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Comment by arc-in-space | Hacker News Reader

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This is a weird comment. We focus on suicidal thoughts because suicidal thoughts are scary to people in a way that vomiting or a rash or blurred vision is not, because the former makes people consider a potentially life ending outcome, while the latter do not. Whether or not you agree with the relative ranking of these concerns, it ought to be easy to understand why.

And the rate of suicidal ideation per reported adverse event is irrelevant as something to compare unless you've also confirmed that the rate of adverse event reports is comparable between the two drugs. Have you? If so, why are you citing the rate per adverse event case rather than the rate relative to number of users, or doses?

Even so, even if they are in fact comparable, we're focusing on these drugs because they're fairly new and have seen an explosive increase in use, just like we've focused on other drugs when they've seen the same explosive increase in use. That people are extra interested in any potentially serious effects of a fairly new drug should not be surprising at all. Why does it surprise you?

Don't worry, I could have made it a much weirder comment. You know what else was reported in similar numbers as suicidal ideation, for Ozempic? Death. I'm pretty sure that's a whole lot scarier than thinking about death! That's a definitely life ending outcome! Incidentally, in a way really emblematic of how useful adverse event reports are, Wegovy has a single case of a gunshot wound, and I don't think the new exciting drug caused that.

Yes, I do play tricks with the aspirin comparison, but only to show just how wacky the original article is. If you think my two numbers are hard to compare, presumably you also agree that using a random case count with literally no context is effectively meaningless.

Furthermore, I think journalists doing statistics must be destroyed.

Hey, could you please not post in the flamewar style to HN? You can make your substantive points without that.

You may not owe journalists doing statistics better, but you owe this community better if you're participating in it.

If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.

> Furthermore, I think journalists doing statistics must be destroyed.

Because you think there are no journalists out there that can do statistics, or because you think they will always use it to make their own point?

You do see a lot of really poor understanding of statistics out there, but on reflection, I want to say the latter is much worse. If journalists with an agenda were actually good at manipulating data, it would be much harder to put trust in anything.

I totally understand that, statistics really is a double edged sword. I think a good journalist can do a lot of wonderful things with data. If we end up living in a world where journalists are banned from using data at all, that would be very disappointing.

Thinking about death is surely scarier than death itself my friend.

I’m pretty sure the nausea side effects of Ozempic/Wegovy is very widely reported and is included in nearly every article that talks about those drugs.

I think it should be pretty obvious why one would talk about suicidal ideation as opposed to nausea, blurry vision, etc.

And this might be one of the first articles I’ve come across talking about the suicidal ideation. The vast majority tend to focus on the other side effects.

My point was that the data doesn't seem point at suicidal ideation in any particular way. Adverse event reports contain literally every outcome in connection with every drug, you need a strong trend to claim that you aren't just seeing report noise. (But you're right that a newly discovered side-effect would be more interesting than a well known one.)

That’s not how much research works. You never have data at the outset. You have to have anecdotal information and/or sometimes even just an unfounded hypothesis before you can collect useful data to prove/disprove the hypothesis.

This would fall into the anecdotal side of things, and should hopefully drive more rigorous research on whether any such concerns exist.

In reality, even if the research is proven, the only likely change is screening out a few people who are at an elevated risk of suicidal ideation and/or better monitoring, or even prescribing regular therapy along with the medication (which might be a good idea anyways).

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