Pour revenir là-dessus: je ferais la même chose si quelqu'un défendait qu'un vaccin doit être largement distribué sur la base d'une étude aussi foireuse de que celle de Gautret [16 auteurs] & Raoult. Pas parce que je suis contre les vaccins, hein, parce que je suis pour le professionnalisme scientifique.Cmous23 a écrit : 25 mars 2020, 19:37Vous restez bloqué à la méthodologie parce que la dimension médicale vous échappe, vous ne prenez pas en compte le rapport bénéfice-risque ni la santé publique, mais vous réclamez des preuves toujours plus solides en fermant les yeux sur le contexte sanitaire actuel
Voici un autre texte critique de l'article (négatif; y en a-t-il des positifs par des scientifiques?). Comme l'auteur ne mentionne Raoult qu'anecdotiquement, et ne participe pas à la controverse franco-française que Raoult alimente, ça vous laisse une chance de saisir le problème résumé par:
"Worst of all, there is no evidence from this paper that these two drugs made any difference in the clinical outcomes of these patients. I understand that this was a pilot study and that it will require a much larger trial to determine if hydroxychloroquine has any effect on clinical outcomes, but the hype over this study is unconscionable. This is at best an uncertain result from a very preliminary study with very serious methodological shortcomings that looked only at viral positivity in nasopharyngeal aspirates. The authors justify their publication thusly:
For ethical reasons and because our first results are so significant and evident we decide to share our findings with the medical community, given the urgent need for an effective drug against SARS-CoV-2 in the current pandemic context.
We show here that hydroxychloroquine is efficient in clearing viral nasopharyngeal carriage of SARS-CoV-2 in COVID-19 patients in only three to six days, in most patients. A significant difference was observed between hydroxychloroquine-treated patients and controls starting even on day3 post-inclusion.
We show here that hydroxychloroquine is efficient in clearing viral nasopharyngeal carriage of SARS-CoV-2 in COVID-19 patients in only three to six days, in most patients. A significant difference was observed between hydroxychloroquine-treated patients and controls starting even on day3 post-inclusion.
No, the ethical thing to do would have been to analyze the data properly and go through peer review. A number of journals are accelerating peer review of COVID-19-related papers, so that they can be published rapidly. This paper almost certainly would have failed peer review, given that it is not randomized, doesn’t do a proper intention-to-treat analysis, and has a whole lot of missing datapoints among the control subjects [...]"
Autres passages notables:
"At least the French government is trying to replicate Dr. Raoult’s trial independent of him; so hopefully we will have some clarity soon. There are also at least three trials of hydroxychloroquine to treat or prevent COVID-19 on ClinicalTrials.gov (NCT04308668, NCT04304053, and NCT04315896).
[...]
So, could hydroxychloroquine and chloroquine be effective drugs to treat and/or prevent COVID-19? Sure, it’s possible. There’s a plausible mechanism by which the drugs could inhibit viral replication (several, actually), plus in vitro evidence of antiviral activity. On the other hand, caution is definitely indicated, as Dr. Raoult notes
[...]
Whenever you see a study like the French study touted, wait a while to see what the experts say about it, and don’t share it before you get a feel for whether it’s a good study or not. Don’t be like President Trump.
"
Je vous laisse remplir les blancs.
En passant, l'auteur est chirurgien et oncologue... il semble pourtant manquer de "dimension médicale", lui aussi.
Jean-François
