Meta-analytic magic, ivermectin, and socially responsible reporting.
S Afr Med J
; 111(10): 934-937, 2021 08 17.
Article
in English
| MEDLINE | ID: covidwho-1478412
ABSTRACT
Some clinicians prescribe ivermectin for COVID-19 despite a lack of support from any credible South African professional body. They argue that when faced by clinical urgency, weak signals of efficacy should trigger action if harm is unlikely. Several recent reviews found an apparent mortality benefit by including studies at high risk of bias and with active rather than placebo controls. If these studies are discounted, the pooled mortality effect is no longer statistically significant, and evidence of benefit is very weak. Relying on this evidence could cause clinical harm if used to justify vaccine hesitancy. Clinicians remain responsible for ensuring that guidance they follow is both legitimate and reliable. In the ivermectin debate, evidence-based medicine (EBM) principles have largely been ignored under the guise thatin a pandemic the 'rules are different', probably to the detriment of vulnerable patients and certainly to the detriment of the profession's image. Medical schools and professional interest groups are responsible for transforming EBM from a taught but seldom-used tool into a process of lifelong learning, promoting a consistent call for evidence-based and unconflicted debate integral to clinical practice.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Ivermectin
/
Practice Patterns, Physicians'
/
Vaccination Hesitancy
/
COVID-19 Drug Treatment
Type of study:
Experimental Studies
/
Prognostic study
/
Randomized controlled trials
/
Reviews
Topics:
Vaccines
Limits:
Humans
Country/Region as subject:
Africa
Language:
English
Journal:
S Afr Med J
Year:
2021
Document Type:
Article
Affiliation country:
SAMJ.2021.v111i10.16021
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