Changes

''USA Today'' attempted to "Fact-check" the article, correctly pointing out that it showed a 50% reduction in death rates, HCQ had no safety problems, and the study was limited by being an observational study, but then it made assertions that were more misleading. The following was what they had said:

''USA Today'' attempted to "Fact-check" the article, correctly pointing out that it showed a 50% reduction in death rates, HCQ had no safety problems, and the study was limited by being an observational study, but then it made assertions that were more misleading. The following was what they had said:

{{A study this month out of the Henry Ford Hospital System in southeast Michigan found death rates were 50% lower among the patients treated with hydroxychloroquine. The study's authors noted the drug posed no safety problems. The research was criticized as an observational study – much less rigorous than a randomized trial – and because patients who received hydroxychloroquine also got steroids shown to be clinically beneficial in treating COVID-19.

{{quotebox|A study this month out of the Henry Ford Hospital System in southeast Michigan found death rates were 50% lower among the patients treated with hydroxychloroquine. The study's authors noted the drug posed no safety problems. The research was criticized as an observational study – much less rigorous than a randomized trial – and because patients who received hydroxychloroquine also got steroids shown to be clinically beneficial in treating COVID-19.

“You want to look at the totality of the data,” said Eric Topol, director of the Scripps Research Translational Institute, in an interview with The Washington Post. “The totality is overwhelmingly in the opposite direction. You have to conclude with the Henry Ford study is an outlier, and there’s some kind of confounder that is skewing the data and not representing the truth.”<ref name=USAfactcheck>[https://www.usatoday.com/story/news/factcheck/2020/07/21/fact-check-hydroxychloroquine-hasnt-helped-covid-19-studies-show/5407547002/ Fact check: Hydroxychloroquine has not worked in treating COVID-19, studies show] by Miriam Fauzia (July 21, 2020) ''USA Today''</ref>}}

“You want to look at the totality of the data,” said Eric Topol, director of the Scripps Research Translational Institute, in an interview with The Washington Post. “The totality is overwhelmingly in the opposite direction. You have to conclude with the Henry Ford study is an outlier, and there’s some kind of confounder that is skewing the data and not representing the truth.”<ref name=USAfactcheck>[https://www.usatoday.com/story/news/factcheck/2020/07/21/fact-check-hydroxychloroquine-hasnt-helped-covid-19-studies-show/5407547002/ Fact check: Hydroxychloroquine has not worked in treating COVID-19, studies show] by Miriam Fauzia (July 21, 2020) ''USA Today''</ref>}}

Some counterpoints.

Some counterpoints.

* The study is ''not'' an outlier.  [https://www.preprints.org/manuscript/202005.0057/v1 Spain's study] had very similar results and had control groups. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325642/#MOESM1 Mount Sanai's] study also had similar results and it is the largest study of its kind to date. [https://jornalggn.com.br/sites/default/files/2020/04/paper-preventsenior.pdf Brazil's study], [https://www.sciencedirect.com/science/article/pii/S1477893920302817 France's study], [https://www.preprints.org/manuscript/202007.0025/v1 Dr. Zelenko's study], [https://pubmed.ncbi.nlm.nih.gov/32611916/ India's study], other studies [https://www.medrxiv.org/content/10.1101/2020.05.28.20114835v1 such as this one from Lebanon], and even the [https://www.nejm.org/doi/full/10.1056/NEJMoa2016638?query%3Dfeatured_home= Boulware study] the article cited to defend its position, have all had positive results, and only Boulware's study failed to reach statistical significance.  The outliers are the studies which haven't had positive results, all of which had inherent problems such as the drug being given late, the drug being given in toxic doses, or the study being a complete fraud.     

* The study is ''not'' an outlier.  [https://www.preprints.org/manuscript/202005.0057/v1 Spain's study] had very similar results and had control groups. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325642/#MOESM1 Mount Sanai's] study also had similar results and it is the largest study of its kind to date. [https://jornalggn.com.br/sites/default/files/2020/04/paper-preventsenior.pdf Brazil's study], [https://www.sciencedirect.com/science/article/pii/S1477893920302817 France's study], [https://www.preprints.org/manuscript/202007.0025/v1 Dr. Zelenko's study], [https://pubmed.ncbi.nlm.nih.gov/32611916/ India's study], and even the [https://www.nejm.org/doi/full/10.1056/NEJMoa2016638?query%3Dfeatured_home= Boulware study] the article cited to defend its position, have all had positive results, and only Boulware's study failed to reach statistical significance.  The outliers are the studies which haven't had positive results, all of which had inherent problems such as the drug being given late, the drug being given in toxic doses, or the study being a complete fraud.     

*The following is how John MeComb described the problem of randomized trials with control groups (in regards to COVID-19 and Zelenko's study).{{cquote|The control group would have to be people with symptoms at high risk for progression of disease. Would this not be unethical for this kind of study? I for one would not want to be in such a control group and, as a patient, if informed as such would decline. As a physician, under the current circumstances, it would violate my hippocratic oath to place people in such a control group... The "control group" has to be a preponderance of the evidence at this point.<ref name =Zalenkostud/>}}  

*The following is how John MeComb described the problem of randomized trials with control groups (in regards to COVID-19 and Zelenko's study).{{cquote|The control group would have to be people with symptoms at high risk for progression of disease. Would this not be unethical for this kind of study? I for one would not want to be in such a control group and, as a patient, if informed as such would decline. As a physician, under the current circumstances, it would violate my hippocratic oath to place people in such a control group... The "control group" has to be a preponderance of the evidence at this point.<ref name =Zalenkostud/>}}  

*While steroids do work and were given about twice as often to patients given HCQ in the study<ref name =Fordstud/>, steroid use doesn't explain the 66-71% hazard reduction - steroids only reduce one's risk by about a third<ref name=Recovery2>[https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19 Low-cost dexamethasone reduces death by up to one third in hospitalised patients with severe respiratory complications of COVID-19] by Chief Investigators of the Randomised Evaluation of COVid-19 thERapY (RECOVERY) (16 June 2020)</ref> and the net effect would only be about 1/6th once one considers the percentage of people not being treated with HCQ but still given steroids. If one was so compelled, one could go through the data and account for the confounding variable of steroids... if it wasn't already done for you.  The HCQ and non-HCQ propensity-matched patients of the study both received steroids 44.2% of the time.  As the study states, "The Cox regression result for the two propensity matched groups (Table 4) indicates that treatment with hydroxychloroquine resulted in a mortality hazard ratio decrease of 51% (p = 0.009)."<ref name =Fordstud/>  51% hazard reduction is not as good as 71%, but it is still pretty freaking good.

*While steroids do work and were given about twice as often to patients given HCQ in the study<ref name =Fordstud/>, steroid use doesn't explain the 66-71% hazard reduction - steroids only reduce one's risk by about a third<ref name=Recovery2>[https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19 Low-cost dexamethasone reduces death by up to one third in hospitalised patients with severe respiratory complications of COVID-19] by Chief Investigators of the Randomised Evaluation of COVid-19 thERapY (RECOVERY) (16 June 2020)</ref> and the net effect would only be about 1/6th once one considers the percentage of people not being treated with HCQ but still given steroids. If one was so compelled, one could go through the data and account for the confounding variable of steroids... if it wasn't already done for you.  The HCQ and non-HCQ propensity-matched patients of the study both received steroids 44.2% of the time.  As the study states, "The Cox regression result for the two propensity matched groups (Table 4) indicates that treatment with hydroxychloroquine resulted in a mortality hazard ratio decrease of 51% (p = 0.009)."<ref name =Fordstud/>  51% hazard reduction is not as good as 71%, but it is still pretty freaking good.