The Problem Of Questionable Data, Ctd

Regarding John Ioannidis my correspondent remarks …

Ioannidis is an interesting guy who has played a great part in the retraction of many medical research papers over the last 15 years. https://www.theatlantic.com/…/lies-damned-lies…/308269/

And that certainly puts him up a couple of points in my book, too. A quote from The Atlantic article:

That question has been central to Ioannidis’s career. He’s what’s known as a meta-researcher, and he’s become one of the world’s foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field’s top journals, where it is heavily cited; and he is a big draw at conferences. Given this exposure, and the fact that his work broadly targets everyone else’s work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.

I still am bothered by the lack of nuance in the Stat article, but I’ll put it down to size constraints. And this won’t make him – or me – happy:

Health officials in New York City and Los Angeles County are signaling a change in local strategy when it comes to coronavirus testing, recommending that doctors avoid testing patients except in cases where a test result would significantly change the course of treatment.

A news release from the Los Angeles Department of Public Health this week advised doctors not to test those experiencing only mild respiratory symptoms unless “a diagnostic result will change clinical management or inform public health response.”

The recommendation reflects a “shifting from a strategy of case containment to slowing disease transmission and averting excess morbidity and mortality,” according to the statement.

The guidance said coronavirus testing at L.A. County public health labs will prioritized those with symptoms, health care workers, residents of long-term care facilities, paramedics and other high-risk situations. Others are encouraged to simply stay at home. [CNN]

This loss of information will make it harder to understand the virus & associated disease, from immediate infection to long term consequences. And there’s at least one article I’ve run across that suggests there are two variants at work here:

When Xiaolu Tang at Peking University in Beijing and colleagues studied the viral genome taken from 103 cases, they found common mutations at two locations on the genome. The team identified two types of the virus based on differences in the genome at these two regions: 72 were considered to be the “L-type” and 29 were classed “S-type”.

A separate analysis by the team suggests that the L-type was derived from the older S-type. The first strain is likely to have emerged around the time the virus jumped from animals to humans. The second emerged soon after that, says the team. Both are involved in the current global outbreak. The fact that the L-type is more prevalent suggests that it is “more aggressive” than the S-type, the team say.