[PiggySpeed]

> To think that all of a sudden it became more dangerous was silly and unreasonable.

This is a dangerous view and not a fair take. Drugs CAN become more dangerous when used in a different context. The sheer permutation of prior/current medical conditions, interacting drugs, demographics, genetics, medical procedures, and a bunch of other factors all play into the equation that determines a drug's safety and efficacy profile. This is why we continue to do research. This is why guidelines are constantly shifting. This is why medicine requires years of study.

> The media was so quick to champion it everywhere though.

I definitely agree with this point. The media has caused harm to the population by taking the results of a single observational study, and parading it around like it was some new concrete medical certainty. This is not how professionals operate. We don't flip our practice on the whims of a single OBSERVATIONAL study.

And I emphasize OBSERVATIONAL because most people here don't understand what that entails. Most people here who comment on clinical trials are not even trained to interpret them. Is it randomized/non-randomized? Double-blinded? What did data collection look like? How were results analyzed? What was the patient population? Timelines? Control arm? Placebos? Previous findings? Primary/secondary endpoint? Do you know the difference between a meta-analysis and a systematic review? NNT? Hazards ratios? Odds ratios?

Too many people outside of medicine think they know how to interpret a study, when in reality they have no idea what they're looking at and cherry-pick the interesting sentences that they're looking for.

> I know I'm not going to trust the Lancet or the NEJM ever again.

This is not a fair take. The journals are responsible for reviewing and publishing the most influential clinical research in the world. Occasionally a bad study makes its way in due to falsified data or other illegitimate factors. Health care professionals are well-aware of this, which is why we are trained to interpret studies, and be conservative in the face of radical findings like this.

If anyone has a problem with the Lancet or NEJM, they should see some of the mess found in lower-impact journals.

[lbeltrame]

I did not agree with the conclusions of the paper, but I fell prey of the same bias that many others had: it was "published in Lancet" and "those journals have strict peer review".

The lesson I learned is that I will always scrutinize papers I read with a more critical eye, regardless of where they were published in.

[caseysoftware]

I think we need to understand exactly what "peer review" is required for publication or publication certain places. Is it:

a) a grammar/spelling check

b) a gut check to make sure it "makes sense"

c) validation of the math/analysis

d) validation of the underlying experimental procedure used to collect the data

e) validation of the underlying selection criteria for inputs/candidates in the experiment

f) reproducibility of the experiment and results

g) something else?

h) all of the above

My impression is that "peer review" generally includes a & b and sometimes c & d.

[pacala]

Sadly, some of us are aware of the mess found in lower impact journals. It doesn't help with the trust issue. At all.