Some 120 doctors have signed a public letter to the Journal of the American Medical Association (JAMA) criticizing the publication of a flawed study claiming to find ivermectin ineffective against COVID-19. In addition to the numerous shortcomings of the study itself, the signatories also warned against medical science’s obsessive focus on randomized controlled trials (RCTs) at the expense of other types of evidence and clinicians’ professional judgment. Elevating RCTs over other studies, specifically controlled observational trials, is especially misguided when the quality of the RCTs can be quite low — as is the case here.
The letter reads in part:
We the undersigned physicians present this letter to call attention to multiple, integral flaws in the Journal of the American Medical Association’s recently published paper ‘Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19′ Above all, the data reported do not support the authors’ conclusion that ivermectin is ineffective as a treatment for mild COVID-19…
Physicians have a solemn duty to care for patients, and randomized controlled trials can provide valuable information. But, as is the case here, they can also be flawed and must therefore always be weighed within the totality of evidence in order to provide the most appropriate patient care.
Over the past year, many government agencies, academic journals, the broader media, and medical associations have departed from historic norms and elevated the status of randomized controlled trials. Such trials are seemingly presented as the only valid basis for making clinical recommendations about COVID-19 treatment, no matter how flawed. This trend has severely hindered the ability of physicians to use clinical experience and observational trials to offer their patients guidance on early treatment for this still not well-understood infection.
We oppose this fixation on randomized controlled trials at the expense of other clinical and scientific evidence and urge medical policymakers to restore balance to the practice of medicine.
Physicians must be free to use all appropriate methodologies in determining the best approach to COVID-19, and to other conditions underlying health disparities throughout our country.
If you are a doctor and would like to add your name to this letter, email sign@jamaletter.com with your full name, credentials, and location exactly as they appear above.
