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Old 27th May 2018, 08:21 AM   #1
Skeptical Greg
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Drug Companies Lie To Sell Drugs

This is an ad seen a while back, touting the benefits of Lipitor.



In 2011, sales from Lipitor had averaged about $11 billion a year since 1996.
Rest assured that thousands of medical doctors saw this ad in a glossy brochure,
provided by a $100k+ a year Pfizer sales rep..

We must wonder if they would have even put it on the market if
their ad had looked like this:



When you take a look at the fine print, you see that they actually told the truth
about the drugs effectiveness in reducing risk of heart attack..




How do the math wizards at Pfizer get 36% out of a 1% difference between their drug and a placebo?

Here is a graph of the data from the study the ad is based on.



At the top, you see where the actual 3% ( placebo ) vs 2% ( Lipitor ) numbers came from.
They divided 2 by 3 and came up with 36%..

The calculation they used is to produce a number called ' relative risk ' , which has virtually nothing
to do with the actual effectiveness of the drug.

A little digging will show you how drug companies do this all the time..

Reporting the findings: Absolute vs relative risk


Since it's legal, why not? Do you give up $11 billion dollars if you don't have to.

Would you have a problem with a financial advisor who touted a 36% return on your investment,
while only showing a 1% ?
How about a Dr. who wants you to take a drug based on the same numbers?

Meanwhile, millions of people take a drug whose effectiveness in doing what it claims is questionable,
while the possible debilitating and life threatening side effects are not.

Statin side effects:


This topic was inspired by a recent lecture by David Diamond Ph.D
( A real doctorate in biology )

YouTube Video This video is not hosted by the ISF. The ISF can not be held responsible for the suitability or legality of this material. By clicking the link below you agree to view content from an external website.
I AGREE


( If you watch the lecture, my images will look familiar.. )
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Old 27th May 2018, 09:48 AM   #2
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Yes. For the companies it's not so important whether it works or not, but whether it makes a great profit.
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Old 27th May 2018, 10:45 AM   #3
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So, if the drop was from 1% to 0%, it would still be a 1% drop? No, it would be a 100% drop. Their math is correct.

Let's say that 2000 people are in the study, 1000 taking Lipitor and 1000 taking a placebo. With a placebo, 3% of 1000 (30) have a heart attack. With Lipitor, 2% of 1000 (20) have a heart attack. The drop from 30 to 20 is a 33% drop, not 1%.

I'm no friend of drug companies, and they do lie to sell drugs, but I really hate innumeracy. You're barking up the wrong tree.
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Old 27th May 2018, 11:59 AM   #4
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Originally Posted by shemp View Post
So, if the drop was from 1% to 0%, it would still be a 1% drop? No, it would be a 100% drop. Their math is correct.

Let's say that 2000 people are in the study, 1000 taking Lipitor and 1000 taking a placebo. With a placebo, 3% of 1000 (30) have a heart attack. With Lipitor, 2% of 1000 (20) have a heart attack. The drop from 30 to 20 is a 33% drop, not 1%.

I'm no friend of drug companies, and they do lie to sell drugs, but I really hate innumeracy. You're barking up the wrong tree.

Shemp, the way I see it is that we take drugs to increase our risk of NOT getting a disease. Using the stats above, our risk of not dying of a heart attack is 97%. Taking Lipitor only improves that by 1%. And I feel that is a valid logoc for each of us as individuals. BUT I also see that drug companies, the AMA, and health insurance companies have to look at the huge number scheme of things. RR is for Epidemiological scale. Somewhere you and I have to evaluate the 1% concept. I am one of those more susceptible to Statin Myopathy, I decided that the pain is not worth the 1% gain. Which is one more reason why I champion the science of Pharmacogenetics.
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Old 27th May 2018, 01:43 PM   #5
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Drug companies lie.

However, I think the OP missed some key aspects of their lying ways.

First, notice the absence of key numbers: the numbers of people in the various studies. tl;dr: nothing about statistical significance.

Second, how many other studies did they do, which they did not report the results of?
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Old 27th May 2018, 02:24 PM   #6
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Surprisingly they do teach you this at medical school. medical doctors do know the difference between absolute and relative risk. A better way of looking at the effects is number needed to treat NNT. In this case 100 people would have to take the tablet to prevent one event. This can be balanced by the number needed to harm depending on the frequency of adverse events.

But you also missed out a vital piece of data, the time duration. If this is one fewer events every month that is much more important than one per ten years. So a better way of putting it is using person years. Remember benefits will be cumulative, so over ten years you may be looking at 45 person years of benefit out of a thousand person years of use even though there was only a 1% absolute benefit. Sometimes survival curves are a better way to show data.

Vaccines may have low benefits in terms of NNT, millions are being treated to prevent one case of polio. The breast cancer screening program is of minimal benefit.
Quote:
Out of 1,000 women aged 50 to 69 years invited every second year, 781 are alive with screening and the same number without screening over the course of 20 years. Correspondingly, 985 women and 982 to 983 women without screening will not die of breast cancer aged 55 to 74 years. Negative framing: out of 1,000 women aged 50 to 69 years invited every second year, 204 women will die with screening and the same number without screening. Correspondingly, 15 women with screening and 17 to 18 women without screening will die of breast cancer between 55 and 74 years old. Number of women dying among women aged 55 to 74 years is based on the observed mortality rates in England and Wales in 2007
The consequence of the event is also important, a 1% benefit for preventing a cold is different from 1% reduction in death. This is why benefits may be framed in terms of DALYs disability adjusted life years. This can take account of the combined benefit of reducing death from a heart attack and disability from a stroke.
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Old 27th May 2018, 04:26 PM   #7
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In other news, statistics don't lie, but liars use statistics.
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Old 28th May 2018, 06:59 PM   #8
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Oddly, I think the use of statistics and graphs in the OP are more misleading.
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Old 29th May 2018, 10:23 AM   #9
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Originally Posted by Tsukasa Buddha View Post
Oddly, I think the use of statistics and graphs in the OP are more misleading.
To what end?
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Old 29th May 2018, 11:53 AM   #10
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Originally Posted by shemp View Post
So, if the drop was from 1% to 0%, it would still be a 1% drop? No, it would be a 100% drop. Their math is correct.

Let's say that 2000 people are in the study, 1000 taking Lipitor and 1000 taking a placebo. With a placebo, 3% of 1000 (30) have a heart attack. With Lipitor, 2% of 1000 (20) have a heart attack. The drop from 30 to 20 is a 33% drop, not 1%.

I'm no friend of drug companies, and they do lie to sell drugs, but I really hate innumeracy. You're barking up the wrong tree.
If you can't see his point, he is not the one that is il-numerate.

Both the OP and Big Pharm use good math. But big pharn chooses to represent the numbers in the way that makes them look best.

So far as the efficacy of Statins, if EVERYBODY took them, our life expectancy would go up by two weeks. The don't actually prevent death (the death rate remains ONE) the only postpone it.

Funny that after decades of Statin use, we don't hear anything about their efficacy in actual clinical practice. If they were say, 37%, it would be trumpeted from every hospital roof in the country. I suspect they do show good, but much less than that 36% in the stats above. Maybe 10%? So make that two weeks I mentioned only 5 days?

I'd love to hear actual numbers from an entity divorced from Big Pharma, an HMO maybe? I know Kaiser keeps data... which makes me think the 10%.
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Old 29th May 2018, 01:03 PM   #11
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Originally Posted by casebro View Post
<snip>
Funny that after decades of Statin use, we don't hear anything about their efficacy in actual clinical practice. If they were say, 37%, it would be trumpeted from every hospital roof in the country. I suspect they do show good, but much less than that 36% in the stats above. Maybe 10%? So make that two weeks I mentioned only 5 days?

I'd love to hear actual numbers from an entity divorced from Big Pharma, an HMO maybe? I know Kaiser keeps data... which makes me think the 10%.
All the research I've read shows that statins have efficacy in preventing cardiac/stroke events in people who are at higher risk for them. I'm not sure where you get your own numbers from but the American College of Cardiology states the following:

Quote:
In a meta-analysis of 27 randomized trials and 174,000 participants, for every ~40 mg/dL LDL-C reduction with statin therapy, the relative risk of major adverse cardiovascular events is reduced by ~20-25%, and all-cause mortality is reduced by 10%. More intense statin regimens yield a 15% further proportional reduction in major adverse cardiovascular events compared to less intense regimens.
So depending on the reduction in LDL-C achieved and how intense the statin regimen is, there is a pretty significant reduction in cardiovascular events and all-cause mortality -no matter how you want to play with the actual statistics, lives are saved.
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Old 29th May 2018, 01:45 PM   #12
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Originally Posted by Skeptical Greg View Post
To what end?
Why graph the number of patients without events when we are trying to compare the numbers of those with events? It's a silly technique to try to minimize the RRR. Yes, when there is a low risk of events, the RRR is greater than the ARR. Why is one the "truth" and one "has virtually nothing
to do with the actual effectiveness of the drug"?

Quote:
It is well recognized that how efficacy and safety data is presented to physicians, patients and health care policy makers influences their decisions. In fact, most studies suggest that all 3 groups make more conservative decisions about therapies when they are presented with numbers needed to treat than when they are presented with the same data presented as relative risk ratio. However, it is not entirely clear that a more conservative decision is necessarily the right one. For example, many British patients with atrial fibrillation who were likely to benefit from anticoagulant therapy because of their risk profiles and their similarity to the participants in randomized trials supporting the efficacy of warfarin declined warfarin therapy when presented with the data about their absolute risks and benefits.
Linky.

And this isn't something the "math wizards" at drug companies do. Most journals report RRR too.
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Old 29th May 2018, 02:20 PM   #13
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This is the statin I take, having being prescribed it when a routine physical at age 60 showed a cholesterol level of 9.1 despite no obvious lifestyle cause. There's early stroke and heart disease in my family so, after reading up on statins, I decided to take it provided I experienced no significant side effects. The evidence of benefit isn't exactly conclusive, but on balance I think it's more likely to do me good than harm.
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Old 29th May 2018, 02:34 PM   #14
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Originally Posted by xjx388 View Post
All the research I've read shows that statins have efficacy in preventing cardiac/stroke events in people who are at higher risk for them. I'm not sure where you get your own numbers from but the American College of Cardiology states the following:

"In a meta-analysis of 27 randomized trials......,"


So depending on the reduction in LDL-C achieved and how intense the statin regimen is, there is a pretty significant reduction in cardiovascular events and all-cause mortality -no matter how you want to play with the actual statistics, lives are saved.
But ALL of that data is from Big Pharma studies. I want data from actual clinical use. Key word is "randomized". REAL clinical use is not randomized .

I'm not saying that there is no benefit, I'm saying the real benefit is less than the 30-something % often quoted. And it may be so small that any individual is not likely to see the benefit at all. But HMOs and insurance companies would be thrilled at 5%.

Something like a study Kaiser did a few years ago. Unrelated to Statins, but they looked into the records of 8,000,000 actual, real, not 'subjects in a study', patients. Leessee that for Statins.
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Old 29th May 2018, 04:04 PM   #15
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Originally Posted by xjx388 View Post
...So depending on the reduction in LDL-C achieved and how intense the statin regimen is, there is a pretty significant reduction in cardiovascular events and all-cause mortality -no matter how you want to play with the actual statistics, lives are saved.
From your link:

Quote:
Statin therapy reduces major adverse cardiovascular events (myocardial infarctions, strokes and death) and all-cause mortality in patients with or at risk for ASCVD.

In my experience, doctors prescribe statins solely on the basis of elevated LDL-c ( a very dubious measurement ), and not the criteria listed above.
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Old 29th May 2018, 05:41 PM   #16
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Originally Posted by casebro View Post
But ALL of that data is from Big Pharma studies. I want data from actual clinical use. Key word is "randomized". REAL clinical use is not randomized .

I'm not saying that there is no benefit, I'm saying the real benefit is less than the 30-something % often quoted. And it may be so small that any individual is not likely to see the benefit at all. But HMOs and insurance companies would be thrilled at 5%.

Something like a study Kaiser did a few years ago. Unrelated to Statins, but they looked into the records of 8,000,000 actual, real, not 'subjects in a study', patients. Leessee that for Statins.
I've never read anyone who generally ranks RCT meta-analysis below observational in the hierarchy of evidence. The problem with large "real" use is the opportunity for uncontrolled bias in the data.
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Old 29th May 2018, 05:55 PM   #17
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As to the title, NO ******!!!!!!!!!!
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Old 29th May 2018, 06:05 PM   #18
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The problem isn't that they lie. The problem is that they have a direct forum to consumers at all. Of major world economies, only the US, Brazil and New Zealand permit direct drug advertising to consumers. Hong Kong sort of does but has some regulations. An average person without scientific or medical training is simply not equipped to sort through the results of drug studies. There's a reason doctors in the US have seven years of post secondary education and several years of on the job training.
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Old 29th May 2018, 07:54 PM   #19
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Originally Posted by Tsukasa Buddha View Post
I've never read anyone who generally ranks RCT meta-analysis below observational in the hierarchy of evidence. The problem with large "real" use is the opportunity for uncontrolled bias in the data.
and geee, there is NO chance of bias is studies sponsored by Big Pharma. No sirreee, none at all. Not even if the meta study looks at 27 studies all paid for by drug companies. Because umm, umm, more of the same = something NOT the same?
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Old 30th May 2018, 12:39 AM   #20
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Originally Posted by casebro View Post
But ALL of that data is from Big Pharma studies. I want data from actual clinical use. Key word is "randomized". REAL clinical use is not randomized .

I'm not saying that there is no benefit, I'm saying the real benefit is less than the 30-something % often quoted. And it may be so small that any individual is not likely to see the benefit at all. But HMOs and insurance companies would be thrilled at 5%.

Something like a study Kaiser did a few years ago. Unrelated to Statins, but they looked into the records of 8,000,000 actual, real, not 'subjects in a study', patients. Leessee that for Statins.
The real effect may also be greater, often people with greater risks, elderly, poor, those with more than one condition are excluded from trials. Drug trials tend to choose healthy people who are relatively low risk. A good example is the trials of flu treatment, mostly done in the community, people with a low risk of dying of flu. The benefits of treating flu in healthy people are little. Real world use of flu treatment in people requiring admission to hospital suggests it decreases flu related deaths, but this is not an RCT so has confounders.

Insurance systems or charities or universities or government could fund more drug trials; some are funded by them. Most trials in TB treatment were not drug company funded (MRC and USPHS). Many malaria trials are funded by charities. The construction of many trials is defined by drug licensing rules, that may insist on a placebo controlled trial rather than versus current best treatment. That is not the fault of the drug company but the 'law'.
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Old 30th May 2018, 01:06 AM   #21
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Originally Posted by Skeptical Greg View Post
From your link:




In my experience, doctors prescribe statins solely on the basis of elevated LDL-c ( a very dubious measurement ), and not the criteria listed above.
This would not be the case in the UK. The criteria would be risk of vascular disease, taking into account blood pressure, diabetes, medical history etc. as well as lipids. If statins are only used in people with elevated lipids then people who would benefit with normal lipids are being denied effective treatment.
https://www.nice.org.uk/guidance/cg1...ecommendations
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Old 30th May 2018, 04:38 AM   #22
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Originally Posted by Pixel42 View Post
This is the statin I take, having being prescribed it when a routine physical at age 60 showed a cholesterol level of 9.1 despite no obvious lifestyle cause. There's early stroke and heart disease in my family so, after reading up on statins, I decided to take it provided I experienced no significant side effects. The evidence of benefit isn't exactly conclusive, but on balance I think it's more likely to do me good than harm.
You might find this interesting:

Low Levels of LDL Cholesterol Predate Cancer Cases by Nearly Two Decades


It's interesting how they still manage to give statins a free pass.

This sounds contradictory to me:
Quote:
Another study published in 2008 by the same researchers showed a similar relationship between low LDL-cholesterol levels and incident cancer, as well as showing that statin therapy, despite significantly reducing LDL-cholesterol levels, was not associated with an increased risk of cancer.
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Old 30th May 2018, 05:19 AM   #23
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Originally Posted by Craig4 View Post
... There's a reason doctors in the US have seven years of post secondary education and several years of on the job training.
To what end?

Why does my primary care physician still insist on recommending statin therapy for me at age 69, when I have a Cardiac CT calcium score of zero?

Also:

Statins: No benefit as primary prevention in elderly

Quote:
The primary outcome, all-cause mortality, was slightly higher in the statin group.
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Old 30th May 2018, 06:24 AM   #24
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Sure, pharma companies lie, this isn't a very good example of it though. Misleading use of statistics, yes but a very common way of doing it.
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Old 30th May 2018, 06:49 AM   #25
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Cochrane, Jan. 31, 2013:
Quote:
All-cause mortality and fatal and non-fatal CVD events were reduced with the use of statins as was the need for revascularisation (the restoration of an adequate blood supply to the heart) by means of surgery (coronary artery bypass graft ) or by angioplasty (PTCA). Of 1000 people treated with a statin for five years, 18 would avoid a major CVD event which compares well with other treatments used for preventing cardiovascular disease. Taking statins did not increase the risk of serious adverse effects such as cancer. Statins are likely to be cost-effective in primary prevention.
Statins for the primary prevention of cardiovascular disease
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Old 30th May 2018, 06:54 AM   #26
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Originally Posted by JeanTate View Post
how many other studies did they do, which they did not report the results of?

That is one of Ben Goldacre's pet peeves: Unpublished trials are a cancer at the core of evidence based medicine | Ben Goldacre

What statins tell us about the mess in evidence based medicine (Ben Goldacre, June 30, 2014)
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Old 30th May 2018, 08:41 AM   #27
Skeptical Greg
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Originally Posted by dann View Post
Cochrane, Jan. 31, 2013:

They cited 18 out of 56,934 patients?

I would like to see a lot more details from that study..

Also the conclusion states:

Quote:
Reductions in all-cause mortality, major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins.
Implying that those with least risk were helped the most, which says nothing about the efficacy of statins in reducing risk among healthy people with elevated cholesterol;
assuming elevated cholesterol in itself is not a risk.

What does " no excess ' mean?

Again, I would like to see the numbers.
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Old 30th May 2018, 09:19 AM   #28
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Originally Posted by dann View Post
Cochrane, Jan. 31, 2013:
Once again, a study made of the compendium of Big Pharma studies: " We found 18 randomised controlled trials with 19 trial arms (56,934 patients) dating from 1994 to 2008. All were randomised control trials comparing statins with usual care or placebo. " So not actual data of actual clinical use.
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Old 30th May 2018, 10:02 AM   #29
dann
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Originally Posted by Skeptical Greg View Post
Again, I would like to see the numbers.

So would a lot of people, but many of those numbers are private property and not accessible.

I didn't know that Ben Goldacre actually published a book about statins and statin research last year. This is how it's described at Amazon.co.uk:

Quote:
A campaigning handbook, a thrilling work of popular science, and a call to arms for doctors, researchers and patients from Britain's finest writer on the science behind medicine. Statins are the single most commonly prescribed class of drugs in the whole of the developed world. They're taken by over 100 million people, with millions more patients being offered them every year. We know that statins do some good. But we don't know how big the benefits are. We don't know which is the best. We don't how common the side effects are. We don't give clear information to patients, so they are deprived of their right to make informed decisions about the trade-off between benefits, inconvenience, and risk. All this can be fixed, with a few simple changes that weld big data onto the heart and art of medicine. Drawing on his own research, Ben Goldacre gives patients the tools they need to make their own decisions. Along the way he explores industry misdeeds; the "nocebo" effect, the evil twin of the placebo effect, where side effects are caused by the power of fear alone; and the differences in patients' desire for treatment, and doctors' failures to empathise with these. With his characteristic wit and energy, Goldacre exposes the flaws in modern medicine, and the future it deserves.
Do Statins Work?: The Battle for Perfect Evidence-Based Medicine Paperback (13 Jul 2017)
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"Stupidity renders itself invisible by assuming very large proportions. Completely unreasonable claims are irrefutable. Ni-en-leh pointed out that a philosopher might get into trouble by claiming that two times two makes five, but he does not risk much by claiming that two times two makes shoe polish." B. Brecht
"The abolition of religion as the illusory happiness of the people is required for their real happiness. The demand to give up the illusion about its condition is the demand to give up a condition which needs illusions." K. Marx
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Old 30th May 2018, 03:06 PM   #30
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Originally Posted by casebro View Post
and geee, there is NO chance of bias is studies sponsored by Big Pharma. No sirreee, none at all. Not even if the meta study looks at 27 studies all paid for by drug companies. Because umm, umm, more of the same = something NOT the same?
You are rejecting a substantial body of high quality evidence because of a potential bias (without evidence, I might add), but promoting a methodology has the potential for even greater and deeper potential biases. Your focus on sponsorship bias is leading to an irrational conclusion.
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Old 30th May 2018, 06:11 PM   #31
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Originally Posted by Tsukasa Buddha View Post
You are rejecting a substantial body of high quality evidence because of a potential bias (without evidence, I might add), but promoting a methodology has the potential for even greater and deeper potential biases. Your focus on sponsorship bias is leading to an irrational conclusion.
Yeah, that must be why scientists have to disclose sponsorship - "Dr. John Q. Eistein is accepted grants from Pharmaco, the biggest maker of Profitumab in the world". Because the rest of the world agrees with you, scientist don't sell out. Ya sure.
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Old 30th May 2018, 07:17 PM   #32
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Originally Posted by JeanTate View Post
Second, how many other studies did they do, which they did not report the results of?
That is the best way to lie. Run 20 tests and, even if there is no effect, at least one of the tests will show an effect. Isn't that how most woo works?
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Old 30th May 2018, 10:59 PM   #33
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Originally Posted by casebro View Post
Yeah, that must be why scientists have to disclose sponsorship - "Dr. John Q. Eistein is accepted grants from Pharmaco, the biggest maker of Profitumab in the world". Because the rest of the world agrees with you, scientist don't sell out. Ya sure.

And they often don't disclose anything. Ben Goldacre again.
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"Stupidity renders itself invisible by assuming very large proportions. Completely unreasonable claims are irrefutable. Ni-en-leh pointed out that a philosopher might get into trouble by claiming that two times two makes five, but he does not risk much by claiming that two times two makes shoe polish." B. Brecht
"The abolition of religion as the illusory happiness of the people is required for their real happiness. The demand to give up the illusion about its condition is the demand to give up a condition which needs illusions." K. Marx
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Old 30th May 2018, 11:15 PM   #34
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Originally Posted by Dr. Keith View Post
That is the best way to lie. Run 20 tests and, even if there is no effect, at least one of the tests will show an effect. Isn't that how most woo works?

No, most woo doesn't do tests at all. Or, if it does, it's woo tests: Danish quack Torben Frank Andersen, Allergikompagniet, who claims that allergies are a kind of "chemical phobia", and this is how he 'tests' if a patient is allergic to something:

YouTube Video This video is not hosted by the ISF. The ISF can not be held responsible for the suitability or legality of this material. By clicking the link below you agree to view content from an external website.
I AGREE
(2:30-3:20)

This guy would never do a double-blind test!
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"Stupidity renders itself invisible by assuming very large proportions. Completely unreasonable claims are irrefutable. Ni-en-leh pointed out that a philosopher might get into trouble by claiming that two times two makes five, but he does not risk much by claiming that two times two makes shoe polish." B. Brecht
"The abolition of religion as the illusory happiness of the people is required for their real happiness. The demand to give up the illusion about its condition is the demand to give up a condition which needs illusions." K. Marx
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Old 31st May 2018, 12:37 AM   #35
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Quite. The results of large scale double blind clinical trials may not be 100% reliable (the file drawer effect is certainly pernicious) but they're a hundred times more reliable than the "tests" on which belief in most alternative medicine is based, which mostly consists of the believer trying it and, if they feel a bit better next day, concluding that it's an effective treatment.
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Old 31st May 2018, 01:58 AM   #36
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However, the question remains: What does more damage? A looney who believes (or maybe only pretends to believe) that birch pollen in an unopened plastic bag placed against the skin will make the patient's 'muscle response' reveal the brain's 'chemical phobia' (= allergy), or drug companies making actual science-based "large scale double blind clinical trials" and never making public the ones that don't show the results that they were hoping for?
So far, the looney has only managed to almost kill a kid whose peanut allergy he declared cured.
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"Stupidity renders itself invisible by assuming very large proportions. Completely unreasonable claims are irrefutable. Ni-en-leh pointed out that a philosopher might get into trouble by claiming that two times two makes five, but he does not risk much by claiming that two times two makes shoe polish." B. Brecht
"The abolition of religion as the illusory happiness of the people is required for their real happiness. The demand to give up the illusion about its condition is the demand to give up a condition which needs illusions." K. Marx
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Old 31st May 2018, 07:17 AM   #37
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But after the DBPC study, isn't there a feedback from actual practicing clinicians? Though I don't think it is as easy as say "Yup, the rash is gone". It would have taken a decade to see an actual effect for Statins.

I chose to use an HMO because I felt they would be more evidence based, they won't do stuff just to make more money. They will do stuff that is proven to save them money in the long run. They still push statins, so they must have some efficacy. And I say they know EXACTLY the efficacy in a clinical setting. And if it was better efficacy than the Big Pharm DBPC studies showed, they would all be trumpeting it from the roof of the Big Pharma Ass Headquarters building. So it must be less efficient than the DBPC's show. And that info is file-drawered- by BP for profit sake, and by the HMO because they don't want us to stop taking it, even if it only shows a 2% benefit.

So what do they call that type of clinical tally? Does the FDA do it? It's the kind of tally that gets drugs taken off the market because of side effects that show up in the huge number of subjects in actual practice. An NSAID? Celebrex? A diabetes med, Actos? You've all heard of Black Box Warnings. They ae usually added after downsides show up in clinical practice. Do they not keep track of actual up-sides?
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Old 31st May 2018, 08:02 AM   #38
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I need to do more research, but I suspect most Dr.s push statins because the criteria for prescribing them, is part of their board certifications.

When I get my check-ups, the Dr is checking boxes, and making recommendations based on the results of some formula they are using.

When I tried to discuss my LDL-c number with my Dr., and asked her what she thought about my getting an NMR lipid panel to look at particle size,
she said she didn't care about that; I just needed to lower the LDL-c number..

Advanced lipoproteins, in particular apo B, total LDL-P, and total HDL-P have been shown to predict CHD at baseline and on treatment, independent of traditional lipid measurements.
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Old 31st May 2018, 02:29 PM   #39
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Originally Posted by casebro View Post
Yeah, that must be why scientists have to disclose sponsorship - "Dr. John Q. Eistein is accepted grants from Pharmaco, the biggest maker of Profitumab in the world". Because the rest of the world agrees with you, scientist don't sell out. Ya sure.
Quote where I said there is no potential for bias due to sponsorship. When you can't, try actually replying to what I wrote.
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Old 31st May 2018, 11:00 PM   #40
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Originally Posted by Skeptical Greg View Post
I need to do more research, but I suspect most Dr.s push statins because the criteria for prescribing them, is part of their board certifications.

When I get my check-ups, the Dr is checking boxes, and making recommendations based on the results of some formula they are using.

When I tried to discuss my LDL-c number with my Dr., and asked her what she thought about my getting an NMR lipid panel to look at particle size,
she said she didn't care about that; I just needed to lower the LDL-c number..

Advanced lipoproteins, in particular apo B, total LDL-P, and total HDL-P have been shown to predict CHD at baseline and on treatment, independent of traditional lipid measurements.
Probably something like Qrisk (the UK NHS version).
You could put your data in here.
https://qrisk.org/three/
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