The VA study is even worse than I thought. They moved patients from control group to HCQ group once they went on ventilator! This garbage will get savaged in peer review.
The conclusion that HC causes higher risk of death is basically wrong due to a huge sampling bias. The problem lies in the fact that once people went on ventilators they were given HC or HC+AZ. This re-categorised the patients by increasing the number of high risk patients in the HC and HC+AZ groups making the No HC an invalid control group.
Before ventilation the statistics was like this: (Table 4 in paper)
HC: 90 - 9 (10.0%) deaths - 69 (76.6%) recover - 12 (13.3%) onto ventilation
HC+AZ: 101 - 11 (10.9%) deaths - 83 (82.2%) recover - 7 (06.9%) onto ventilation
No HC: 177 - 15 ( 8.4%) deaths - 137 (77.4%) recover - 25 (14.1%) onto ventilation
We see that death-rate is about the same for all groups but HC+AZ seams to have the highest recovery rate but it might not be statistically significant.
Now once people hit ventilation the re-categorisation occurs. More patients where given HC and HC+AZ which moved them from the No HC group to the HC or HC+AZ group. These groups therefore have a much higher % of ventilation patients because they were given the drugs after they hit ventilation.
The following data can be derived from the paper but is not presented:
Once people hit ventilation we have the following results.
HC: 19 - 18 (95%) deaths - 1 (11%) recover
HC+AZ: 19 - 14 (73%) deaths - 5 (27%) recover
No HC: 6 - 3 (50%) deaths - 3 (50%) recover
If you compare these 2 tables, you see that 25 patient with No HC reach ventilation. Once they reach ventilation, 19 of these where give HC or HC+AZ, thereby moved from the No HC group to the other two. 79.5% of all patients reaching ventilation died so arguably 14 patients that died where moved from the No HC group to the other 2 groups only once they reach the much higher risk state.
Here are the number of people per group that got ventilation:
HC: 97 - 19 (19.6%) got ventilation
HC+AZ: 113 - 19 (16.8%) got ventilation
No HC: 158 - 6 ( 3.4%) got ventilation
So the conclusion that HC causes more death is basically wrong. All it shows is that people that need ventilation are more likely to die.
Last edited by GoodLife; 04-28-2020 at 07:13 PM.
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