The hazards of medicine by tweet: the case of anti-cytokine therapy for Covid-19
Positive news about a potential Covid-19 treatment — a drug that blocks the receptor for the inflammatory protein interleukin-6 (IL-6) — highlight the hazards of sharing research findings via Twitter and other social media.
Researchers with the large REMAP-CAP clinical trial reported through a variety of channels, most notably Twitter, that the use of the IL-6 agonists tocilizumab or sarilumab significantly reduced deaths among critically ill patients with Covid-19.
In response to what should have been good news, some experts essentially shrugged it off on social media, partially because several earlier studies had yielded disappointing results.
It’s important to note that REMAP-CAP was conducted after the antiviral drug remdesivir and the anti-inflammatory drug dexamethasone were adopted as the standards of care in some countries, while the earlier studies were conducted before these other drugs were widely used.
We include that detail not to delve into the murky world of anti-IL-6-receptor therapy in Covid-19, but to note that the data from trials testing this approach are difficult to interpret. And for good reason: The many positive and negative studies, several of which have still not been released in sufficient detail to allow for in-depth review, studied patients at different stages of disease, in different countries, and at different times during the pandemic.
Randomized clinical trials usually produce valid and interpretable results, unless they are very small, but it is often unclear — even to experts — how to reconcile conflicting results.
Twitter and other social media platforms, which allow rapid dissemination of top-line findings, tend to generate messages lacking in nuance. We are seeing more and more clinicians and other interested parties come to view proposed Covid-19 treatments in black and white terms — not necessarily due to the underlying quality of evidence but because of the manner in which they have been shared on social media and discussed in academic circles.
The typical approach by the Twitterati has been to take a majority or minority position and defend it. Every complex problem has a solution that is clear, simple — and wrong.
https://www.statnews.com/2021/02/12/hazard-publishing-science-via-twitter/
