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A Bayesian reanalysis of the effects of hydroxychloroquine and azithromycin on viral carriage in patients with COVID-19

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Hulme, OJ, Wagenmakers, E-J, Damkier, P, Madelung, CF, Siebner, HR, Helweg-Larsen, J, Gronau, QF, Benfield, TL & Madsen, KH 2021, 'A Bayesian reanalysis of the effects of hydroxychloroquine and azithromycin on viral carriage in patients with COVID-19', PLoS One, vol. 16, no. 2, e0245048, pp. e0245048. https://doi.org/10.1371/journal.pone.0245048

APA

Hulme, O. J., Wagenmakers, E-J., Damkier, P., Madelung, C. F., Siebner, H. R., Helweg-Larsen, J., Gronau, Q. F., Benfield, T. L., & Madsen, K. H. (2021). A Bayesian reanalysis of the effects of hydroxychloroquine and azithromycin on viral carriage in patients with COVID-19. PLoS One, 16(2), e0245048. [e0245048]. https://doi.org/10.1371/journal.pone.0245048

CBE

MLA

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Author

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. / A Bayesian reanalysis of the effects of hydroxychloroquine and azithromycin on viral carriage in patients with COVID-19. In: PLoS One. 2021 ; Vol. 16, No. 2. pp. e0245048.

Bibtex

@article{feb18154e01d4a6cb36d83a26fc3fb3f,
title = "A Bayesian reanalysis of the effects of hydroxychloroquine and azithromycin on viral carriage in patients with COVID-19",
abstract = "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.",
author = "Hulme, {Oliver James} and Eric-Jan Wagenmakers and Per Damkier and Madelung, {Christopher Fugl} and Siebner, {Hartwig Roman} and Jannik Helweg-Larsen and Gronau, {Quentin F} and Benfield, {Thomas Lars} and Madsen, {Kristoffer Hougaard}",
note = "Publisher Copyright: {\textcopyright} 2021 Hulme et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = feb,
day = "19",
doi = "10.1371/journal.pone.0245048",
language = "English",
volume = "16",
pages = "e0245048",
journal = "PLOS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "2",

}

RIS

TY - JOUR

T1 - A Bayesian reanalysis of the effects of hydroxychloroquine and azithromycin on viral carriage in patients with COVID-19

AU - Hulme, Oliver James

AU - Wagenmakers, Eric-Jan

AU - Damkier, Per

AU - Madelung, Christopher Fugl

AU - Siebner, Hartwig Roman

AU - Helweg-Larsen, Jannik

AU - Gronau, Quentin F

AU - Benfield, Thomas Lars

AU - Madsen, Kristoffer Hougaard

N1 - Publisher Copyright: © 2021 Hulme et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/2/19

Y1 - 2021/2/19

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85101540217&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0245048

DO - 10.1371/journal.pone.0245048

M3 - Journal article

C2 - 33606702

VL - 16

SP - e0245048

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 2

M1 - e0245048

ER -

ID: 62368704