New Coronavirus News from 25 Mar 2023

The rest of the story — how to read the medical literature [Williamsport Sun-Gazette, 25 Mar 2023]

A recent Let’s end COVID! article (February 25th) talked about the process of medical research and how the results are communicated to the world at large via public and social media. Journalists who translate the mysterious pronouncements of medical researchers and other scientists provide a valuable public service by helping us non-scientists keep up with current developments. This is especially important in a public health crisis such as the current COVID-19 pandemic, where it is a matter of life and death.

Scientific research is supposed to be objective, impartial. Of course, scientists are human, and even the most careful scientist can unknowingly let bias affect their work and how they interpret and communicate their results. When scientific information is communicated by non-scientists to other non-scientists, it’s a little like the “telephone game” where one person whispers a word or phrase to the person beside them, that person whispers to the next one in line and so on, until the last person announces what they heard, which often is not what the first person said. Journalists reporting medical news may have their own biases that unintentionally color their communication.

Sometimes the people communicating research results deliberately misinterpret scientific findings that disagree with their own partisan agendas. We have seen this several times during the current pandemic including, for example, when some people continued to recommend using ivermectin to prevent or treat COVID-19 although no studies have shown that it works.

When reading a news article about COVID-19 (or any medical issue) I look for the source of the information. If the author hasn’t included a link to the study being discussed, or at least enough information (author and journal title) to find the study easily, I get suspicious. Does the author not want me to look at the original information for some reason? As the Russian proverb popularized by Ronald Reagan advises, I like to “trust but verify.” If I’m going to apply this new information to my own healthcare, I want to see–and decide–for myself.

Researchers strive for clarity, conciseness, and precision when reporting their results because they are communicating to other busy scientists who are coping with the same daily flood of information, and who need to determine quickly whether the article is relevant or provides new knowledge.

Fortunately, this helps the rest of us, too. Professional journals publish several kinds of articles, including editorials, case reports, and even letters to the editor, but when you are following up medical news you will be looking at primary research articles. These reports of studies and results follow a consistent outline:

• Abstract (Summary)
• Introduction (Context)
• Methods and Materials (The Experiment)
• Results (The Data)
• Discussion (Explanation)
• Conclusions (Interpretation)

The abstract reviews the article’s key points–the question being studied, why it’s important, how the research was conducted, and the study results and conclusions. Non-scientists should read the abstract first to get a sense of what information the article contains, but don’t stop there. Read the introduction next for context and background information, including previous studies on which the new research builds. It helps you understand where the new research “fits.” The introduction will clearly state the purpose of the research and the question (the hypothesis) it answers.

Some experts recommend reading the introduction first and the abstract last. That way you can draw your own conclusions and see whether they match the authors’.

It’s OK to skip the methods section, which explains in detail how the research was done so that other scientists can evaluate the study’s quality, repeat the research to confirm the results, or develop new studies based on its methods and findings. You may also–unless you are familiar with statistical concepts and vocabulary–skip the results section, which presents and analyzes the data the investigation produced.

Finally, read the discussion and conclusions (sometimes separate sections) to see how the authors interpret their findings. They should also tell you of any limitations in the study that might affect the results, the strength of their evidence, the implications for practice change and future research, and what additional studies may be needed.

Various online guides for nonscientist readers exist. “Anatomy of a Scientific Journal Article” by Erica Mitchell (https://blog.eoscu.com/blog/anatomy-of-a-scientific-journal-article) and “How to read and understand a scientific article” by Jennifer Raff
(https://cdn.ymaws.com/www.oandp.org/resource/resmgr/docs/skc/journalclub/How_to_Read_and_Understand.pdf) are good ones.
Michael Heyd, a retired medical librarian from Fairfield Township who spent more than 40 years searching the literature for professional hospital staff, is a member of Let’s end COVID!, a group of concerned people in Northcentral PA working to overcome the COVID-19 pandemic through education, outreach and mitigation. Currently the Lycoming County COVID-19 Community Level used to define interaction in general public spaces is low. At this level the CDC recommends optional masking any time for extra protection.

FDA warning shuts down ivermectin site [North Platte Telegraph, 25 Mar 2023]

By GEORGE HAWS

website promoting ivermectin to treat COVID-19 has been shut down. The action was in response to a warning letter issued by the U.S. Food and Drug Administration on March 16.
Legal products containing ivermectin have long used for control of parasites, especially in livestock, and are available only by prescription.

However, according to the FDA warning, ivermectin4covid.com was promoting a product called Iverheal 12mg, manufactured by Healing Pharma, to control not only parasites, but also COVID-19, a viral infection.

The FDA’s letter noted that Iverheal 12mg is not an approved product and that ivermectin is not approved for COVID-19. The letter listed a number of alleged violations related to lack of FDA approval, mislabeling, violations of rules related to interstate commerce, etc.

The letter also lists addition concerns related to unapproved or misbranded drugs, and contains the following statement:

“There are inherent risks to consumers who purchase unapproved new drugs and misbranded drugs. Unapproved new drugs do not carry the same assurances of safety and effectiveness as those drugs subject to FDA oversight,” the warning said. “Drugs that have circumvented regulatory safeguards may be contaminated, counterfeit, contain varying amounts of active ingredients, or contain different ingredients altogether. We request that you cease the sale of any unapproved and misbranded products, whether for the mitigation, prevention, treatment, diagnosis, or cure of COVID‐19, or any other disease for which the drugs you are selling are not approved by FDA for distribution in the U.S.”

The warning letter was also posted to the FDA website.