How often are we asked to give our “evidence base” for the very effective treatments that we give?
How often are the people who ask these questions really not interested in what we do and only see us as inconvenient irritants to their version of the truth and as competition that should be rooted out?
I believe that there is a place for empirical medicine along side of conventional medicine. Especially when conventional medicine does not have a safe or effective treatment, like for example the use of prolo/neural therapy in the treatment of all kinds of pain syndromes instead of highly addictive and largely ineffective narcotic analgesics. It’s interesting to note, that conventional doctors will promote a treatment system with all their collective “might” until they find a more effective treatment. Then they own up to how they mislead us.
I believe that there should four levels of evidence.
- The gold standard double blind trials, especially for dangerous stuff.
- “Evidence based” medicine, as I will elaborate, I have serious troubles with.
- Empirical medicine for things that can’t be double blinded like acupuncture, chiro/osteopathy, neural therapy which are patently safe, or which have been around for a long time like herbal medicine.
- The circumstance, where there are thousands of people experiencing a condition and there are only a few papers to say that there is no connection. The classic example is autism by the hundreds of thousands vs. the few papers to the contrary published by industry.
A paper published in Scientific American Nov. 11, 2011 concluded that reducing cholesterol and blood fats made no difference to the incidence of cardio-vascular episodes.
A systematic review of 500 studies, published in the Archives of Internal Medicine, found no evidence to link saturated fats in the diet with coronary heart disease.
The vast majority of so-called scientific studies focused on cancer research are inaccurate and potentially fraudulent, suggests a new review published in the journal Nature. A shocking 88 percent of 53 “landmark” studies on cancer that have been published in reputable journals over the years cannot be reproduced, according to the review, which means that their conclusions are patently false.
In an editorial published in New Scientist, Bayer found that it was unable to reproduce 60% of the all the papers it looked at. In the same editorial, Amigen was unable to reproduce 47 out of 53 trials.
The Conclusion Reached
Researchers at the University of California published their findings in the October issue of the Annals of Internal Medicine. They reviewed 167 placebo-controlled trials published in peer-reviewed medical journals in 2008 and 2009 and found that 92 percent of those trials never even described the ingredients of their placebo pills. Placebo pills are supposed to be inert. But what if they aren’t? You can affect the outcome of a trial by using an appropriate placebo, e.g. sugar pills in a diabetes trial.
Did you know research shows that patients who have the lowest intake of salt are at greatest risk of dying earlier than those who consume large amounts? There are many more papers showing that moderate to high consumption of salt is safe, than there are papers that show salt consumption is deleterious. The Cochrane Review said that “reduced salt appeared to harm patients with bas hearts and both forms of diabetes”.
There is good evidence to suggest that salt has been empirically demonized.
The CDC published a paper in 2005 stating that “all chronic illnesses were due to infections”. Have you noticed the absence of the stampede to treat patients with chronic illnesses with antibiotics? In fact there is a movement to reduce the use of antibiotics.
Didn’t a bloke called Hannemann say something like that, only 200 years ago?
Did you know that the conventional medical profession has “proved” that the major cause of chronic pain is medically and non-medically administered analgesics. Pain killers. Didn’t Hannemann say something like that, only earlier?
You will remember the Cox 2 episode, where the offending company hid the nasty heart attack stuff in the small print, where no-one was expected to look. Where were the so-called “experts in the field” whose job it was and still is to “keep the bastards honest”?
Heck, when they don’t get the data they want from conducting real science, they just invent whatever data they want! This is what Dr. Scott Reuben did – a key researcher for Pfizer and Merck. He literally just dreamed up whatever data he wanted and authored over twenty studies which were published in mainstream medical journals – even though they were all complete fraud! To make himself more authenticated, he even enlisted real experts to “co-author” his papers with him.
The pharmaceutical giant Pfizer agreed to pay $2.3 billion to settle civil and criminal allegations that it had illegally marketed its painkiller Bextra, which has been withdrawn. This was at the time, the largest criminal fine of any kind….ever.
The Australian TGA admitted before a Senate Estimates Committee into the adverse effects of its Fluvax on children that the TGA was made aware in 2009 of findings from a published trial that 22.5% of toddlers younger than three experienced fever after being given Fluvax in 2005. That figure jumped to 39.5% in 2006, but only the 2005 data was included in the 2010 Fluvax medical information manual.
At the same hearing Liberal Senator Concetta Fierravanti-Wells also quizzed the TGA about the US Food and Drug Administration’s concerns about CSL’s manufacturing process, including its accusation of an “inadequate” examination of dark particles found in vaccines sold in the US. “Why are we leaving it to the US FDA to identify deficiencies with CSL?” Senator Fierravanti-Wells said. “Why isn’t the TGA doing that?”
John Sherman, a Queens Counsel, (a big nob in the law industry), stated that in Australia, if a woman developed breast cancer after a termination of pregnancy, the indemnity insurers would settle out of court for whatever sum they thought was reasonable – with a signed confidentiality agreement of course. So terminations of pregnancy are “safe”. Where is the “evidence base”?
Beware. Sunlight causes cancer. Sadly yes. The relatively harmless BCC and SCC varieties. The malignant melanoma, I believe is due to staying indoors and being exposed to fluorescent energy saving lights. In the meantime, the world is being exposed to the very real risks of Vitamin deficiency.
The Nordic Cochrane Centre has shown that there is no benefit to be derived from mammography. UK analyses have estimated that 1610 women needed to be screened for one death to be avoided.
Mammograms have increased the diagnosis of DCIS. The statistics show that if you do nothing for DCIU, most will disappear with no therapy. However there is absolutely no change in the outcomes for metastatic breast cancers. So if you include DCIU, you get a massive improvement in the benefits of conventional medicine for the treatment of breast cancer.
The Lancet:
Monica Morrow from Memorial Sloan-Kettering Cancer Center, New York said “There is little to no evidence that breast MRIs have any benefit for the vast majority of women. In fact, there’s not even evidence showing breast MRIs are particularly effective at helping direct breast-conserving surgery. There was no evidence to show that MRIs, even in high risk women, contribute in any significant way to their longevity”
The Australian Prescriber:
Study lead author Dr. Graeme Morgan, director of radiation oncology at Royal North Shore Hospital in Sydney, said cancer patients were being led to believe that newer chemotherapy drugs would help them live longer, despite there having been no great advances in survival rates with chemotherapy in the past 20 years. “We’re using [newer] and more expensive drugs [but] the outcome hasn’t changed at all,” he said.
In a literature review, Dr Morgan found there was only a minimal survival benefit when adults were treated with cytotoxic chemotherapy alone. While cancer patients in Australia had an average 60% five year survival rate, chemotherapy contributed only about 2% of this (Clinical Oncology 2004;1654960).
He said most chemotherapy drugs were given as palliation, without clear evidence of efficacy and at a spiralling cost, meanwhile raising false hopes for the vulnerable patient. “It may be better to come clean and say this is not going to cure you, and therefore we’re better off not giving you anything and waiting until symptoms develop,” he said.
One in five papers are written by ghost writers:
Current and former editors from the Journal of the American Medical Association (JAMA) surveyed authors of nearly 900 research articles, review articles and editorial/opinion articles from their own journal, The Annals of Internal Medicine, The Lancet, Nature Medicine, The New England Journal of Medicine and PLoS Medicine.
But they won’t tell us which ones because it might “lead to a loss of public confidence”. BMJ 2011; online 25 Oct
The Journal of Urology
Prostate biopsies are landing more and more men in the hospital where they are dying, not from any cancer that was discovered but from what happens to them while hospitalized. Prostate biopsies were linked with approximately a 7 percent rate of hospitalization within 30 days of the procedure compared to a 2.9 percent hospitalization rate among the control group of men who didn’t have prostate biopsies.
Science Oct 27, 2012.:
Anthony Letai, MD, PhD, of the Dana-Farber Cancer Institute states “Chemotherapy only works on cancer cells that were going to die anyway.”
BMJ
States that only 12% of all current drugs have established benefits.
The Cochrane’s Study
Says that less that 30% of medical drugs passed the gold standard of double blind studies.
Surgery
Surgery has rarely ever been subjected to double blind trials. The one that did showed that sham surgery was just as effective as the real McCoy.
Tamoxifen, the wonder breast cancer drug:
In a study on 7000 women, tamoxifen reduced the incidence of relapse by a massive 32 women. However, what they don’t want you to know is that 14 more women died taking tamoxifen than in the placebo group. But that was only a statistical aberration.
One could go on and on for a lot longer. But I only wanted to make a point.
Lack of evidence does not mean evidence of lack.
Remember no one ever thought that the communist USSR behemoth would ever implode. Implode it did. Overnight.
So keep to the truth. Keep your heads down and your precious little tooches out of the firing line.
The truth will always out. Thank you.
Finally, one more nail in the coffin. Excerpts from Scientific American
How Drug Company Money Is Undermining Science
Charles Seife / 1 Dec 2012
Campbell argues some of these liaisons co-opt scientists into helping sell pharmaceuticals rather than generating new knowledge.
Researchers “think what these companies are after are their brains, but they’re really after the brand,” says Marcia Angell, former editor in chief of the New England Journal of Medicine. “To buy a distinguished, senior academic researcher, the kind of person who speaks at meetings, who writes textbooks, who writes journal articles – that’s worth 100,000 salespeople.”
A 2009 study in Cancer showed that participants somehow survived longer when a study’s authors had conflicts of interest than when the authors were clean.
A 1998 study in the New England Journal of Medicine found a “strong association” between researchers’ conclusions about the safety of calcium channel blockers, a class of drugs used to reduce blood pressure, and their financial relationships with the firms producing the drugs.
When a pill does not work as advertised and is withdrawn from the market or relabeled as dangerous, there is often a trail of biased research and cash to scientists. In one Vioxx study, for example, academic researchers appear to have signed on to a Merck-sponsored project after the company had already done all the data analysis.
According to a 2010 study that appeared in the British Medical Journal, 87 percent of researchers who expressed “favorable views” of GlaxoSmithKline’s diabetes drug Avandia, despite indications that it might increase the risk of heart attacks, had some financial involvement with the drug’s manufacturer.
And when a U.S. Food and Drug Administration committee debated whether or not to pull Avandia from the market because of the link to heart attacks, it came out that members of the committee, too, had been taking money from drug companies.
More shockingly, the NIH is not only failing to enforce ethics laws intended to stop the creeping influence of drug company money, but it may also be breaking those laws.
The effort of pharmaceutical companies to influence science discourse often takes the form of ghostwriting. Once a drugmaker can steer the way that a research article is written, it is able to control, to a large degree, how a scientific result is understood and used by clinicians and researchers.
Drug company money has seeped into the NIH itself. If the agency knew about its employees’ potential conflicts and failed to ensure that those conflicts did not affect their decisions on the committees, the agency itself is violating the law.
Researchers cannot stop the influence of drug company money. Hospitals and universities will not do it. The NIH refuses to do it.
Starting in 2008, Senator Charles Grassley of Iowa led a set of congressional inquiries into several incidents in which NIH grantees failed to reveal payments from drug companies and universities failed to discipline the researchers involved properly.
An Exclusive Article for Members
From THE BRIDGE Newsletter of OIRF
Published December 2012
© Copyright 2012, Dr. Sir Zenon Gruba, Australia
