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Lies, Damned Lies, and Medical Science

Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors—to a striking extent—still drawing upon misinformation in their everyday practice? Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science.

By David H. Freedman

Image credit: Robyn Twomey/Redux

In 2001, rumors were circulating in Greek hospitals that surgery residents, eager to rack up scalpel time, were falsely diagnosing hapless Albanian immigrants with appendicitis. At the University of Ioannina medical school’s teaching hospital, a newly minted doctor named Athina Tatsioni was discussing the rumors with colleagues when a professor who had overheard asked her if she’d like to try to prove whether they were true—he seemed to be almost daring her. She accepted the challenge and, with the professor’s and other colleagues’ help, eventually produced a formal study showing that, for whatever reason, the appendices removed from patients with Albanian names in six Greek hospitals were more than three times as likely to be perfectly healthy as those removed from patients with Greek names. “It was hard to find a journal willing to publish it, but we did,” recalls Tatsioni. “I also discovered that I really liked research.” Good thing, because the study had actually been a sort of audition. The professor, it turned out, had been putting together a team of exceptionally brash and curious young clinicians and Ph.D.s to join him in tackling an unusual and controversial agenda.

Last spring, I sat in on one of the team’s weekly meetings on the medical school’s campus, which is plunked crazily across a series of sharp hills. The building in which we met, like most at the school, had the look of a barracks and was festooned with political graffiti. But the group convened in a spacious conference room that would have been at home at a Silicon Valley start-up. Sprawled around a large table were Tatsioni and eight other youngish Greek researchers and physicians who, in contrast to the pasty younger staff frequently seen in U.S. hospitals, looked like the casually glamorous cast of a television medical drama. The professor, a dapper and soft-spoken man named John Ioannidis, loosely presided.

One of the researchers, a biostatistician named Georgia Salanti, fired up a laptop and projector and started to take the group through a study she and a few colleagues were completing that asked this question: were drug companies manipulating published research to make their drugs look good? Salanti ticked off data that seemed to indicate they were, but the other team members almost immediately started interrupting. One noted that Salanti’s study didn’t address the fact that drug-company research wasn’t measuring critically important “hard” outcomes for patients, such as survival versus death, and instead tended to measure “softer” outcomes, such as self-reported symptoms (“my chest doesn’t hurt as much today”). Another pointed out that Salanti’s study ignored the fact that when drug-company data seemed to show patients’ health improving, the data often failed to show that the drug was responsible, or that the improvement was more than marginal.

Salanti remained poised, as if the grilling were par for the course, and gamely acknowledged that the suggestions were all good—but a single study can’t prove everything, she said. Just as I was getting the sense that the data in drug studies were endlessly malleable, Ioannidis, who had mostly been listening, delivered what felt like a coup de grâce: wasn’t it possible, he asked, that drug companies were carefully selecting the topics of their studies—for example, comparing their new drugs against those already known to be inferior to others on the market—so that they were ahead of the game even before the data juggling began? “Maybe sometimes it’s the questions that are biased, not the answers,” he said, flashing a friendly smile. Everyone nodded. Though the results of drug studies often make newspaper headlines, you have to wonder whether they prove anything at all. Indeed, given the breadth of the potential problems raised at the meeting, can any medical-research studies be trusted?

That question has been central to Ioannidis’s career. He’s what’s known as a meta-researcher, and he’s become one of the world’s foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field’s top journals, where it is heavily cited; and he is a big draw at conferences. Given this exposure, and the fact that his work broadly targets everyone else’s work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.

The city of Ioannina is a big college town a short drive from the ruins of a 20,000-seat amphitheater and a Zeusian sanctuary built at the site of the Dodona oracle. The oracle was said to have issued pronouncements to priests through the rustling of a sacred oak tree. Today, a different oak tree at the site provides visitors with a chance to try their own hands at extracting a prophecy. “I take all the researchers who visit me here, and almost every single one of them asks the tree the same question,” Ioannidis tells me, as we contemplate the tree the day after the team’s meeting. “‘Will my research grant be approved?’” He chuckles, but Ioannidis (pronounced yo-NEE-dees) tends to laugh not so much in mirth as to soften the sting of his attack. And sure enough, he goes on to suggest that an obsession with winning funding has gone a long way toward weakening the reliability of medical research.

He first stumbled on the sorts of problems plaguing the field, he explains, as a young physician-researcher in the early 1990s at Harvard. At the time, he was interested in diagnosing rare diseases, for which a lack of case data can leave doctors with little to go on other than intuition and rules of thumb. But he noticed that doctors seemed to proceed in much the same manner even when it came to cancer, heart disease, and other common ailments. Where were the hard data that would back up their treatment decisions? There was plenty of published research, but much of it was remarkably unscientific, based largely on observations of a small number of cases. A new “evidence-based medicine” movement was just starting to gather force, and Ioannidis decided to throw himself into it, working first with prominent researchers at Tufts University and then taking positions at Johns Hopkins University and the National Institutes of Health. He was unusually well armed: he had been a math prodigy of near-celebrity status in high school in Greece, and had followed his parents, who were both physician-researchers, into medicine. Now he’d have a chance to combine math and medicine by applying rigorous statistical analysis to what seemed a surprisingly sloppy field. “I assumed that everything we physicians did was basically right, but now I was going to help verify it,” he says. “All we’d have to do was systematically review the evidence, trust what it told us, and then everything would be perfect.”

It didn’t turn out that way. In poring over medical journals, he was struck by how many findings of all types were refuted by later findings. Of course, medical-science “never minds” are hardly secret. And they sometimes make headlines, as when in recent years large studies or growing consensuses of researchers concluded that mammograms, colonoscopies, and PSA tests are far less useful cancer-detection tools than we had been told; or when widely prescribed antidepressants such as Prozac, Zoloft, and Paxil were revealed to be no more effective than a placebo for most cases of depression; or when we learned that staying out of the sun entirely can actually increase cancer risks; or when we were told that the advice to drink lots of water during intense exercise was potentially fatal; or when, last April, we were informed that taking fish oil, exercising, and doing puzzles doesn’t really help fend off Alzheimer’s disease, as long claimed. Peer-reviewed studies have come to opposite conclusions on whether using cell phones can cause brain cancer, whether sleeping more than eight hours a night is healthful or dangerous, whether taking aspirin every day is more likely to save your life or cut it short, and whether routine angioplasty works better than pills to unclog heart arteries.

But beyond the headlines, Ioannidis was shocked at the range and reach of the reversals he was seeing in everyday medical research. “Randomized controlled trials,” which compare how one group responds to a treatment against how an identical group fares without the treatment, had long been considered nearly unshakable evidence, but they, too, ended up being wrong some of the time. “I realized even our gold-standard research had a lot of problems,” he says. Baffled, he started looking for the specific ways in which studies were going wrong. And before long he discovered that the range of errors being committed was astonishing: from what questions researchers posed, to how they set up the studies, to which patients they recruited for the studies, to which measurements they took, to how they analyzed the data, to how they presented their results, to how particular studies came to be published in medical journals.

This array suggested a bigger, underlying dysfunction, and Ioannidis thought he knew what it was. “The studies were biased,” he says. “Sometimes they were overtly biased. Sometimes it was difficult to see the bias, but it was there.” Researchers headed into their studies wanting certain results—and, lo and behold, they were getting them. We think of the scientific process as being objective, rigorous, and even ruthless in separating out what is true from what we merely wish to be true, but in fact it’s easy to manipulate results, even unintentionally or unconsciously. “At every step in the process, there is room to distort results, a way to make a stronger claim or to select what is going to be concluded,” says Ioannidis. “There is an intellectual conflict of interest that pressures researchers to find whatever it is that is most likely to get them funded.”

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Perhaps only a minority of researchers were succumbing to this bias, but their distorted findings were having an outsize effect on published research. To get funding and tenured positions, and often merely to stay afloat, researchers have to get their work published in well-regarded journals, where rejection rates can climb above 90 percent. Not surprisingly, the studies that tend to make the grade are those with eye-catching findings. But while coming up with eye-catching theories is relatively easy, getting reality to bear them out is another matter. The great majority collapse under the weight of contradictory data when studied rigorously. Imagine, though, that five different research teams test an interesting theory that’s making the rounds, and four of the groups correctly prove the idea false, while the one less cautious group incorrectly “proves” it true through some combination of error, fluke, and clever selection of data. Guess whose findings your doctor ends up reading about in the journal, and you end up hearing about on the evening news? Researchers can sometimes win attention by refuting a prominent finding, which can help to at least raise doubts about results, but in general it is far more rewarding to add a new insight or exciting-sounding twist to existing research than to retest its basic premises—after all, simply re-proving someone else’s results is unlikely to get you published, and attempting to undermine the work of respected colleagues can have ugly professional repercussions.

In the late 1990s, Ioannidis set up a base at the University of Ioannina. He pulled together his team, which remains largely intact today, and started chipping away at the problem in a series of papers that pointed out specific ways certain studies were getting misleading results. Other meta-researchers were also starting to spotlight disturbingly high rates of error in the medical literature. But Ioannidis wanted to get the big picture across, and to do so with solid data, clear reasoning, and good statistical analysis. The project dragged on, until finally he retreated to the tiny island of Sikinos in the Aegean Sea, where he drew inspiration from the relatively primitive surroundings and the intellectual traditions they recalled. “A pervasive theme of ancient Greek literature is that you need to pursue the truth, no matter what the truth might be,” he says. In 2005, he unleashed two papers that challenged the foundations of medical research.

He chose to publish one paper, fittingly, in the online journal PLoS Medicine, which is committed to running any methodologically sound article without regard to how “interesting” the results may be. In the paper, Ioannidis laid out a detailed mathematical proof that, assuming modest levels of researcher bias, typically imperfect research techniques, and the well-known tendency to focus on exciting rather than highly plausible theories, researchers will come up with wrong findings most of the time. Simply put, if you’re attracted to ideas that have a good chance of being wrong, and if you’re motivated to prove them right, and if you have a little wiggle room in how you assemble the evidence, you’ll probably succeed in proving wrong theories right. His model predicted, in different fields of medical research, rates of wrongness roughly corresponding to the observed rates at which findings were later convincingly refuted: 80 percent of non-randomized studies (by far the most common type) turn out to be wrong, as do 25 percent of supposedly gold-standard randomized trials, and as much as 10 percent of the platinum-standard large randomized trials. The article spelled out his belief that researchers were frequently manipulating data analyses, chasing career-advancing findings rather than good science, and even using the peer-review process—in which journals ask researchers to help decide which studies to publish—to suppress opposing views. “You can question some of the details of John’s calculations, but it’s hard to argue that the essential ideas aren’t absolutely correct,” says Doug Altman, an Oxford University researcher who directs the Centre for Statistics in Medicine.

Still, Ioannidis anticipated that the community might shrug off his findings: sure, a lot of dubious research makes it into journals, but we researchers and physicians know to ignore it and focus on the good stuff, so what’s the big deal? The other paper headed off that claim. He zoomed in on 49 of the most highly regarded research findings in medicine over the previous 13 years, as judged by the science community’s two standard measures: the papers had appeared in the journals most widely cited in research articles, and the 49 articles themselves were the most widely cited articles in these journals. These were articles that helped lead to the widespread popularity of treatments such as the use of hormone-replacement therapy for menopausal women, vitamin E to reduce the risk of heart disease, coronary stents to ward off heart attacks, and daily low-dose aspirin to control blood pressure and prevent heart attacks and strokes. Ioannidis was putting his contentions to the test not against run-of-the-mill research, or even merely well-accepted research, but against the absolute tip of the research pyramid. Of the 49 articles, 45 claimed to have uncovered effective interventions. Thirty-four of these claims had been retested, and 14 of these, or 41 percent, had been convincingly shown to be wrong or significantly exaggerated. If between a third and a half of the most acclaimed research in medicine was proving untrustworthy, the scope and impact of the problem were undeniable. That article was published in the Journal of the American Medical Association.

Driving me back to campus in his smallish SUV—after insisting, as he apparently does with all his visitors, on showing me a nearby lake and the six monasteries situated on an islet within it—Ioannidis apologized profusely for running a yellow light, explaining with a laugh that he didn’t trust the truck behind him to stop. Considering his willingness, even eagerness, to slap the face of the medical-research community, Ioannidis comes off as thoughtful, upbeat, and deeply civil. He’s a careful listener, and his frequent grin and semi-apologetic chuckle can make the sharp prodding of his arguments seem almost good-natured. He is as quick, if not quicker, to question his own motives and competence as anyone else’s. A neat and compact 45-year-old with a trim mustache, he presents as a sort of dashing nerd—Giancarlo Giannini with a bit of Mr. Bean.

The humility and graciousness seem to serve him well in getting across a message that is not easy to digest or, for that matter, believe: that even highly regarded researchers at prestigious institutions sometimes churn out attention-grabbing findings rather than findings likely to be right. But Ioannidis points out that obviously questionable findings cram the pages of top medical journals, not to mention the morning headlines. Consider, he says, the endless stream of results from nutritional studies in which researchers follow thousands of people for some number of years, tracking what they eat and what supplements they take, and how their health changes over the course of the study. “Then the researchers start asking, ‘What did vitamin E do? What did vitamin C or D or A do? What changed with calorie intake, or protein or fat intake? What happened to cholesterol levels? Who got what type of cancer?’” he says. “They run everything through the mill, one at a time, and they start finding associations, and eventually conclude that vitamin X lowers the risk of cancer Y, or this food helps with the risk of that disease.” In a single week this fall, Google’s news page offered these headlines: “More Omega-3 Fats Didn’t Aid Heart Patients”; “Fruits, Vegetables Cut Cancer Risk for Smokers”; “Soy May Ease Sleep Problems in Older Women”; and dozens of similar stories.

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  • Is Dr. John Ioannidis investigating medical science or climate science?
  • I suspect that the Dr.'s results, certainly his methodology, would apply equally well to either "side" of just about any scientific question.
  • You are correct. He is basically stating the obvious: non-randomized studies suck, multiplicity is a problem, qualitative outcomes have assessment bias, publication bias is a much bigger and more widespread issue than anyone seems to admit, and researchers will find a way to validate their theories.

    These are uncontroversial statements. The funny thing is that all of these problems were doubled-down on by the governments recent health-care reform and stimulus bills. Maybe Dr. I can speak to Congress during his next travel trip?
  • He is not just saying that non randomized studies suck. Read the article again. He claims that 25% of randomized studies suck. That's a relatively large number.

    How do we know that we can trust his study? Seriously, he claims that he does not intend for people to wave their hands in despair and just do whatever, but what's his alternative?

    They point out how there are conflicting studies on whether or not obesity shortens or lengthens life spans, but how do you say which one had the faulty methodology and which was one had researchers trying to prove an attention grabbing hypothesis. Did this guy and his team seriously examine the methodology in detail of all those researches?

    Should we seriously believe that being overweight isn't a health risk and that checking more often for breast cancer doesn't have a greater chance of detecting it than checking less often?
  • Follow the money. The energy industry wins big with the continuing delay in dealing with climate change. Mainstream science and all the rest of us stand to lose big if climate change isn't dealt with.

    The evidence for climate change - scientific and circumstantial - is overwhelming and easy to understand:

    http://towardcommonground.word.../
  • Jim you miss the point entirely. I'm truly boggled that you could read this article and come away with your particular take on it.

    Climate "science" is easily as prone to the error and fraud spoken of in this article. Yes, there is "climate change" -- but anthropogenic climate change is not remotely a proven fact, and much of the so-called "science" is merely barely disguised political agenda and is driven by the pursuit of government and industry funding (and thus pre-determined outcomes with whatever massaging of the data is necessary).

    Have you actually looked at the state of the research? It's a complete mess -- which is why Freedom of Information requests are routinely ignored by the "scientists" involved.

    A Green religionist like yourself would not be remotely happy with the results if someone like Ioannidis were to apply his mathematical methodology to the field. That is the real message of this article.
  • I say again: follow the money. The energy industry has a huge stake in preventing a change to clean energy. Why would universities and think tanks all over the world accept climate science and want to change the status quo . What's in it for them? What's in it for any of us? Nothing, if the science is phony.

    Remember the "controversies" about smog and second hand smoke. The climate change " controversy" is exactly analogous.

    The basic science is easily understood. See

    href="http://towardcommonground.wordpress.com/2010/09/26/78" rel="nofollow">http://towardcommonground.wordpress.com/2010/09/26/78/

    Besides, conducting a colossal uncontrolled experiment on the earth's environment can't possibly be a good idea. We don't know anywhere near enough about the systems involved. Remember the DDT fiasco.

    (Name calling is never productive.)

    (Edited by author 3 months ago)

  • I disagree. What is in it for the scientist if they continue to publish poorly founded research supporting global warming or anything else generally accepted among academia? Protection of reputation! Membership in the club! You don't want to be seen as the one loony that is actually questioning what all of his co-scientists accept as gospel truth. And thus you are looked upon favorably by your peers and your research department and funding is a little easier to come by, et cetera. It's not always a greed for money...it can also be a desire to be accepted. Who wants to be the outsider or the one that delays research and publication because he just isn't convinced that the data is good enough or that the methods were sound?
  • I disagree. Man-made climate change IS the status quo in academia. What is in it for the scientist to agree by publishing poorly supported research that matches what the academic world already believes? Acceptance! Membership in the club! Who wants to be the loony that goes against the grain? Publishing agreeable science will earn respect from like minded co-workers or department heads and funding becomes just a little bit easier. The scientist that misses deadlines because he just isn't sure that the data is good or that the experiment methods are sound will become speedbump to 'progress'.



    I'm not saying that all scientists fall into such groupthink, but I do believe that there can be social/psychological motivations that feed a scientist's biases...not just money.
  • To further your point populations don't even need studies to mislead. The media is full of so called fact that we get every day form our televisions.

    Climate science uses surface mounted thermometers which have been shown to be highly inaccurate. It changed the entire premise of the study.
    "Follow the money"? guess who has graciously become the poster boy for pushing the global warming scam -- David Derothschild. Sure his family has been folowwing the money for centuries they are the richest family on earth. Do you think they got that way by being honest? Does Jim Flint really trust what comes from the mouths of elites such as Rothschild and Gore. By the way they, also gave Henry Kissinger a nobel peace prize. Al Gore deserves a puch in the head from Ross Perot Hahahahahahaha

    I think the thing to take away from this study is to believe non of what you here and about half of what we see.

    If it's hard enough to believe supposedly well conducted medical experiments how are we supposed to believe proven liars like politicians and banksters.

    Here is a few of the lies we have been made to believe: 911 , the war on terror, golf of tonkin, alquaeda, weapons of mass destruction, no new taxes, i have never had sex with that girl monica lewensky, JFK, etc etc.

    Last but not least climate change caused from Co2 emissions.

    Peace brother's
  • Follow the money cuts both ways. Enron, remember them? You may know James Hanson was a science consultant to Al Gore. Did you know he was also a global warming consultant for Enron?

    Senator Tim Heinz and Tim Wirth co-sponsored the bill 'Project 88' which became the clean Air Act. Hanson's testimony in 1988' helped make that happen. James Hanson was paid $250,000 as a grant from the Heinz Foundation.
    Under the clean Air Act in the early 1990s Sulphur Dioxide was capped by the EPA and then traded, in a $20 Billion market, largely brokered by Enron.

    Enron, in particular Ken Lay (yes that Ken lay) lobbied the Clinton administration, particularly vice-president Gore and Wirth (now Under secretary of state for global affairs), to declare Carbon Dioxide a pollutant (gee didn't that just happen under a President that owns shares in the Chicago carbon exchange?) which Enron could then trade as it did with Sulphur Dioxide.

    Enron contributed $990,000 to the National sciences centre and 1.5 million to other AGW proponent groups including the Pew centre. Enron backed (and may well have helped craft) the Kyoto agreement. From an internal Enron memo "The Kyoto agreement, if implemented would do more to promote Enron’s business than almost any other regulatory initiative"

    What happened to Enron? Oh yeah it collapsed owing billions due to massive accounting fraud.

    How much had Gore made since leaving office again?
    There is money to follow at both ends of this thing mate.

    And last but not least look up the 1995 UN Human Development Report, you'll find this "Global taxation may become necessary...some of the promising new sources include tradable permits in human pollution."

    Where am I getting all this from? The book ‘Air Con’ by Ian Wishart. All the above is documented in that book.
  • So how do you make the sun's rays less intense?

    Is our Co2 causing the rise in temperature we see on other planets climates as well?


    "Global warming doomsday called off" is an excellent documentary and challenges the pseudo science of Al gore and Rothschild and other elites attempting to scare us all back to the stone age.

    Thousands of scientists agree that we are slightly warmer but it is the sun that is getting hotter not our co2 causing a greenhouse like effect. Politicians are terrific liars, should' nt Al gore at least have some numbers on his graphs? When did he become a climatologist?
  • http://www.prisonplanet.com/gl...


    http://www.telegraph.co.uk/com...


    Corbyn, who predicted the extreme winter, on global warming.



    http://www.youtube.com/watch?v...

    1999 global warming causing warmer winters.

    http://www.giss.nasa.gov/resea.../

    2008 Warming winters caused by wind patterns above the Arctic. They`ve found the reason!!

    http://www.nature.com/nature/j...

    2010 extreme cold winters due to wind patterns above the Arctic. They have found the reason, again.

    http://www.sciencedaily.com/re...
  • Mr Flint if you relly are following the money in the climate change question you will end up finding that it is the really big corporations and world-banksters who are running this scam.
    Please visit www.scienceandpublicpolicy.org to get youur eyes opened
  • cmonman 3 months ago
    The US Government is relying on industry developed lies about healthcare information technology, taking it to the taxpayers. There are not any studies showing improved outcomes and none showing reduced costs. The HiTech is madness.
  • So much common sense...ignore the studies, skip the supplements, and stop going to the doctor so damn much. And when you do go, find a doctor that will listen to you.
  • there is a definite trend among clinicians to accept treatment modalities which include costly investigations,medications,high tech surgical procedures and implants even in developing countries like india.Anybody can guess what is the driving force
  • Two science attributes from Ioannidis quotes that would do well to go viral:
    1. No compromise with truth: “If we don’t tell the public about these problems, then we’re no better than nonscientists who falsely claim they can heal."
    2. Being wrong is a feature, not a bug: "We could solve much of the wrongness problem if the world simply stopped expecting scientists to be right. That’s because being wrong in science is fine, and even necessary."
  • Insofar as information glut ("so many papers to read, so little time") is responsible for bad science - medical and otherwise, I foresee machines coming to the rescue: machine learning based approaches (read Google et. al) could soon provide filters for human referees to weed out the papers where ambition hides shoddy statistics.

  • I'm no math genius, but if a) 41 percent of research is inaccurate or biased, and b) since most research relies on other references, how many generations of research papers are required before inaccuracy and bias permeates all research in a given field?

    The Office of Medical & Scientific Justice (OMSJ) is currently testing this theory in criminal courts throughout the US. In one year, OMSJ helped defense attorneys compel ten prosecutors and two judges to drop all criminal charges that were based entirely upon scientific evidence related to HIV and AIDS. OMSJ is currently involved in 40+ other criminal cases plans to take one to trial - if prosecutors don't capitulate first. The cost of human life and injury because of this profit-generating corruption is incalculable

    OMSJ was formed by a private investigator (retired LAPD) when he discovered that local, state and federal law enforcement does not investigate scientific corruption that hospitals and universities routinely profit from. Until Congress addresses this outrage, questionable medical research will continue to waste billions of taxpayer dollars and ruin the lives of millions.
  • jillherendeenicbe 3 months ago in reply to OMSJ
    "wasting billions of taxpayer dollars"? Only if you're the hapless taxpayer--a goldmine, if you're on the receiving end! Why do you think we have a for-profit health "care" system? Why do you think Obama & most of Congress bent over backward to keep single payer, universal healthcare from getting "on the table?" So (some) people can get RICH. If everyone's healthy, there's a lot fewer people getting RICH off of them. Flawed studies are just part of the propaganda which passes for "news" in the corporate-owned media. Doctors aren't free agents---they don't pay off their med school loans and live cushy lives unless they're HIRED by hospitals, etc.
  • The best example, "The Cholesterol Myth". We could pay for all of health care with the money wasted on this one fraud.
    Pharmacist who's life was ruined by Lipitor
  • Dr. Ioannidis has actually described fluoride science. Even researchers who discover fluoride is ineffective and causing more harm than good will publicly extol the virtues of fluoridation so as not to lose their government grants for themselves, their students and their Universities or their jobs, in my opinion. Scientists who dared publicly flog fluoride have been fired (e.g., Mullenix, Marcus)

    Even the Centers for Disease Control "quietly" tells parents on its web site to avoid using fluoridated tap water to make infant formula - but publicly defend fluoride as the only substance on earth without side effects that no one can possibly be allergic to or intolerant of.

    Organized dentistry is made rich by corporations that profit from fluoride. Biting the hand that feeds them would hurt them politically. The American Dental Association and its constituent groups are among the most influential lobbying health groups in Washington and state governments - getting laws passed (or not-passed) that tend to make their member dentists richer.


    “Fluoridation campaigns provide a unique opportunity for dentistry to help reduce the incidence of dental disease while establishing political viability...,” according to the Journal of the American Dental Association, “Fluoridation Election Victory: A Case Study for Dentistry in Effective Political Action,” April 1981.

    However, the evidence shows that fluoridation does NOT reduce tooth decay. But that hasn't stop US government agencies from misrepresenting the evidence.

    Originally released : 28 October 2003

    A statement from the Centre for Reviews and Dissemination (CRD).

    In 1999, the Department of Health commissioned CRD to conduct a systematic review into the efficacy and safety of the fluoridation of drinking water. The [York] review specifically looked at the effects on dental caries/decay, social inequalities and any harmful effects. The review was published on the CRD Fluoridation Review website and in the BMJ in October 2000.

    We are concerned about the continuing misinterpretations of the evidence and think it is important that decision makers are aware of what the review really found. As such, we urge interested parties to read the review conclusions in full.

    We were unable to discover any reliable good-quality evidence in the fluoridation literature world-wide.

    What evidence we found suggested that water fluoridation was likely to have a beneficial effect, but that the range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth.

    This beneficial effect comes at the expense of an increase in the prevalence of fluorosis (mottled teeth). The quality of this evidence was poor.

    An association with water fluoride and other adverse effects such as cancer, bone fracture and Down's syndrome was not found. However, we felt that not enough was known because the quality of the evidence was poor.

    The evidence about reducing inequalities in dental health was of poor quality, contradictory and unreliable.

    ---

    In March 2008, The CDC's fluoridation "expert" told the Fairbanks City Council that the York Review "said that water fluoridation is safe and effective and healthy."
    http://www.fluoridealert.org/b...

    ---

  • I think you overstate your case. I grew up without floridated water, but used flouride toothpaste, and I have a mouth full of metal to show for it. My children grew up WITH floridation, and they all reached adulthood without cavities, in spite of eating as much sugary snacks as I did as a child. My dentist confirms that children today have many fewer dental problems than I had. Floridation (0.7 ppm by volume in Miami, FL) WORKS for me, regardless of what anyone else says.

    (Edited by author 3 months ago)

  • What the research is finding is that caries is most likely caused by a particular bacteria--and fluoridation helps little, if at all. I'm 38. I grew up in the country, on well water, certainly no fluoride in it, and Dad's favorite toothpaste was Close-up, which did NOT have fluoride till well after I started school. Toothpastes marketed more to kids came out about the same time I started school--Aim was the first, followed by Aqua-Fresh, both with fluoride. Anyway, we did not even always have fluoridated toothpaste. I don't use fluoridated toothpaste now, and neither do my kids. I have never had a filling. Or needed one. I don't even go to the dentist, as I don't have insurance, and have seldom had extra money for such things. But I have gone a few times when dental hygienist courses were looking for "victims" for their students to give teeth cleanings to for state board exams. The last time I went was 3 years ago. My teeth were not dirty enough for me to be useful for the state boards, despite using non-fluoride toothpaste and not having had a cleaning since 1988.
    Fluoride just doesn't have much to do with it.
  • Caries are caused by bacteria, I agree. But fluoride in the drinking water has been demonstrated by millions of people in cities all over this country to be beneficial in making teeth less susceptible to caries regardless of the cause of this decay. You might be one of the lucky few who are naturally resistant to such damage, but most of the rest of us are not, and flouride is a great help to us. This practical experience trumps any "evidence" to the contrary.
  • Your comment, "But fluoride in the drinking water has been demonstrated by millions of people in cities all over this country to be beneficial in making teeth less susceptible to caries regardless of the cause of this decay," is again based upon flawed thinking. Do we also conclude things like, "houses prevent mosquitos?" because in areas where there are many houses, there are far fewer mosquitos as compared to areas where there are swamps and few houses.

    Statistical methods, such as regression analysis, are used to flesh out the variables in a system that are actually responsible for the observed effect. A supreme example is that the HMG-CoA Reductase inhibiting cholesterol lowering drug, Lipitor, was found to reduce mortality, but this reduction was found to be due to an antioxidant effect, rather than the lipid lowering effect. This is crucial information because mortality rates in patients taking previous generations of HMG-CoA reductase inhibiting drugs showed that taking the drug either had no effect on mortality or actually INCREASED mortality. Anyone taking Lipitor?
  • If caries are caused by bacteria, please explain why ancient skeletons are found with their teeth intact, while bacteria have rotted away all the flesh.

    Fluoride does go into teeth. It displaces calcium, causing brittle, mottled teeth. Most European countries have banned adding it to drinking water.
  • Fluoride only causes mottled teeth at much higher concentrations than most people get from fluoridated drinking water. The harder enamel from adding fluoride to the drinking water makes teeth much more resistant to decay. This is incontrovertible, and the lack of adolescent tooth decay in Miami-Dade County, Florida (Pop. ~3.3 million), confirmed by all the dentists I've talked to in the last 20 years (> 10), proves the point. Miami-Dade water & Sewer adds only 0.07 ppm of fluoride to the drinking water, and mottled teeth are almost non-existant here.

    Other places can do what they want, but the benefits of fluoridated drinking water here in Miami, FL are available for all to see.
  • Like you, I grew up without floridated water and I have many cavities. But my children also grew up without floridated water and like your children mine also reached adult hood without any cavities. They do not have floridated water to thank for that. ?? Better nutrition and dental care. I don't know the reason.
  • Like you I grew up without floridated water and like you have many cavities.
    My children,however, also grew up without floridated water and like your children they also reached adulthood without any cavities. ?? better nutrition and better dental care, I don't know the reason...just shows the problems with anecdotal evidence.
  • Cavities don't come from sugary snacks, they come from mineral deficiencies and mineral leeching from the teeth. Neither brushing with fluoride nor fluoride in water prevent cavities. There are reasons why you got cavities and your kids haven't which are unrelated to fluoride. Your belief that fluoride worked for you is a belief based on coincidence, not any empirical analysis of relevant factors... based on what is known about fluoride it's an illogical belief.
  • If a shocking number of publications are wrong, who will look at Dr. Ioannidis's research to validate it?
  • Great point
  • And who will review this "thought" piece as being representative of Dr Ioannidis' research? I would but what's the point if I'm not a published journalist great at causing stirs and, oops, choosing to omit and/or distort?!
    Seriously, med research is done because we are trying to do things better! Of course, there'll be findings of error. We're human, not robots!
    My girlfriend died of Hodgkin's lymphoma at 20, now 25 years later my mother has the exact same illness. I can't begin to tell you the breakthroughs in diagnosis and treatment there's been over that period. But I'm not going to lament about the mistakes made that meant a quick death for my friend. I'm only going to marvel at what research has made possible for my mother right now...
  • Lou,
    I can only imagine how horribly depressing for you to lose a close friend to cancer, and now, 25 years latere, having to revisit that pain and horrible fear of losing your mother. Please check out the link,
    http://www.thehealthierlife.co.... It give information on IV vitamin C as a treatment that is either complementary to conventional care or alternative (when conventional options don't exist, which sadly the case with most cancers -chemotherpeutic agent research is usually proprietarily witheld from PubMed and for good reason...these agents are almost always unproven for the purposes they are used in every day oncology practice).

    I bring the issue of IV vitamin C up because, even after several DECADES, no company wants to study it despite the fact that it one of the most promising agents known for treating cancer. Pharmaceutical companies aren't evil (conceptually), they have a financial responsibility to their shareholders to make a profit. With hundreds of millions of dollars at stake for developing a new drug, it is obvious that study designs would be rigged to get the result they need to make a profit, including adherence to study designs that, despite being "gold standard" in methodology, have been proven historically to churn out ineffective and often dangerous drugs. Also, they cant profit from vitamin C, so why would they study it? Especially considering that positive vitamin C findings essentially would destroy future possibilities of developing profitable medicines? Plain and simple.

    Not knowing the specifics to either your friend's or your mother's cases, I can not comment on the appropriateness of Vitamin C or the chemotherapies used. You will have to consult with a knowledgable oncologist and/or naturopathic oncologist. I wish you luck and strength!
  • These two questions will always point you in the right direction:

    1) Who is paying for the study
    2) Who benefits from the study

    It's that simple. Academics want to publish to get tenure. Journals only publish "interesting" results. Somebody paid for the study and on and on.

    Everybody in the chain has a vested interest in the results and to think that doesn't create all the incentive in the world to choose your language very carefully (or outright lie) you're just being naive.

  • I absolutely agree.
  • Are you nuts? You think vaccines, antibiotics, cancer treatments (chemo, etc.), all types of surgery, meds for blood pressure, etc., are figments of our imagination? We've eradicated smallpox worldwide, polio throughout the developed world, seriously limited the impact of bacterial disease, and increased the survivability of many diseases such as cancer and heart disease. All of those things came from medical research (that was, yes, funded by someone). Some doctor didn't just dream up the treatments out of the blue and then give them to patients to try. Sure, some research is wrong, and bias can be a problem. However, in the end, the system does work.
  • You seem to be missing the very point of this article - take any of the treatments you mention and research them properly, looking for real evidence of their actual clinical outcomes (good and bad) and almost all of them turn out to be less effective than they have been cracked up to be, or are commonly thought to be. For example, we all know how effective vaccines are don't we? Yet if you gather data on the historic mortality trends for the vaccinated diseases you find that 90% of the reduction in deaths from those diseases occured BEFORE the vaccine was introduced. I'm not saying vaccines don't work. I'm saying that they have contributed far less to the reduction in disease than is made out. Antibiotics on the other hand are administered far too often and inappropriately (e.g. for viral colds), leading indirectly to deaths from resistant strains (MRSA), and damaging gut microfloral colonies in regular users.
  • I didn't miss the point of the article. I disagree with it. The concerns it raises are legitimate but overblown.

    I doubt the validity of your assertion that all of the diseases we vaccinate against coincidentally disappeared right at the same time as the vaccines came out (and in the same geographic regions that vaccination was implemented). I think the onus is on you to provide reliable sources if you want to be taken seriously on that point.
  • Oo! Touchy!
    1. I did NOT say 'ALL diseases we vaccinate against coincidently disappeared right at the same time as we vaccines came out'. But by your deliberate misinterpretation and misrepresentation of my far more moderate words demonstrates you are not capable of reading without bias!
    2. 'The onus is not on me to convince you of anything. The data on historic infectious disease rates are widely available and really not very contentious. Just for a starter: how do you account for the declines in mortality and morbidity in say the US and UK due to scarlet fever and typhoid - diseases which were not vaccinated against?
    3. Look at the graphics on this site:
    http://www.csiss.org/learning_...
    Particularly the one next to question II C. It shows the death rates for diptheria, measles, scarlet fever and whooping cough in England and Wales between 1851 and 1960. I challenge you to point to the step change in decline brought about by the vaccine introduction.
  • Also, your point about MRSA is irrelevant. If we didn't have antibiotics in the first place, MRSA (if it existed by some random occurrence) wouldn't be any worse than many other bacterial infections. The only thing that makes it "worse" now is that we can't use antibiotics against it.
  • Staphylococcus Aurelius has been an often-fatal bacterial infection throughout most of human history. Antibiotics prevented SA's most fatal consequences for decades, and many people survived only because of the medicine.

    Multi Resistant Staph A. is equally as fatal as ordinary SA was before antibiotics. So the 'only thing that makes it "worse",' so flippantly referred to is actually the difference between living and dying in most cases.
  • Did you read the post I was replying to and my previous post? I think we're arguing on the same side of the issue. My point was that MRSA is no more lethal than other strains of staph. Therefore, the many the advantages of antibiotics far outweigh the one and only disadvantage - that they eventually don't work anymore, as in the case of MRSA.

    (Edited by author 1 month ago)

  • Lethality is a contextual concept. In terms of the damage done to a body without treatment, sure you can say MRSA won't kill you any deader than traditional SA.

    But because MRSA will likely kill you despite our best medical interventions, whereas traditional SA, when treated will very likely not kill you, MRSA is more lethal.

    Same thing as a standard lead bullet and an armour-piercing round. Both will kill an unprotected torso, but an armour-piercing round is more lethal because a bullet-proof vest is no protection against it.

    I may agree with you, but I thought your wording was misleading. MRSA represents a much greater threat to the survival of a 21st century person than ordinary SA. Unless you live in a developing nation, where I agree that either one would probably kill you with equal lethality.
  • yeah but when you discount infant mortality and complications due to child birth, the increase in life expectancy seems negligible. progress for progress sake is worse than stagnation.
  • Remember the plague (you know, the now-treatable bacterial infection that killed ~1/3 of the world's population before the advent of antibiotics)? How about smallpox (remember, the disease that nearly eradicated the Native Americans) and polio? You don't think that those were significant advances that increased human expectancy?
  • The bubonic plague was cured because it killed the 1/3 of the European population that did not have a resistance to it, half a millennium before antibiotics and vaccines were deployed.

    Quite true that scientific research and application eradicated smallpox from everywhere but the biological weapons research facilities of some bellicose nations, and polio from most places where the injections have not been demonised as 'sterilisation injections' by those who wish no collaboration with Western culture.

    Anti-vaccination propaganda:

    http://socioecohistory.wordpre.../




  • The average life expectancy in Britain 150 years ago was 35. 50% of children died before the age of five. That seems a lot of deaths to be attributed to infant mortality and childbirth complications alone.

    Medicine and vaccination kept a lid on tuberculosis for much of the 20th century, only now manifesting antibiotic-resistant strains through bad administration of vaccine. Typhus has been quashed in developed nations through sanitary improvements based on sound and repeatable scientific research.

    Wing-nuts should stop looking to science to discredit the scientific method. It has always been part of scientific progress to refute or modify current 'received scientific wisdom'.

    If scientists identify that the current scientific publishing model is subject to 'the buttered side of the bread' thinking and the vanity of being published, that is a cause for auditing and improving the current paradigm, not for defenestrating any scientific finding we experience as personally confronting.
  • DiseasedWhore 3 months ago
    Just about the checks, if these doctors can sit on their ass or golf, they will

    a lot of this money comes from your taxes NIH
  • mikegale 3 months ago
    Like the doctors I think a lot of us are aware of this sort of thing.

    Medicine, Climate Science, Economic Policy... often seem a bit nutty and when you look more deeply, they often are.

    This stuff can cost a lot. Your life, your health, increased taxes, GFC...

    It would be cool if we could tip the balance a bit. Reduce the amount and severity of the pseudo-science. I guess we can each do our best to see the problems that impact us directly and maybe work extra hard to help growing minds be more critical.

    (Treat the media with scepticism where they deserve it!)

    Great article. Thanks.
  • "Medicine, Climate Science, Economic Policy... often seem a bit nutty and when you look more deeply, they often are.

    This stuff can cost a lot. Your life, your health, increased taxes, GFC... "

    What, specifically, is "this stuff" that can cost me my life?

    How did skewed scientific papers cause the Global Financial Carcass?

    Most science does not seem 'a bit nutty' to me, although to someone with a poorer grounding in how science actually works, I suppose it could appear mysterious and confusing.

    If science is so flawed, how is it that the International Space Station got built? - oh sorry, that is just another hoax like the moon landings.

    The danger of people like Johnathon Schooler is that in his desire to be 'front page news', he is willing to overwhelm unsophisticated readers with the idea that if some bits of scence are bunk, then all science is bunk.

    America's version of Ockham's Razor is that the least intellectually sophisticated explanation is the only one that is not the biased product of some elitist book-learnin'.
  • Good to see somebody putting effort into these threads. (At say 10 replies and 5 minutes a piece, that's about an hour.)

    It would be cool to find ways to continue debate with those who put in more effort.

    A couple of points. (I'm not going to address some issues where you didn't read what I wrote.)

    There is a lot of science that works. I didn't say otherwise.

    Cost Life: I've seen iatrogenic impacts on people I know. (i.e. problems caused by medical misadventure.) I've seen FDA approved drugs have their approval revoked after the corruption that got them approved is revealed. ... if you haven't seen this sort of thing in your own life, I recommend taking a look around. A lot of medicine is something we don't want to lose but that should not blind us to the downside.

    GFC: Look into the work on the Black-Scholes equation which gave rise to some of the problems. Check how the work was mis-treated by decision makers.
  • YouKnowBestOfAll 3 months ago
    Very interesting article which shows the things as they are – priority No. 1 for many doctors is NOT health and wellbeing of the patients let alone maximizing health of populations (1), but making more money (2) by inducing and performing unnecessary procedures + drugs (3). Then comes their loyalty to the profession (4). Third, eventually, comes the patient.

    As already mentioned in many of the comments:
    What about all of us who finance this collectively as taxpayers? Who takes into account our – taxpayers’ – preferences when the decisions for allocating limited resources are made? And more importantly – on what basis these decisions are made?

    There is a proverb in Europe which can be translated as: "He is not crazy – the one who eats the cake – but the one who grants it".

    References (although that in the light of this article these might be considered misleading):

    1) Nutbeam (1998) defines the new public health as “a social and political concept aiming at improving health, prolonging life and improving the quality of life among whole populations“, Nutbeam, “Health promotion glossary”, Health Promotion International, 13(4), 349-364, 1998

    2) Jacobs (1997) noted that “studies made of the profits accruing from medical practice have shown these profits to be persistent and considerable”, Jacobs Ph., The Economics of Health and Medical Care - 4th edition, Aspen Publishers 1997

    3) Rice (1999) has noted that “the waste is thought to be generated through provision of unnecessary services far more than through excess demand by patients”, Rice T., The Economics of Health Reconsidered, Health Administration Press 1999

    4) Draper (1999) has pointed out that “Even for doctors employed by hospitals, primary loyalties are to their profession and their patients”, Draper M., Ch.7 Casemix: Financing hospital services, in Health Policy in the Market State, Allen & Unwin 1999


  • *"by inducing and performing unnecessary procedures + drugs"

    Please do not forget that many physicians perform unnecessary procedures because they fear malpractice lawsuits and have GOOD reason to.

    Second of all, do not overlook the power of the consumer in demanding they be given drugs for their problems. For many patients, the mantra is ask and you shall either receive or be denied, and if you are denied, you will probably go to another doctor who will prescribe.

    As a physician, I am taught to give the risks and benefits of my medical advice and let the patient make the decision. Only the paternalistic physicians of the past practice the kind of medicine you describe. That being said, I'm not going to deny that the driving force of many physicians in terms of their decision for choosing a specialty involves where the money is. But, do I blame them? I myself have 140K plus in medical school debt. But, I'm going into primary care because I believe that is what we need to emphasize if we want a health care system that is patient-centered.
  • It really is like old the Watergate Era saw, "Follow the money." As a medical research insider, let me assure you that he is correct. However, through this all, there are still some medical interventions that work, and there are drugs that work. The problem with drugs is that pharmaceutical companies have merged, acquired, and reached such giant sizes that the kinds of treatments good enough to keep companies viable half a century ago, no longer suffice . So now they exaggerate benefits, and, worse, they lower levels of blood pressure, cholesterol, etc. that trigger a prescription. Even worse, they extend usage of drug to conditions not approved by the FDA, but simply supported by research papers paid for or and even written by the companies. These are totally subject to bias and conflict of interest. Docs can prescribe a drug for whatever condition they wish. Pharma's scientists are mostly good, honest, hard-working people, but the marketing people are under enormous pressure to keep the sales and profits growing to satisfy Wall Street's eternal hunger for corporate growth.
  • TheNaturalPsychotherapist 3 months ago
    What's missing with the "gold standard" research in general and with nutrition in particular is taking into account holistic principles versus using Cartesian logic. There can be dozens of actual underlying causes of ADHD or depression for example so studying drugs to treat people with the same symptoms without studying their individual physiology to understand the actual cause is ineffective on several levels. Randomized trials don't often lend themselves well to holistic medicine with is more individual, and cheaper in the long run.

    And the vitamin E "never mind" is a great example of myopic nature of research without a holistic lens. A basic tenant of nutrition and naturopathy is that an excess of any nutrient causes the same symptoms as a deficiency. Our more of a good thing is better doesn't fit with our body's narrow homeostatic settings.

    I'm thankful for Ioannidis and his team's research. I'd love to see them use their sharp skills to study things with holistic factors in consideration.

    Christine Marr
    www.thenaturalpsychotherapist....
  • You didn't really understand this article at all, did you? You believe that holistic medicine is better so you look for any result that might support your belief whether or not it has any scientific merit.
  • She has a point about homeostasis
  • You really didn't understand this article at all, did you? You believe that holistic medicine is not better, so you look for any method you know nothing about (holistic medicine) and assume it has no scientific merit.

    You mock a holistic practitioner who, for all you know, is speaking from a great deal of personal experience, possibly having helped many of her patients in ways that you cannot begin to imagine and who's methods may well have been deliberately overlooked by medical research.

    How dare you say that her methods have no scientific merit! How could you possibly know? You have no idea what her methods are, but that didn't stop you mocking her! This is the very epitome of the cocky self-righteous arrogance that the 'new rationalists' trott out at the drop of a hat. It is you who are drawing spurious conclusions with no evidence not TheNaturalPsychotherapist.

    Your attitude is the very antithesis of Athena Tatsioni, who said in the article "Just having a good talk with the patient and getting a close history is much more likely to tell me what’s wrong.” How much time did you spend listening to the patient 'holistic medicine', before proclaiming her as sick and in need of a dose of 'rationalism'?

    Physician heal thyself.
  • As a naturopathic physician, I am always looking to new scientific findings to help explain why the treatmens I provide work so well, despite often not having been subjected to "gold standard double-blind, placebo-controlled cross-over studies." We vastly undervalue empricism in medicine, yet many experienced conventional docs use unproven empirical treatments all the time. They figure out what works, despite what the "gold standard" research says.

    Some of the treatments I provide have been around for thousands of years and I continue to be surprised how well my patients respond to acupuncture, nutrients, herbs, homeopathy, hydrotherapy and other approaches. I use several therapies simultaneously with my patients, an approach that is difficult to study using "gold standard" methodology. Additionally, you have to consider that "gold standard" methodology makes a massive and impossible assumption right out of the gate, that the population being studied is socially, phenotypically and genetically homogenous. Perhaps my medicine's focus on the individual overall health and function does work best -not labelling him with a diagnosis for the purpose of justifying a FDA/ industry accepted, standard-of-care treatment. The treatment X for condition Y approach sounds scientific and rational; but the catch is in determining the "condition," the whole health picture of the patient, not just that they have an affected part.

    Yes, I use the available science to best direct my treatments, whether the approach is "conventional" or "alternative." I just like to practice good medicine; what I know works based upon my experience and what has worked for doctors who've come before me. It's ironic that the word, physician, means 'one who knows nature.' It seems that the only thing conventional physicians know these days is what is taught to them in medical school, from drug reps and practice guidelines that are dictated by their industry, drug companies and insurance firms. I actually feel sorry for MDs these days. Even if they wanted to do things differently, the various industry influences would prevent it. In addition, with ever-dwindling reimbursement from insurance, they have to provide even less individualized care than ever before; having to squeeze in more patients in a day just to pay their bills. Many MDs these days are virtually slaves with no choice but to practice medicine in a way that is both acceptable to their peers and profitable for drug companies.

    No, every day MDs aren't evil. They are (most of them) very decent, well-intentioned individuals who are, unfortunately, caught up in a meat grinder of an industry. MOST of them aren't the ones churning the meat-grinder handle, so don't lump them all together. I say this even though MOST of them have bought into the anti-complementary and alternative medicine bias that is fed to them.
  • Well said.

    I believe their (MDs) intention is good, but there comes a point in time during their careers that they are unplugged from their biases and actually start to question or doubt a treatment or medication and its effectiveness. This is the critical point where they can choose to seek answers to those questions, or tuck it away and conduct business as usual. This is a sell your soul to the devil situation.

    How many “decent, well-intentioned individuals” does that leave us with now?
  • "I say this even though MOST of them have bought into the anti-complementary and alternative medicine bias that is fed to them."

    They aren't biased because this point of view is fed to them. They are biased because it is rarely ever taught. What they do not understand or learn, they will not trust. Instead, we go through 20,000 hours of education that focuses on understanding how the body works (basic medical sciences) and how the body can malfunction (pathophysiology), and how to practice medicine (clerkships) inside and out of the hospital.

    I, however, have worked with 3 physicians in my community who practice some form of integrative, complementary or alternative medicine because I am interested in it, because I believe my patients will ask for it, and because I want to know the risks and benefits of different modalities of care.
  • "A basic tenant of nutrition and naturopathy is that an excess of any nutrient causes the same symptoms as a deficiency."

    Carotene is a nutrient. Excess carotene causes the eyes and skin to turn yellow. Does a deficiency of carotene produce "the same symptoms"?

    A side effect of excess calcium is kidney-stones. Does a calcium deficiency cause that?

    It might be a basic tenet (not tenant) of naturopathy, but any nutritionist would laugh at that ludicrous pseudo-wisdom.
  • CATTIE trial about comparison of benefits of typical and Atypical medications in Psychiatry is a point to be taken especially not including the best Atypical available at that time CLOZAPINE. Even the side effects of medications are very cleverly included in black box warnings with help from Drug MNCs funded FDA that they can kill a good molecule.
  • The story breaks in The Atlantic in the middle of international Open Access week. If the problem is so prevalent in medical research, where lives are impacted, why would it be any different in the research of physics, the humanities, religion? Does Open Access have the potential to solve some of the underlying causes?
  • post
  • Interesting article - however, while our system of medical (and other) research is certainly not perfect and there is much error that gets through, it is noteworthy that no one has come up with a better system that itself is not subject to even greater problems. One measure of whether or not our system is working, albeit imperfectly, would be to look at historical life expectancy. This provides something of an overview of how effectively medical research and public health measures have improved our lives.

    In this regard, the following is worth considering before discounting the progress which has been achieved due to scientific research in medicine and public health in the United States over the past 160 years.

    Year of birth Life expectancy
    1850 39 years
    1900 50 years
    1950 69 years
    2000 77 years
    2004 78 years

    These numbers certainly suggest that, in spite of serious flaws and limitations in medical research, overall a great deal of real progress has been made which has dramatically increased life spans, and I believe also our quality of life. There is also reason to expect that further dramatic improvements in both quality of life and life span may occur in the next five years.
  • The following is worth considering before assessing the progress in outcomes.

    Looking into “OECD Health Data 2010” available at
    http://stats.oecd.org/Index.aspx?DatasetCode=HEALTH

    Total health expenditure per capita, US$ (THE)
    Life Expectancy at birth (LE)
    Infant mortality (IM)

    .....Country: Czech Rep.............. Australia..................... USA
    Year...... THE / LE.. / IM......... THE / LE.. / IM........ THE / LE.. / IM
    2000.... 982 / 75.1 / 4.1.... 2,266 / 79.3 / 5.2.... 4,703 / 76.7 / 6.9
    2007. 1,621 / 77.0 / 3.1.... 3,353 / 81.4 / 4.2... 7,285 / 77.9 / 6.8

    These numbers certainly suggest that there is a great deal of inefficiency in USA, since by any definition efficiency is comparing of results (LE & IM) with resources spent (THE). The only explanation is that in USA the real progress is in the growth of income of providers.

    Considering the reality (economic situation & health reform), there is NO reason to expect any further improvements in both quality of life and life expectancy in the next five years.
  • I would have to ask the following questions:



    "How many of us are alive and on medication?"

    "Is it ethical to profit on sustaining one's life through long term medication? "

    "What are the consequences of this trend to our future generations monetarily, ethically and genetically?"

    At what expense are we willing to allow modern medicine, government and corporations to control our health and well-being? Who determines what quality of life is to each individual? This article should alert us all that we must be responsible for our own lives.



    We know that the conflicts of interest are there. What will you do about it?



    No matter how many letters follows a doctor's name; do not succumb to intimidation or pressure, but question, question, question.



    It's time to THINK! It's your life and you have one crack at it! Get it right!

    (Edited by author 3 months ago)

  • If the central principle here was to promote a drug-free society given the intrinsic flaws alluded to here, then some sort of paternalistic (or perhaps, totalitarian?) argument could be cobbled together that to do so would be oppressively violating freedom of choice. But, on reflection, the issue should not amount to drugs or no drugs, but to allowing people the choice to opt for better ones...
    Perhaps 80% of the population in Western countries currently self-medicate by drinking ethanol or smoking cigarettes. Often they do both. Whether viewed in terms of mortality, morbidity or overall quality of life, we'd be better off if we switched to enhancing receptor selective dopaminergic, opioidergic, serotonergic and cholinergic function by using the relatively safe, if crude, agents derided by Ionnidis, or should I say, Freedman; and perhaps it might be even better to opt for the more exciting products under development. As a bare minimum, people should not be robbed of the right to do so, since they choose to use alcohol and nicotine, when no level of use could be deemed truly therapeutic if truth be known.
    The only catch is that the level of expertise required to make informed decisions from the wider selection available exceeds that of the average person...
  • This is an issue of personal responsibility.

    Smoking cigarettes and drinking alcohol are about personal choice. One must be responsible when choosing. Big pharma allows many to conitnue to be irresponsible and they make it quite convenient to continue this pattern of recklessness. Give your body what it needs and it will take care of you; failure to do so, and your local pharmacy will be happy to pick up the pieces, "they're conveniently located."

    "Freedom of choice" This is a great thing to have, but many don't make good choices. I doubt many even really have this freedom. Why? Because there is so much stimuli that influence everyones personal decision. I don't think they can rationalize and decipher the good from the bad. Is this really freedom?

    Practice wellness people!

    Remember who's there to profit off your poor choices! No reason for big pharma to promote wellness, there's no money in it.

    Oh, and this Lou guy is crazy.
  • HM - Aaaaaaaahhh, this guy is Australian actually. And, I take it, you're American?!
    We Aussies have a tendency towards sarcasm... Sorry, it went over your head. Should've realised this was on a US site.

    One thing though. You've baffled me here, so I'm trying to get my head around your post... You think it's better to have a Nanny state? That we need Govt authorities to tell us what to do because "many don't make good choices"??? Wow.
    So, it's damn the Pharma companies who are the bad guys. But, hey, Beer & wine companies and cigarette companies are cool and don't ever attempt to "influence" ?! It's fine for our kids to smoke and drink, because that's personal choice...? And, somehow, taking medication is so much worse? Gee. What if a kid actually has a mental disorder that veers them into addictive habits like drinking and smoking, and much worse?
    Crikey - You've worn my sarcasm down. Now I'm genuinely worried that this is how people think?!! Scary...
  • Lou, you don't have to get your head around my postings, just get your head out of the Fosters!

    You are taking my postings and doing a croc death roll with it and putting it back together the way you would like it to read.

    Focus now...

    There would be less disease if people made better choices. No one is going to stop you from your poor choices, but many are willing to profit from them.

    There, very simple. Isn't it?
  • "There would be less disease if people made better choices." is as good as far as it goes, but it doesn't go very far.

    Certainly, if people 'chose' not to abuse alcohol, nicotine and other life-damaging drugs, they would be healthier. That is a tautology.

    But it's a falsehood to imply that personal choice is the only reason for ill-health. Apart from the many ailments that have been demonstrated beyond doubt to be relieved or cured by pharmaceuticals, therapy etc., there are people with psychiatric disorders who self-medicate with alcohol, nicotine and other life-damaging drugs.

    For those unfortunates who have slipped through the cracks, only a stone-hearted person would say that their only ailment was 'poor choices'.
  • "falsehood to imply that personal choice is the only reason for ill-health"

    Tafkao, read carefully: there would be "less disease." Do not misguide my argument. I am not saying that it is the “only” reason for ill-health. Some things are beyond our control like environment and genetics. Yet, we could even make better choices with information on these two factors.

    Stone-hearted? People slipping through the cracks? Profit motivation drives those that are stone-hearted. The search for cures in the industries you speak of starts with sorting through the medical books for a drug to treat, that’s right, treat a patient. What cures are you talking about? Do you have a cure for something that you would like to share with the world?
  • "No one is going to stop you from your poor choices,"
    A bit naive here, don't you think?

    "but many don't make good choices. I doubt many even really have this freedom. Why? Because there is so much stimuli that influence everyones personal decision. I don't think they can rationalize and decipher the good from the bad. Is this really freedom?"

    Would you rather have a bunch of legislators decide what is good for you?
  • Yes, in this context it does sound naïve, but in the proper context,

    “There would be less disease if people made better choices. No one is going to stop you from your poor choices, but many are willing to profit from them.”

    There you go, now that is called sarcasm.

    Please people, climb out of that box you are living in and start thinking for yourselves. Is government our only alternative? Ask what you can do for you!
  • "This is an issue of personal responsibility.

    Smoking cigarettes and drinking alcohol are about personal choice. One must be responsible when choosing."

    I assume Heavenly Mist would not object to people using personal responsibility in consuming cannabis as well.

    Mitch Earleywine has surveyed the research into cannabis use, in his book "Understanding Marijuana". of course, if one distrusts all science, his book and be put down to agenda-driven propaganda.
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