Generating evidence during a pandemic: what’s reliable?

Dear Editor, Well stated and concluded. It is obvious that in times of crisis, such as COVID 19 pandemic in the earlier phases, with high morbidity and unusual mortality, treatment with what is ' probably known ' exemplified by Hydroxy Q , was commenced, soon followed by Ivermectin. This was an act of commission -(therapeutic) , and no serendipity. Awaiting results from an RCT could be a luxury against the passage of crucial time. Clinical observations / observational research acquired an elevated status and importance in the intermediate time gaps, as response and experience demonstrated. Though considered gold standard, limitations against the time frame, need to be accepted and acknowledged, Further, the matching of some results between the RCTs and observational research lends credence to the utility of later in specific situations, with the population component considered. Generating evidence may be time/situation specific and disregarding / underestimating observational findings may turn erroneous and could deprive some of 'legitimate' care. Dr Murar E Yeolekar, Mumbai.