Talk:Ivermectin: Difference between revisions
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Point 1: Omission of symptom reduction as a finding of the paper |
Point 1: Omission of symptom reduction as a finding of the paper |
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The study itself, entitled "The effect of early treatment with ivermectin on '''viral load, symptoms and humoral response''' in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial", finds a strong significant difference in symptom reduction in the patient group using ivermectin vs placebo group. While the procedure did specify a negative PCR test as the primary pass/fail metric, a significant symptom reduction is relevant to the substance of the Wikipedia article, and was seemingly relevant enough to the authors of the paper for them to include the subject in the title. |
The study itself, entitled "The effect of early treatment with ivermectin on '''viral load, symptoms and humoral response''' in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial", finds a strong significant difference in symptom reduction in the patient group using ivermectin vs placebo group. While the procedure did specify a negative PCR test as the primary pass/fail metric, a significant symptom reduction is relevant to the substance of the Wikipedia article, and was seemingly relevant enough to the authors of the paper for them to include the subject in the title. |
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Point 2: Inaccurate claim of no difference in viral loads |
Point 2: Inaccurate claim of no difference in viral loads |
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The Wikipedia article states that the study "found no difference...in viral load." This is directly contradicted by the paper itself, which states "the ivermectin group had non-statistically significant lower viral loads at day 4 (p = 0·24 for gene E; p = 0·18 for gene N) and day 7 (p = 0·16 for gene E; p = 0·18 for gene N) post treatment as well as lower IgG titers at day 21 post treatment (p = 0·24)." The paper did ''not'' find "no difference," it found a non-statistically significant difference. To be clear, these findings are closer to "significant difference" than "significant no difference." |
The Wikipedia article states that the study "found no difference...in viral load." This is directly contradicted by the paper itself, which states "the ivermectin group had non-statistically significant lower viral loads at day 4 (p = 0·24 for gene E; p = 0·18 for gene N) and day 7 (p = 0·16 for gene E; p = 0·18 for gene N) post treatment as well as lower IgG titers at day 21 post treatment (p = 0·24)." The paper did ''not'' find "no difference," it found a non-statistically significant difference. To be clear, these findings are closer to "significant difference" than "significant no difference." |
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Point 3: Overall mismatch between tone of study and characterization of it in article |
Point 3: Overall mismatch between tone of study and characterization of it in article |
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The authors characterize their study as a "pilot [that] points towards a potential use of ivermectin in COVID-19 which warrants further exploration under larger trials." This is not communicated by the Wikipedia article, which portrays it as one data point of many which illustrate ivermectin's ineffectiveness. |
The authors characterize their study as a "pilot [that] points towards a potential use of ivermectin in COVID-19 which warrants further exploration under larger trials." This is not communicated by the Wikipedia article, which portrays it as one data point of many which illustrate ivermectin's ineffectiveness. |
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Ideal sources for Wikipedia's health content are defined in the guideline Wikipedia:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Ivermectin.
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COVID-19
It is truly shocking the lengths taken to suppress information about this potentially life saving treatment for covid. The WHO and CDC have sat on this cheap safe potential treatment since August, meanwhile promoting an unproven expensive vaccine. Why? This is another tool in the toolbox, yet only negative articles are allowed on Wikipedia. When did Wikipedia become so politicized? Is this source good enough for mention? https://clinicaltrials.gov/ct2/show/NCT04668469 .2mg / kg is a low dosage proven to be safe, not the nonsense stated in this wiki
— Preceding unsigned comment added by 2601:603:4A80:5870:3910:DA7:2204:1AE2 (talk) 23:34, 25 December 2020 (UTC)
Incoming edits due to https://www.news.com.au/lifestyle/health/health-problems/coronavirus-australia-ivermectin-antiparasitic-drug-kills-covid19-in-lab/news-story/615c435e56aefc4b704f4fd890bd4c2c for sure.... — Preceding unsigned comment added by 193.116.241.225 (talk) 14:15, 3 April 2020 (UTC)
- Right now [48] and [78] are duplicate refs to the same COVID-19/invermectin article. Boud (talk) 23:38, 5 April 2020 (UTC)
Article incorrectly refers to SARS-COV-2 as a negative sense RNA virus. It is a positive sense RNA virus.
On December 8th 2020 Dr Pierre Kory, speaking as a representative of a group of doctors who together have published nearly 2,000 peer-reviewed publications appeared at a meeting of the Senate Homeland Security and Governmental Affairs Committee to plead that the NIH be forced to review the most recent evidence on the use of Ivermectin as a treatment and prophylactic for Sars-Cov-2 and Covid 19. He claimed that the use of Ivermectin on Covid 19 patients had a "miraculous impact", and this description was based on "mountains of evidence that has appeared in the last three months". He pointed out that the NIH's recommendation that Ivermectin not be used outside of controlled trials was made in August 2020, before the "mountains of data" that emerged subsequently. Dr. Kory presented a summary of this data, and the committee chairman Senator Ron Johnson promised to pass this on to the NIH for review.... <https://osf.io/wx3zn/> <https://www.youtube.com/watch?v=Tq8SXOBy-4w>
It is okay to publish the truth about this drug now, and the results it has proven for Covid Treatment. Now that the marxists that control Wikipedia and all the internet have defeated Trump, the truth can come out. https://buffalonews.com/news/local/2nd-wny-hospital-ordered-to-treat-covid-19-patient-with-experimental-drug/article_f32339f0-5d01-11eb-b752-4f8966804581.html — Preceding unsigned comment added by 24.116.87.50 (talk) 11:39, 30 January 2021 (UTC)
- I would delete this comment per WP:TPG, but perhaps it's instructive to leave it as an illustration of where the pro-Ivermectin boosterism is coming from. Alexbrn (talk) 11:48, 30 January 2021 (UTC)
AussiePete56 (talk) 02:46, 15 December 2020 (UTC)
- Unreliable. Would need WP:MEDRS. Alexbrn (talk) 06:17, 15 December 2020 (UTC)
Here is some more reliable evidence on the effectiveness of Ivermectin in preventing and treating Covid-19 . https://covid19criticalcare.com/wp-content/uploads/2020/11/FLCCC-Ivermectin-in-the-prophylaxis-and-treatment-of-COVID-19.pdf .
https://c19ivermectin.com/ . AussiePete56 (talk) 05:40, 21 December 2020 (UTC)
- Unreliable. Would need WP:MEDRS. Alexbrn (talk) 05:43, 21 December 2020 (UTC)
I dispute the claim of "unreliable" by Alexbrn since the two articles are secondary reviews of others' research and therefore qualify as reliable as per the WP:MEDRS guidelines. I notice that the "unreliable" tag was applied to this page three minutes after the links to the two review articles were published - three minutes isn't enough time to read even half of one of the reviews, let alone properly evaluate both. The charge of "unreliable" is therefore itself seemingly unreliable AussiePete56 (talk) 14:47, 21 December 2020 (UTC)
- We need secondary sources in reputable medical journals (or medical textbooks, etc). These are obviously not that, and appear to be self-published web sites. Alexbrn (talk) 14:59, 21 December 2020 (UTC)
- Using medical journals , textbooks etc is ideal, but as the guidelines state, "It is a generally accepted standard that editors should attempt to follow, though it is best treated with common sense, and occasional exceptions may apply." We are currently in a "war" with a virus which is currently killing nearly 14,000 people a day worldwide - a number which is increasing every day. Information which can save lives is desperately needed. As per guidelines, "Wikipedia's articles are not meant to provide medical advice. Nevertheless, they are widely used among those seeking health information." I maintain that this is clearly a time where an exception to the normal stringent editorial standards should apply. Ivermectin has been taken 3.7 billion times over 40 years and its safety is not in dispute - the only unknown is its efficacy. There is after all, no alternative medicine for Covid 19, and even ventilation in hospital will allow about 23% of patients to die. Surely the "mountains of evidence that Ivermectin works miraculously on Covid 19" that Dr Kory and his team refers to should be mentioned on these pages to allow access to as many medical professionals as possible the information they need to make their own assessments on how to best treat their patients. AussiePete56 (talk) 15:53, 21 December 2020 (UTC)
- The current situation is all the more reason why we used the best quality sources, which is why general sanctions apply for this topic requiring WP:MEDRS, of which you have been notified. What you're proposed to add is dodgy (as the word "miraculous" should clue you in to at once). We already cite high quality WP:MEDRS: PMID 33227231. I shall not respond further unless new sources are proposed as this is a clear-cut case. Alexbrn (talk) 16:03, 21 December 2020 (UTC)
- Using medical journals , textbooks etc is ideal, but as the guidelines state, "It is a generally accepted standard that editors should attempt to follow, though it is best treated with common sense, and occasional exceptions may apply." We are currently in a "war" with a virus which is currently killing nearly 14,000 people a day worldwide - a number which is increasing every day. Information which can save lives is desperately needed. As per guidelines, "Wikipedia's articles are not meant to provide medical advice. Nevertheless, they are widely used among those seeking health information." I maintain that this is clearly a time where an exception to the normal stringent editorial standards should apply. Ivermectin has been taken 3.7 billion times over 40 years and its safety is not in dispute - the only unknown is its efficacy. There is after all, no alternative medicine for Covid 19, and even ventilation in hospital will allow about 23% of patients to die. Surely the "mountains of evidence that Ivermectin works miraculously on Covid 19" that Dr Kory and his team refers to should be mentioned on these pages to allow access to as many medical professionals as possible the information they need to make their own assessments on how to best treat their patients. AussiePete56 (talk) 15:53, 21 December 2020 (UTC)
My point is that the information being presented in these reviews IS the "best quality source" available - ie, the very latest real-world studies demonstrating life-saving treatments. Alexbrn didn't even read these studies. 6% hospital deaths versus 23% are the results achieved. Some of these studies lack peer-review which typically takes months - time that these 14,000 people who are dying daily no not have. To give priority to ideological purity over thousands of daily deaths is insane and inhumane. To repeat a point that Alexbrm ignores - 3.7 billion doses of Ivermectin has been taken over 40 years. It is safe. There is only potential benefits to using it and strong and growing evidence supports such use. Allowing this information to be available, together with suitable disclaimers, is the appropriate and responsible decision. AussiePete56 (talk) 23:26, 21 December 2020 (UTC)
"In November 2020 a meta-analysis found only weak evidence of benefit.[89]"
I propose changing this vague and ambiguous sentence to, "In November 2020 a meta-analysis found a 47% reduction in mortality (statistically significant) for Ivermectin-treated Covid-19 patients, however, due to a relatively small sample size (629 patients) the evidence is considered weak. [1] AussiePete56 (talk) 05:40, 25 December 2020 (UTC)
- Alexbrn The actual meta-analysis linked as reference is much more positive as to the effectiveness of Ivermectin that what is stated in this wiki: There is only very weak evidence of ivermectin's benefit when used as an add-on therapy for people with non-severe COVID-19; there is no evidence for people with severe disease.[85]
- Why not just quote the conclusion of the actual meta-analysis? Ivermectin is an established drug with a long history of clinical use and with minimal safety concern. Recent observational studies have reported the effectiveness of this drug as add-on therapy in patients with COVID-19. Our meta-analysis also supports this finding and suggests the modest utility of ivermectin in reducing all-cause mortality and improving clinical outcomes. Currently, many clinical trials are on-going, and definitive evidencefor repurposing this drug for COVID-19 patients will emerge only in the future. — Preceding unsigned comment added by Adriaandh (talk • contribs) 17:48, 31 December 2020 (UTC)
}}
"The National Institutes of Health recommend against the use of ivermectin for COVID-19". In the interests of full disclosure, I propose amending this to, "The National Institutes of Health recommended against the use ivermectin for COVID-19 in August 2020". Since then, dozens of research reports on Ivermectin and Covis 19 have been released. Putting a date on the recommendation flags for the reader that it does not necessarily encompass the most recent research. AussiePete56 (talk) 17:36, 1 January 2021 (UTC)
- This would be possible is it was also added "... and is still current as of 2021", because of course such guidelines are under constant review. And we wouldn't want to give the false impression that the NIH is somehow outdated, now would we? Alexbrn (talk) 17:41, 1 January 2021 (UTC)
I would accept your suggestion on a "better than nothing" basis. Do you really think that the NIH's position is not outdated Alexbrn? You always exude the attitude that conformity to authority equals virtue. Do you have any theories on why the NIH, CDC and FDA allocated zero public funds to the investigation of re-purposing existing drugs against Covid 19, and instead went "all-in" on developing novel vaccines? I'm not cynical, but cynics would say, "Because that's where the money is." Many billions of dollars. And the vaccines don't work on patients who already have the virus. And it will take about a year for 80% of first-world countries to get vaccinated, and many more years for third-world countries.
So we're up to 15,000 people per day dying from Covid 19 at the moment, most of whom could be saved on the evidence of dozens of studies that the NIH ignores.... AussiePete56 (talk) 14:37, 2 January 2021 (UTC)
- Please do not use Talk pages to push conspiracy theories. As multiple editors have now advised you, WP:FOC. Alexbrn (talk) 14:46, 2 January 2021 (UTC)
We should try to avoid turning this into a discussion board, and try to focus on reporting what our sources say. Since regulatory bodies routinely change their positions, their prior positions by their own admission were outdated. Teishin (talk) 14:51, 2 January 2021 (UTC)
Alexbrn, you have repeatedly referred to the 28 studies which each independently found that Ivermectin works to alleviate Covid 19 illness as "fake" - that sounds like a conspiracy theory to me. AussiePete56 (talk) 14:50, 3 January 2021 (UTC)
- Something trying to pass itself off as a journal article, when it's just a self-published web site, is a "fake" journal article. As noted, people sharing it on Facebook get banned. Maybe Wikipedia should do the same. Alexbrn (talk) 14:55, 3 January 2021 (UTC)
I have no skin in this game. I just saw this chart stating far lower cumulative deaths from COVID-19 in the Mexican state of Chiapas compared to all the others and how that correlates with it being alone amongst them in using Ivermectin: https://twitter.com/Covid19Critical/status/1347721731272830976 (That mention of Ivermectin brought me here.) The correlation may be something which can be readily verified or disproved as it claims to be from public official data and the outcome mentioned on the main page. ― Ralph Corderoy (talk) 12:08, 10 January 2021 (UTC)
I'm late for this discussion. c19early, c19study, c19legacy, c19ivermectin, ivmmeta, c19hcq, hcqmeta, and others, use grossly incorrect methodology, producing biased results with bizarre p-values. They are still being used as "evidence" by political groups in Brazil to spread medical disinformation.[1] (talk) 01:23, 26 April 2021 (UTC)
Does the recommendation from the ministry of health of India count as a reliable source ?
https://www.icmr.gov.in/pdf/covid/techdoc/COVID19_Management_Algorithm_22042021_v1.pdf
I hear also IVM is used in Mexico city now
https://mexicobusiness.news/health/news/ivermectin-controversial-covid-19-drug-used-mexico-city
Isn't it enough to say at least that there is no consensus on efficacy?
We don't live in Disneyland, health agencie's recommendations in rich countries account for billions in drug purchasing.How could there be no influence when there are choices like $1000 remdesivir vs $5 hcq or ivermectin ?
In countries with lower financial resources there are also bright people, but less pressure not to reuse existing drugs.— Preceding unsigned comment added by Pweltz (talk • contribs) 15:34, 28 April 2021 (UTC)
- Reliable for their view, but since the Indian govt. is a busy hive of quackery and pseudoscience not reliable for any rational assertion about reality. Alexbrn (talk) 15:50, 28 April 2021 (UTC)
break
Note the imprecise wording of the Invermectin COVID-19 Wikipedia entry: "As of January 2021, the U.S. National Institutes of Health COVID-19 Treatment Guidelines state that the evidence for ivermectin is too limited to allow for a recommendation for or against its use." This wording does not make clear that ivermection is now a treatment option for COVID-19. In fact, the “neither for nor against” NIH classification is the "recommendation given to monoclonal antibodies and convalescent plasma, both widely used across the nation." [2] Unfortunately, this clarification can not be made because the COVID-19 section is locked down for edits even from autoconfirmed users--which is contrary to the edit notification for that section. I hope this is just a mistake and not a tragic example of "cancel culture" impacting Wikipedia. — Preceding unsigned comment added by Swisswiss (talk • contribs) 18:48, 20 January 2021 (UTC)
Concerns about reporting of study results:
This statement is false: A randomized controlled trial (RCT) of 24 patients with non-severe COVID-19 and no risk factors found no difference in PCR-positive nasal swabs nor in viral load between patients who received ivermectin and those given placebo. I quote directly from the study: the median viral load for both genes was lower at days 4 and 7 post treatment in the ivermectin group with differences increasing from 3-fold lower at day 4 (p = 0·24 for gene E; p = 0·18 for gene N) to around 18-fold lower at day 7 (p = 0·16 for gene E; p = 0·18 for gene N)
The study DID find a difference - it was just not statistically significant based on the threshold chosen. Even the PCR found a difference - RR 0·92. If you want to write something negative based on the results of this extremely small study, then write that it was underpowered to find statistically significant difference. Because every single endpoint found a difference showing benefit of Ivermectin use.Adriaandh (talk) 09:53, 10 February 2021 (UTC)
The section on Covid seems to be highly subjective
The section on Covid seems to be highly subjective and possibly inaccurate. I believe it should be changed to more neutral and objective as Wikipedia standards dictate - removing the word "misinformation" and to change "no reliable evidence exists" to "no large scale studies have been done."
All research that has been performed to my knowledge has shown that ivermectin is effective at treating Covid. A meta-analysis of four papers, accessible through the NIH, shows a .02 p value that adding ivermectin to a treatment regimen leads to improved clinical outcomes.
While they do stipulate that the quality of the individual papers included in the meta-analysis is "very low," they go on to say "currently, many clinical trials are on-going, and definitive evidence for repurposing this drug for COVID-19 patients will emerge only in the future."
As far as I am aware, all subsequent papers have all found that ivermectin was effective in treating Covid. This website that performs a real time meta-analysis of all papers (as of comment, 55 studies) shows a p value of disproving the clinical results as p = 0.000000000000043.
While there are no large scale studies of ivermectin as of yet, there is nothing but positive research (again, as far as I know) that show that it is effective. Therefore, "misinformation" does not objectively apply to this situation. It should only be applied when we have reliable information that the claim is false. On the contrary, the only reliable information we do have is that the claim is true, though I grant that it is far from settled science due to lack of large scale studies.
Further, while any of the smaller studies on their own might not be considered "reliable," surely a meta-analysis of 55 studies demonstrating a remarkably small p-value, could arguably considered reliable. Notwithstanding the lack of a large scale study, the meta-analysis data should disqualify the descriptor "not reliable" from being used by an objective source such as Wikipedia. 2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 08:45, 16 May 2021 (UTC)
- ivnmeta.com is not a reliable source. This article cites several reliable sources. Alexbrn (talk) 08:57, 16 May 2021 (UTC)
- I believe my overall point stands even with only the first source. The authors find a statistically significant beneficial effect in their meta-analysis of 4 papers (though they stipulate the individual papers to be of very low quality) and say only time will tell when there is more of a body of evidence shown.
- As others have pointed out, since the publication of that paper, many other papers have shown significant results in favor of ivermectin, even if not all 55 papers included in the website you mention are legitimate (I wonder, which aren't? I genuinely don't know).
- My argument against the use of the word disinformation therefore stands, as this is an active ongoing area of research (and I might add, the overwhelming body of evidence, however inconclusive, points to its efficacy).2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:09, 16 May 2021 (UTC)
- Things have moved on since November, but in fact we already cite that review (actually, at COVID-19 drug repurposing research#Ivermectin which is transcluded here). The line from ivermectin proponents was for a long time that high-quality evidence of benefit was just around the corner. It hasn't appeared, and ivermectin advocacy has passed into the realm of quackery, antivax, COVID denial and conspiracy theorizing.[3] There's not much more Wikipedia can do than report the caution from our best (WHO, FDA, NHS, etc.) sources and the shame of the misinformation that's been spread. Alexbrn (talk) 09:15, 16 May 2021 (UTC)
- Why is science based medicine deemed reliable here and not the other websites of individual physicians? Again, I am relatively new to this issue and am trying to understand the terrain here. As for "ivermectin advocacy has passed into the realm of quackery, antivax, COVID denial and conspiracy theorizing," this again reads as highly subjective.2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:24, 16 May 2021 (UTC)
- We don't cite that SBM article (there's no need when we have top-level WP:MEDRS), but SBM is regarded as a reliable source for fringe medical claims (see WP:RSP). I'm not sure what you mean by subjective. If you want to read about the sociological aspects of ivermectin/COVID advocacy - which Wikipedia does not really cover - there's plenty of reading to be done, starting here maybe? As far as (lack of) evidence of efficacy goes, we have unimpeachable sources already cited. Alexbrn (talk) 09:32, 16 May 2021 (UTC)
- Your linked source (New Statesman) does not address any of the points I am making RE subjective use of "disinformation." It reiterates that the papers have been included in meta-analyses are low quality, and that a large scale trial at Oxford is underway. Where is the sufficient objective basis to label this issue "misinformation?" 2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:46, 16 May 2021 (UTC)
- The subjective/objective distinction, if meaningful anywhere, is not meaningful for the purposes of reflecting what reliable sources say. By any measure the claim that ivermectin is a "miracle cure" or indeed effective at all, is misinformation. Reliable sources contain that knowledge, Wikipedia reflects it. That is the function of an encyclopedia. There is more detail on the misinformation at the COVID-19 misinformation article. Alexbrn (talk) 10:10, 16 May 2021 (UTC)
- "By any measure the claim that ivermectin is a "miracle cure" or indeed effective at all, is misinformation." According to the WHO, no conclusion has been reached on this question. Certainly an investigator who finds an effect, in an ongoing worldwide clinical effort, in not spreading misinformation by reporting their finding. Certainly the WHO's own analysis that no conclusive finding has been reached, should outrank a non-SME deeming ivermectin benefits to be "misinformation." I also question why the European Medicines Agency recommending against its use, is being cited over the WHO, which does not recommend either for or against.2600:1700:7CC0:4770:D89C:66EE:D017:775B (talk) 21:06, 16 May 2021 (UTC)
- From the New Statesman article linked above by Alexbrn as a reputable source - "at the moment the only scientific response is to withhold judgement." This language far more accurately describes the current state of the science as far as I can tell. I remain confused as to why "misinformation" is an accurate characterization of the potential benefits of ivermectin, and further why it should be included in a single-sentence synopsis on the topic - seems to me that something more akin to the official WHO language would serve to inform readers better, rather than arbitrarily shepherd them towards adopting a subjective opinion RE misinformation. 2600:1700:7CC0:4770:D89C:66EE:D017:775B (talk) 00:04, 17 May 2021 (UTC)
- The WHO is already cited. Claims that ivermectin is an effective COVID treatment are misinformation. A statement that we should "withhold judgement" would not be; but that's not what the advocates are saying. That's the reality according to the sources. Alexbrn (talk) 05:48, 17 May 2021 (UTC)
- Surely, under your definition, misinformation is spread about every drug known to humanity. The question is, what is the most informative way to present the relevant information in a one-sentence synopsis? Is it to debunk a notion that the reader may or may not have prior to reading the article, in a manner that easily could lead others to a false understanding of the scientific record - ex. "Wiki says Ivermectin being effective against Covid is misinformation, so this must mean it is not effective!" Or is it to provide a simple summary of the science - "research to ascertain effectiveness is underway"? In my opinion, the current language creates a false impression in the reader and endeavors to "correct" rather than inform. If use of "misinformation" is strictly necessary, then more specificity as to what is misinformation and what is not would seem to me to be of the utmost importance.2600:1700:7CC0:4770:8C96:D3CD:38B2:2270 (talk) 18:51, 17 May 2021 (UTC)
- The WHO is already cited. Claims that ivermectin is an effective COVID treatment are misinformation. A statement that we should "withhold judgement" would not be; but that's not what the advocates are saying. That's the reality according to the sources. Alexbrn (talk) 05:48, 17 May 2021 (UTC)
- The subjective/objective distinction, if meaningful anywhere, is not meaningful for the purposes of reflecting what reliable sources say. By any measure the claim that ivermectin is a "miracle cure" or indeed effective at all, is misinformation. Reliable sources contain that knowledge, Wikipedia reflects it. That is the function of an encyclopedia. There is more detail on the misinformation at the COVID-19 misinformation article. Alexbrn (talk) 10:10, 16 May 2021 (UTC)
- Your linked source (New Statesman) does not address any of the points I am making RE subjective use of "disinformation." It reiterates that the papers have been included in meta-analyses are low quality, and that a large scale trial at Oxford is underway. Where is the sufficient objective basis to label this issue "misinformation?" 2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:46, 16 May 2021 (UTC)
- We don't cite that SBM article (there's no need when we have top-level WP:MEDRS), but SBM is regarded as a reliable source for fringe medical claims (see WP:RSP). I'm not sure what you mean by subjective. If you want to read about the sociological aspects of ivermectin/COVID advocacy - which Wikipedia does not really cover - there's plenty of reading to be done, starting here maybe? As far as (lack of) evidence of efficacy goes, we have unimpeachable sources already cited. Alexbrn (talk) 09:32, 16 May 2021 (UTC)
- Why is science based medicine deemed reliable here and not the other websites of individual physicians? Again, I am relatively new to this issue and am trying to understand the terrain here. As for "ivermectin advocacy has passed into the realm of quackery, antivax, COVID denial and conspiracy theorizing," this again reads as highly subjective.2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:24, 16 May 2021 (UTC)
- Things have moved on since November, but in fact we already cite that review (actually, at COVID-19 drug repurposing research#Ivermectin which is transcluded here). The line from ivermectin proponents was for a long time that high-quality evidence of benefit was just around the corner. It hasn't appeared, and ivermectin advocacy has passed into the realm of quackery, antivax, COVID denial and conspiracy theorizing.[3] There's not much more Wikipedia can do than report the caution from our best (WHO, FDA, NHS, etc.) sources and the shame of the misinformation that's been spread. Alexbrn (talk) 09:15, 16 May 2021 (UTC)
- My argument against the use of the word disinformation therefore stands, as this is an active ongoing area of research (and I might add, the overwhelming body of evidence, however inconclusive, points to its efficacy).2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:09, 16 May 2021 (UTC)
Mechanism of action? Stimulant effect? Lacking GABA neurotoxicity because of P-glycoproteins?
There is this statement
Ivermectin, although still an investigational drug, has become the drug of choice for onchocer-ciasis (river blindness). Ivermectin intensifies GABA-mediated neurotransmission in nematodes and causes immobilization of parasites, facilitating their removal by the eticuloendothelial system. Selective toxicity results because in humans GABA is a neurotransmitter only in the CNS, and ivermectin does not cross the blood-brain barrier.
Im wondering regarding the recent large-scale human use of Ivermectin in central europe: where are the patient reported rejuvenating/stimulant effects coming from? Is it the action of Ivermectin on the intestines or other body parts, or is it a direct action of a minute/trace amounts acting in the brain? Since some other antihelminthic was being metabolised to amphetamine, and is added to all south-american cocaine production, is it possible that Ivermectin has a similar effect on a selected group of patients? How can it make some people feel better, stronger? Or is it just because they have slept better, because of the effect on GABA?
Another barrier is due to membrane transporters, which actively export drugs from the cellular or tissue compartment back into the blood (Chapter 5). A well-known example is the P-glycoprotein. Although the octanol-water partition coefficient would favor lipophilic molecules to transverse across cell barriers, P-glycoprotein exports structurally unrelated amphiphilic and lipophilic molecules of 3-4 kDa, reducing their effective penetration. Examples of antimicrobial agents that are P-glycoprotein substrates include HIV protease inhibitors, the antiparasitic agent ivermectin, the anti-bacterial agent telithromycin, and the antifungal agent itraconazole.[1]
There are notes on other pages saying that ivermectin is severely neurotoxic to mice that have some genes knocked out, and on another page that the lack of neurotoxicity in humans may be precisely because of the P-glycoprotein membrane transporters, which would mean that some of it WILL exhibit GABA action in humans. You can find those by searching in the 2108-page pdf for ivermectin.
Wikipedia should not be used for crusades
The lead paragraph has this sentence tacked on to it :
> There exists no evidence that the drug works for COVID-19.
Now I'm not interested in arguing the case regarding Ivermectin and Covid at all. What is wrong with this sentence being in the lede is that it is completely out of place. We do not summarise a drug by saying what diseases and afflictions it has so far not shown evidence to treat. So why is this sentence here? I suspect that, as is increasingly the case on Wikipedia, certain ppl want to push an agenda.
Yes, I have not written this dispassionately but I am getting really tired of faux 'enlightened' individuals pushing agendas on wikipedia. Please treat this project as an encyclopedia, not a place to push agendas. This is directed at the person who just reverted my edit removing this rubbish and to all others who can't leave well enough alone. Oska (talk) 04:07, 12 May 2021 (UTC)
- It might be better to say something like "During the 2020 COVID-19 pandemic misinformation was widely spread claiming that ivermectin was beneficial for treating and preventing COVID-19. Such claims are not backed by evidence". This is an odd case where the "what it doesn't do" aspect has become part of the knowledge.[4] However, before this we would really need something in the "Society and culture" section about this misinformation phenomenon, summarizing the content at COVID-19 misinformation. Alexbrn (talk) 04:40, 12 May 2021 (UTC)
- Readers are fully capable of scanning the table of contents and jumping down to the section on research into its possible use against Covid, if that is what interests them. It does not need to be in the lead. The reason that that sentence was added to the end of the first paragraph is, I very strongly suspect, because agenda pushers know that just the first paragraph is what Google quotes when it presents a grab from the wikipedia article in search results. Hence the contamination of a lot of 'controversial' articles with agenda-pushers trying to stuff the agenda they are pushing into the first paragraph. As disinterested & dispassionate editors we shouldn't care how Google uses wikipedia articles and it certainly should not influence how we write them. Oska (talk) 04:50, 12 May 2021 (UTC)
- Then why do you care? Ledes should summarize bodies, and a sentence or two to reflect the multiple paragraphs on this in the body is not unreasonable, surely? Alexbrn (talk) 04:56, 12 May 2021 (UTC)
- I care because it is completely moronic to tack that sentence on to the end of the first paragraph. I'm trying to read an article on an important drug and I get stopped in my tracks by idiotic faux do-gooders pushing an agenda on wikipedia. "Here's information about a drug and wait, did we tell you that 'no evidence has been found' that it 'works for' one of 10 million afflictions that humankind can suffer from. And we'll ignore that absence of evidence is not evidence of absence because no, it's very important that we dispel any ideas that you might have that Ivermectin might have a use case against Covid. So we're going to do it right in the first paragraph so that Google quotes us. Because this is a very important agenda that enlightened people like us know is the correct one to push."
- And I would not be in a minority in feeling like this. Wikipedia is becoming unusable to casual readers of controversial articles who just want information, not an agenda pushed at them. Oska (talk) 05:03, 12 May 2021 (UTC)
- I've just removed the sentence for a second time. I think the lead three paragraphs read much more naturally now. Imagine, just for a minute, that you're coming to this article without any controversy about Covid and Ivermectin in mind. Shouldn't be that hard to imagine really; Ivermectin is an important drug that has been in continual use around the world for the last 40 years, being taken by literally billions of people. So for those readers they can now just read the lead-in without topical controversy being pushed in their face. And if they are interested in research around Covid and Ivermectin then yes, we have a section discussing that that they can scroll down to. Oska (talk) 05:17, 12 May 2021 (UTC)
- Calling the sentence "completely moronic" and calling the people who are in favor of the sentence "faux do-gooders pushing an agenda" does not help your cause. I could just as well say that removing the sentence is completely moronic and that you are a faux do-badder pushing an agenda, with as much justification. So, just stay on the factual level.
- At the moment, the stuff is pushed as a COVID cure, so it needs to be mentioned that it isn't. That you do not want the information is not a reason for omitting it - you are not the only customer, and for others, it is relevant. Alexbrn's suggestion about spreading misinformation is good. After this virus fest is over, we can drop it from the lede again. --Hob Gadling (talk) 07:46, 12 May 2021 (UTC)
- Then why do you care? Ledes should summarize bodies, and a sentence or two to reflect the multiple paragraphs on this in the body is not unreasonable, surely? Alexbrn (talk) 04:56, 12 May 2021 (UTC)
- Readers are fully capable of scanning the table of contents and jumping down to the section on research into its possible use against Covid, if that is what interests them. It does not need to be in the lead. The reason that that sentence was added to the end of the first paragraph is, I very strongly suspect, because agenda pushers know that just the first paragraph is what Google quotes when it presents a grab from the wikipedia article in search results. Hence the contamination of a lot of 'controversial' articles with agenda-pushers trying to stuff the agenda they are pushing into the first paragraph. As disinterested & dispassionate editors we shouldn't care how Google uses wikipedia articles and it certainly should not influence how we write them. Oska (talk) 04:50, 12 May 2021 (UTC)
- Hob Gadling I hope you are not purposefully misquoting me. I did not call the sentence 'completely moronic'. I said that tacking it on to the end of the first paragraph (in a disjointed and breaking the flow way) is completely moronic. Please refer back to what I actually said and I would hope that you can see that there is a large difference between the two positions. I don't have any issue with the article documenting the controversy around Covid and Ivermectin. What I do have an issue with is ppl pushing agendas and making articles worse through their crusading. That's my complaint and hence the section title I chose "Wikipedia should not be used for crusades". I don't have a bee in my bonnet about Ivermectin and Covid, despite people trying to colour this discussion that way (but often it seems that crusaders see everything through the prisms of their personal crusades.) I'm just trying to keep wikipedia articles useful and informative to ordinary readers. And readers turn off and become dubious of a source when they feel that they are getting preached to, or that an agenda is being pushed.
- Further, I find your suggestion that we promote some statements while an event is happening (in this case the pandemic) and then drop them later concerning. That is an agenda; I do hope you can see that. This is an encyclopedia, not a public health warning service. Readers should be able to come to an article and get information presented dispassionately and not coloured by current events. Oska (talk) 10:16, 12 May 2021 (UTC)
- I should have written
Calling putting the sentence at this place "completely moronic"
, but that looked clumsy to me, and I did not expect you to make such a drama about such a minor difference. It does not change my point one bit. My point was "it does not help that you are doing this", and, surprise, surprise, calling putting the sentence at that place "completely moronic" is every bit as disingenious as calling the sentence itself "completely moronic" would have been. I don't know why I expected a drive-by ranter like you to be reasonable enough to recognize this as a non-difference. I don't have a bee in my bonnet about Ivermectin and Covid, despite people trying to colour this discussion that way
Nobody did. Look carefully at what Alexbrn and I wrote. You are the only person here who is colouring anything.- So, my point whooshed right by your head, and instead, you invent motivations and people coloring stuff. You want to continue blaming your fellow users for your woes. You do not want this to be a discussion about how the article should look, you want this to be a jeremiad about crusaders pushing agendas. You have no objective reason against the existence of such a sentence, your real beef is with the hypothetical sinister motivation you smell out behind it.
- Alright, then you should be treated the same way we treat all the other ranters: we, or at least I, will ignore you, and if you continue whining about other users supposedly having non-encyclopedic intentions, instead of working constructively, you will probably be blocked. Don't ping me. Bye. --Hob Gadling (talk) 11:19, 12 May 2021 (UTC)
- I do not find the response above by Hob Gadling at all substantive. Most importantly, after betraying that they had an agenda and my criticism (in my second paragraph) of that agenda pushing (and how it worsens wikipedia generally and this article specifically) was not addressed at all. In my view they are dodging the main issue which was my impetus for my removal of that sentence and opening this discussion. Wikipedia articles should be written dispassionately and with no view to 'getting a message out', whatever is currently happening in the wider world. There are other channels for that. Oska (talk) 11:54, 12 May 2021 (UTC)
- Your perception is crooked. You smell "agendas" behind everything. The "main issue", your original "impetus", by your own reasoning on this Talk page, was that you did not like what you believed to be the reason behind the sentence. But "I don't like what I believe to be the reason why people wrote this" is not a valid reason for removing something. Unless you come up with something that does not mainly consist of you pointing at other people and squealing, like Donald Sutherland at the end of The Body Snatchers, that sentence will stay in. --Hob Gadling (talk) 07:46, 13 May 2021 (UTC)
- And ironically, the "crusading" that has been in evidence around ivermectin on Wikipedia, has been from users trying to push the "it's a miracle cure for COVID-19, not the vaccines THEY are deploying" line, as the roster of banned users attests. Alexbrn (talk) 08:02, 13 May 2021 (UTC)
- What's ironic Alexbrn is that you are blind to crusading from your own 'side'. As someone who has stood completely outside the controversy, that is obvious to me. Propagandists often rationalise their own dubious actions as necessary in the fight against others propaganda. Neutrality and dispassionate documentation in this encyclopedia project loses out. Oska (talk) 10:06, 13 May 2021 (UTC)
- I've spent a little time now reviewing Alexbrn & Hob Gadling's activity and they are both heavily involved in editing Covid related articles and active crusading on wikipedia in this area. Their talk pages include various back-slapping messages enthusing the valiant to keep up the good fight and sneering at their enemies. And as soon as I entered their orbit - not pushing any Covid related agenda but simply decrying how agenda stuffing had badly affected the lead of an article on an important drug - Alexbrn swung into passive aggressive attempt-to-intimidate mode and whacked an inappropriate warning message on my talk page, which I am still waiting for him to properly justify. Such bullying behaviour (motivated by the desire to 'fight the good fight') is unfortunately what drives a lot of less experienced editors away from the project. Oska (talk) 10:21, 13 May 2021 (UTC)
- Bravo! you've identified the sterling work of active editors like me! If you have any substantive complaint (though I suspect this is just trolling, so I doubt it), then take it to an appropriate forum with your evidence. Otherwise, you should probably abide by our behavioural policies, unless you want to join the roster of miscreants the Project has needed to block. You have been warned. Alexbrn (talk) 10:55, 13 May 2021 (UTC)
- @Oska: Calm down mate and stay focused. It's better to concentrate on sources rather than continuing this never-ending conversation. See below. AXONOV (talk) ⚑ 20:33, 13 May 2021 (UTC)
- And ironically, the "crusading" that has been in evidence around ivermectin on Wikipedia, has been from users trying to push the "it's a miracle cure for COVID-19, not the vaccines THEY are deploying" line, as the roster of banned users attests. Alexbrn (talk) 08:02, 13 May 2021 (UTC)
- Your perception is crooked. You smell "agendas" behind everything. The "main issue", your original "impetus", by your own reasoning on this Talk page, was that you did not like what you believed to be the reason behind the sentence. But "I don't like what I believe to be the reason why people wrote this" is not a valid reason for removing something. Unless you come up with something that does not mainly consist of you pointing at other people and squealing, like Donald Sutherland at the end of The Body Snatchers, that sentence will stay in. --Hob Gadling (talk) 07:46, 13 May 2021 (UTC)
- I do not find the response above by Hob Gadling at all substantive. Most importantly, after betraying that they had an agenda and my criticism (in my second paragraph) of that agenda pushing (and how it worsens wikipedia generally and this article specifically) was not addressed at all. In my view they are dodging the main issue which was my impetus for my removal of that sentence and opening this discussion. Wikipedia articles should be written dispassionately and with no view to 'getting a message out', whatever is currently happening in the wider world. There are other channels for that. Oska (talk) 11:54, 12 May 2021 (UTC)
- I should have written
- I support the proposals by Alexbrn and will be happy to help in drafting something useful. TrangaBellam (talk) 11:10, 13 May 2021 (UTC)
- I would just add my two cents here and say that the Covid 19 pandemic situation is nowhere near its resolution and we should be very humble about what we know and what we don't know. I don't believe an objective source like Wikipedia should be involved with sheparding public opinion as to what is true information and what is misinformation, *if we do not have the facts* about that particular issue. Given that there is an ongoing large scale trial on the efficacy of ivermectin at Oxford, and a large body of evidence does exist (albeit, not strong evidence) as to its benefits, I *strongly* believe an objective summary needs to demonstrate more humility and acknowledgement of the uncertainty of the developing situation that is Covid 19 more generally and ivermectin's role in it. 2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 10:03, 16 May 2021 (UTC)
- The Wikipedia rules, such as WP:SOURCE and WP:FRINGE, directly contradict your opinion. When reliable sources say "it's like this", we say it's like this. You are free to start your own encyclopedia without those rules. Suggestions for the name: "OnTheFencePedia", "IHaveNoIdeaPedia", "SomeSayThisSomeSayThatPedia". --Hob Gadling (talk) 15:24, 16 May 2021 (UTC)
- ”when reliable sources say ‘it’s like this,’ we say it’s like this.” Great, then how about changing the article to reflect the far more neutral and accurate language used by WHO: “The current evidence on the use of ivermectin to treat COVID-19 patients is inconclusive. Until more data is available, WHO recommends that the drug only be used within clinical trials.“2600:1700:7CC0:4770:D1B7:CD9:6351:3A39 (talk) 19:06, 16 May 2021 (UTC)
- "Inconclusive" means that if there is an effect, it is so small it could not be measured conclusively. That is what will happen when something does not have an effect: statistical noise will ensure that the measured effect size is not zero, but somewhere around zero. Sometimes, in 5% of all studies, it will even be statistically significant; that is the very definition of statistical significance. But those results will not be replicable.
- This is the minimum amount of evidence which is mathematically possible, also called "no evidence" by people who know how measurements work. If they are generous, they call it "inconclusive", but it's the same thing really. --Hob Gadling (talk) 06:05, 17 May 2021 (UTC)
- As far as I am aware there was one study that is being widely cited that had an inconclusive result which had some sampling issues that contributed to an insignificant result. If a massive body of evidence had been compiled, all of which show "inconclusive" results, then your argument RE statistical noise would certainly be relevant. As it stands, I don't believe this is anywhere close to a resolved question.2600:1700:7CC0:4770:8C96:D3CD:38B2:2270 (talk) 18:57, 17 May 2021 (UTC)
- The matter as it stands now is that there is no good clinical evidence of benefit, but most big health organisation have no objection to continued research. The way "questions" are "resolved" in medicine is for good evidence to be produced. Meanwhile, despite the lack of evidence, a number of quacks and fools are falsely promoting ivermectin as a silver bullet. All this is clear from good sources, which we cite. If the situation changes, Wikipedia will change too. We cannot change reality as reported by reliable sources. Alexbrn (talk) 19:29, 17 May 2021 (UTC)
- Again, I must disagree with your subjective conclusions that are not supported by factual evidence. You deem anyone with a belief that ivermectin is beneficial to treating or preventing Covid as a "quack" or "fool." This might be a valid position to take, if this were a long standing issue with a substantial body of research which in summation finds no evidence to support the use of ivermectin. It seems to me you repeatedly conflate that hypothetical scenario with the actual current status of the issue - an unquestionably insubstantial body of research leading us to be unable to ascertain whether or not ivermectin in fact has any beneficial effect. This conflation is, in my opinion, reflected in the misleading text of the article.2600:1700:7CC0:4770:8C96:D3CD:38B2:2270 (talk) 20:41, 17 May 2021 (UTC)
- The matter as it stands now is that there is no good clinical evidence of benefit, but most big health organisation have no objection to continued research. The way "questions" are "resolved" in medicine is for good evidence to be produced. Meanwhile, despite the lack of evidence, a number of quacks and fools are falsely promoting ivermectin as a silver bullet. All this is clear from good sources, which we cite. If the situation changes, Wikipedia will change too. We cannot change reality as reported by reliable sources. Alexbrn (talk) 19:29, 17 May 2021 (UTC)
- I would support adding an info on Covid-19 treatment effectiveness but the problem is that a significant share of the research is mostly WP:RECENT. So it's best wait for a certain amount of critical weight to gain. I also disagree with Hob Gadling on that WP:FRINGE is applicable here. See discussion below (#Sources on effectiveness against Covid-19). AXONOV (talk) ⚑ 21:31, 17 May 2021 (UTC)
Sources on effectiveness against Covid-19
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
Before discussion gets out of hand I got some sources to discuss. Both are reviews but a bit contradictory. The first review finds that Ivermectin brings down morbidity rates. I propose to adopt them in relevant subsections (lead/research). Please checkout:
- Kory, Pierre; Meduri, Gianfranco Umberto; Varon, Joseph; Iglesias, Jose; Marik, Paul E. (April 22, 2021). "Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19". American Journal of Therapeutics. 28 (3): e299–e318. doi:10.1097/MJT.0000000000001377. ISSN 1075-2765. PMC 8088823.
- "EMA advises against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials". March 22, 2021.
{{cite web}}
: CS1 maint: url-status (link)
--AXONOV (talk) ⚑ 20:30, 13 May 2021 (UTC)
- The "American Journal of Therapeutics" does not look good on SCImago. --Fernando Trebien (talk) 23:47, 13 May 2021 (UTC)
- Yeah WP:REDFLAG, especially since this article was previous rejected by a Frontiers (a Frontiers!) journal, with a statement that it was bollocks[5]. We have very good sources on this and we shouldn't undercut them with marginal ones. Alexbrn (talk) 05:35, 14 May 2021 (UTC)
- @Alexbrn:
...a Frontiers! ...
Frontiers claims that the article didn't review controlled trials meanwhile there were 18 controlled ones (I've checked at least 2).[6] - As a fun fact, the Frontiers in Life Science and Frontiers of Medicine journals are rated lower than AJT by SJR.[7][8]. AJT has 59 points: [9] vs junky 35/33. And what about second source by EMA?
- BTW, I wonder now what you would say about Nature as it's rated very highly[10]. AXONOV (talk) ⚑ 09:01, 14 May 2021 (UTC)
- EMA is always good. As is Nature. Assuming all the usual WP:MEDRS boxes are ticked. If we stick to high-quality sources all shall be well. Alexbrn (talk) 12:42, 14 May 2021 (UTC)
- @Alexbrn:
- @Ftrebien: Hardly an issue. I think we are obliged to mention it. Probably also worth to mention Frontiers's rejection. It seems baseless though. AXONOV (talk) ⚑ 19:31, 14 May 2021 (UTC)
- According to WP:MEDRS, it surely is an issue. WP:MEDRS exists to prevent Wikipedia from spreading deadly false hopes. If this kind of "good news" was published by a trusted source like Nature, it would have a huge impact on the entire planet. 14 months into the pandemic, with tons of resources invested in research on drug repurposing for a long time in many countries, I'm sure that the EMA and the WHO (as well as the other regulatory agencies already mentioned in the article) have seen this paper and are most interested in changing their current stance if they think they now have better evidence. As there is a lot of potential profit involved, there has been a lot of sophisticated disinformation around ivermectin, particularly in Brazil (currently politically polarized with a denialist president promoting unproven cures), which is the main source of the information in this meta-analysis. Given this political context, Wikipedia should not suggest, by providing what looks like a credible scientific source to lay readers, that taking ivermectin offers any level of protection against COVID-19, unless we see a change in the consensus reported by the most trusted sources. --Fernando Trebien (talk) 22:35, 14 May 2021 (UTC)
- @Ftrebien:
... WP:MEDRS exists to prevent Wikipedia from spreading ...
Don't cite guidelines arbitrarely. Reviews are acceptable as they are secondary. Considering that WP:MEDRS is highly abused guideline I would like to see exact provisions (WP:BMI?) forbidding the first source above. ... which is the main source of the information in this meta-analysis. ...
Are you saying that the first source is somehow compromised by Brazilian or any other govt? I'm fully aware of politicization over Covid-19 drugs over here but given WP:RS I don't think this opinion has a great weight. Review in Nature says that Ivermectin is promising in treating Covid-19 and should be investigated.[11]... Wikipedia should not suggest, by providing what looks like a credible scientific source to lay readers, ...
You oppose to cite both and let the readers to decide which they trust the most? It would be nice to balance each other per WP:NPOV/WP:WEIGHT. AXONOV (talk) ⚑ 07:37, 15 May 2021 (UTC)- WP:MEDRS isn't an abused guidelines, so much as the basis of the quality of Wikipedia's well-respected medical content. Granted, we have occasional problem editors trying to undermine it who don't like Wikipedia's quality requirements, but that's the same for pretty much all topic areas on Wikipedia. Per WP:REDFLAG this new review is not suitable for use. If in doubt, raise a query at WT:MED where experienced editors can offer further guidance. (BTW, you have not cited any review in Nature, so I'm not sure what is going on.) Alexbrn (talk) 07:43, 15 May 2021 (UTC)
- @Alexbrn:
WP:MEDRS isn't an abused guideline ... "
Whatever. Unless it turns out in provision - it's clear abuse. ... you have not cited any review in Nature.
Nature which says that the drugs poses some effectiveness in combating viruses, including COVID-19 (second paragraph in conclusion section): NATURE ARTICLE. In light of this I don't think the WP:REDFLAG makes up a case here. We are obliged to mention the first source under WP:WEIGHT I think. I propose to put it under COVID-19_drug_repurposing_research#Ivermectin section. AXONOV (talk) ⚑ 08:08, 15 May 2021 (UTC)- That's not in Nature; You seem confused. Please do not put quackery in Wikipedia, you could end up sanctioned. Alexbrn (talk) 08:11, 15 May 2021 (UTC)
- @Alexbrn: My mistake. It's The Journal of Antibiotics . AXONOV (talk) ⚑ 08:19, 15 May 2021 (UTC)
- @Alexbrn: Stop citing policies, guidelines and essays arbitrarily or you may end up sanctioned for excessive abuse.
... Please do not put quackery ...
There is no evidence for that. SCImago rates it higher than Frontiers: [12] AXONOV (talk) ⚑ 08:22, 15 May 2021 (UTC)- The promotion of ivermectin is misinformation per multiple RS (see COVID-19 misinformation#ivermectin). As I said, if you want to widen consensus ask at WT:MED. You are now aware of the general sanctions in effect for this topic. Alexbrn (talk) 08:32, 15 May 2021 (UTC)
- That's not in Nature; You seem confused. Please do not put quackery in Wikipedia, you could end up sanctioned. Alexbrn (talk) 08:11, 15 May 2021 (UTC)
- @Alexbrn:
Review in Nature says that Ivermectin is promising in treating Covid-19 and should be investigated.
June 2020. Research has come a long way since then. We can write at the top of Review / Evidence something like "In June 2020, a review suggested that ivermectin was promising. However, later results found weak evidence." This presents the information (which in fact I find relevant when narrating how the controversy started and unfolded) in the appropriate tone.Are you saying that the first source is somehow compromised by Brazilian or any other govt?
Very likely. If it were in fact neutral, reliable and of high quality, it would have been sent for review by a more reputable publisher, such as Nature, and we would see interest from other important health organizations such as EMA and WHO. But that is not happening at all.You oppose to cite both and let the readers to decide which they trust the most?
Yes, because there is no evidence, because WP:MEDRS exists to prevent the relativizing truths and facts in ways that could harm laypeople, and because the debate around it is currently tainted by economic and political interests, especially in Brazil. If it can cause injury by incorrectly modulating risky behaviours, leave the debate to experts and trusted health organizations.- Simply put, the article already says that ivermectin is being studied and I think that is sufficient because its sources are better than the one you propose. --Fernando Trebien (talk) 12:30, 15 May 2021 (UTC)
- WP:MEDRS isn't an abused guidelines, so much as the basis of the quality of Wikipedia's well-respected medical content. Granted, we have occasional problem editors trying to undermine it who don't like Wikipedia's quality requirements, but that's the same for pretty much all topic areas on Wikipedia. Per WP:REDFLAG this new review is not suitable for use. If in doubt, raise a query at WT:MED where experienced editors can offer further guidance. (BTW, you have not cited any review in Nature, so I'm not sure what is going on.) Alexbrn (talk) 07:43, 15 May 2021 (UTC)
- @Ftrebien:
- According to WP:MEDRS, it surely is an issue. WP:MEDRS exists to prevent Wikipedia from spreading deadly false hopes. If this kind of "good news" was published by a trusted source like Nature, it would have a huge impact on the entire planet. 14 months into the pandemic, with tons of resources invested in research on drug repurposing for a long time in many countries, I'm sure that the EMA and the WHO (as well as the other regulatory agencies already mentioned in the article) have seen this paper and are most interested in changing their current stance if they think they now have better evidence. As there is a lot of potential profit involved, there has been a lot of sophisticated disinformation around ivermectin, particularly in Brazil (currently politically polarized with a denialist president promoting unproven cures), which is the main source of the information in this meta-analysis. Given this political context, Wikipedia should not suggest, by providing what looks like a credible scientific source to lay readers, that taking ivermectin offers any level of protection against COVID-19, unless we see a change in the consensus reported by the most trusted sources. --Fernando Trebien (talk) 22:35, 14 May 2021 (UTC)
- Yeah WP:REDFLAG, especially since this article was previous rejected by a Frontiers (a Frontiers!) journal, with a statement that it was bollocks[5]. We have very good sources on this and we shouldn't undercut them with marginal ones. Alexbrn (talk) 05:35, 14 May 2021 (UTC)
References section
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
- 12:44, May 14, 2021 - «Restored revision 1023063928 by DMacks talk): Let the software do the work; forcing width mucks up the appearance»
- 10:27, May 14, 2021 - «Undid revision 1023063928 by DMacks talk) At 100% width references are completely unreadable. Let's make it more consistent with the rest of Wiki.»
- 04:15, May 14, 2021 - «Making the columns 50% narrower than standard makes this worse and not better. Undid revision 1023014905 by Alexander Davronov talk)»
- 20:35, May 13, 2021 - «References»
I propose to change the width of the {{reflist}} to 20em
. Currently it's unreadable. Some good examples: Egalitarianism#References, Dendrite#Notes, Gdańsk#References --AXONOV (talk) ⚑ 19:37, 14 May 2021 (UTC)
- The default/standard of {{reflist}} is 30em, not 100%. That specific width has consensus as default on enwiki, so presumably that's what generally is most usable for most readers. If your window is just slightly too narrow for two 30em columns, you get one column. But that's unusually narrow. Try adjusting your window. Setting 20em makes lots of nonstandardly-narrow columns for most readers. Obviously "50%" is not the right math. DMacks (talk) 21:17, 14 May 2021 (UTC)
Misinfo: Pierre Kory
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
- 09:21, May 15, 2021 - «COVID-19 misinformation: Witnesses making statements at the hearing - the context makes this sufficiently clear.»
- 07:51, May 15, 2021 - «COVID-19 misinformation: Reword and cite EMA per talk.»
- 09:50, May 15, 2021 - «COVID-19 misinformation: See Talk:Ivermectin#Misinfo: Pierre Kory»
- 10:03, May 15, 2021 - «Undid revision 1023252048 by Alexander Davronov talk) Let's do it in a right way.»
@Brunton: See WP:DONTREVERT and WP:DETAG. The problem is that Pierre Kory is not mentioned in the NYC article cited before so I'm going to place failed verification tag if you don't mind. Please provide a quote if you can so I can remove it. Thanks. --AXONOV (talk) ⚑ 09:49, 15 May 2021 (UTC)
- That's not the cited source. I am beginning to suspect a WP:CIR issue here (or, with the PA in the template, maybe something worse). Alexbrn (talk) 09:54, 15 May 2021 (UTC)
- @Alexbrn: The source cited in the first statement about hearing. I'm beginning to suspect that WP:CIR is an issue here because you don't catch that two unrelated statements coexist next to each other. AXONOV (talk) ⚑ 09:59, 15 May 2021 (UTC)
- @Alexbrn: I have clarified what I'm talking about, take a look. NYC article is paywalled but I have access to it. I don't see Pierre Kory mentioned. --AXONOV (talk) ⚑ 10:07, 15 May 2021 (UTC)
- He’s mentioned in the source placed after the statement referring to him (the one you placed the “failed verification” tag against), which would be the usual place to find the reference. If you want a quote, it says, “Dr. Pierre Kory, a pulmonary and critical care specialist at Aurora St Luke’s Medical Center in Milwaukee, described ivermectin as a “wonder drug” with immensely powerful antiviral and anti-inflammatory agents at the hearing before the Senate Homeland Security and Governmental Affairs Committee. Clips of Kory’s comments on ivermectin during the hearing were shared widely on social media with one clip receiving more than 1 million views on YouTube.” I think that adequately supports the content it is being used for. He doesn’t need to be mentioned in a reference supporting the previous sentence, because that sentence doesn’t refer to him. Brunton (talk) 10:18, 15 May 2021 (UTC)
- @Brunton: You don't mind I cite the following to prove that he has participated in hearings?: LINK AXONOV (talk) ⚑ 10:21, 15 May 2021 (UTC)
- No, because it's fringe junk. I don't know what you're playing at here, but it isn't good. Alexbrn (talk) 10:28, 15 May 2021 (UTC)
- @Brunton: You don't mind I cite the following to prove that he has participated in hearings?: LINK AXONOV (talk) ⚑ 10:21, 15 May 2021 (UTC)
- He’s mentioned in the source placed after the statement referring to him (the one you placed the “failed verification” tag against), which would be the usual place to find the reference. If you want a quote, it says, “Dr. Pierre Kory, a pulmonary and critical care specialist at Aurora St Luke’s Medical Center in Milwaukee, described ivermectin as a “wonder drug” with immensely powerful antiviral and anti-inflammatory agents at the hearing before the Senate Homeland Security and Governmental Affairs Committee. Clips of Kory’s comments on ivermectin during the hearing were shared widely on social media with one clip receiving more than 1 million views on YouTube.” I think that adequately supports the content it is being used for. He doesn’t need to be mentioned in a reference supporting the previous sentence, because that sentence doesn’t refer to him. Brunton (talk) 10:18, 15 May 2021 (UTC)
Mischaracterization of the results of Chaccour et al
The characterization of the Chaccour et al study appears to be an example of the subjective and selective point of view currently conveyed by this article. I will not question the methodology, findings, or relevance of the paper here, as it has already been deemed relevant and reliable enough for inclusion in the article.
Point 1: Omission of symptom reduction as a finding of the paper
The study itself, entitled "The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial", finds a strong significant difference in symptom reduction in the patient group using ivermectin vs placebo group. While the procedure did specify a negative PCR test as the primary pass/fail metric, a significant symptom reduction is relevant to the substance of the Wikipedia article, and was seemingly relevant enough to the authors of the paper for them to include the subject in the title.
Point 2: Inaccurate claim of no difference in viral loads
The Wikipedia article states that the study "found no difference...in viral load." This is directly contradicted by the paper itself, which states "the ivermectin group had non-statistically significant lower viral loads at day 4 (p = 0·24 for gene E; p = 0·18 for gene N) and day 7 (p = 0·16 for gene E; p = 0·18 for gene N) post treatment as well as lower IgG titers at day 21 post treatment (p = 0·24)." The paper did not find "no difference," it found a non-statistically significant difference. To be clear, these findings are closer to "significant difference" than "significant no difference."
Point 3: Overall mismatch between tone of study and characterization of it in article
The authors characterize their study as a "pilot [that] points towards a potential use of ivermectin in COVID-19 which warrants further exploration under larger trials." This is not communicated by the Wikipedia article, which portrays it as one data point of many which illustrate ivermectin's ineffectiveness.
2600:1700:7CC0:4770:8C96:D3CD:38B2:2270 (talk) 23:08, 17 May 2021 (UTC)
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