
Hydroxychloroquine lowers Covid-19 death rate, Henry Ford Health study finds - forgingahead
https://www.detroitnews.com/story/news/local/michigan/2020/07/02/michigan-henry-ford-health-study-finds-hydroxychloroquine-lowers-covid-19-death-rate/5365090002/
======
gus_massa
Do they have a control group? From the press article it looks like they are
comparing with the global average that is meaningless because there is too
much variation.

This is probably a good hospital with good staff and good equipment. Globally
many hospitals are not so good.

There may be some involuntary selection of the patients. For example here in
Argentina the retired people have a special health plan that include only some
hospitals. That may change the population that goes to each hospital and
change the expected death rate. Some hospitals get more rich patients. Some
hospitals may get more athletes. It is very difficult to be sure, so you need
a randomized control group.

~~~
zaroth
> _The study analyzed 2,541 patients hospitalized among the system’s six
> hospitals between March 10 and May 2 and found 13% of those treated with
> hydroxychloroquine died while 26% of those who did not receive the drug
> died._

~~~
loopz
Worthless without control group

~~~
AstralStorm
Technically people who did not take the drug are a control group. It's just
not placebo controlled. (Which is quite a big no. Unless there's a known
working treatment, which should be used as the control then.)

The big question is, how well randomized are these, and what's the effect size
- could be suspiciously small.

If it's not randomized at all, the results do not necessarily show the drug is
good - just that it's given to healthier patients. You can try to reduce such
artifact by considering matching reference subgroups.

~~~
gus_massa
Did they have the same inclusion criteria? The people in the treatment group
probably have to sign a conformity form, this implicitly exclude people that
is too wasted to even hold a pen and that probably have a worse prognosis than
the average. Did they include people with more than 90 years old? People with
a recent previous heart attack? Small children (parents are annoying)?

Without the same inclusion criteria it's not a control group but a unrelated
bunch of guys.

~~~
AstralStorm
Also known as randomized control group. That said, it should be equivalent to
treatment group. Which is exactly what I said.

That's the reason why in RCTs treatment and control groups are split from the
same pool - less need to make sure they are.

~~~
gus_massa
I think we agree.

Just remember that the first study by Raoult claims to have a control group,
but it's better described a a unrelated bunch of guys in another city. And
there are other studies with similar tricks.

------
whoisjuan
If Covid has done anything for me, is that it’s teaching me how little we
understand drugs and how unreliable are studies.

I have seen Hydroxychloroquine go from promising to helpful to not-helpful to
damaging to promising again.

~~~
forgingahead
pg talks about this phenomena - I think it's less about the studies themselves
but rather how they are covered and described by third parties with vested
interests:

[http://www.paulgraham.com/submarine.html](http://www.paulgraham.com/submarine.html)

[https://www.wsj.com/articles/covid-19-drug-remdesivir-to-
cos...](https://www.wsj.com/articles/covid-19-drug-remdesivir-to-
cost-3-120-for-typical-patient-11593428402)

------
solvorn
Still not voting for Trump.

------
Ghjklov
Flagged article because even the slightest chance of Trump being right is not
worth positive coverage of a drug he endorses that might be effective in
fighting this pandemic.

------
twirlock
Let's all pray that it isn't true. Let's all hope really hard that it doesn't
help and Trump is still wrong. That is the most important thing.

~~~
jeegsy
I sense sarcasm but I could be wrong

------
mkbkn
So does several immunity-based herbals but we since we can't patent those,
they are scam and HCQ with side effects is the "real deal".

~~~
dogma1138
HCQ is a generic drug it’s not restricted by patents, you can only get a short
term application patent for a new use of a drug if the original patent still
hasn’t expired.

