In 2021 and 2022, ivermectin occupied a central place in debates about Covid-19 treatments. Two landmark publications clashed in the media and on social networks. The same molecule. The same question. Opposite conclusions. And, according to Publi-Score, 68 points apart.
This case study is not here to say whether ivermectin works. It is here to show how Publi-Score differentiates robust evidence from fragile evidence — regardless of the result.
| TOGETHER Trial | Bryant et al. | |
|---|---|---|
| Publi-Score | A— Reliable (76/100) | E— Unreliable (8/100) |
| Type | Randomized controlled trial | Meta-analysis |
| Publication | NEJM, 2022 | American Journal of Therapeutics, 2021 |
| Patients / studies | 3,515 patients | 24 included studies |
| Conclusion | No significant effect on hospitalizations | Suggested efficacy on several criteria |
The TOGETHER Trial — A — Reliable (76/100)
The TOGETHER Trial (Reis et al., New England Journal of Medicine, 2022 — DOI:10.1056/NEJMoa2115869) is a randomized double-blind placebo-controlled trial. 3,515 patients. Pre-registered on ClinicalTrials.gov before the trial started. Funding: FAST grants and the Canadian government — with no link to an ivermectin manufacturer.
- ✓Randomization and double-blind
- ✓Pre-registration
- ✓Adequate statistical power
- ✓Independent funding
- ✓Data shared
Bryant et al. — E — Unreliable (8/100)
- ✗Included studies retracted
- ✗High unexplained heterogeneity
- ✗Publication bias uncorrected
- ✗Data unavailable
What Publi-Score does not say
Publi-Score does not say that ivermectin is ineffective, nor that it is effective. It says that the TOGETHER Trial produced grade A evidence concluding no effect, and that the Bryant et al. meta-analysis produced grade E evidence concluding a benefit.
Directional neutrality in practice
This is the fundamental principle of Publi-Score: the score does not depend on the conclusion, but on the process. This is why Publi-Score is not an anti-ivermectin tool — it is a pro-methodology tool.
The lesson
68 points apart between two studies on the same molecule — this signals that the methodological question is not a technical detail. It is the heart of the problem.