St George’s student uncovers false data in influential Covid-19 research papers

Published: 26 October 2021

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When Biomedical Science student Jack Lawrence started a piece of coursework in the third year of his degree, he didn’t expect the work would influence an international debate on Covid-19 research data. However, after reviewing a highly cited preprint research paper on the use of the drug Ivermectin for treatment and prevention of Covid-19, the inconsistencies in the data would lead Jack down a path uncovering false information that could put lives at greater risk.

We spoke with Jack to find out more about how he ended up in the heart of the debate and the challenge of correcting unreliable data.

Ivermectin is typically used to treat parasite infections, not viruses

Ivermectin is a drug that is used to treat a range of parasite infections in humans, including head lice, scabies and intestinal worms – and is not usually used as an antiviral medicine. Early on during the Covid-19 pandemic, a laboratory experiment showed that the drug was powerful at neutralising the Covid-19 virus in a dish and could potentially be considered as a treatment for the disease. But, according to Jack and other scientists, the study didn’t represent real-world conditions.

“The doses used in the study were much higher than typically approved for humans,” he says.

“There wasn’t any good evidence in people to show that the drug would be effective at treating Covid-19.”

However, this research led to a wave of further studies investigating Ivermectin’s use in people with Covid-19, to see if the inexpensive drug might improve people’s outcomes. There were vast differences in the quality of the studies developed, but with some papers showing positive results, Ivermectin began to develop hype as a “wonderdrug” among certain communities. A hype that has yet to die down, despite international health bodies such as the World Health Organization advising against the drug’s use to treat Covid-19 outside of clinical trials.

One of the studies which strongly influenced the debate, was a non-peer-reviewed paper by a research group led by Dr Ahmed Elgazzar from Benha University, Egypt. The same paper which found its way into Jack’s hands to be reviewed as a piece of coursework.

Plagiarism, strange language choices and inconsistent data

The first thing that struck Jack when he read the paper was the strange language choices. Initially assuming the writing was a product of English not being the first language of the authors, Jack then began to realise that the sections that were written in perfect English had been plagiarised from a variety of sources.

“Their entire introduction apart from one sentence seemed to be plagiarised,” he says.

“It was patchwork plagiarism, where they’d used a thesaurus to change certain words, but kept the overall meaning and structure of the sentence.

“The biggest example was when they changed ‘Severe Acute Respiratory Syndrome’ to ‘Extreme Intense Respiratory Syndrome.’ They weren’t even checking to see if it made sense,” he adds.

Upon uncovering the rogue language choices, Jack then looked further into the data. Downloading not just the data in the paper, but the full dataset from a file transfer website – even guessing the password to unlock it after paying for the download.

“Once I got in, I added up the deaths in the paper,” says Jack.

“I added them up and the numbers in the spreadsheet didn’t match. They’d got the numbers of the people who had died wrong.”

After realising the clear mistakes, Jack decided it was time to investigate further. Looking for people who work on fraudulent data, he approached Dr Nicholas Brown from Linnaeus University in Sweden, who then introduced him to Gideon Meyerowitz-Katz, an epidemiologist from Sydney. Working together internationally with a wider team, including Dr Kyle Sheldrick (Australia) and Dr James Heathers (USA), the group were immediately successful in having the paper led by Dr Elgazzar taken down from the pre-print server. They then set about uncovering further inconsistencies in the data in multiple studies related to Ivermectin.

This work led to a paper, recently published in Nature Medicine, highlighting the unreliable results in studies using data from trials related to Ivermectin and Covid-19. The paper was Nature Medicine’s most accessed paper in September, and as a result of the work, one of the major meta-analyses (papers that use data from multiple clinical trials to generate an overall conclusion) withdrew the paper led by Dr Elgazzar from its dataset, completely changing their conclusion on the use of Ivermectin to treat Covid-19.

This has now spurred the group on to continue ensuring that the information around Ivermectin and Covid-19 contains only reliable data. Jack is clear, the group don’t hold the position that Ivermectin won’t work to treat Covid-19, just that better evidence is needed from ongoing trials.

Going above and beyond the work of an undergraduate

For Jack, this work has taken considerable effort outside of the time focused on his degree and final year research project investigating pancreatic cancer.

“This piece of coursework has inadvertently launched my career,” he says, adding that “the things I’ve learnt at St George’s have helped develop my background knowledge and skills so I could take this further.”

From Jack’s perspective, the most important thing is that no patients should be harmed from the misinformation on Ivermectin.

“Fortunately, Ivermectin is a very safe drug,” he says. “There have been some unfortunate cases where people have taken extremely large doses, but these are rare.

“The biggest problem is if someone takes it thinking it will work and rejects other medicines that have been proven to be effective,” he adds.

Jack hopes that his and the rest of the group’s work will continue to counter the misinformation, which has encouraged some people to refuse vaccines in favour of taking Ivermectin. With potentially millions of people having taken the drug, it’s crucial the work continues to ensure only the best, well-evidenced treatments are used to tackle the pandemic.

If you are interested in learning the skills that inspired Jack to tackle the false information surrounding Ivermectin, you can find out more about Biomedical Science at St George’s on the course webpages.