4 replies to this topic

[stocks]

Typical perversions of medical papers

Key findings in the body do not appear in the abstract.

References selected only the ones that support the conclusions.

Relative risks given in the absence of absolute risks.

Trials may not have control group.

Trials fail to compare new drug with older effective drug of supplements.

Drop-out rates are omitted from abstract.

Adverse effects depreciated.

Trails only run as long as outcome favorable.

Unfavorable results not published.

Endpoints only use easy measurement (cholesterol) and not real endpoint (all-cause death)

Real end-points combined with non-fatal outcomes to make outcome look better.

Data for men and women combined to conceal adverse results (e.g. aspirin and a statin)

Subjects are 20-60 years old, but recommendations include children and elderly.

Bell curve stats presented w/o indication if they really follow a bell curve.


Examples of these appear in:

Malignant Medical Myths
Dr Joel M. Kauffman

BS, 1958, Phila. Coll. Phcy. & Sci.
PhD, 1963, Mass. Inst. Tech.
80 peer-reviewed papers
11 patents, 2 on anti-TB drugs
14 years in drug development

http://www.traders-t...mp;#entry521347

[stocks]

Typical perversions of medical papers

Relative risks given in the absence of absolute risks.

Trials fail to compare new drug with older effective drug or supplements.

Statin (Crestor) Trial Results

am I going to deny them a drug that reduces their chance of a heart attack or stroke by 40 or 50 percent?”
Dr. Steven E. Nissen, chairman of cardiology at the Cleveland Clinic

500 people would need to be treated with Crestor for a year to avoid one usually survivable heart attack.
At $3.50 a pill, the cost of prescribing Crestor to 500 people for a year would be $638,000 to prevent one heart attack.
“That’s statistically significant but not clinically significant,”
Dr. Steven W. Seiden, a cardiologist



We’ve had this drug for a while, and we’re just now finding out that there’s this diabetes problem with it?”
Dr. Hlatky, professor of cardiovascular medicine at the Stanford University medical school.

Generic statins cost pennies a day
No mention of how a year of Crestor compares with a year of fish oil, magnesium, vitamin E, and coenzyme Q10

http://www.nytimes.c...s...wanted=2

[stocks]

Typical perversions of medical papers

Adverse effects depreciated.

Five out of six new prescription drugs don't work, doctor claims

Large firms hyped-up patented medicines, spent vast amounts on getting doctors to prescribe them and underplayed serious side effects, said Prof Donald Light, a sociologist and professor of comparative health policy at the University of Medicine and Dentistry in New Jersey, US.

He said: "Sometimes drug companies hide or downplay information about serious side-effects of new drugs and overstate the drugs' benefits.
"Then, they spend two to three times more on marketing than on research to persuade doctors to prescribe these new drugs.

With statins, he said drugs companies had boiled down complex set of relationships between heart disease and saturated fats and cholesterol into the over-simplistic message that "cholesterol kills".
Yet two major trials of statins found little evidence they reduced the risk of heart attacks. One major meta-analysis of a number of studies, found that "statins were not associated with reduction in the risk of all-cause mortality", he said.

He accused companies of swamping drugs regulators with large numbers of "incomplete, partial, sub-standard clinical trials".

"The result is that drugs get approved without anyone being able to know how effective they really are or how much serious harm they will cause," he said.
When patients complained of adverse reactions, studies showed doctors were likely to dismiss them, he said.

http://www.telegraph...tor-claims.html

Edited by stocks, 21 August 2010 - 01:55 PM.

[stocks]

Overdosed America: The Broken Promise of American Medicine

Abramson is a former family practitioner who teaches at Harvard Medical School

Much of what Abramson reports involves the drug industry. He gives specific examples where published drug studies focus on recipients non-representative of typical (target) users - eg. younger, and less prone to adverse reactions. Sometimes the reported data show (if one has the time to read carefully) that the true targets do WORSE with the medication, and this finding is obscured by positive results with the more numerous (atypical) younger selected test patients.

Other medical research reporting ploys utilized by drug companies include: 1)reporting initially positive results, while omitting adverse subsequent outcomes, 2)combining serious (when increased) and minor (when decreased) adverse event numbers to cover up problems, 3)comparing a strong dose of a new medicine with an inappropriate weak dose, comparing a new drug with a placebo, instead of existing efficacious drugs, 4)not reporting negative drug trials, 5)failing to point out that lifestyle changes often provide much better results than drugs, and 6)pulling advertising from medical journals running unfavorable articles.

The result is typically increased cost of care, and less than ideal results. Sometimes, however, it is much worse. Dr. Abramson reports that anti-arrhythmic drugs (reduce dangerous rapid heartbeat) were found to INCREASE death rates in '80 - however, the results were not published until '93, resulting in an estimated 20-75,000 extra deaths/year.
Link

[stocks]

Overdosed America: The Broken Promise of American Medicine

Abramson is a former family practitioner who teaches at Harvard Medical School

Other medical research reporting ploys utilized by drug companies include: 1)reporting initially positive results, while omitting adverse subsequent outcomes, 2)combining serious (when increased) and minor (when decreased) adverse event numbers to cover up problems, 3)comparing a strong dose of a new medicine with an inappropriate weak dose, comparing a new drug with a placebo, instead of existing efficacious drugs, 4)not reporting negative drug trials, 5)failing to point out that lifestyle changes often provide much better results than drugs, and 6)pulling advertising from medical journals running unfavorable articles.

GlaxoSmithKline, the world’s fourth largest drug company, was found guilty of a range of misdemeanours by the US Department of Justice.

Here’s some of them:

The creation of “misleading” articles in medical journals claiming that paroxetine was effective in the under-18s, even though the cited study failed to find benefit.

The hiding of relevant trials that had negative findings.

The creation of “sham advisory boards” (supposedly expert boards that advice on management of medical condition that are populated my hand-picked ‘experts’ who are known to be sympathetic to a drug and may be being paid to sit on these boards).

Provision of travel inducements (bribes) to promote unauthorised use of the drug.


http://www.drbriffa....-going-to-jail/