buyes nearly everybody, but not all, e.g. Marinos
A legitimate meta-analysis should only include clinical trials with proper regimens in appropriate populations. That is, trials of at least 5 days of ivermectin started reasonably early that included sufficient numbers of moderate to high risk patients. Just look at the Paxlovid trial (by far the most successful clinical trial for COVID, period): 5 days of Paxlovid twice a day, started 3 days after symptom onset on average, with over 250 patients aged 65+ and the entire study population considered "high risk". Ironically, Paxlovid itself is a combination drug- why isn't ivermectin allowed to be studied in combination with other effective supplements, or perhaps ivermectin+fluvoxamine, etc?
What should ABSOLUTELY NOT be included in any meta-analysis are the designed to fail "3 days or less of ivermectin alone on an empty stomach after almost a weeklong delay" garbage trials having almost no patients over 60, like TOGETHER, ACTIV-6, COVID-OUT, etc.
As Pierre Kory recently posited in his recent articles on the success of Ivermectin in UP, the war on Ivermectin is over. You have doctors who prescribe at and doctors who deride it. Im a believer in early treatments, of which the Borody protocol was one.
It might be beyond your scope (or time constraints) but what happens to the analysis if the exclusion criteria is strictly followed and I-Tech, Together etc are excluded?
And vice-versa, if all 14 trials are included?
Do you think this would change the outcome of the meta-analysis?
Sadly, I lack the tools to do this. Would be awesome if someone reinstated the 5 or 6 excluded studies and re-ran the Cochrane analysis. My spidey-sense tells me that at least some of the results would be positive.
Strange how the Cochrane analysis comes away with the exact OPPOSITE findings for the TOGETHER study than even the study's senior author:
"I presented this a couple weeks ago at the NIH Collaboratory Rounds and, if they listened, I advocate that actually, there is a clear signal that IVM works in COVID patients, just that our study didn’t achieve significance. In particular, there was a 17% reduction in hospitalizations that would be significant if more patients were added. I really don’t view our study as negative and, also in that talk, you will hear me retract previous statements where I had been previously negative. I think if we had continued randomizing a few hundred more patients, it would have likely been significant."
I’ve seen a lot of facepalm-worthy moments in this pandemic, but this one has my jaw on the floor.
Same. I *must* be missing something. Right?
....right?
You're missing Bill Gates and his dirty cash corrupting the once-proud Cochrane organization. See my comment below.
You are.
What you are missing is that nobody ever reads inclusion criteria of meta-analyses; including the authors themselves. It just so boring and dry, and then it actually requires you to do all this grunt work of collecting tidbits of information that cant readily be queried from a database. You just write the criteria so they sound reasonable and strict and sciency; and then you proceed to just cobble together a list of studies you actually liked.
This is unironically completely routine procedure. Move along people, nothing to see here.
If you haven't heard about the Roman et al. meta-analysis, it was amazing as well... They simply inverted or truncated about half of the results from the studies they included. These "errors" were clearly exposed by readers' comments under the preprint version, but it was nevertheless peer-reviewed and published with no correction.
I can't remember which one, but at least one Asian country withdrew ivermectin from its guidelines because of that meta-analysis.
First pre-print version : https://www.medrxiv.org/content/10.1101/2021.05.21.21257595v1 (check the comments)
Second pre-print version (they corrected one of the numerous mistakes) : https://www.medrxiv.org/content/10.1101/2021.05.21.21257595v2 (check the comments)
Published : https://academic.oup.com/cid/article/74/6/1022/6310839?login=false (No comment was allowed, but a request for retraction was sent : https://bird-group.org/letter-to-editor-of-journal-requesting-retraction-of-roman-et-al-meta-analysis/ With no effect so far.)
If you can find more info on that, especially which country withdrew ivm, please let me know. I wrote this piece while looking into the broader question of meta-analyses of ivm, so it will come in handy when I continue. In general anything you have on insane meta-analyses :)
What I remember is that through the "altmetric" tool attached to one of the versions of Roman's paper, I had found a link to the official page of a country's health authorities, stating that the guideline had been changed. Later, I never could find the link again. Today I searched again. I still couldn't find the link, but I found that other important authorities took Roman seriously:
- New Zealand's Ministry of Health, p.5: "Roman = good work; Bryant = bad work" (summary by myself :-) )
https://www.health.govt.nz/system/files/documents/pages/csu_09_july_2021_covid-19_pharmaceutical_treatments.pdf
- Nova Scotia Health: http://policy.nshealth.ca/Site_Published/covid19/document_render.aspx?documentRender.IdType=6&documentRender.GenericField=&documentRender.Id=85295 (I had to use a VPN pretending I was in Canada to access the link.)
- Sciensano (Belgium's equivalent of the NIH): they refer to Roman et al. on p.37: "A recently published systematic review and meta-analysis of RCT’s concluded that ivermectin did not reduce all-cause mortality, length of stay or viral clearance in COVID-19 patients with mostly mild disease (200).": https://covid-19.sciensano.be/sites/default/files/Covid19/COVID-19_InterimGuidelines_Treatment_ENG.pdf
- British Columbia Covid-19 Therapeutics Committee: https://physicians.northernhealth.ca/sites/physicians/files/physician-resources/covid-19/Ivermectin-NOT-for-COVID-19-Prophylaxis-Treatment-01July21.pdf
- Carilion Clinic (a health system with one million patients in VA and WV) stated "Roman, et al. was a carefully done systematic review that included only 10 studies (1173 subjects) because of strict inclusion criteria (...)": https://www.carilionclinic.org/news/413---ivermectin-and-covid-covid-booster-follow-up-diabetes-screening/
- Even in 2022, publications keep writing such things as : "Current evidence based on higher quality data suggests no benefit [of ivermectin] [[151], [152], [153]]."
Where 151 is Roman et al., 152 is a correspondence by Garegnani and 153 is the I-TECH trial. https://www.sciencedirect.com/science/article/pii/S0735675722001942
On the other hand, Nebraska's attorney general seemed to understand the problem with Roman (pp.14-15) : https://ago.nebraska.gov/sites/ago.nebraska.gov/files/docs/opinions/21-017_0.pdf
I'm more appalled than shocked to see such a flawed review coming out of the Cochrane Collaboration. I used to be a huge fan of CC and relied heavily, and rather unquestioningly, on their reviews. That all stopped in 2020, after I discovered just how poor their 2018 review of the evidence for the HPV vaccine was. I still remember reading and rereading the 2018 BMJ article by Peter Gotzsche, Lars Jorgensen, and Tom Jefferson laying out the many serious problems with the review, including that the HPV vax review had missed *nearly half of the eligible trials* and was influenced by reporting bias and biased trial designs. And, Cochrane had failed to deal adequately (e.g. they didn't follow their own rules) with the conflicts of interest on the part of the lead author, among others. If folks want to read this critical piece they can check here. https://ebm.bmj.com/content/23/5/165.abstract. You could also read pp 146-150 (Section titled: "Cochrane review of the HPV vaccines was flawed and incomplete") in Gotzsche's 2020 book "Vaccines".
Bill Gates started "donating" to Cochrane in 2016 and directed much of the HPV vax research.
I didn't know that. Thanks for sharing the information.
Also this from Gotzche's "Vaccines": "I found many other serious problems with the WHO report ["from 2014 that seems to have been carried out in response to [Peter] Aaby’s findings of increased mortality of the trivalent diphtheria, tetanus and pertussis (DTP) vaccine in Guinea-Bissau.7 It assessed the effect of three vaccines on total mortality in infants and children: BCG (Bacille Calmette-Guérin; against tuberculosis), DTP and measles."]. This is very surprising because two of the three authors of the WHO report are senior researchers in the Cochrane Collaboration. These two are the current editor-in-chief, Karla Soares-Weiser, and statistician Julian Higgins, who is editor of the Cochrane Handbook of 636 pages that describes how to do reliable systematic reviews. These researchers even used vote counting in the WHO report (how many studies are for and how many against?), which is a method recommended against in the Cochrane Handbook."
“Tell me the conclusion I’m supposed to find, and I’ll give you the systematic review.”
—Cochrane, a formerly scientific organization.
Hello,
BIRD, British Ivermectin Recommendation Development, did a rebuttal* to the Roman et al. meta-analysis.
https://bird-group.org/wp-content/uploads/2021/06/Roman-etal-rebuttal-29jun21.pdf
The original paper with the transposed numbers showed that Ivermectin was effective (Risk Reduction for all cause mortality), but not statistically significant. The conclusion was that Ivermectin was not effective.
However, after the transpose is corrected the results (if you run the numbers) become effective AND statistically significant. But, only the table listing the Niaee transpose was corrected. The table with the results of the meta-analysis was not updated. The most noteworthy point for me is that Roman did correct the table with the transposed Ivermectin arm and control arm, but did not correct the results. The paper still states that Ivermectin is not effective.
*The rebuttal was written by Dr. Tess Lawrie and LinkedIn censored her for posting a peer reviewed paper.
https://www.reddit.com/r/WayOfTheBern/comments/oq2n34/linkedin_censors_dr_tess_lawrie_for_posting/
the reddit page is still up, but the embedded link on that page is now dead so I can't be sure, but I think it was her own Ivermectin meta-analysis that got her censored.
Mathew Crawford over at https://roundingtheearth.substack.com/ did a much more comprehensive write up:
https://roundingtheearth.substack.com/p/the-meta-analytical-fixers-an-ivermectin
I hope you find this helpful.
Just in case you want to get in touch with Dr Tess Lawrie, she has her own substack:
https://drtesslawrie.substack.com/p/ivermectin-works-just-not-for-big
And I tracked down a reference. She was censored on LinkedIn for posting a link to her own published and peer reviewed meta-analysis on ivermectin.
https://m.facebook.com/AntiMediaUK/posts/on-a-scale-of-1-10-how-concerned-are-you-about-the-censorship-of-doctors-and-sci/2923992441199837/
More ivermectin meta-analysis backstory by Phil Harper at The Digger
https://philharper.substack.com/p/the-very-unusual-paper-part-1
Several unusual decisions at important points were made against adopting ivermectin by individuals linked to Unitaid.
We should never throw out data on a whim. We will throw out data if we can demonstrate that it is somehow compromised or untrustworthy. Being a few days off in registration doesn’t look like a data compromise. It looks like selection of data to obtain a desired result. That’s untrustworthy.
Thank you for this substack and all the work that went into it. As a retired scientist I am saddened to see this coming from Cochrane and as a volunteer in their collaboration I am disgusted and will rethink giving any future time to their endeavours. Prior to this reading I had the highest respect and confidence in this group which is why I have given of my time to them. ( Head shaking......)
Maybe there's a way to bring this to the attention of the relevant people on the inside? I wouldn't know where to start.
Last year, I did a deep dive into the 2021 Cochrane IVM meta-analysis. I noticed that Cochrane buried the results (in a tiny footnote in the summary, and in the Forrest plot at the end of the paper) of Shoumann's study of preventing Covid with IVM [NCT04422561]. Shoumann gave IVM to close contacts of infected patients. The results: RR 0.13 [0.08 , 0.21] i.e. 87% effective in prevention of Covid!
Hard to quibble much with the significance of that data, so Cochrane claimed high risk for “measurement of outcome” and then ignored it since it “reported results .. in a way [?] that we could not include in our analysis”. Whatever that means; perhaps because it doesn't support their anti-IVM narrative?
It's worth noting that Shoumann was one of the studies excluded from the 2022 revised Cochrane meta- analysis! In their revised edition (p.3), they state, “No trial investigated ivermectin to prevent SARS-CoV-2 infection”. Yeah, you threw it (and others) out!
If Alexandros gets some time, Cochrane's burial of a successful IVM prophalytic study might be worth investigating. Maybe even a follow-up Substack post?
P.S. I just noted that Cochrane 2021 mispelled the name; should be "Shouman" not "Shoumann" (IVMmeta had it right).
. . .
From my hi-lighted notes from the 2021 Cochrane IVM meta-analysis [pdf page #s]. I haven't looked at this in over a year, so I may have missed something in my quick review today):
p.4: Plain Language Summary: Preventing Covid-19: This study [Shoumann] reported results for development of COVID-19 symptoms (but not confirmed SARS-CoV-2 infection) and unwanted events, but in a way [?] that we could not include in our analyses
p.9: Summary of findings 3. Ivermectin compared to no treatment for prevention of SARS-CoV-2 infection … No study with low risk or some concerns of bias reported development of clinical COVID-2
p.10 [Tiny footnote] a.) No evidence available from studies with low risk or some concerns of bias. We included one study with high risk of bias in a secondary analysis (risk ratio (RR) 0.13, 95% CI
p.61-62: Brief summary of Shoumann 2021
p.136: Risk of Bias: Shoumann [given high risk for “measurement of the outcome”]
p. 152 – 153: Analysis 3.1. Comparison 3: Ivermectin compared to no treatment for prevention of SARS CoV-2 infection, Outcome 1: Development of clinical COVID-19 symptoms (secondary analysis) [Shoumann forest plot, buried at very end of paper!]
RR 0.13 [0.08 , 0.21
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015017.pub3/read-comments
Just noted Comments about the Shouman study by Gideon Meyerowitz-Katz and one of the authors, Stephanie Weibe:
She wrote, "Dear Dr Meyerowitz-Katz, Thank you for your submitted comment. The review authors have written to the study authors of Shoumann 2021 to request for the study data prior to the breakdown in the randomization. If the trial authors send the randomized data set, the review author team will correct the data in the next Cochrane review update version. If the study authors do not clarify or send the data that relates to the study period prior to randomization breaking down, the review authors will exclude the study from the next Cochrane review update. ..."
So, Shouman may have been excluded for than reason and not for failure to register prior to patient enrollment.
Except in the most recent meta-analysis, they note that the TOGETHER team also didn't give them data, but that was apparently fine, even though they are also suspected (and IMO certainly) suffering from randomization failure due to offsetting of control/treatment group.
Spending way too much time today on this today! But, on p. 164, 2022 Popp says that Shouman's "Trial did not pass research integrity check*, due to wrong study design; direct contact with the author revealed that the study is not a RCT."
Here's Meyerowitz-Katz 11/21 comment to Cochrane:
... This study is reported as a randomized trial, and included in this review on the basis that it is an RCT ... however there are serious concerns about whether this randomization actually took place. In the methods section of the paper at the end of a paragraph the authors write:
“It was planned to include contacts of 50 RT-PCR confirmed COVID-19 patients in each arm. But during recruitment and as the trial was non-blinded, the high protective efficacy detected for ivermectin made the researchers to stop prematurely the non-intervention arm”
This seems to imply that the authors have stopped allocating patients into the control arm at some point in the study, and began giving all patients recruited ivermectin. ... This would appear to indicate that the authors did indeed cease allocation to the control group, while continuing to allocate patients to intervention, and thus this is not actually a randomized trial at all. ..."
One more point: From Popp 2022, p. 19: "One included trial from the previous review turned out to be a non-randomized trial (Shouman 2021). The authors described the method used for randomization via personal communication, which we then assessed as non-randomized alternate allocation; we excluded this trial from this review update."
The phrase, "... we then assessed....", seems to leave some wiggle-room to me. Was it, or wasn't it "alternate allocation"?
And, as noted above, Stephanie Weibel had written "If the trial authors send the randomized data set [prior to randomizaton breaking down], the review author team will correct the data in the next Cochrane review update version." I wonder if Shouman sent them that data? If so, perhaps Cochrane didn't like what they saw?
I think I may have a way to get that answer.
Just read Pierre Kory's Substack about the difficulty Shouman had getting his paper published. (see "Rejection #4): https://pierrekory.substack.com/p/the-criminal-censorship-of-ivermectins
I can explain this in two words: Bill Gates. He started buying (tainting) the Cochran seal of approval in 2016, his restricted donations directed exactly where he wants. He corrupted Cochrane's evaluation of covid treatments so as to steer healthcare industry toward injections and novel treatments. In fact, we went upstream anf tainted original ivermectin studies (Andrew Hill ring a bell?) first, then tainted the systematic review of the ivermectin studies. This likely explains the inclusion criteria.
Gates started his meddling with the dirty HPV studies, along with the vaccine manufacturers and Remdesivir. Strategically buying influence throughout medical research has been great for his pHarma portfolio, but he would say this is purely coincidental.
https://docbrown77.substack.com/p/reviewed-the-financial-statements
I came across a book written if I understand correctly, by the founder of the Cochrane group, Peter Gotzsche, founded it some 20 years ago or more??? was forced out in the 2018 timeframe give or take?? including a Bill Gates putting his people in place for a takeover of the board??? .... Not sure if I have all of that exactly right ... just came across tidbits here and there. I bought the book and read parts of it ....it was published January 2013 ...... Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare by Peter C. Gøtzsche https://www.goodreads.com/book/show/18428805-deadly-medicines-and-organised-crime ................ one of my memorable takeaways from the book ..... SSRIs anti depressant class of drugs.... studies manipulated ... when someone in the study committed suicide they were removed from the study .... so the link between this class of drugs and suicides may be hidden ..... I was wondering if 2 charts ... one of the trajectory of use of SSRIs and one of the increases in suicides year by year .... wondering if the trajectories would be similar.
It is a tragedy to see formerly highly respectible institutions like Cochrane Collaboration, BMJ, NEJM etc ruin their reputation built up in increments over any years only to ruin it within just 2 years. A doubt they will ever regane that reputation. Mony buyes nearly everybody, but not all, e.g. Marinos
A legitimate meta-analysis should only include clinical trials with proper regimens in appropriate populations. That is, trials of at least 5 days of ivermectin started reasonably early that included sufficient numbers of moderate to high risk patients. Just look at the Paxlovid trial (by far the most successful clinical trial for COVID, period): 5 days of Paxlovid twice a day, started 3 days after symptom onset on average, with over 250 patients aged 65+ and the entire study population considered "high risk". Ironically, Paxlovid itself is a combination drug- why isn't ivermectin allowed to be studied in combination with other effective supplements, or perhaps ivermectin+fluvoxamine, etc?
What should ABSOLUTELY NOT be included in any meta-analysis are the designed to fail "3 days or less of ivermectin alone on an empty stomach after almost a weeklong delay" garbage trials having almost no patients over 60, like TOGETHER, ACTIV-6, COVID-OUT, etc.
Great work here
Captured institutions should be jettisoned from your thinking tool box.
As Pierre Kory recently posited in his recent articles on the success of Ivermectin in UP, the war on Ivermectin is over. You have doctors who prescribe at and doctors who deride it. Im a believer in early treatments, of which the Borody protocol was one.
It might be beyond your scope (or time constraints) but what happens to the analysis if the exclusion criteria is strictly followed and I-Tech, Together etc are excluded?
And vice-versa, if all 14 trials are included?
Do you think this would change the outcome of the meta-analysis?
Sadly, I lack the tools to do this. Would be awesome if someone reinstated the 5 or 6 excluded studies and re-ran the Cochrane analysis. My spidey-sense tells me that at least some of the results would be positive.
Strange how the Cochrane analysis comes away with the exact OPPOSITE findings for the TOGETHER study than even the study's senior author:
"I presented this a couple weeks ago at the NIH Collaboratory Rounds and, if they listened, I advocate that actually, there is a clear signal that IVM works in COVID patients, just that our study didn’t achieve significance. In particular, there was a 17% reduction in hospitalizations that would be significant if more patients were added. I really don’t view our study as negative and, also in that talk, you will hear me retract previous statements where I had been previously negative. I think if we had continued randomizing a few hundred more patients, it would have likely been significant."
https://stevekirsch.substack.com/p/did-the-together-study-show-that