Tag Archives: BMJ

Medicine is a religion

8 Jan

And here are its tables of law

Ten Commandments

Thou Shalt Not (musical)

Image via Wikipedia

  • Thou shalt treat according to level of risk rather than level of risk factor.
  • Thou shalt exercise caution when adding drugs to existing polypharmacy.
  • Thou shalt consider benefits of drugs as proven only by hard endpoint studies.
  • Thou shalt not bow down to surrogate endpoints, for these are but graven images.
  • Thou shalt not worship Treatment Targets, for these are but the creations of Committees.
  • Thou shalt apply a pinch of salt to Relative Risk Reductions, regardless of P values, for the population of their provenance may bear little relationship to thy daily clientele.
  • Thou shalt honour the Numbers Needed to Treat, for therein rest the clues to patient-relevant information and to treatment costs.
  • Thou shalt not see detailmen, nor covet an Educational Symposium in a luxury setting.
  • Thou shalt share decisions on treatment options with the patient in the light of estimates of the individual’s likely risks and benefits.
  • Honour the elderly patient, for although this is where the greatest levels of risk reside, so do the greatest hazards of many treatments.

Amen.

Time for a little of that religion.

The list was published on Richard Lehman’s blog but it was written by John Yudkin.

We fully acknowledge and thank Gary Schwitzer’s health news watch dog , the Carlat Psychiatry Blog and the BMJ blogger Richard Lehman who led us to these sound and wise tables of law full of awareness.
These ten commandments stem from the wisdom of practitioners all along the years. My preferred one is the tenth: “Honour the elderly patient, for although this is where the greatest levels of risk reside, so do the greatest hazards of many treatments.”
Because of my Confucians way of thinking?
And you, which is your preferred one?

If you want to read more:

http://www.healthnewsreview.org/2012/01/ten-commandments-of-the-new-therapeutics/

http://carlatpsychiatry.blogspot.com/2012/01/bmjs-ten-commandments-for-ideal.html

http://blogs.bmj.com/bmj/2012/01/03/richard-lehmans-journal-review-3-january-2012/

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Bogus evidence

5 Jan

Full access to raw data becomes more and more necessary.

Photo of linear accelerator

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The number of scientists which manipulate data increases tremendously, one solution could be the obligation to make raw data accessible on the internet. A second solution is to make mandatory the publication of all the randomized controlled trials that have been registered even if they conclude to less benefit or more harm for the studied innovative procedure. A third solution is to be very circumspect if the authors have already patented their own research topics. For example prostate cancer screening and lung cancer screening are two field of highly interesting the biomedical industry and associated with large amount of potential revenue.

The latest example is a Prostate cancer screening marker research which appeared to be entirely fake. Moreover the scientist involved had already sold the discovery to a bio engineering start-up. All that stuff ended up before a court, you can see a report of the lawsuit here. The lung cancer screening has become also a competition for X-ray industrials and searchers as you can see here.
When are at stake the academic glory, the economic greed and some time no more than just finding a job for a post doc searcher the pressure to publish always surpasses the sense of honour and the Hippocratic oath?
The BMJ journal has just been recently whistle-blowing the problem in a in-depth review of the question. Bogus evidences are not only dangerous for patients but also lead to unjustified health care spending deepening the nation debt crisis.
More information on the topic is findable below:

http://www.naturalnews.com/034577_quack_science_clinical_trials_BMJ.html

http://retractionwatch.wordpress.com/2012/01/04/hopkins-scientists-retract-prostate-cancer-screening-study-at-center-of-2009-lawsuits/

http://retractionwatch.wordpress.com/2012/01/04/cancer-issues-expression-of-concern-about-two-henschke-i-elcap-lung-cancer-screening-papers/#more-5783

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