Hacker News Reader

Comment by inglor_cz | Hacker News Reader

Here in the Czech Republic, doctors in Brno are trying a combination of remdesivir and convalescent plasma in oncological Covid patients. They say that the combo has, so far, worked much better than either of the components in isolation. Out of the small cohort, they lost no one so far.

Source in Czech: https://ct24.ceskatelevize.cz/jihomoravskykraj/3278822-brnen...

View on HN

That's the treatment that I got back in September in the US. I think they stopped using Remdesivir since then because it didn't correlate with any positive outcome. It also was destroying my liver, so they had to cut off the treatment halfway through.

https://www.forbes.com/sites/jvchamary/2021/01/31/remdesivir...

Maybe the total balance of results is better for immunosuppressed oncologic patients.

Or maybe it is just a form of medical nationalism, given that the leader of the Remdesivir scientific team, Tomáš Cihlář, is a Czech scientist.

We had some critical patients improve and heal on remdesivir, though. I wonder how big of a role genetic diversity plays. There are many uncertain suspicions that Covid hits some people harder than others based not just on lifestyle, but things such as blood groups.

Research into that will be a good PhD material for years to come.

One thing I've learnt from the whole C19 treatment debacle is to never ever trust any single study.

Unlike computer science where if you test something and it works once you and then you expect it to work for everyone, in medical research if you see an effect in one treatment study you probably won't see the same effect elsewhere.

For treatments (unlike controlled vaccine studies) the cohorts are too small and there are too many other variables.

Absolutely. The study may even be valid in certain conditions, but still fail to replicate elsewhere.

People differ. Healthcare systems differ. Too many small details, too small to document, differ.

Journalistic interpretation of these tiny, rushed studies has also been god awful since the beginning. This is true during the best of times, but every clickbait headlines spreading disinformation during an actual pandemic should not be tolerated, especially amongst the more reputable news sources (looking at you NYT).

This right here. If people look at the actual study, they'll see the number of caveats and various exact conditions where the study proved something, whereas the media tends to pretend that those caveats or conditions don't exist therefore, the study works everywhere. That's why people don't trust science, "oh, its probably wrong again".

That's a fascinating idea, the learned doubtfulness towards science due to its exaggerators.

This isn't always really true.

Some of the worst offenders have been scientists, who promote their own studies (eg, the French hydroxychloroquine studies).

It's possible to pick holes in these studies if you know the field. But these holes aren't pointed out in the papers themselves, and peer review doesn't stop this.

Peer reviewers are experts in the field. So they know if they are looking at a 30 person study it isn't conclusive, and wouldn't expect the author to state that. It's just assumed the readers know that.

We see the real impact of this with things like the Vitamin D studies. Experts know that Vitamin D deficiency is highly correlated with age and other health issues, but that the causation chain is "Person is unhealthy so doesn't get outside as much so gets less Vitamin D, and in some cases are deficient which can make health issues worse". Non-experts read the report and see the causation going the other way, ie, they think: "High Vitamin D fixes health issues".

True, and it's even worse in social sciences.

Outside of the "hard" sciences, there is always a study that "proves" X and another that "disproves" it.

Not because scientists cheat, but because science is hard.

Social science studies tend to be agenda driven, too.

Do you have any evidence showing that social scientists are any more agenda driven than, for instance, biologists?

What, I should do a social science study to show that social science studies are driven by agendas? :-)

I broadly agree but I usually trust one of the big ones (e.g. ‘recovery’ in the UK) since they have pretty big sample sizes and seem to be on top of stats.

Even in computer science I don't think that holds. Lord knows there are enough stories about issues with unusual hardware and unreproducible heisen-bugs that I would never assume that something will work for everybody just because it worked once, on your own machine.

Reply on news.ycombinator.com