The drugs don't work: a modern medical scandal

[Ian]

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

 

[heapsreal]

I read the first few paragraphs about reboxetine, its no dummy pill but i wasnt using it for depression but for energy. First day at a 1/4 of normal dose and it kicked in with good energy, but i have never sweat so much in my life. As night time came the energy wouldnt go away, even with sleep meds i couldnt sleep more then a few winks. So the pill does something but maybe not in the best way. I have tried it a few times but only on days i wasnt going to work as i didnt want to be at work sweating my little A--- off. I would class it more as a stimulant/sweating drug.

 

[Esther12]

I thought this was a good piece, but I also think that the same concerns apply to cognitive and behavioural treatments More so really,as it's harder to even get good data, never mind deal with the danger of it then being misrepresented. So many of Goldachre's points apply to the PACE trial.

They found more than 500 trials in total: 85% of the industry-funded studies were positive, but only 50% of the government-funded trials were.

While I think it's fair to assume that pharmaceutical companies are keen to have their products look as good as is possible, is it not also possible that some governments may not want to approve expensive drugs that could prove a burden to their own budgets? It needs to be recognised that all of those involved in RCTs can have desires for a particular result.

 

[Waverunner]

While I think it's fair to assume that pharmaceutical companies are keen to have their products look as good as is possible, is it not also possible that some governments may not want to approve expensive drugs that could prove a burden to their own budgets? It needs to be recognised that all of those involved in RCTs can have desires for a particular result.

Exactly. This is why in my eyes, the patient should decide, what medication he buys/takes. In the end, only he can decide, if a drug helps or not.

 

[heapsreal]

I thought this was a good piece, but I also think that the same concerns apply to cognitive and behavioural treatments More so really,as it's harder to even get good data, never mind deal with the danger of it then being misrepresented. So many of Goldachre's points apply to the PACE trial.



While I think it's fair to assume that pharmaceutical companies are keen to have their products look as good as is possible, is it not also possible that some governments may not want to approve expensive drugs that could prove a burden to their own budgets? It needs to be recognised that all of those involved in RCTs can have desires for a particular result.

I wonder if this is why many govts ignore herpes virus problems in cfs/me because if they stated this was a problem the govt's like australia and the UK with govt funded healthcare would have to pay for antiviral treatments which arent cheap.

 

[Marco]

Reads like special pleading for bureaucratised medicine to me.

 

[GhostGum]

I thought this was a good piece, but I also think that the same concerns apply to cognitive and behavioural treatments More so really,as it's harder to even get good data, never mind deal with the danger of it then being misrepresented. So many of Goldachre's points apply to the PACE trial.

Maybe someone should write to Ben, show him how the recent Lipkin results were portrayed, link him some of the better articles and give him a basic run down of ME and the PACE trial.

Looking at this article he seems to be a very rare beast, someone who can see through all the bs, see the flaws in how the scientific process is being abused/manipulated and write a real investigative piece. Having him write about ME and following it would probably be invaluable, even if it is a long shot.

On the topic of this article it is no surprise really, organizations like the FDA who should be scrutinizing the science, chasing down and charging companies doing the wrong thing, questioning those being paid off by big pharma putting out research papers recommending drugs, they are nothing but a red stamp for big pharma most of the time; as I understand it the whole board of the FDA is a revolving door for people previously involved in chemical or pharma companies.

The whole anti-depressions issue is one of the biggest fallacies of our times, along with the continued over diagnosis of mental illness. Just like we look back on how archaic medical/psychiatric methods were 50 or 100 years ago people will look back on all this wondering how the system could be so corrupt. Not to say that all anti-depressions do not have value in some cases, it just seems like such a crap shoot.

 

[GhostGum]

I wonder if this is why many govts ignore herpes virus problems in cfs/me because if they stated this was a problem the govt's like australia and the UK with govt funded healthcare would have to pay for antiviral treatments which arent cheap.

What I find really surprising about this is why the pharma companies actually are not all over this trying to come up with a vaccine, these are their cash cows after all.

As much as I am against over vaccination it would appear if we need a vaccination for anything it is the herpes family and especially EBV which is now potentially being linked to all kinds of complications, could have massive benefits.

 

[alex3619]

Goldacre has a mixed reputation with us, he appears to be an ME denier but I am happy to be proven wrong, as I have yet to look at the evidence (his prior publications) very closely. Its also possible I am confusing him with someone else.

I do NOT want to see more bureaucratic medicine, I want to see more scientific medicine. The two are not the same, and if medicine gets even more bound up by rules that allow them to ignore the science, or prevent the science, its a bad thing.

Bye, Alex

 

[GhostGum]

Seems ironic that someone who can write an article like that on the failings of an industry to be held accountable for the science they produce/withhold could be an ME denier, but no surprise. It seems getting high profile reporters to do a real investigative piece on ME in the UK is like asking them to stand in front of a firing squad.

 

[alex3619]

Some references relating to Goldacre and others; I have only investigated a couple of these sources so far.

http://quackbengoldacre.wordpress.com/references/

The sceptic movement, healthwatch, biopsychosocial medicine advocates and ME deniers are overlapping groups. Though its hard to say with certainty that a member of one of these groups is a member of the others, without direct evidence, anybody in one of these groups has a higher chance of being in the others.

Please note that there are many sceptics who are not ME deniers too. I regard scepticism as a refusal to come to conclusions without facts. The label is also adopted by deniers though - people who are anti-something because, they claim, there is no evidence for it. A more balanced sceptical position would be "I am not convinced this is correct, and wont be without more evidence" not "this is wrong and I am not looking at more evidence".

Bye, Alex

 

[Esther12]

he appears to be an ME denier

I don't really know what that means, but I'm not aware of any evidence of something like that.

I do know that he has already been contacted about PACE stuff, and showed no interest. He's meant to be connected to Wessely (don't know if that's true), and did some radio documentary during the run up of benefit reform which seemed to fit in with the Aylward narrative.

 

[biophile]

Perhaps Goldacre could be reached by speaking the same language and using criticisms he has for drug studies. He may be interested in how the Science Media Centre portrayed the PACE Trial, a non-blinded study without placebo control, as the "highest grade of clinical evidence" on par with "drug intervention studies". He may also be interested in how the dubious claims of "normal range" in fatigue and physical function were confused for "recovery", not only in the news articles, but also by pro-CBT/GET authors commissioned to write a Lancet editorial on the PACE Trial.

However, I read that Goldacre is a fan of Wessely, whom was like a mentor to him during his formative years? So if true, I doubt Goldacre will be coming after the cognitive behavioural model and CBT/GET for CFS. Also, Goldacre appears to be a true believer in a powerful placebo effect, which may make him more tolerant of mind over body ideologies without applying adequate skepticism to them or examining alternative explanations for the evidence.

As Alex touched upon, skepticism is not about denial and speculative counter-claims, it is about doubt towards claims and a critical evaluation of the evidence. I have found that equal opportunity skepticism is rare. People naturally focus on their own interests and care less about criticizing their own beliefs. I do not expect Goldacre to give a flying toss about the questionable flaw-riddled research into ME/CFS if it involves criticizing a model which Wessely has helped to develop.

 

[Tally]

Here is his Ted Talk