Map of life expectancy at birth from Global Education Project.

Monday, April 06, 2020

Why we do clinical trials

We've all gotten sick of the Resident's constant boasting about the greatness of his intellect. Axios has a roundup compiled in January. It's too long to reproduce, but highlights include:

ISIS: "I know more about ISIS than the generals do." (November 2015.) 
Trade: "Nobody knows more about trade than me." (March 2016.)
The U.S. government system: "[N]obody knows the system better than I do." (April 2016.) Renewable energy: "I know more about renewables than any human being on Earth." (April 2016.) Taxes: "I think nobody knows more about taxes than I do, maybe in the history of the world." (May 2016.) 
Infrastructure: "[L]ook, as a builder, nobody in the history of this country has ever known so much about infrastructure as Donald Trump." (July 2016.
The economy: "I think I know about it better than [the Federal Reserve]." (October 2018.)
Technology: "Technology — nobody knows more about technology than me." (December 2018.)
Drones: "I know more about drones than anybody. I know about every form of safety that you can have." (January 2019.)
Since then among other grandiosity, there was his notorious visit to CDC headquarters.

“I like this stuff. I really get it,” Mr Trump boasted to reporters during a tour of the Centers for Disease Control (CDC) and Prevention in Atlanta, where he met with actual doctors and scientists who are feverishly scrambling to contain and combat the deadly illness.
Citing a “great, super-genius uncle” who taught at MIT, Mr Trump professed it must run in the family genes. “People are really surprised I understand this stuff,” he said. “Every one of these doctors said: ‘How do you know so much about this?’ Maybe I have a natural ability.” . . . Sporting his trademark red 2020 campaign hat with the slogan “Keep America Great”, the president repeatedly second-guessed and waved off the actual medical professionals standing next to him.

Well, we can add pharmacy to that list.  Abetted by his trade representative, who somehow has managed to worm his way into coronavirus task force meetings, he "knows" the hydroxychloroquine is the miracle cure. He has decided to order Anthony Fauci to shut up about it.

Well I may or may not be a stable genius, but I do happen to know more about this stuff than he does. There has never been a single controlled clinical trial of the drug for coronavirus. And while it has shown activity against other viruses in vitro and in animals, clinical trials in humans have all been failures. All that has happened so far is that doctors have given it to some patients and observed that some of the patients got better.

Well yeah. Most people do get better if you give them M&Ms. This happens all the time. Doctors or uncredentialed cranks give people their pet miracle cure and decide that it works. 99% of the time, no it doesn't. That's why we do placebo-controlled randomized trials. There are many reasons people can fool themselves. As I say, most people get better on their own. You want it to work so you're inclined to see an effect, but you aren't actually comparing it to anything so your bias leads you to a false conclusion. Also, too, most drugs -- including this one -- can have serious adverse effects so you need to make sure that the benefits, whatever they may be, justify the risk. And this stuff can kill you.

I think it's very unlikely that it has much value, if any. But I do know one thing for sure. Anthony Navarro and Ronald T. Dump have no fucking idea what they are talking about and they may do enormous harm by their ignorant claims.

1 comment:

Don Quixote said...

People are very selective about what they hear, even when it comes to a self-proclaimed stable genius like Ronald T. Dump.

I remember what he said before the election of 2016 because I was paying attention. I paraphrase here, but his meanings were abundantly clear:

"No, I don't go to therapists. I'm afraid [if I look at myself] I might not like what I see."

"No, I'm not going to release my taxes. If people saw my taxes now, they wouldn't elect me."

So the world's greatest genius [sic] doesn't know himself, but he knows he's an empty fraud.

And that negates his definition of himself.

QED