From vjp2.at@at.BioStrategist.dot.dot.co@21:1/5 to All on Sun Aug 29 06:31:35 2021
The problems and benefits of antique medicines are much more complicated. Isn't there just a BIT of hypocrisy in endorsing generics like warfarin over eliquis and niacin over lipitor while condemning ivermectin and
hydroxyquinone? I wonder what the long term effect will be on the likes of GNC, DSHEA and Prevention magasine. If Biden is destined to emulate Carter,
I am reminded of Laeatrile. First, if many of them work in thin, young patients in third world countries, the same antique medicines are deadly with America's older, more obese populations. A lot of the antique medicines were known to work on similar diseases before the pandemic and their postulation
was not as off the wall as some on the left suggest. Further in a poor
country where the modern medicines are not fully available, they are worth trying. These are the same folks who holler at the right as anti-science on climate but who flock to "home remedies" or at least OTC on many other
things. In the soviet union, traditional medicine was often promoted by bureacrats as a budget saving tool, and this has carried over to the USA in recent years.
Further structual biology has allowed a lot of defunct old medicine to be resurrected and repurposed, circumventing expensive trials. I have argued I don't mind accupuncture but you better use modern sterilisation. In other words, take something like the US Pharmacopoeia of a century ago, before the FDA killed off a lot of tradional meds as "snake oil", and run everything through structural biology screens and modern safety testing. Pharmacopoeia had a lot of European, AmerIndian and Asian traditional meds in it, so I
think it's a good starting point. The maximum likelihood integral used to be done by hand over the entire sample, but now could be done case by case using symbolic manipulation - that's the adaptive trials that speed up remdesevir. I'm not talking about loosening the standards but making the methods more effective. The simple principle is confidence level is a function of error over the square root of sample size, if you reduce error, you can reduce
sample size which is the major cost driver in trials which in turn are THE major cost driver in modern medicine. A new drug costs a billion dollars because of clin trials, but that includes collapsing the contingent claims options tree for failed drugs into the successful ones. Before Vioxx blew I attended a panel organised by CMU MBAs at NYC Yale club where they discussed how new math methods could produce cheaper and more effective trials. After Vioxx I met an investment banker who used to be a medical professor: he told
us his doc wanted to put him on Vioxx anticancer trials and he admonished his doctor about the heart risk warnings. One of my teachers did QC for the nuclear navy and NASA and he, like the post Vioxx crowd, wants to make the sample size much larger.
A lot of this hysteria is their reluctance to reform. Both Cailif under Obama and Gottlieb under Trump made major strides, after prior strides were overturned by the Vioxx debacle. Cailif works for Google Verily and wants to scan the internet for anecdotal trials. There is a major industry in
clinical trials that is threatened. They are definitely part of the swamp. A lot of them show up in political clubs of right and left to recruit test subjects. There was snake oil a century ago and the FDA was partly tight,
but it may have killed off the babies with the bath water. The rancour of
today is because both sides insist only THEY can be right, but that is not
how democracy and scientific progress works.