Another poorly designed interpretation of a #HCQ data set for #COVID19. A larger poorly designed "trial" only leads to larger erroneous conclusions. For analysis, see the threadhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="👇" title="Down pointing backhand index" aria-label="Emoji: Down pointing backhand index"> @JamesTodaroMD @niro60487270 @danaparish @marybethpf https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext">https://www.thelancet.com/journals/...

This study implies that it& #39;s an early treatment study because hospitalized patients were treated within 48 hours of diagnosis. It& #39;s a late treatment study, and here& #39;s why: https://abs.twimg.com/emoji/v2/... draggable="false" alt="👇" title="Down pointing backhand index" aria-label="Emoji: Down pointing backhand index">

About 2/3 of patients were from N. America. Unlike Asia and Europe, we haven& #39;t had access to early #C19 testing & quick turn around times. By the time patients get to the hospital, 5-7 days have typically gone by, results have been taking about 4 days, & add 48 hours to that. https://abs.twimg.com/emoji/v2/... draggable="false" alt="👇" title="Down pointing backhand index" aria-label="Emoji: Down pointing backhand index">

Unlike parts of Europe & Asia, #HCQ early #COVID19 treatment isn& #39;t embraced in the US. It& #39;s given only to the sickest patients, without contrary evidence in this study. To state that the baseline disease severity between treatment & control is equal was incorrect, here& #39;s whyhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="👇" title="Down pointing backhand index" aria-label="Emoji: Down pointing backhand index">

The authors provide almost no data to assess disease severity at baseline between groups. They rely on qSOFA which in a study in Annals of Intensive Care, was found to be "...not appropriate to identify Covid-19 patients to have poor outcomes..." https://abs.twimg.com/emoji/v2/... draggable="false" alt="👇" title="Down pointing backhand index" aria-label="Emoji: Down pointing backhand index"> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7167215/">https://www.ncbi.nlm.nih.gov/pmc/artic...

And they don& #39;t say who got what other antiviral, grouping 3 different ones together. Big confounders. Except anyone who took remdesivir was excluded from the analysis. Why? Don& #39;t want to risk it being associated with a bad outcome in a faulty study?https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤑" title="Money-mouth face" aria-label="Emoji: Money-mouth face"> https://abs.twimg.com/emoji/v2/... draggable="false" alt="👇" title="Down pointing backhand index" aria-label="Emoji: Down pointing backhand index">

I agree with one thing the authors said: "Randomized clinical trials will be required before any conclusion can be reached regarding benefit or harm of these agents in COVID-19 patients."

Actually, #HCQ RCT& #39;s have been done & they show benefits, but we need more of them.