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Originally Posted by MuseChaser
I appreciate the reply. When I first looked into the studies about ivermectin, I did find more negative "hits" rather than positive, although there were enough studies showing some promise that, coupled with the WHO's view that clinical trial usage may still be warranted, completely discounting any usage or effectiveness of ivermectin appears premature.
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You have to be careful here. You could find 5 studies in a sea of 2000 studies that support medication X's use. The point of the meta analysis is to survey a large quantity of random studies and then to determine what the studies show. Occasionally, studies are omitted on either side for bad statistical analysis or low sampling size, and weight is attributed to robust studies that follow large sample sizes and that use techniques like having a randomized, double-blind, placebo-controlled studies. The saying goes you could demonstrate anything if you cherrypick, which is why a meta analysis is done after there is a large body of research.
If there isn't a large body of research or the research is inconclusive then it will be the suggestion of the community to continue to not use said medication outside of research studies. The community will suggest that more studies are need for a conclusive understanding, which isn't to say that they are dismissing the possibility, but that the use is contraindicated until such time that it has been demonstrated to be efficacious.
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Originally Posted by MuseChaser
The increasing number of doctors PRESCRIBING ivermectin indicates that ivermectin has, indeed, shown some efficacy in alleviating Covid symptoms.
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Quote:
Originally Posted by MuseChaser
To piggybck on your point about "some doctors will prescribe anything for money," perhaps the fact that ivermectin is inexpensive and not very profitable could make it less attractive to certain parts of the healthcare and pharmaceutical industries. I'm NOT sceptical enough to believe that's the case, but who knows.
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Prescribers have been giving out prescriptions for antibiotics to treat URIs for a long time, and this has been problematic, but you can read the reasons why doctors do it in the articles. The chief reasons are patient satisfaction, time constraints to explain why antibiotics are not needed, for a lack of understanding of the literature, or for fear of the possibility of being sued for malpractice if they don't provide something the patient wants and the patient gets worse or dies.
Similarly, we have gotten patients coming in our ED demanding hydroxychloroquine or whatever. At the PCP level, they probably just avoid a 15 minute conversation on why the medication isn't efficacious, a conversation that leads to the patient leaving upset and wanting to switch PCPs, so these providers just write the prescription to appease the patient, speed up their work flow and improve their Yelp rating, even if it is contraindicated or is nothing more than a placebo effect.
In light of this well-documented phenomenon, it would be inappropriate for you to conclude that 'prescribing prevalence' is proportional to 'use efficacy'.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC140007/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542152/