Cochrane, once respected organization producing systematic reviews of peer-reviewed medical literature, issued a cherry-picked and biased review of Ivermectin for COVID-19, claiming not enough evidence. It is debunked by C19___ as Outdated very biased cherry-picking retrospective meta analysis …
That reminds the Cochrane’s HCQ review, published on Feb. 12, 2021. It was a similar piece of junk science and scientific fraud. This said, it contains three non-obvious methodological mistakes behind such non-positive reviews of Hydroxychloroquine and Ivermectin treatments for COVID-19, which some people might make unintentionally.
Mistake #1: selection of randomized control trials (RCTs) and exclusion of observational studies. RCTs are gold standard for detecting small (like 20%) improvements. However, RCTs are meaningless or even unethical when the treatment improves the odds by 3–6 times, as the case with Hydroxychloroquine and Ivermectin. In such situation, RCTs tend to be small or using the main ingredient incorrectly.
Mistake #2: the same main ingredient can be used in many ways, including different phases of the disease, doses, and additional medications. A proper review would have identified the best protocol, using the main ingredient, and reviewed the studies using this protocol. This mistake arises from a habit to review pharma-sponsored trials of patented drugs, in which the manufacturer determines the best way to use the drug.
Mistake #3: reliance on academic papers and exclusion of the real world evidence. Well, Cochrane cannot be blamed because reviews of literature are what it does, but the users of these reviews should not call them “the scientific evidence” or similar.
From the Cochrane’s HCQ review
“We performed all searches up to 15 September 2020.” Enough said. They published a review of 13 trials with 9030 participants (including one post-exposure prophylaxis trial) in what was seemed to be the end of the pandemic, with a review cutoff date 5 months earlier.
“Treatment of COVID‐19 disease. We included 12 trials involving 8569 participants, all of whom were adults.” Enough said. By September 2020, millions of people had been treated with Hydroxychloroquine.
“Preventing COVID‐19 disease in people at risk of exposure to SARS‐CoV‐2. Ongoing trials are yet to report results for this objective.”
Cochrane Review receives most of its charitable funding from the governments of the UK, Denmark, Germany, and the US (https://archive.is/AbjHf). It also sells subscriptions, mainly to government-funded universities, to the pharmaceutical and healthcare industries, which are effectively controlled by governments. It is essentially a governmental organization masquerading as an independent non-profit research organization. Cochrane also serves as a partner and source for Wikipedia on medical topics. Many people consult Wikipedia. The result looks like an echo chamber in a mental asylum!