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A Bayesian reanalysis of the effects of hydroxychloroquine and azithromycin on viral carriage in patients with COVID-19.
Hulme, Oliver James; Wagenmakers, Eric-Jan; Damkier, Per; Madelung, Christopher Fugl; Siebner, Hartwig Roman; Helweg-Larsen, Jannik; Gronau, Quentin F; Benfield, Thomas Lars; Madsen, Kristoffer Hougaard.
Afiliação
  • Hulme OJ; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
  • Wagenmakers EJ; London Mathematical Laboratory, London, United Kingdom.
  • Damkier P; Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands.
  • Madelung CF; Department of Clinical Chemistry & Pharmacology, Odense University Hospital, Odense, Denmark.
  • Siebner HR; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
  • Helweg-Larsen J; Department of Clinical Chemistry & Pharmacology, Odense University Hospital, Odense, Denmark.
  • Gronau QF; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
  • Benfield TL; Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen NV, Denmark.
  • Madsen KH; Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen NV, Denmark.
PLoS One ; 16(2): e0245048, 2021.
Article em En | MEDLINE | ID: mdl-33606702
Gautret and colleagues reported the results of a non-randomised case series which examined the effects of hydroxychloroquine and azithromycin on viral load in the upper respiratory tract of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients. The authors reported that hydroxychloroquine (HCQ) had significant virus reducing effects, and that dual treatment of both HCQ and azithromycin further enhanced virus reduction. In light of criticisms regarding how patients were excluded from analyses, we reanalysed the original data to interrogate the main claims of the paper. We applied Bayesian statistics to assess the robustness of the original paper's claims by testing four variants of the data: 1) The original data; 2) Data including patients who deteriorated; 3) Data including patients who deteriorated with exclusion of untested patients in the comparison group; 4) Data that includes patients who deteriorated with the assumption that untested patients were negative. To ask if HCQ monotherapy was effective, we performed an A/B test for a model which assumes a positive effect, compared to a model of no effect. We found that the statistical evidence was highly sensitive to these data variants. Statistical evidence for the positive effect model ranged from strong for the original data (BF+0 ~11), to moderate when including patients who deteriorated (BF+0 ~4.35), to anecdotal when excluding untested patients (BF+0 ~2), and to anecdotal negative evidence if untested patients were assumed positive (BF+0 ~0.6). The fact that the patient inclusions and exclusions are not well justified nor adequately reported raises substantial uncertainty about the interpretation of the evidence obtained from the original paper.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Antivirais / Azitromicina / Carga Viral / SARS-CoV-2 / COVID-19 / Tratamento Farmacológico da COVID-19 / Hidroxicloroquina Tipo de estudo: Clinical_trials Limite: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Dinamarca País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Antivirais / Azitromicina / Carga Viral / SARS-CoV-2 / COVID-19 / Tratamento Farmacológico da COVID-19 / Hidroxicloroquina Tipo de estudo: Clinical_trials Limite: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Dinamarca País de publicação: Estados Unidos