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Doctors Doing Harm since Hippocrates


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#11 stocks

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Posted 09 January 2011 - 12:45 PM

Publication Bias

... the tendency of scientists and scientific journals to prefer positive data over null results, which is what happens when no effect is found. The bias was first identified by the statistician Theodore Sterling, in 1959, after he noticed that ninety-seven per cent of all published psychological studies with statistically significant data found the effect they were looking for.

Sterling saw that if ninety-seven per cent of psychology studies were proving their hypotheses, either psychologists were extraordinarily lucky or they published only the outcomes of successful experiments. In recent years, publication bias has mostly been seen as a problem for clinical trials, since pharmaceutical companies are less interested in publishing results that aren’t favorable. But it’s becoming increasingly clear that publication bias also produces major distortions in fields without large corporate incentives, such as psychology and ecology.

Selective Reporting


... an equally significant issue is the selective reporting of results—the data that scientists choose to document in the first place. Palmer’s most convincing evidence relies on a statistical tool known as a funnel graph. When a large number of studies have been done on a single subject, the data should follow a pattern: studies with a large sample size should all cluster around a common value—the true result—whereas those with a smaller sample size should exhibit a random scattering, since they’re subject to greater sampling error. This pattern gives the graph its name, since the distribution resembles a funnel.

The funnel graph visually captures the distortions of selective reporting. For instance, after Palmer plotted every study of fluctuating asymmetry, he noticed that the distribution of results with smaller sample sizes wasn’t random at all but instead skewed heavily toward positive results. Palmer has since documented a similar problem in several other contested subject areas. “Once I realized that selective reporting is everywhere in science, I got quite depressed,” Palmer told me.

Acupuncture


One of the classic examples of selective reporting concerns the testing of acupuncture in different countries. While acupuncture is widely accepted as a medical treatment in various Asian countries, its use is much more contested in the West. These cultural differences have profoundly influenced the results of clinical trials. Between 1966 and 1995, there were forty-seven studies of acupuncture in China, Taiwan, and Japan, and every single trial concluded that acupuncture was an effective treatment. During the same period, there were ninety-four clinical trials of acupuncture in the United States, Sweden, and the U.K., and only fifty-six per cent of these studies found any therapeutic benefits. As Palmer notes, this wide discrepancy suggests that scientists find ways to confirm their preferred hypothesis, disregarding what they don’t want to see

The problem of selective reporting is rooted in a fundamental cognitive flaw, which is that we like proving ourselves right and hate being wrong. “It feels good to validate a hypothesis,” Ioannidis said. “It feels even better when you’ve got a financial interest in the idea or your career depends upon it. And that’s why, even after a claim has been systematically disproven”—he cites, for instance, the early work on hormone replacement therapy, or claims involving various vitamins—“you still see some stubborn researchers citing the first few studies that show a strong effect.


Bias science

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If liberty means anything it means the right to  tell people what they do not want to hear. - George Orwell


#12 Rogerdodger

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Posted 21 January 2011 - 12:31 AM

Well since we are piling on doctors (I respect most of the ones I know):

Little Canada-based St. Jude allegedly paid participating doctors a fee that ranged up to $2,000 per patient as a way of encouraging use of the company's pacemakers and defibrillators.

St. Jude Medical to pay $16 million to settle charges that it paid kickbacks to doctors - Star Tribune http://bit.ly/gc3CmN

#13 Rogerdodger

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Posted 21 January 2011 - 12:55 PM

Analysis cautions against wider use of statins
http://www.msnbc.msn...397/ns/health/#

There is not enough evidence to recommend the widespread use of statins like Pfizer's Lipitor or AstraZeneca's Crestor in people with no previous history of heart disease, scientists said on Wednesday.

In a systematic review published in The Cochrane Library journal, researchers said the cholesterol-lowering drugs -- already among the world's the biggest selling medicines -- should be prescribed "with caution" for those at low risk of cardiovascular disease (CVD).

In a review of 14 trials involving 34,272 patients, they also found that all but one trial were industry-sponsored, a finding they said meant the overall results could be "limited by unclear, selective and potentially biased reporting".
"We know that industry-sponsored trials are more likely to report favourable results for drugs versus placebos, so we have to be cautious about interpreting these results," she added.

Commenting on the Cochrane review, Amy Thompson of the British Heart Foundation charity said that in part it confirmed what experts already know -- "that statins have huge benefits for people with heart and circulatory disease, or those who are high risk (smoking, diabetes and obesity are included in high risk factors,) as they help to reduce the risk of heart disease including heart attacks."

But she added there was little to suggest that statins should be prescribed for people without heart and circulatory disease and who are at low risk of developing it. (Reporting by Kate Kelland; Editing by Greg Mahlich)

Edited by Rogerdodger, 21 January 2011 - 01:07 PM.


#14 stocks

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Posted 24 January 2011 - 09:29 PM

Why Almost Everything You Hear About Medicine Is Wrong

“People are being hurt and even dying” because of false medical claims, he says: not quackery, but errors in medical research.


It’s a disturbing view, with huge implications for doctors, policymakers, and health-conscious consumers. And one of its foremost advocates, Dr. John P.A. Ioannidis, has just ascended to a new, prominent platform after years of crusading against the baseless health and medical claims.

A major study concluded there’s no good evidence that statins (drugs like Lipitor and Crestor) help people with no history of heart disease
. The study, by the Cochrane Collaboration, a global consortium of biomedical experts, was based on an evaluation of 14 individual trials with 34,272 patients. Cost of statins: more than $20 billion per year, of which half may be unnecessary.

Even a cursory glance at medical journals shows that once heralded studies keep falling by the wayside. Two 1993 studies concluded that vitamin E prevents cardiovascular disease; that claim was overturned by more rigorous experiments, in 1996 and 2000. A 1996 study concluding that estrogen therapy reduces older women’s risk of Alzheimer’s was overturned in 2004. Numerous studies concluding that popular antidepressants work by altering brain chemistry have now been contradicted (the drugs help with mild and moderate depression, when they work at all, through a placebo effect), as has research claiming that early cancer detection (through, say, PSA tests) invariably saves lives. The list goes on.

Surgical practices, for instance, have not been tested to nearly the extent that medications have. “I wouldn’t be surprised if a large proportion of surgical practice is based on thin air, and [claims for effectiveness] would evaporate if we studied them closely,” Ioannidis says.


Medicine Newsweek

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If liberty means anything it means the right to  tell people what they do not want to hear. - George Orwell


#15 Rogerdodger

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Posted 29 January 2011 - 11:59 AM

From the files of Ben Dover, MD:
Bend over, MD. Get it? :D

REPORT: Medical students conducted genital, rectal, breast exams on unconscious patients...

* "Examinations performed without consent"
* Students face ethical dilemma - study
* "Most people would not be pleased"

AUSTRALIAN medical students are carrying out intrusive procedures on unconscious and anaesthetised patients without gaining the patient's consent.

The unauthorised examinations include genital, rectal and breast exams, and raise serious questions about the ethics of up-and-coming doctors, Madison reports.

The research, soon to be published in international medical journal, Medical Education, describes - among others - a student with "no qualms" about performing an anal examination on a female patient because she didn't think the woman's consent was relevant.

Read more: http://www.news.com....1#ixzz1CRciYKfk

Edited by Rogerdodger, 29 January 2011 - 12:01 PM.


#16 Trendy

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Posted 01 February 2011 - 05:49 PM

I have several docs as clients.
They mostly seem to be humans, and nice ones at that, unlike lawyers. :P


95% of lawyers give the rest of lawyers a bad name.

#17 Rogerdodger

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Posted 15 July 2011 - 08:21 AM

Practice makes perfect!

“Dr. Midei said my heart was 90 percent blocked, a review showed it was 10 percent”

World-Renowned Heart Surgeon's License Revoked For Performing Hundreds Of Unnecessary Surgeries...

The 88 page report from the Maryland Board of Physicians blasts Dr. Marc Midei for violations they call repeated, serious and indefensible. So severe–they revoked Midei’s medical license.
“What I did is what I would have wanted for myself for anybody in my family, my mother, my father,” Dr. Midei said in October of 2010.
But the State Board of Physicians found in 4 of the 5 patients cases they reviewed, Midei willfully fabricated information about the severity of blockages.
Marrs is one of 585 people who received a letter from St. Joseph Medical Center saying Midei may have unnecessarily given her a stent–a tiny device designed to open up blocked arteries. A charge Midei has vehemently denied.
Marrs says Midei lied about how blocked her arteries were too.
“Dr. Midei said it was 90 percent and after they reviewed everything it was 10 percent,” Marrs said.

Edited by Rogerdodger, 15 July 2011 - 08:25 AM.


#18 stocks

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Posted 12 August 2011 - 07:55 PM

Retractions Of Scientific Studies Are Surging

The apparent rise in scientific fraud “is a scar on the moral body of science.”


Over the past decade, the number of medical journals that have issued retractions has climbed precipitously. Since 2001, the overall number of papers that were published in research journals increased 44 percent, but at the same time, the number of papers that were retracted climbed more than 15-fold, according to The Wall Street Journal, citing data from Thomson Reuters.

Meanwhile, retractions related to fraud rose more than sevenfold between 2004 and 2009, exceeding a twofold rise traced to mistakes, according to an analysis published in the Journal of Medical Ethics. After studying 742 papers that were withdrawn from 2000 to 2010, the analysis found that 73.5 percent were retracted simply for error, but 26.6 percent were retracted for fraud. Ominously, 31.8 percent of retracted papers were not noted as retracted

And why is there more fraud? As the Wall Street Journal notes, there is a lot to be gained - by both researchers and journal editors - to publish influential papers. “The stakes are so high,” The Lancet editor Richard Horton tells the Journal. “A single paper in Lancet and you get your chair and you get your money. It’s your passport to success.”

Link

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If liberty means anything it means the right to  tell people what they do not want to hear. - George Orwell


#19 stocks

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Posted 19 September 2011 - 04:27 PM

Believing in Treatments That Don’t Work

Emergency room physician Dr. David H. Newman explores how medical ideology often gets in the way of evidence-based medicine.


The practice of medicine contains countless examples of elegant medical theories that belie the best available evidence.

Recent press reports detailing the dangers of cough syrup for children have noted that cough syrup doesn’t work. True: No cough remedies have ever been proven better than a placebo, either for adults or children. Yet their use is common.
Patients with ear infections are more likely to be harmed by antibiotics than helped. While the pills may cause a small decrease in symptoms (for which ear drops work better), the infections typically recede within days regardless of treatment. The same is true for bronchitis, sinusitis, and sore throats. Unnecessary antibiotics are still given to more than one in seven Americans each year for these conditions alone, at a cost of more than $2 billion and tens of thousands of serious adverse medication effects requiring treatment.
Back surgeries to relieve pain are, in the majority of cases, no better than nonsurgical treatment. Yet doctors perform 600,000 of these surgeries each year, at a cost of over $20 billion.
More than a half million Americans per year undergo arthroscopic surgery to correct osteoarthritis of the knee, at a cost of $3 billion. Despite this, studies show the surgery to be no better than sham knee surgery, in which surgeons “pretend” to do surgery while the patient is under light anesthesia. It is also no better than much cheaper, and much less invasive, physical therapy.

Treatment based on ideology is alluring. Surgeries to repair the knee should work. A syrup to reduce cough should help. Calming the straining heart should save lives. But the uncomfortable truth is that many expensive, invasive interventions are of little or no benefit and cause potentially uncomfortable, costly, and dangerous side effects and complications.

The critical question that looms for health care reform is whether patients, doctors and experts are prepared to set aside ideology in the face of data. Can we abide by the evidence when it tells us that antibiotics don’t clear ear infections or help strep throats? Can we stop asking for, and writing, these prescriptions? Can we stop performing, and asking for, knee and back surgeries? Can we handle what the evidence reveals? Are we ready for the truth?

Ideology vs Evidence

Dr. Newman is author of “Hippocrates Shadow: Secrets From the House of Medicine.”
(this book is a gem)

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If liberty means anything it means the right to  tell people what they do not want to hear. - George Orwell


#20 stocks

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Posted 23 September 2011 - 10:27 AM

Top 5 Threats To Science In Medicine

#1: Congress

Money is the most powerful gasoline that can be poured on the fire of pseudoscience. And thanks to Senator Tom Harkin, and a few merry enablers, there is now legislation in the Senate healthcare reform bill that would allocate tax dollars to disproven and unproven medical therapies.

#2: Mainstream Media

For some reason, snake oil has captured the imagination of the mainstream media. Thanks to people like Oprah and the major news networks, there is a steady parade of pseudoscientific poppy cock being spoon fed to the public. And because of the lack of critical thinking taught in schools, Americans (on average) have a 6th grade understanding of medicine.

#3: Academic Medical Centers

Often referred to by David Gorski as “Quackademic” Medical Centers – there is a growing trend among these centers to accept endowments for “integrative” approaches to medical care. Because of the economic realities of decreasing healthcare reimbursements – these once proud defenders of science are now accepting money to “study” implausible and often disproven medical treatments because they’re trendy. Scientists at these centers are forced to look the other way while patients (who trust the center’s reputation that took tens of decades to build) are exposed to placebo medicine under the guise of “holistic” healthcare.

#4: NCCAM

Even though we’ve invested $2.5 billion tax payer dollars and 10+ years of time on studying complementary and alternative medicines – we have discovered NO single breakthrough in medical treatment as a result.

#5: New Media

Just as mainstream media is beginning to fade in its influence and popularity, online and “new” media are making exponential leaps in influence. The Huffington Post and Age Of Autism are two strongholds of health misinformation that come to mind. Of course, “user generated content” and unvetted health advice and claims are easily made by anyone anytime. And thanks to the magic of Google, a health claim need only be popular to be promoted


sciencebasedmedicine

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If liberty means anything it means the right to  tell people what they do not want to hear. - George Orwell