https://trialsitenews.com/auth…al-news-rundown-episodes/
So i'd like to thank FM1 for pushing me to re-examine this issue. Here trialsite is complaining about being censored. Specifically, it says it is balanced, objective, just posts scientific research.
That is partly true. Not the whole truth. Its mission is:
https://trialsitenews.com/about-us/
TrialSiteNews was launched to drive more interest and awareness in clinical research, as well as to develop trust and facilitate engagement of researchers and the public. TrialSite started toward the end of 2018, financed solely by the founder, to create a new disruptive force in the world of biomedical research.
TrialSite emphasizes the trial site organization and its staff, whether a hospital, health system, community clinic, or commercial research center, and the breakthroughs, challenges, best practices, and mishaps, all in a bid to provide more transparency for the broader population as to the nuts and bolts of clinical trials.
Have something important to share with our editorial team? Email us
Mission & Values
TrialSite’s mission is to drive awareness, introduce transparency, and facilitate engagement among people all over the world, from pharmaceutical professionals and academic researchers to regulators and healthcare professionals along with a wide array of the consuming public.
We value transparency, objectivity, and the scientific method in pursuit of the truth wherever it may lead us.
Whereas the mainstream journals use peer review to sort out what has merit (imperfect - but diverse because every editorial board is different - and we have no better filter) trialsite says it is a news site. Therefore its publication will be determined by editorial policy, not science.
I can see the need for independent views on medical trails - to counteract big pharma pushing fake positive results for profitable drugs. That does not apply in the same way for COVID vaccines which are subject to very strong regulatory interest and also are not money-spinners. Maybe trialsitenews does this job OK?
Looking at the op ed authors:
https://trialsitenews.com/op-ed-authors/
(the only medic) Pierre Kory - FLCC. He is the strongest proponent of Ivermectin as an early COVID treatment. He may be right, or wrong. He sure is not neutral or objective on this issue, it is his hobbyhorse!
Ron B Brown - PhD - published https://pubmed.ncbi.nlm.nih.gov/32782048/. This was questioning the lethality of COVID in June 2020, when the mainstream view was around an IFR of 0.5% - 1.5% - much higher than Flu. He says here that this is questionable, and suggests:
In testimony before US Congress on March 11, 2020, members of the House Oversight and Reform Committee were informed that estimated mortality for the novel coronavirus was 10-times higher than for seasonal influenza. Additional evidence, however, suggests the validity of this estimation could benefit from vetting for biases and miscalculations. The main objective of this article is to critically appraise the coronavirus mortality estimation presented to Congress. Informational texts from the World Health Organization and the Centers for Disease Control and Prevention are compared with coronavirus mortality calculations in Congressional testimony. Results of this critical appraisal reveal information bias and selection bias in coronavirus mortality overestimation, most likely caused by misclassifying an influenza infection fatality rate as a case fatality rate.
[RBB says] Almost as a parenthetical afterthought, the NEJM editorial inaccurately stated that 0.1% is the approximate case fatality rate of seasonal influenza. By contrast, the World Health Organization (WHO) reported that 0.1% or lower is the approximate influenza infection fatality rate,5 not the case fatality rate
Agreed, the Flu rate quoted is IFR not CFR. And that must therefore be compared with the COVID IFR, lower than the COVID CFR. But COVID IFR is still 0.7%ish (dependent on age profile - as also is Flu IFR). A lot higher than seasonal Flu.
RBB argues in a way I find tricky (wrong) in his paper:
In NIAID testimony before the House Oversight and Reform Committee Hearing on Coronavirus response, Day 1,3 the Committee learned that mortality from seasonal influenza is 0.1%. Additionally, it was reported to Congress that the overall coronavirus mortality of approximately 2-3% had been reduced to 1% to take into account infected people who are asymptomatic or have mild symptoms. The adjusted mortality rate from coronavirus of 1% was then compared with the 0.1% mortality rate from seasonal influenza, and the conclusion was reported to the House Committee that the coronavirus was 10-times more lethal than seasonal influenza.
In a comparative analysis with WHO and CDC documents, the coronavirus mortality rate of 2-3% that was adjusted to 1% in Congressional testimony is consistent with the coronavirus CFR of 1.8-3.4% (median, 2.6%) reported by the CDC.13 Furthermore, the WHO reported that the CFR of the H1N1 influenza virus (1918) is also 2-3%,14 similar to the unadjusted 2-3% CFR of the coronavirus reported in Congressional testimony, with no meaningful difference in mortality. As previously mentioned, the WHO also reported that 0.1% is the IFR of seasonal influenza,5 not the CFR of seasonal influenza as reported in the NEJM editorial.
So the adjusted COVID rate (down to 1% from 2-3%) referred to here is actually an estimated IFR, and it is correct to compare that with the Flu IFR of 0.1%.
NEJM may have got this wrong (I have not checked). But we have still this 10X figure, because the adjustment here gives us an estimate IFR. The actual figure is 7X (original COVID) going up because of alpha which is more lethal - and maybe down because of better treatment. But those further adjustments could not be known in 2020. Oh, and the WHO 0.1%, RBB says, is an upper estimate for Flu IFR. So in this comparison these figures maybe need to go up a bit if Flu is less lethal than 0.1% IFR.
RBB is right that confusion between IFR and CFR is common. Wrong that the 10X figure, from evidence presented, is not a fair initial assessment of the relative risk.
Here is RBBs estimate which ironically suffers the problem he points out (confusion about CFR):
In NIAID testimony before the House Oversight and Reform Committee Hearing on Coronavirus response, Day 1,3 the Committee learned that mortality from seasonal influenza is 0.1%. Additionally, it was reported to Congress that the overall coronavirus mortality of approximately 2-3% had been reduced to 1% to take into account infected people who are asymptomatic or have mild symptoms. The adjusted mortality rate from coronavirus of 1% was then compared with the 0.1% mortality rate from seasonal influenza, and the conclusion was reported to the House Committee that the coronavirus was 10-times more lethal than seasonal influenza.
In a comparative analysis with WHO and CDC documents, the coronavirus mortality rate of 2-3% that was adjusted to 1% in Congressional testimony is consistent with the coronavirus CFR of 1.8-3.4% (median, 2.6%) reported by the CDC.13 Furthermore, the WHO reported that the CFR of the H1N1 influenza virus (1918) is also 2-3%,14 similar to the unadjusted 2-3% CFR of the coronavirus reported in Congressional testimony, with no meaningful difference in mortality. As previously mentioned, the WHO also reported that 0.1% is the IFR of seasonal influenza,5 not the CFR of seasonal influenza as reported in the NEJM editorial.
RBB is now comparing Flu and COVID CFRs, noting they are similar, and deducing from that that there is no meaningful difference in mortality. Wrong. It is IFR not CFR that determines mortality. CFR dpends on case identification rate which varies widely and is not reliable.
So the 2nd op-ed writer for trialsite is a PhD published on COVID - but his paper is an outlier and has this obvious fault in its argument. It is pushing the (politically right-wing) hope that COVID is in fact no more serious than Flu and therefore should be treated the same way. That was, even at the time, an obviously poor judgment.
The other op-ed writers have no stated expertise on medicine:
- Steve Kirsch - Tech Entrepeneur
- Peter Yim - Computer Scientist
- Mary Beth Pfeiffer - investigative journalist.
As result of this investigation I would say the editorial policy at trialsitenews will certainly be colored by its in-house op-ed writers, and therefore will be:
- biassed towards Ivermectin
- biassed towards underestimating severity of COVID
These two biasses are quite large in that the op-ed house writers have way out views.
- I am of course sympathetic with any argument that says CFR overestimates severity and therefore should not be used. You remember how much time we spent trying to guess IFR on this thread. the resulting 0,7% or so (though higher than I was hoping initially) was about right for typical Western population demoraphucs. (W - please note this is NOT typical of Uttar Pradesh pop'n demographics! The adjusted IFR for them would be much much lower).
- I am not sympathetic with RBB here who uses a CFR compariosn to estimate mortality of COVID! Influenza cases, from his figures, are massively undercounted because in most cases people just stay in bed and suffer a cold. or, for mild cases, go to work and ignore it! Anyway he should have known that CFR is a very unreliable way to judge the ratio, whereas correcting for IFR (the adjusted COVID figure) a better bet.
- Would I ignore trialsitenews? No. Would I view it as reliable? No, it has no scientific peer review, calling itself a news organisation. It has people in charge with fringe views, one of whom has published a paper on COVID that makes really (known at time to be) poor arguments.
- Do I dismiss Ivermectin as a possible helpful drug in treating COVID? No. But I see the likely bias from doctors, and non-RCT studies. I don't see convincing RCT evidence yet. I would want to go on testing it with more RCTs. Do I think Ivermectin would be pretty safe anyway? Probably, but I would have said that about HCQ in the early days not taking into account the issues about its interaction with the immune system that might combine with COVID. I think there is less likely to be a problem with Ivermectin but am no expert on this - so would not like to go against regulatory authorities. I also see the issue about people in this case maybe overdosing (because people will overdose on anything) Ivermectin - and perhaps using Ivermectin for animal which might be less safe. All of those things are reasons to be very cautious about the "take Ivermectin to save yourself from COVID" meme. I can see it as likely doing more harm than good if it means people take fewer other precautions, even if there are no safety issues. That does not apply to people here who are more careful no doubt.