The drugs don't work: a modern medical scandal

[brianvds]

A long read, but a must-read. It is not just in "alternative" medicine where quackery now reigns...

http://www.guardian.co.uk/business/2012/sep/21/drugs-industry-scandal-ben-goldacre

Also see Ben Goldacre's website at http://www.badscience.net/

[Mefiante]

An extensive and very worthwhile assessment of publication bias in clinical drug trials.  What is truly shameful (and I was unaware of this) is the fact that drug trial sponsors (typically the drug manufacturers) get to control the publication of impartial researchers’ results and sometimes even the conduct of the trial itself.  Even more disturbing are the instances where profit is prioritised ahead of children’s safety.

Will seek out the book soonest.

I agree with Goldacre that the checks and balances are out of kilter and contra-scientific but I also think the solution could be fairly simple in principle:  No new drugs will be admitted onto the market unless they are tested successfully by three (or more) independent, reputable authorities that have an obligation to publish their results and findings in their entirety, as well as minimum criteria governing the trials (such as number and characteristics of trial participants and testing personnel).  Any inappropriate or corrupt action on the part of the testing authorities should be severely dealt with.  In short, the drug manufacturer still funds the trials but does not get to reserve any rights other than to the drug’s name and to manufacturing it.  You’d certainly need most of the world’s countries to buy into this scheme and here the UN’s WHO could prove its worth by establishing the necessary regulations and standards.

Healthcare is just too important to be subjugated under the vagaries of capitalist values, and these shenanigans serve only to undermine the public’s confidence in evidence-based medicine.

'Luthon64

[cr1t]

Yes it is all a bit worrying. The best would be to make legalization that requires Drug companies to higher independent external companies, and not the same one all the time, to do the testing and they would be required to publish all result positive and negative.

 

[brianvds]

As pointed out, there are indeed very simple solutions to the problem. So why are they not implemented? Because all over the world, governments are increasingly in the pocket of big companies, and I don't see that it will change any time soon. If anything, it will just get worse.

[cr1t]

So shall we ditch big pharma and go with homeopathy.   

[Mefiante]

So shall we ditch big pharma and go with homeopathy.   

… or, as journalist Michael Specter pithily put it in a 2010 TED talk: “We hate Big Pharma. … We don’t trust the man. … So we run away from it, and where do we run?  We leap into the arms of Big Placebo.”

'Luthon64

[brianvds]

Big Placebo will at least not do any harm, whereas Big Pharma frequently does. Fact is, we're in trouble here. The good news is that most conditions will clear themselves up in a few days or weeks. The western world suffers from an epidemic of medicalization of everything, and hypochondria, more than anything else. :-)

[cr1t]

Big Placebo will at least not do any harm, whereas Big Pharma frequently does. Fact is, we're in trouble here. The good news is that most conditions will clear themselves up in a few days or weeks. The western world suffers from an epidemic of medicalization of everything, and hypochondria, more than anything else. :-)

I'm going to differ from you here Brain, when people don't pursue proper treatment for medical conditions. Then sometimes treatable condition move into life treating conditions. So the big placebo often does do harm. I'm not saying the science based medicine is with out fault but at least in theory it relies on evidence and not wishful magical thinking.  

http://whatstheharm.net/

[Hermes]

An extensive and very worthwhile assessment of publication bias in clinical drug trials.

Among the questions readers are posing to the Guardian on this article, many are of the "who will guard the guardians" type, questioning Goldacre's own publication bias:

How many of your investigations into the ethics of scientists and business have returned negative results -i.e. no clear evidence of bias or malpractice, and were they all still published?

This constitutes flawed logic.  You don't need to quote all the instances when an accused did not commit murders in order to find him guilty of one.  One cannot compare the treatment of empirical data with assessing evidence of malpractice.  However, when it comes to assessing how widespread the malpractice is, then empirical data, and by implication publication bias by the author, indeed becomes an issue.  I guess one would have to read the book in order to judge the perspective.

[brianvds]

Big Placebo will at least not do any harm, whereas Big Pharma frequently does. Fact is, we're in trouble here. The good news is that most conditions will clear themselves up in a few days or weeks. The western world suffers from an epidemic of medicalization of everything, and hypochondria, more than anything else. :-)

I'm going to differ from you here Brain, when people don't pursue proper treatment for medical conditions. Then sometimes treatable condition move into life treating conditions. So the big placebo often does do harm. I'm not saying the science based medicine is with out fault but at least in theory it relies on evidence and not wishful magical thinking.  

http://whatstheharm.net/

Actually, I quite agree. The problem with some of modern medicine s that it now fails to follow the evidence. Of course, people who are really sick should by all means seek out treatment.

But I also worked in the medical industry, and it is just that: an industry. It's purpose is to make money. I also know from personal experience that the vast majority of people who present to the emergency room have absolutely nothing wrong with them, or suffer from nothing more than mild conditions which will clear themselves up. I suspect that this massive wave of hypochondria is partly why the medical industry often gets away with prescribing what amount to placebos.