In a shocking development, a widely-publicized pair of studies relating to COVID-19 were quickly retracted when their authors couldn’t confirm their data or analysis. What the health??

Dr. Adrian Hernandez is a cardiologist and director of the Duke Clinical Research Institute. His group has created the HERO Registry to enroll healthcare professionals in clinical trials to help solve the coronavirus dilemma, including a randomized controlled trial using hydroxychloroquine for prevention.

Here was my initial take on the Lancet study.

– What’s up Zpack, welcome to the ZDoggMD show. This is Dr. Z. Listen today I got a guest because I opened up my newsfeed this morning and I was like, “Wait, what?” So the article in the Lancet that I talked about on a show talking about hydroxychloroquine azithromycin and this sort of observational study across multiple countries, thousands of patients were saying there was no benefit. And there may actually have been increased mortality, increased harm, we talked about it. I talked about the downsides of that trial, that it was observation was not randomized and that they were already starting with the sickest people and all the different biases. But this morning news came out that changed everything. And I reached out to my friend, Dr. Adrian Hernandez, who is the he’s a professor at Duke. He is a cardiologist and he is the director of the Duke Clinical Research Institute at Duke University Clinical Research Institute. And he happens to be running a registry, helping out with a registry called the HEROs Registry that, is registering healthcare professionals like many of you for participation in trials around COVID. And we’re gonna talk about that in the show, but what I want to ask them about now is the retraction of the Lancet paper, which blew everybody’s mind. Adrian welcome to the show, man.

– Hey, thanks for having me ZDogg,

– Dude, I got to say, man it’s rare that a paper gets retracted this quickly and the authors actually requested the retraction. So can you just walk me through what the paper kind of was saying and then why they retracted it? Cause it’s just, it’s crazy to me.

– Yeah, so it’s actually even bigger. So actually two papers got retracted on the same day. So one from the Lancet that we’re talking about for our hydroxychloroquine, but also another one from the new England journal of medicine from the same authorship. And so really incredible that something like that could happen, but just shows some of, the challenges for trying to address big data, rural data in the setting of a pandemic. People are really trying to get answers and it turns out that what they’re using no one could really understand or validate. So that was a big problem.

– This is crazy to me because we do science normally then the pandemic happens and it seems like we throw everything out the window in this rush to get data, especially when things seem so politicized. So what happened here? Because it seems to me this thing was peer reviewed. It’s published in a major two journals now, new England journal, different paper and Lancet. And so what did, what happened here? Can you walk me through this? Help me understand.

– Yeah, so, I mean, if you think about the process normally starts with, what’s the question, how do you answer the question where the data, how to validate it, what’s the review process. Editors say this is good or not. And all that time usually takes honestly months, but in the setting of COVID-19, people want answers like yesterday. And so the pressures from authors from peer review, from editors that got squanched into a matter of not weeks but days. And so I think the system broke down that, at least three times there was a chance to say, is this real or not? Is it the best answer or best way to answer it? And if not, how would you actually understand it? And that one was a complete failure in three steps.

– You know, okay, first of all, I wanna compliment you on the use of the word squanched which is an amazing word. And one of my favorites, but second, I wanna say this. You were one of the authors cause the process of how this thing came to light to be not a good science, let’s just be honest. Was a group of scientists actually wrote a letter saying we have a lot of problems with this. Like we know it’s gone through peer review, unlike many of the things that have been put out on, these archives that are not pure pre-print archives, but this is peer reviewed. So, when I was talking about, and I got to say, Adrian, I want to ask you at some point here like, did I screw up even talking about this thing when I did, when it came out and we can get to that but a group of scientists that included you wrote a letter saying we have a lot of concerns that, how did that come about? What, were the concerns that were raised and how were they discovered?

– Yeah, so there were, a group of investigators that are part of the it’s hydroxyl chloroquine trials. And as they were reviewing it and thinking they have this responsibility for the people that are in their trials, hey, you have this day that shows that’s, potentially unsafe. So let’s take a deeper look in it. And so when people are taking a look at that and saying, this doesn’t quite match up so over 600 hospitals, six continents, places where we’ve never seen this rapid data with electronic health data inconsistencies in terms of these number of COVID-19 cases in Australia and Africa, which doesn’t match up with what the paper is saying. So then that start generating the question, is this real or not? And so a group of people came together and decided let’s make an open letter since the initial requests. Weren’t actually being people weren’t really being responsive to. And so well let’s open it up and ask everyone, to take a look at that. And so that’s what started the snowball here.

– Wow, you know so it makes sense. Cause you look at that paper and you’d wonder, okay, they got, how many patients were they talking about? 96,000 or something.

– Yeah, yeah. So almost a hundred thousand people across the world, yeah.

– Now you and me, Adrian working with electronic health records know that you can’t get records from across the street, let alone across the world in record time for 96, 000 patients, de-identify it make sure that they meet the criteria, make sure the data was actually accurate, all that stuff and get it processed in a way that’s meaningful. That seems to me a challenge I might thinking about that wrong.

– Yeah, and especially if you think about this from January where COVID was barely on the radar for people to say March and April where things were changing, that’s incredible. Like how was that possible?

– How can that happen? And then of course the study results showing that it doesn’t help and it may harm started to ripple around the world. And in fact, the WHO show then put a pause on one of their trials thinking, Oh, now if their safety data that’s concerning, we better be careful and watch out. So this did not have no effect, right? And other ongoing trials were happening including something that you guys are doing or were you guys doing a trial on hydroxychloroquine?

– Yeah in a different space in terms of prophylaxis, protecting for healthcare workers. But one of the things to note is that this group also had a pre-print about another drug that actually was started to use in and South America. So, and so these things have important implications.

– You, I read this, that it was ivermectin was the drug.

– Yeah.

– And what happened in South America is they started putting it out and saying, okay, this is part of the armamentarium based on a pre-print by the same authors or the same database.

– Same similar authors and same database, so yeah. So like this is where, we have to really be careful, what we do.

– So tell me about this database, because, so it seemed like you guys recognize that there were some problems, like the fact that publicly reported figures for COVID-19 cases didn’t match, they were under reporting by like a factor of something, how many were in the paper and what was their response when you guys reached out to them and said, why is this that shouldn’t they match?

– Yeah, so initially the author referred us to the CEO of this company Surgisphere and that’s where things got blocked. And so there wasn’t really a mechanism for that company to share which hospitals, which places, how did you get the data? What’s the the data quality, what are the methods, all those different steps. And so that’s ultimately what led to the retractions.

– See, this is crazy. It’s the craziest thing I’ve ever heard because you have this company Surgisphere, which was founded in 2008 by this guy, Desai this doctor. And they were providing these robust almost too hard to believe datasets to the researchers. And the question is to the research questions,

– I’m not even sure they were providing data sets, but actually they ran the analysis, that’s how we interpret it so.

– So they basically did the trial and then these guys maybe did a little statistics am I wrong?

– I think they took the tables and wrote the paper, I don’t know that they actually did the analysis, so.

– Wow so let me ask you just a question right away. And this is the elephant in the room, are the authors, not the database guys, but the authors, other authors of these papers, are they just absolutely negligent in how they do science or was this an honest mistake where it was a vendor that was providing data an analysis that screwed up what’s going on?

– Well, you certainly they had blind spots here. So they didn’t have enough experience with electronic health data dint know dint know what the right questions to answer, you know in the time of COVID where people are really trying to get to fast answers, like here’s this wonderful database, look at these results. You can imagine, you know blind spots that people wanna have to say like, oh, we need to get this out, but didn’t have the right question. So historically they’ve done good work. But in this case, you know their responsibilities fell so they didn’t fall through.

– You know so it’s so interesting because we’re seeing a pattern of this during this time where at least the, accusations of this, for example, the Stanford Sarah prevalence study was so controversial in terms of their methods, this idea that the testing they were using was invalidated properly, there was controversy, there was whistle blowers, there was in the press. You don’t normally see this kind of drama with science. It’s usually pretty quiet. So what’s different now, It’s just Covid you think that everyone is rushed.

– Yeah I mean, normally science is iterative, slow deliberative. So in the setting of a pandemic where people are really trying to grasp or get any answer, whether it’s right or partially, right, or maybe completely wrong, like anyone is looking for any answer. And so this is what can happen. And so everything that we would normally do for the scientific process, you know just gets thrown out. And so this is why we need to change that we have to get back to, we can still do things fast, but we can also make sure to be attentive, to quality and ensure that we have the so called nutritional label. Is this study good? Is this healthy? Is this actually important? So like, how do we actually grade these studies? So people understand it.

– Would it make sense to have like an independent body that just objectively reviews, even peer reviewed data, like, and just starts to put those nutritional labels on? Or is that just crazy thinking?

– No, that I think in this setting, that can be very helpful because the biggest consumers are, you know people out there who don’t necessarily know what the research process is.

– So how would you grade it? So A, B or C like, so that way people understand that, hey, this is great a work okay, terrific. I can trust that grade C well, maybe not enough it’s enough. Like we shouldn’t even be paying attention to it, but how things have been treated as everything was looked like a grade A.

– And you know what’s interesting about this too, is that there are there, we have a scientific method that works. We’ve just been really rushing through it. There’s been a lot of pre-print stuff. And then people send it to each other on social media. It’s amplified, everything is politicized because people wanna spend, I know hydroxychloroquine, oh my God, that’s, Trump’s drug. You know, no, no, no it’s a medicine. Let’s study it correctly. There’s a biological plausibility, it doesn’t mean that it actually works, so we got to study it. And there’s different applications. Like you said, whether it’s prophylac preventing the disease or whether it’s treating people and then how sick they are science is tough. It’s complicated, but people, especially the press, it’s very hard to parse that for the public. And then everybody gets confused. And like you said, something interesting, you said, and other researchers who don’t necessarily understand the methodology sometimes. Have you seen a lot of that?

– Yeah, yeah, I mean, if you just think about that witnessed or expect a molecular biologist to understand, say research around electronic health records or someone who’s focused on clinical trials to understand this or vice versa, so that’s why it’s so important, especially now that the world’s gotten so complicated. And so you have these specialties that can take advantage of different parts of data creation and knowledge generation.

– Now, does this mean that hydroxychloroquine works cause that’s what the public’s gonna think. They’re like, oh, this paper was debunked. There was probably a conspiracy because hydroxychloroquine is cheap and easy to push things towards the rim desert. You can see where this thinking would happen. Well, how would you respond to that?

– Yeah, well, you know when remove that paper out of the max and so at least there’s not a safety question here, but there two other things have come around this week. So another trial this week, which is our first really randomized trial with hydroxylchloroquine looked at this question and people who had recently been exposed to COVID-19 as a smaller study, 800 people, and it didn’t show any effect there. So people who had a known exposure while there was a trend for hydroxychloroquine being beneficial. It didn’t meet the bar in terms of saying, yes it is, but it was safe. And then just actually today there’s another trial called recovery that just released just top line results. These are in patients who are really sick in the hospital have a, about a 25% mortality rate at 30 days, it didn’t work there. And so the story here, that’s coming down and said, just like any virus, if it goes so far out, it’s really hard to treat. That was a case where the rimdozovia. That seems to be the case from a hydroxychloroquine And so the question is, can you get in front? Can you actually prevent it? And so that’s why the people are interested in us for hydroxylchloroquine vaccines, other therapies to actually see if you can prevent it from happening.

– Yeah, that’s the main thing because when you do it is key and you can, there are a lot of people who do science on a lot of different things. And if something becomes, there’s a negative result, you can always question, did we do this right? Did we give it at the time when this is actually gonna be helpful? You said vaccines, and this is important because I think there’s a couple of takeaways that I have and I’m curious what you think one of them is that the public, especially the public, that’s afraid that really has lost trust in science can spin this two ways. The way they’re probably gonna spin it is science is worthless, you can’t trust anything. Don’t trust these guys ’cause they screwed up and made a huge mistake, the other way to spin it, which is the correct way is look what happened. Scientists looked at this and said, wait, there’s a problem. And we need to investigate this. And the process worked, the authors retracted it. They couldn’t find the answers they needed from this vendor Surgisphere, which by the way, smells to me like a fraudulent thing. I mean, like, this is like fire festival level stuff I mean like, do you have any thoughts on that? Or am I crazy?

– Yeah, so I, exactly, so I really worry about this example. Losing public trust here. And so the only way to to change that is to actually be part of this. And so in this case, I mean, that’s why the community of scientists, you know stood up quickly. We’re not gonna tolerate something that’s so slow. And when that is misinformation we need to change this right now. I can’t go through the usual process. And so no matter of two weeks, both articles got retracted. And so now we can move forward.

– And you were a part of that process so thank you for doing that and I got to say this, so this is the follow-up question is so science works. The follow-up question is since science works, are you scared that we’re gonna similarly screw up a rushed vaccine study process, given the immense pressure to formulate a vaccine quickly?

– I am worried about it. So I think that’s one of the things that we wanna do is make sure that we are able to do the right type of trials as fast as possible, but ensure we have the understanding of, the benefits and any risk because for vaccines to work and it needs to be extremely safe and also make sure that it’s protective and so we wanna ensure that we have the right structure, right approach to get that quick.

– Now that’s a good segue into what you’re actually doing to make this better as a researcher and as a fellow physician, because when we first talked offline, I was impressed with what you were doing with the HEROs Registry so much so that I shared it. And the idea that you’re creating a registry and you’re gonna help me understand this better so that my audience can participate. Cause that’s our call to action here is this registry of health care professionals. And I’m not talking doctors and nurses. I’m talking everybody in healthcare, even if you’ re furloughed, even if you work in the kitchen, which is such an important job, all these other pieces can be a part of this registry that is studying the effects on health care workers, COVID science, mental health effects in a broad way so that we can actually get enough data that we can actually make a difference in changing the course of this. So teach me about this because this is so important.

– Yeah, so we’re aiming to create a community of healthcare workers across the US and so two goals are one understand their needs. Like what’s your stress points, you know what’s going on that we can try to make sure that your individual voice is amplified. The second thing is that we know that COVID-19 is not gonna go away overnight we’re already seeing it kind of come back. So we have to protect healthcare workers the way to do that will be likely through vaccines or some other protective drug. And so to get the best science, we want to make sure that people are able to participate in these trials and be ready when it fits for them. And they’re also a series of trials, series of steps. So some people may not wanna be part of the very first trial, but they may wanna be part of the second or a third phase of this. And so we wanna understand where do you wanna be part of that? Or maybe you wanna know when the result is out. And so then we can share with you the result of a trial that you may wanna get to say a vaccine quickly. And how do we do that for you?

– So people who would register for the possibility. In other words, you’re not signing up for the trial. You’ re saying, hey, I’m putting my hat in the ring. When you reach out to me, I can decide how, you know they go to heroesresearch.com. Is that right, or .org

– .org

– .org, heroesresearch.org. And we’ll put it in the show notes, but how are they guaranteed that they have privacy then are they giving you data name, medical stuff? That’s gonna put them at risk in any way.

– So we do ask for information about them, but it’s all protected in terms of keeping everything in a very secure environment that others can’t access. And just like anyone who’s using say their, specific email only they would know their password etc. And it also requires two steps to get in to make sure you or you and no one else is trying to get to your account. The other thing is that it’s, we also wanna learn like, what is happening so called a pulse of the nation of healthcare workers. So if you imagine two months ago it was about PPE. Like I can’t get the next is I wanna have like a test. Like, do I, have I been exposed or not? Which test do I trust next could be, there’s a vaccine, which one should I trust? So that’s also, we’re trying to do as well.

– So to me, this is the most powerful thing. In the interview, we can talk about the science of hydroxychloroquine and how we’ve, caught a mistake and all that. But what matters, I think most to me in this audience is the fact that they can be a part of something that makes all the things that we’ve gone through and suffered on the front lines. No PPE, how do we get tested? How do we keep our families safe? How do we keep us safe? Is there a prophylactic hydroxychloroquine, whatever it is what’s gonna happen when the vaccine happens and actually be a part of the solution, feel empowered because what we are at the highest risk, which means we’re already the perfect population to study. We’re smart enough to make informed consent decisions about participating in a trial, knowing risks and benefits, understanding randomized control trials, and then lending our voice to something that will actually change the practice, not just for us on the front lines, but for everybody in the world. I can’t think of a stronger pitch for people who’ve already dedicated their lives to helping others than that, which is why the HEROs Registry is perfectly named. You guys are brilliant. What does it stand for by the way?

– And what it actually stands for Healthcare Workers, Exposure and Outcomes Registry, but the, that, and that’s exactly right. We want people to be able to raise their hand. I have a problem I wanna join, I wanna change. So that’s what we’re trying to do.

– I will, please tell my audience right now. This is something you should register for, okay. I’m registering. We all wanna be a part of the solution and it’s, there’s no obligation, but I think it’s so important. And one of the things, so let me ask you this, if like, how many people do you have registered now?

– So we have over 13,000.

– Wow, healthcare professionals, all stripes.

– That’s right, and one other thing is we also know that in the first kind of surveys of what people’s interests are we’re, also worried about their families. And so another phase we’re gonna do is like, how do we also make sure to get family members on board? So, cause they may also be interested in vaccines as well.

– It makes total sense, actually that would be a key thing actually in many of us are actually more concerned about our families than we are about ourselves, by far. One question about this is if you have like, say, let’s say you got 50,000 people signed up. You know listen, I will push as hard as we can because I think if we can get a ton of Zpack, people signed up, there’s 2 million people across the Zpack tribes and they’re mostly healthcare professional. If we can get even a fraction of those, we can do such good science and make such a difference in the world in a way that I would never have anticipated that this platform would have been able to do. So it’s important to me too, I have a question about once you have those guys there, and let’s say a vaccine comes out that they’ re studying, can you just activate that army of potential research subjects very quickly then? Is that the idea here that you can just activate that many people?

– So you know for these vaccine studies, they’re gonna need at least 30,000 for each of them. And so we would like to make sure that we have 30,000 day one, cause that’s the normal vaccine study would take months. And so how do we get this done? Where everyone signs up in a matter of days. So that shortens the timeline.

– So people ask all the time and I had offered a pull off it on the show and others named Peter Hotez normally there’s just a long process and what you just said is enlightening because it says the process is long for reasons. But one of the reasons is it’s really hard to enroll people in trials. If we Zpack can actually put ourselves out there and put our money where our mouth is, right? We’ve been talking about the importance of science studies vaccines, then we can actually solve that problem. Speed up the vaccine development without compromising safety and quality. Does that sound about right?

– That’s exactly right.

– And so we can be a part of the solution instead of feeling powerless. And I tell you, I get so many messages, people feel powerless and who came up with this idea? Like, how did this thing, how was it designed? What’s the background?

– Yeah, so back in March a group called the patients in our outcomes research Institute came to us and said, how can we help this area? And specifically health care workers. And so that’s where we started saying like that we understand the interest in hydroxylchloroquine let’s answer that let’s, this story is not gonna go away overnight and the problems aren’t gonna go away, at least as what we could tell. And there’s gonna be a series of things that we need to do. And a group of people on the front lines, they’re taking care of patients all the time, but who’s making sure that their voice is represented. Who’s making sure that they design what’s needed next. And then everything was blowing up in terms of PPE, etc. And so this became like a call to action.

– You know you had a series, your team sent me a series of sort of bullets on this and they were really well done. I’m gonna include them in the show notes of what we share so that you guys can read about the rationale, the background Q and A all kinds of great points before you register. Cause you should be informed, but I’ll tell you like this is such a powerful thing that you’re doing and you guys are big nerds, man. I’m not even kidding. Like the Duke Clinical Researchers do this is not like some fly by night, you know operation that like an anti-vaxxer would say, well, you know, you know, Mr. Pickles et. al with Dr.Bozo said that this is like legit science. So to be a part of that would actually be a huge honor for me. So I’ll be registered and ready to ready to sign up for those trials when they’re ready to go. And I think, I think a lot of the, a lot of the followers would too. Do you have any other sort of calls to action, yeah.

– Yeah I mean, we want to make this go viral. So, as others actually register, like share with your colleagues, share with your friends and that way we can like build this community quickly. And then when there are these questions that come up, whether it’s in Washington DC or somewhere else, like how can we quickly get an answer that says pay attention to us? And one other thing that you mentioned, I just wanna highlight is that it’s not just about nurses and physicians. When we talk about healthcare workers, it’s everyone part of the system from people who are going out, responding to nine one, one calls, policemen, firemen EMS to those who are actually caring for people and skilled nursing facilities, or we know COVID-19 is a really big deal. So it’s a whole spectrum, as well as people that actually see patients room to room from food services or environmental services, often they have the biggest exposures.

– They do, and actually in New York, it’s often minorities doing those jobs and they were dying of infection. Cause they did not get the same PPE. That’s a, an ICU doc would get or a Papper or anything like that, it’s really heartbreaking. And, it’s an inequity issue at heart.

– Often those people actually don’t even know when, say they could be part of, say a vaccine trial. Cause there no one has thought about them and we need to change that.

– So one thing I got to say, and I’m very proud of is that we have an audience that is the cross section of all health care workers in the US and activist patients so I think now, I get a lot of criticism from some doctors that say that I am pandering to ancillaries, whether it’s nurses or PAs or nurse practitioners. And it really is outrageous because how are we gonna transform healthcare? How are we gonna be better if we don’t look at the entire team, including our patients, including our policy makers, including our administrators to exclude, that’s not my, what I wanna do now there are people who can do that, but it’s an increasingly, you know Adrian, I’m frustrated by the polarization and the division, I’ve been a part of it. I have, I’ve done things that are very divisive because I know it’s gonna get traction and get eyes on us so that we can do other things. That’s the wrong way to do it from now on I’m about I’m really gonna be trying to be about more connection and more building bridges, which means calling it out when I think we’re trying to be too divisive. So that’s one thing I think that your registry is just the perfect way to bring us together in service of something bigger than ourselves, which is helping everybody.

– Yeah, and so that’s what we wanna hear as create this community, hear people’s ideas and act on them.

– Now here’s a question that I said I’d asked in the beginning that I make sure I don’t forget. I did a video on the Lancet piece I don’t know if it was a week or two ago saying, hey, this study came out, this is what it showed here are the flaws, so it just, you know just here’s what, here’s the information did you, would you, you didn’t see that video, did you?

– Actually I did and a I’m a follower. I watch it come on.

– The nerds watch me and by nerds, that’s the highest compliment I can give ’cause I’m the biggest nerd in the world. So wait, so Adrian, you saw the video. I need your honest feedback on that video. Did I, did I jump the gun? Did I say something wrong? What can I do better to communicate that? Do I need to do a follow up beyond this?

– Yeah, so, you know it’s actually interesting. So most people did the same thing. You look at the main paper and that’s what you judge it on, but it’s when you get to the say the other parts of it, actually the appendix that’s where people really picked up like, hey, this does not make sense. The same thing for the new England journal paper, it was the appendix, that really like show things. And so that’s where like we depend on editors and peer review bringing out these issues here. And there are a lot of other people well known almost as well known as you that had the same problem, you know Dr.Topol same thing. So and,

– Eric, Eric

– But in the end yeah,

– So I’m in good company then.

– Yeah.

– Yeah. So again, like, just thinking like, when people take a first glance and you have trust in the system, that’s gonna be what happens and 90%, 99% that’s right. But there are, you know these cases, this one’s extreme that where there was, really bad science.

– You know I’ve learned a lot during this pandemic. And it started in the beginning when I really took what the WHO and the CDC were saying quite literally early on. And I was burned so badly and was talking publicly, you know guys calmed down, everybody calmed down, which calming down is always a good idea. Being prepared is always a good idea, but I was really led down a path that was not correct because I don’t have the primary data and I didn’t have the ability. I was talking to people on the inside, but they don’t have that ability either. And we’re blind on so many levels. And with this Lancet thing, it’s an interesting thing, because I think it’s important. What you said is important to trust people who it’s their job to actually review those things, but then hold them accountable when it screws up, what you guys did was you said this isn’t right. You looked at the details of the paper because it’s your space and said, no, this is what we need. We have questions that need answering before we can trust this data. Now here’s a question how much of our science that isn’t done under pressure that isn’t getting, the scrutiny that this study is getting is done badly this way. Do you think are fraudulent even worse?

– Well, bad science, there’s definitely a several percent that that happens. You know fraudulent, I think it’s actually rare. I mean, but it does happen. So there, is an organization that’s always watching for this in terms of retractions every year. So you may know about them and they do a great job keeping track of these things. But this is why, you know it is a community of scientists and researchers that have to pay attention to it and always just have a little ounce of skepticism. My biggest lessons early on was a mentor said like, prove it and reprove it. And so making sure that like, each step, you question yourself and you actually question others and that’s a good scientific process make sure to not take anything for granted.

– Yeah, I think I quoted this the other day, Richard Feynman saying, you gotta make sure you’re not fooling yourself ’cause you’re the easiest person to fool because you have all your biases. You wanna believe them you wanna go down that route.

– Yeah.

– Yeah.

– Cause I’m usually no, I’m always right. But I have to question myself. I need to make sure that, I question them before someone else does and that will be healthier.

– Yeah, yeah. You know I’ve had to evolve my own thinking to actually get joy when I’m wrong to be shown wrong because it shows that then I’m gonna learn something from that cause being right is like something that you get a little burst of dopamine when you’ re right. At least a lot of people do. But I’ve sacked had to, recondition myself to get a burst of dopamine, when I have to apologize when I’ve gotten something wrong, I’m like, oh, okay this is an opportunity to actually be a human being. And it’s hard cause, it hurts, it’s like a mix of dopamine. It’s like sadomasochism, like that kind of dopamine. Like it hurts I got, I want more of it. So that all being said, are there any other parting words you want to lend to our audience? I’m gonna put all the links and everything in the, in the show notes.

– Hey thanks for joining. We wanna hear from you and then we’re gonna do our very best to honor what you do.

– I believe him guys, I believe him. And I’ve spoken to Adrian before and he was connected with me by incredibly good and rational scientists. So I’m excited to be a part of sharing this with you. I’m excited to be a part of it. I hope you learn something about the hydroxychloroquine, retraction. I hope you’ve actually gotten a renewed faith in the scientific process when done correctly. You correct errors before they become avalanches of misinformation, like Andrew Wakefield’s paper, which was never replicated and ultimately found to be fraudulent. Great example of that. When the retraction watches the organization that I think you’re referring to.

– Yep.

– Fantastic org If you wanna contribute or learn about them, it must be retraction watch org. I imagine

– That’s right.

– And let’s just science the crap out of this become a part of this thing. That’s the call to action. Please share this video with your friends and colleagues so that we can grow this thing into a viral thing. And remember all the research. A lot of people don’t realize this we’re a podcast on audio, any iTunes, Stitcher, any of those things you use Google play. We’re also a website where everything is archived and searchable and zdoggmd.com, Facebook, Instagram, Twitter, all that stuffs ancillary to the message that’s archived on the sites. If you want links and all those things, and you don’t see them here in whatever you’re looking at, go to my website all right, guys, I love you. Thanks to Adrian and everybody at the Clinical Research Institute at Duke University. and everybody’s doing science around the world, please stay safe during this very difficult time. And we are out, peace.

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