哥伦比亚大学医学博士詹姆斯·托达罗医生解析NIH支持的明尼苏达大学羟氯喹随机对照试验 – 针针见血!

图片来源:https://twitter.com/JamesTodaroMD

有着著名的哥伦比亚大学医学博士学位的詹姆斯·托达罗医生(Dr. James Todaro),于8月1日发系列推文,以明尼苏达大学发表的一项最新羟氯喹研究为例,详细解析了被国家医学研究院的福奇博士常常挂在嘴边的“随机对照试验”的可能的缺陷和由此带来误导和欺骗性。这项所谓的“随机对照试验”漏洞百出,误导没有医学和流行病学常识的普通美国民众,使一个自3月份以来,被广大战斗在抗疫第一线的美国医生,用他们大量临床治疗经验证明了的,目前最有效的药物-羟氯喹无法让美国民众使用。美国越来越多的民众开始认识到科研和医药领域可能存在的腐败和看到所谓的“专家”和“科学家”的假冒伪善。

推文(中英文对照)

1/ Dr. Fauci is misleading the American people when he says that randomized controlled trials have shown hydroxychloroquine to be ineffective. Here’s why.

福奇博士在谈到随机对照试验显示羟氯喹无效,是在误导美国人民。

下面就是原因:

2/ There’s only one double-blind RCT on HCQ in early treatment of COVID-19. All of the other RCTs (SOLIDARITY, RECOVERY, etc) were in very sick patients and are borderline worthless because they just support what we’ve been saying since March—HCQ is for early disease, not late.

目前仅有一个关于新冠病毒早期治疗的双盲临床试验。所有其它临床试验(例如SOLIDARITYRECOVERY等 [注:大写英文为临床试验简称])都招募了重症参与者而且是近乎无用的,这也恰恰支持我们早在3月份的宣传:羟氯喹需要用于疾病的早期,而不是晚期治疗。

3/ The “randomized controlled trial” for EARLY treatment of COVID-19 that Dr. Fauci is too embarrassed to even mention by name is the one done by the University of Minnesota, “Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19” (Jul 2020) 

令福奇博士羞于提及试验名字的新冠病毒早期治疗的随机对照临床试验,是由明尼苏达大学完成的《羟氯喹用于非住院成年人的新冠病毒早期治疗》(2020年7月)。

4/ The Minnesota study is honestly an embarrassment to the term “randomized controlled trial” and should actually be called an “anonymous online survey” instead.

老实说,明尼苏达的研究是对“随机对照试验”的侮辱,充其量只能被称为“匿名线上调查”。

5/ Only 34% of participants had a positive PCR test. The remaining 66% either did not have a PCR test or actually tested negative. This means that a positive diagnosis was made based on only SYMPTOMS for the vast majority of participants. This isn’t great, but it gets worse.

参与者中仅有34%PCR检测阳性。其余66%的参与者要么没有进行PCR检测要么检测阴性。这就意味着对大多数参与者的阳性诊断是基于症状。

这还不是最糟糕的,后面还有更多。

6/ The participants were evaluated via a static online survey and not actually seen by physicians or medical personnel. So the quality of the diagnosis was essentially equivalent to someone typing symptoms into WebMD.

参与者是由一个静态线上问卷调查,而不是医生或医疗工作者评估的。所以诊断的质量基本上等同于一个人自己在网络医生网站(WebMD)上输入症状。

7/ What happens if a large percent of the participants didn’t actually have COVID-19? It would diminish the observed therapeutic effect of hydroxychloroquine (HCQ probably isn’t going to help allergies or the common cold).

如果试验参与者中大多数人实际没有感染新冠病毒,会怎样?这会使羟氯喹治疗效果消失,没法被观测到(羟氯喹估计不会对过敏和普通感冒有帮助)。

8/ Next point. If the researchers had kept their original end point (hospitalization/death), the study would’ve actually shown a strong trend toward benefit for HCQ. Instead, the researchers changed the end point mid-study from hospitalizations/death to symptoms at 14 days.

下一点。如果研究人员能保持原始临床终点(入院/死亡)不变,这项研究应该能显示很强的羟氯喹有效的趋势。相反,研究人员在研究中间把临床终点从入院/死亡改成第14天(有无)症状。

9/ The conclusion of the study is actually a ~40% reduction in hospitalizations/deaths in patients treated with HCQ vs placebo (2.5% vs 4.1%). This did not reach significance, but would have been strong encouragement to proceed with additional higher powered RCTs.

这项研究的结论是服用羟氯喹的参与者比对照组的入院/死亡率降低了40% (2.5% 比 4.1%)。试验结论并未达到统计显著,但这为以后开展一个高功效、随机对照临床试验是一个强有力的鼓舞。

10/ The good news is that Dr. Fauci & the NIH started a trial in May doing just this. The bad news is they cancelled the trial after enrolling only 20 subjects in order to focus on a new trial evaluating remdesivir plus baricitinib (another “novel” patented drug).

一个好消息是福奇和美国国家医学研究院在5月份启动了一个检验这个(羟氯喹)的临床试验。坏消息是他们在招募20个参与者后就取消了临床试验,因为他们要专注于一个新的研究瑞德西韦加巴立替尼(另一个“新”注册药)疗效的临床试验。

11/ In conclusion, it’s been >4 mos since HCQ was proposed for early stage COVID-19. Yet, with their vast resources, neither the WHO nor NIH conducted a trial on this. Instead Dr. Fauci’s evidence for the inefficacy of HCQ comes from an online survey under the guise of an RCT.

总之,在羟氯喹被建议用于新冠病毒早期治疗四个月后,尽管世界卫生组织和美国国家医学研究院有海量的资源但却并未开展一个临床试验。反过来福奇博士关于羟氯喹无效的证据是来自一个披着随机对照试验外衣的线上调查。

You look at the scientific data & the evidence. And the scientific data…on trials that are valid that were randomized & controlled in the proper way, all of those trials show consistently that HCQ is not effective in the treatment of coronavirus

– Fauci

“你来看科学数据和证据。而且这些科学数据 … 是来自有效的而合适的随机对照试验,所以这些临床试验都一致地显示羟氯喹对于治疗新冠病毒是无效的。”

– 福奇

阅读明尼苏达大学论文全文

翻译:【John】校对:【Michelle】编辑整理:【Michelle】

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