SCIENCE — OR PAP?
In an earlier article I commented on the lies that the PharmacoMafia uses in its ads to physicians. Now there is an article that contains one of the more serious indictments of ''scientific'' reporting.
''Contradicted and Initially Stronger Effects in Highly Cited Clinical Research: JAMA, July 13, 2005, 294: 218-228.
Interestingly this expose of the inadequacy of major American medical journals to police themselves, comes from Greece, in the article by Dr. John Ioannidis. ''Contradictions and initially stronger effects are not unusual'' in articles that, because of their ''promises of great advances, become highly cited.'' Conservatively, 32% of such articles are eventually discredited, most often by much larger studies. A huge number of drugs reach the market as the result of small clinical studies!!!! Indeed, it is rare for any drug to have been tested in a few thousand patients before it is fostered on gullible physicians and the public. As I report frequently, most drugs have relatively little ''success'' ABOVE PLACEBO, AND COMPLICATIONS RATES OFTEN EXCEED THE TRUE EFFICACY RATE (EFFICACY SHOULD BE THE EFFECT above PLACEBO. The articles reviewed for this JAMA paper had had many more scientific citations, often further enhancing the concept of success. Indeed the ones reviewed in this important article had had OVER 1000 subsequent citations. Talk about compound interest!
Almost half the later discredited articles had as few as 9 patients (you read it correctly) to 22 to 100. Generally these exceptionally ''believed'' and frequently quoted papers were ''refuted'' usually by studies with much larger numbers of patients from 535 to over 16,000!! And most of those initial studies that later became essentially insignificant (UNTRUE OR NON-SCIENTIFIC) because of far poorer outcomes included large subsequent studies including from 2440 to 105,000 participants!
What can we conclude from this data? Essentially the old adage ''When a new drug comes out, better use it fast before it loses its efficacy.'' And the Congressional Office of Technological Assessment concluded that 86% of drugs in the Physician's Desk Reference had not had adequate proof to be on the market!
I am constantly aware that ''significant'' results with a drug should not be based on statistical significance but FIRST AND FOREMOST on safety and secondly on just how good it is ABOVE placebo. If a drug has 15% effectiveness, but at least a 15% risk (''side effect'') rate, I would not use it in any circumstance! Most drugs on the market today have a reported efficacy of 40% to 60%, against a 35% average placebo effect. Most drugs also have complications, called side effects. We must constantly remember that stress reduction can effectively control MOST symptoms without any significant risks. Indeed, good stress reduction with Progressive Relaxation or Autogenic Training is one of the few approaches which are remarkably superior to virtually all drugs, with 80% effectiveness.
Yes, there are good drugs and essential ones for life and function. How are you to know? Read all possible data, success RATES, ''side effects'' and use your intuition. Remember that well over 100,000 people each year die because of prescription drug complications and at least 16,000 from OTC drugs. The best way to avoid being one of the complications is to keep yourself healthy with optimal habits and attitude. The science behind this fact is sound!
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