An article on Medical Studies

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An article on Medical Studies

Postby Valkenar » Tue Jan 31, 2006 4:52 pm

http://www.commondreams.org/views06/0107-28.htm

Even our most trusted journals are dependent on drug-company money. Drug makers don't just buy advertising in their pages. According to Richard Horton, editor of the Lancet, they also pay up to $1.75 million for reprints of articles favorable to their drugs, which sales reps then hand out to doctors.


And many journal articles are biased in favor of their sponsors' products. A 2003 report in the Journal of the American Medical Assn. found that clinical studies funded by drug companies are three times more likely to conclude that the sponsor's drug is the treatment of choice, compared to studies of the same drug that were not commercially funded. (This study of the effects of commercial bias, by the way, was funded by Danish research institutions.) The disturbing conclusion is that most of the evidence in what doctors believe to be "evidence-based medicine" is more infomercial than dispassionate science.


Interesting article I thought. Heavily slanted, of course, and I certainly don't agree with all of the positions it takes, but worth a read.
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Postby -Metablade- » Tue Jan 31, 2006 5:01 pm

Heh.
Indeed.
I work for a Medical Software company, and we do it all the time!
I also have noticed my Doctor carrying around a new PDA every 3 months, and I mean, a nice one.
But more importantly, the PDA was given as a promotion by Pfizer, (Big logo on it) and it contains a "helpful" diagnostic software tool in which the Doc inputs a symptom or other criteria, and when warranted, the appropriate drug (which Pfizer just happens to make) is displayed along with other data. The Doc can also pre-order the meds from the device to the pharm dept.
Also, has anyone noticed the TV kiosks in waiting rooms these days have less TV's and more "pre-programmed" medical infomercial crap disguised as a show?

Brilliant marketing.
Bad for patients.
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Postby Panther » Tue Jan 31, 2006 6:29 pm

-Metablade- wrote:Also, has anyone noticed the TV kiosks in waiting rooms these days have less TV's and more "pre-programmed" medical infomercial crap disguised as a show?

Brilliant marketing.
Bad for patients.


Yep... Noticed this just the other week when I went in for a follow-up...

TV in the waiting room has had cable as long as I can remember, but the other week, it had a "medical infomercial" on that was playing on a loop... Most everyone had tuned it out and was reading the magazines laying around (which, quite frankly, were mostly MORE medical propaganda from drug companies)... Soooooo, I went to the TV, grabbed the remote from the shelf beside the thing (good thing I'm 6'2" and could reach it easily) and changed the input from "AV" to "cable". Voila! But wait... There's more! I checked the local cable guide on air and turned it to the "Outdoors Channel"... hehehehe... Nice show about harvesting bambi! No one in the waiting room complained, but the receptionist came out and gave me an earful. I listened patiently and when I went in to see the Dr, I gave my opinion. Dr lives in the same town as I do and I see her around town fairly frequently. She laughed and said she'd take care of it. I, personally, haven't been back, but the wife has been in since. (I gave her a bunch of old "American Rifleman", "America's First Freedom" and "Guns & Ammo" magazines with the mailing labels cut off which she dutifully put on the tables when she went in.) The remote is down on the table and the bulletin board has directions on how to change the channel to whatever you want. The wife said that some guy had it on the Speed Channel when she went in and everyone else was reading magazines. She said that when she left every guy and at least one woman were reading the magazines I'd asked her to drop off. Chaulk one up for simply taking action!

:mrgreen:
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Postby -Metablade- » Tue Jan 31, 2006 6:46 pm

Way to stick it to the man!
Sweet!

P.s:
"Harvesting Bambi".....

ahahahha!

:lol: :lol: :lol: :lol:
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Postby Bill Glasheen » Tue Jan 31, 2006 6:47 pm

There's no free lunch on this anywhere.

It's well known that the pharmaceutical industry has a BIG influence on medical utilization. Whenever I do reports on the top 10 drugs by volume, it's basically a top 10 TV commercial list. It's medication for all those drugs that treat conditions which maybe you did and maybe you didn't know you had a problem with. But of course you could "ask your doctor." And of course your doctor had some freebie samples to give you. And those freebie samples were given to them by cute little drug reps with tight buns, short skirts, and breasts that hang at an unnatural angle. And of course said drug reps bring free lunch so they can get some of the physicians' time while they "educate" them on these new drugs, all while shaking their bootie and flashing their smiles.

I could go on and on, like about all those sporting event tickets that they offer my spouse, and of course I can go along if I want (I refuse...), etc., etc.

And I know, because I work for a health information company and I've dated and married health care practitioners.

The health care system has a LOT of money flowing through it. And a certain percentage of that money is devoted to marketing. That's the American way.

What I don't particularly care for is this phenomenon of "supply-induced demand" and "consumerism" - to the extent that it adversely affects patient outcomes. And believe me it can.

But that's the American way.

Back in the day when I was doing bench research, we were investigating a brand new cardiac imaging technique (imaging tissue blood flow via injection of albumen microbubbles). There was a company around that was making the bubbles. After it was clear they could make them better than we could in the lab, we went ahead and accepted the use of their product in the research. Nothing wrong with that - to a point. Academia gets breaks on the cost of everything, because the pay ***** and the grants are lean.

But then came time where we were going to present results at an ACC or AHA meeting. Days before the abstracts were submitted, investors would be calling us up, wanting some inside information.

We were good. We valued our reputation more than the "influence." That's just the way ethical people work, and in the long run they are better for it.

But I understand the temptation.

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Postby Valkenar » Tue Jan 31, 2006 8:27 pm

Bill Glasheen wrote:But that's the American way.


So does this excuse or just explain the phenomenon? Can something be the American way and still be wrong? I certainly think that while there are many great things about the American ideal, there are also some pretty lousy things that result from the American way, as such.
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Postby Bill Glasheen » Tue Jan 31, 2006 9:38 pm

Justin wrote:
So does this excuse or just explain the phenomenon?

The latter.
Justin wrote:
Can something be the American way and still be wrong?

Ask me some time about trial attorneys... ;)

As the saying goes, money talks and BS walks. Money can influence in a good way and a bad way. To the extent that the latter is common, we probably should take a closer look. But I'm often hesitant to use more laws to fix things, or encourage litigation to exact revenge or seek compensation. It's always better for people to behave well in the first place.

It is far from a perfect system, Justin.

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Postby Panther » Thu Feb 02, 2006 1:52 am

As a wise man (my Daddy) once pointed out to me (as he went and got his bible and turned to the verse in question)...

"Money isn't the problem. It's the love of money that's the root of evil."
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Postby -Metablade- » Thu Feb 02, 2006 3:45 pm

One who keeps impropriety and the lust for money always goes hungry;
And I've often found that there is nothing which the hungry will not eat.
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Postby IJ » Tue Feb 07, 2006 11:07 pm

I think the biggest problem is the bureaucracy of it all. It's a lot easier to to create a policy that directs people to fire missiles at coordinates on a grid than it is to stab somone--and these drug companies do a lot of things that no "normal" person would be able to do face to face. The ads are insane--there's one for ketek documenting heavy use that is somehow supposed to imply that its better; there's another for phoslo that suggests patients like capsules over tablets (has anyone ever told you they'd like to spend extra money because they have a slight preference for the formulation of their phosphate binder?) and all sorts of graphs for the alzheimer meds that gloss over the fact that they do next to nothing as far as "patient oriented outcomes" go, that is, quality of life, as opposed to a few points on a meaningless test score. These would be hard ruses to maintain face-to-face. Merck concealing cardiac outcomes and Guidant covering up defibrillator failures--these were decisions made in a board room based on economic calculations far removed from individual patients. Sit these executives next to a grandmother and the story might be different... just like a lot of those tobacco executives might feel differently about their endorsement of smoking choice if they had to take a Q&A from a real 14 year old not unlike the ones they've been following in their market analyses.

Whatever happens, its nobody's fault, we were all doing our job, and we have to think of the stockholders!

The solution is economic incentives for these people to do the right thing--ask Russia if complete state control works at all. Examples would include the legislation to promote "orphan drugs" (ones that treat uncommon diseases and are generally not lucrative--the reason why we had a shortage of penicillin a few years ago and a shortage of iv thiamine recently), protection of drug companies from lawsuits for properly made and marketed drugs and products (especially vaccines), and patent extensions for desperately needed products such as antibiotics that are not big money makers because they're given short term and generally avoided in order to save them for later use.
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Postby benzocaine » Fri Feb 10, 2006 9:59 am

I also have noticed my Doctor carrying around a new PDA every 3 months, and I mean, a nice one.
But more importantly, the PDA was given as a promotion by Pfizer, (Big logo on it) and it contains a "helpful" diagnostic software tool in which the Doc inputs a symptom or other criteria, and when warranted, the appropriate drug (which Pfizer just happens to make) is displayed along with other data. The Doc can also pre-order the meds from the device to the pharm dept.


Yeah... but it's illegal for pharmacy reps to reward doctors for using one product over another. Also it's not as though they would be more favorable to a doctor who say, ordered pfizer drugs directly fromthere PDA... nahhhhhhh never!!

It's to the point now that when ever I get a prescription I ask my doc if there is a generic alternative. For me it's the difference of a 7 dollar co pay , 26 dollars, or 56 dollars.
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Postby Stryke » Fri Feb 10, 2006 10:11 am

Can something be the American way and still be wrong?


the only thing that scares me about america is people asking questions like this with a straight face ....
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Postby Dana Sheets » Fri Feb 10, 2006 1:32 pm

:lol: Thanks Stryke. I needed a good chuckle this mornin'.
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Postby Stryke » Sat Feb 11, 2006 12:18 am

Excellent :) , my work here is done 8)
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Postby Valkenar » Mon Feb 13, 2006 5:42 am

Stryke wrote:
Can something be the American way and still be wrong?


the only thing that scares me about america is people asking questions like this with a straight face ....


If that scares you, just think that some people would unequivocally answer "No."

Maybe it's somewhat worn off now, but for a while there was a palpable sense that any criticism of America whatsoever constitutes treason.
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