To the question of whether Ivermectin is useful as a treatment: I don’t know. A skim through Google Scholar certainly suggests it has some promise, and the side-effect profile is mild enough that the risk-reward seems likely to work out.
This question has gotten far too little attention from good intellectuals. A good distillation of the research would be very valuable.
To the question that was asked, about whether you should do advocacy on this topic (in either direction): No. You are not ready.
The COVID-19 pandemic has had a long string of incidents where prominent institutions look at something which has a complicated, messy and unclear evidence base, decide they need to take a stance, and either pretend to be confident, or pretend that cost-benefit analysis is impossible so their lack-of-confidence means no one should do anything. This happened with masks early in the pandemic, with the question of whether there’s aerosol transmission, with the question of whether there’s presymptomatic transmission, with the mRNA vaccines between when the study results came in and when the FDA finally approved them, with the AstraZeneca vaccine and phantom worries about blood clots. The WHO, US CDC, and US FDA all severely tarnished their reputations this way, and it’s unlikely they’ll earn back trust any time soon.
If the place you start from is that you’re going to do public advocacy, but you need to decide whether you’re advocating for or advocating against, then it will be hard to engage with a complicated/messy/unclear evidence base and remain honest. You’ll be incentivized not to see the situation for what it is.
Suppose there’s a 25% chance that Ivermectin works. If you convey that information honestly, that’s a good thing to do, but it isn’t an advocacy campaign—you’re doing useful research, but not advocating a policy position.
Suppose the answer is that ivermectin definitely works, but only a little bit—eg, it reduces mortality by 10%. A big chunk of the public thinks it works a lot better than that, and is taking dumb risks on that basis. You’ll be tempted to lie to those people.
To the question of how one can form better beliefs about effective medical treatments:
For questions that are not politicized and not fast moving (ie, most things other than COVID-19), use UpToDate to orient, then go to primary-source papers only when you have a specific question in mind, and only when you’re kind of desperate.
For questions that are politicized or fast moving (ie, COVID-19 treatments), where you’re doing original distillation work: use Wikipedia to orient on the relevant biology and terminology, then collect primary-source studies from PubMed, Google Scholar, and (for COVID-19 in particular) medrxiv. You have to be pretty systematic about it, since the number of usable studies tends to be small enough that accidentally omitting one is a big deal. You’ll need to know how to reliably bypass the paywalls (mostly Sci-Hub), and how to judge reliability based on a methodology section.
When I said public advocacy though, I mainly meant making a Facebook post communicating my beliefs about Ivermectin and whether people should take it or not, which 50-500 people in my network might see. So I could convey my beliefs honestly about Ivermectin in that post and at length, and I’m open to conveying I am uncertain about it.
That being said, from your comment, I realize that there’s a large chance that whatever beliefs I communicate about Ivermectin will be wrong, and being wrong about it publicly can tarnish my reputation. It’s also hard to communicate nuance about it, and I’m no expert here. So based on your comment, I don’t plan on making any public post about Ivermectin to my network.
Thanks for linking about UpToDate, PubMed, and medrxiv. I hadn’t known of UpToDate and PubMed, and didn’t really take note of medrxiv. I’ve also heard about and used Google Scholar before, but I forgot to use it for my recent research on COVID. I was mainly searching on Google and adding “NCBI” to the end, like “Vitamin D COVID-19 studies NCBI”.
Also, do you have any resources, articles, or books to recommend on how to get better at doing literature review / distillation work, whether on politicized/fast-moving or non-fast moving topics? I want to get better at this skill and am not sure where to start. Thanks!
To the question of whether Ivermectin is useful as a treatment: I don’t know. A skim through Google Scholar certainly suggests it has some promise, and the side-effect profile is mild enough that the risk-reward seems likely to work out.
This question has gotten far too little attention from good intellectuals. A good distillation of the research would be very valuable.
To the question that was asked, about whether you should do advocacy on this topic (in either direction): No. You are not ready.
The COVID-19 pandemic has had a long string of incidents where prominent institutions look at something which has a complicated, messy and unclear evidence base, decide they need to take a stance, and either pretend to be confident, or pretend that cost-benefit analysis is impossible so their lack-of-confidence means no one should do anything. This happened with masks early in the pandemic, with the question of whether there’s aerosol transmission, with the question of whether there’s presymptomatic transmission, with the mRNA vaccines between when the study results came in and when the FDA finally approved them, with the AstraZeneca vaccine and phantom worries about blood clots. The WHO, US CDC, and US FDA all severely tarnished their reputations this way, and it’s unlikely they’ll earn back trust any time soon.
If the place you start from is that you’re going to do public advocacy, but you need to decide whether you’re advocating for or advocating against, then it will be hard to engage with a complicated/messy/unclear evidence base and remain honest. You’ll be incentivized not to see the situation for what it is.
Suppose there’s a 25% chance that Ivermectin works. If you convey that information honestly, that’s a good thing to do, but it isn’t an advocacy campaign—you’re doing useful research, but not advocating a policy position.
Suppose the answer is that ivermectin definitely works, but only a little bit—eg, it reduces mortality by 10%. A big chunk of the public thinks it works a lot better than that, and is taking dumb risks on that basis. You’ll be tempted to lie to those people.
To the question of how one can form better beliefs about effective medical treatments:
For questions that are not politicized and not fast moving (ie, most things other than COVID-19), use UpToDate to orient, then go to primary-source papers only when you have a specific question in mind, and only when you’re kind of desperate.
For questions that are politicized or fast moving (ie, COVID-19 treatments), where you’re doing original distillation work: use Wikipedia to orient on the relevant biology and terminology, then collect primary-source studies from PubMed, Google Scholar, and (for COVID-19 in particular) medrxiv. You have to be pretty systematic about it, since the number of usable studies tends to be small enough that accidentally omitting one is a big deal. You’ll need to know how to reliably bypass the paywalls (mostly Sci-Hub), and how to judge reliability based on a methodology section.
This was really helpful Jim!
When I said public advocacy though, I mainly meant making a Facebook post communicating my beliefs about Ivermectin and whether people should take it or not, which 50-500 people in my network might see. So I could convey my beliefs honestly about Ivermectin in that post and at length, and I’m open to conveying I am uncertain about it.
That being said, from your comment, I realize that there’s a large chance that whatever beliefs I communicate about Ivermectin will be wrong, and being wrong about it publicly can tarnish my reputation. It’s also hard to communicate nuance about it, and I’m no expert here. So based on your comment, I don’t plan on making any public post about Ivermectin to my network.
Thanks for linking about UpToDate, PubMed, and medrxiv. I hadn’t known of UpToDate and PubMed, and didn’t really take note of medrxiv. I’ve also heard about and used Google Scholar before, but I forgot to use it for my recent research on COVID. I was mainly searching on Google and adding “NCBI” to the end, like “Vitamin D COVID-19 studies NCBI”.
Also, do you have any resources, articles, or books to recommend on how to get better at doing literature review / distillation work, whether on politicized/fast-moving or non-fast moving topics? I want to get better at this skill and am not sure where to start. Thanks!