The aggregation of data from studies with small sample sizes can lead to a low certainty of a causal relationship between a treatment and a clinical endpoint.

“And so at the end of the day, when you're looking at a clinical endpoint, for example, hospitalization, when you have 50 people in a group, you know, then if 2 people end up in the hospital, so you have 2 people in the control group end up in the hospital, but out of the other 50 people, you have zero end up in the hospital, so let's say in the ivermectin group because you'll find studies like this, it's such a low sample size that the risk of that event happening, the certainty of that event happening being actually, you know, causal by that treatment is so low.”