A Bad Weekend For Medical Science

Funny how just as I was thinking Machiavelli was in for a few quiet weeks during the silly season for news, Big Pharma and the medical care industry show their intention of keeping the old pot boiling right through to the day Gordon Brown calls the General election (October 24 – the announcement, not the election, is being hotly tipped.

And then in the course of five days we hear of four reasons to mistrust the medical industry.

First was the announcement of loony plans to put all men over fifty on cholesterol lowering drugs whether they have raised cholesterol levels or not. (Cue a raiding party of boy – scientists from Ben Goldacre’s Bad Science Forum to come storming in yelling that I am not a “scientist” and do not understand the science. Oh I just love winding them up.

Now I do not claim to have any understanding of cholesterol related problems in men over fifty, my LDL (low density lipoprotein or naughty cholesterol) is lower than average I’m told, while my HDL (high density lipoprotein level is healthy. So, having enough side effects from medication I do need, I do not want any more from medication I don’t need.

We do not need a medical qualification to understand that cholesterol is a vital component of human cells so to lower levels in people who don’t need their levels lowered might just cause more problems than it solves. But while that would be bad for us it would be good for Big Pharma, creating a vast new market for drugs to reverse the effects of the unneeded drugs we had already taken. And it would not be bad news for the senior doctors. More work for their teams would mean bigger budgets and bigger salaries.

If it ain’t broke, don’t fix it. You don’t need to be a brain surgeon to understand that, just capable of using common sense. But of course cholesterol is not the first problem that medical science has proposed wholesale medication for. Not so long ago someone was talking about threating the drinking water with anti – depressants.

Next out of the loony laboratory was the news that the until recently acclaimed diabetes drugs Avandia and Actos have been linked to increased risk of heart failure. Researchers say that as many as one in fifty patients put on these drugs have been hospitalised for heart failure in the 26 months since the study of side effects was launched.

Call Little Nicky old fashioned if you like possums, but I thought the point of medicine was to make people better not iller.

Third comes the news that Pharmaceutical companies and the medical establishment are refusing to sanction clinical trials of a drug which is widely used in the U.S.A. and other places to treat deterioration of eyesight in the elderly.

Over 20,000 people per year suffer some loss of vision due to macular degeneration. The drug Lucentis can halt deterioration and improve vision but is priced at around £750 per shot, way beyond the budgets of most NHS Doctors. Which is tough, or would be if a cheap alternative was not available. That alternative, already widely used elsewhere, is a drug called Avastin which was developed to treat bowel cancer. Avastin, in eye sized doses, would cost around £10 per shot. Very affordable, yet NHS Doctors cannot prescribe it because nobody will fund the clinical trials that must be done before the drug is licensed for such use in the UK.

Lastly comes news that Ritalin, widely prescribed for children affected by ADHD but suspected of having serious side effects including, allegedly, death in a few cases is about to become news again. Ritalin has been suspect for a long time, but as with the Autism / MMR issue, Medics have dismissed concerns as “associative fallacy” and said cases of serios illness are just coincidence. But isn’t that what they said about the dibetes drug / heart failure connection (I know it is because my friend who put me up to using Machiavelli to voice the concerns of who can’t reveal their names, is a diabeytes specialist) It’s also what they said about the alleged Autism / MMR link, AND the harmful effects of seroxat, AND the addictive nature of many prescription painkillers.

So we can expect that one to run and run.

Now some people may get the idea I have a grudge against the medical professions. That is not so, I owe the fact I am around to write this to the fine work of an ITU team and the patience and commitment of a rehab team. I just wish that those professionals were not constantly hampered by the incompetence, self – interest or sheer stupidity of the Pharmaceutical industry and the Medical establishment.

And I also wish the boy scientists of Bad Science Forum would shout the fuck up and leave serious issues to experienced political campaigners. Their Mickey Mouse degrees from Portakabin University do not make up for a painful lack of life experience. Which is of course the essential qualification for a career in medicine. (That BTW is a taunt aimed at goading them into steaming in with comments on what they think I have written rather than what I have written rather than things I actually said, thus adding a lot of content to Machiavelli and pushing my blog up to the top of the search engine listings.)
It is a lack of life experience that makes them argue about the quality of the scientific methods used in these study’s. Had they adequate life experience of course, they would understand that it is not the egos of “scientists that matter but the wellbeing of patients undergoing therapy.
Let’s see if that gang of arrested adolescents fall for my rather entry level Machiavellian ploy a THIRD time :DD

JUST A WORD for regular readers. After a post recenntly that attracted far more comments than usual I said there seemed to be a orchestrated attempt to shout me down. As I expected someone involved in the attack responded that all the adverse comments came from the Bad Science Forum after the forum leader had linked my site but it was not an orchestrated attack (see what I mean about thick?) and I was a conspiracy theorist. Well you know Little Nicky’s attitude to orchestrated attacks. Bring ’em on 😛

Medicines out of control

Pharmageddon

12 thoughts on “A Bad Weekend For Medical Science

  1. your ‘Bad Science Forum’ sound just like a bunch of politicos to me and I’m not going over that ground again because I did it to death a few months ago and I’m not ready to start again.
    it’s the shouting down part that sounds familiar.

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    1. Couldn’t access your blog to leave a comment Ann so I’ll invite you as a friend.
      I don’t think my lot are politicos, just very immature people who can’t accept the evidence when it points to an inconvenient conclusion.

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  2. Yeah, what do these scientists know? We all know that ‘vaccines’ and ‘medicine’ kill far more people than they ‘cure’. Now they think their ‘science’ is more accurate and believable than politics. Keep your rants coming Mr. Machiavelli, they are very revealing.

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    1. Irony is always welcome here Richard.

      I did say though that I owe my life to doctors and mentioned that drugs keep me alive, it is the drive to over-medication that is eroding trust.

      And if you had read before commenting you would see that I never suggested drugs and vaccines kill more than they cure. Could it be you are one of those Bad Science boys, you have a similar tendency to comment on what you assume I think rather than what I actually wrote.

      Oh and “rants” is off target. Machiavelli is much more playful than that.

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      1. You are quite correct and I apologise for assuming you are stupid. I still take issue with several things you have written though. You have a tendency to wilfully, or perhaps ignorantly, misinterpret scientific evidence and medical advice to suit your agenda. To me much of the public distrust of medicine and science stems from the media behaving in the same way. Given that misinformation and misrepresentation of science can lead to public health issues and irresponsible politicking by our elected representatives do you not think that the media should have a moral obligation to offer facts first then opinion rather than twisting the former to fit the latter?

        I look forward to your response.

        PS If your blog continues to climb up the google rankings thanks to your baiting of ‘boy scientists’ you would be foolish not to have some form of advertising. Or is that against your principles?

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      2. Of course, you’re conveniently ignoring that his opinion is backed up by other scientists and qualified medical professionals who don’t have a vested interest in keeping things the way they are but do have a vested interested in keeping their jobs.

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      3. I do not wilfully misrepresent, but perhaps because in my career as a consultant I was unfortunate enough to work with drug companies three times and so am very aware of their methods of misrepresenting truth, I take an extremely sceptical view of their business and their far too cosy relationship with the medical establishment.

        To let you see what is really going on here its necessary to go back to my original post on the MMR / Autism story that resurfaced recently. Now I did not make any comment other than to ask why if what we were told is true, the story keeps coming back.

        “Now I cannot say the MMR vaccine causes autism, though its promoters will claim that is exactly what I am suggesting, but there is enough evidence to warrant an independent judicial enquiry. The statistics can be manipulated to support the government and Big Pharma case, but as long as children keep developing symptoms soon after the treatment we must keep asking the difficult questions.”

        A reasonable point I think. I also said,

        ” the case that MMR vaccine did not contribute to autism was never convincingly made, we were fobbed off with “well you can’t actually PROVE beyond doubt that it is harmful” rather than the more ethical but less cost effective “we can’t prove beyond doubt it isn’t harmful so we will stop using it until we are certain.”

        Nobody can prove a negative of course, so it is up to the pharma industry to show what does cause autism. The other way out is to show the figures, acknowledge there is a slight risk and offer parents a choice of single vaccines (at a cost but with the option to have that cost covered by benefits in hardship cases)

        I did make some provocative remarks about Guardian columnist Ben Goldacre whose devotion to the erronious interpretation of “post hoc non ergo propter hoc” argument leads him to repeatedly blether about “association fallacy” and conincidence. Well there are five thousand families queueing up to sue the manufacturers of the vaccine in the USA. The saying goes “once is circumstance, twice is coincidence, three times is hostile action.” So what is 5000 times? The purpose of the provocation was to draw him out. Based on use of certain phrases and verbal style I think he was behind some of the comments but did not use the name Ben Goldacre.

        We should be wary of assuming connections on the basis of correlation, but in the case of MMR, because no link to autism onset has yet been found that does not mean there is no link. Nothing has been proved either way. And I get really irritated at the “there is no evidence” brigade. Now I am not a chistian but I acknowledge that Jesus has been the single most important figure in the history of western civilisation. And yet there is no evidence this man ever really existed. The Roman Imperial annals make a brief mention of somebody who was proclaimed as The Messiah by his followers being crucified ( this person was named Brian perhaps?) The rest is myth and legend yet it has shaped history.

        We should not place too much importance on evidence.

        Someone bought me the book based on the TV series QI last Christmas. One of the “fallacies” it exposes (or perhaps not) is the idea that several million women were killed for being witches between the fourteenth and seventeeth centuries. Actually there are very few cases of women being executed for witchcraft. Until we look more closely. The methods of trial were based on ordeal to find out if “the devil” would come to the aid of the accused. So women were thrown off church towers, ducked in ponds or rivers for several minutes, crushed under large stones, thrown into fires or “tried” in many even more creative ways. If they survived they were guilty and were executed.

        No wonder then there were so few executions, but that number is misleading. Far more women were killed having been accused of witchcraft than were executed according to law. We have no idea of the actual number.

        Did the ancient Egyptians build the pyramids? We could not build the pyramids today, we have cranes that could lift the stones of course but even those could not support such weight and achieve the reach required. So the technical evidence suggests the Egyptians did not build the pyramids. We need to be very careful about evidence.

        Recently my friend Sally mentioned her interest in crop circles (an interest I do not share, although they are a fascinating phenomonon) and somebody claiming he is “a scientist” made scathing remarks about Little Green Men. That guy is no more a scientist than I am a champion sprinter. A true scientist (who would be unlikely to refer to himself as “a scientist,” all the ones I’ve known tend to name their scienticic discipline) would be open minded.
        We simply do not know what makes the most complex crop circles. Two old blokes with rope and planks could make the crude, simple ones, but in 1994 or 5 when there was a spectacular crop of them one summer, a friend of mine, a mathematician by education, a computer programmer by profession and open minded by nature got me and a few mates to help him recreate a complex pattern on the car park of an empty office block. He proved it would have taken several nights, so the “rational” explanation was as unfeasible as the ones “scientists” sneer at. My favourite crop circle cause is the mating dance of rutting hedgehogs but it is very very unlikely to be the real cause.

        Who knows, the crop circle investigators may just one day stumble upon something that will provide us with a source of unlimited, clean, zero cost power.

        So you see my critics had no case to back up their assertions. We can throw doubt on anything by using their method of “scientific” investigation. There was no evidence Wakefield was right but I had not supported him, and there is certainly no evidence of the opposite. I don’t recall anybody suggesting that autism was triggered by MMR in any but a few cases.

        So when Goldacre’s followers at his Bad Science forum came charging in to accuse me of supporting the discredited findings of Dr. Wakefield (I never have)and of “not understanding the science because I am “not a scientist” (I do and I am – I worked in computers and logic is a pure science wheras medicine is not)and suggested that I ought not to post on MY blog things they disagree with, I decided to be naughty. I steered them towards irrational conclusions, provoked them to cite non sequiturs and finally got what I wanted, an admission that Goldacre had highlighted my site and they had all followed his link to have a go.

        I have a few long standing issues of my own with the medical establishment, mainly based in my experience of medical ethics which seems to be as big a contradiction in terms as military intelligence. That said, most of the doctors, nurses and therapists I’ve met have been excellent and deserve more support from their managers and the leaders of their professions.

        In my latest post, though it was not related to the MMR issue, I decided to give the Bad Science boys a final tweak and spell out for them, because there was no other way they’d ever get it, that they have been had over. I’m not worried about my more outrageous statements, nobody reads comments and responses.

        Advertising on my blog? Making money is not against my principles but to put advertising on a blog.co.uk blog requires “pro” membership which costs £15 per month. That is too expensive for what they offer and the returns from Google pay per click ads would barely cover the cost even if I got way above the average click rate (response is poor because Google’s idea of context is very different to the dictionary definition.) But the better Machiavelli and Boggart Blog fare, the more their links boost traffic to my paid gigs at American sites. And what I make there, because I am not hard up, is for my Texan sweetie who is getting over a liver transplant and needs every penny.

        Best regards,
        Ian Thorpe

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      4. I think you perhaps misunderstand my point. I have no quarrel with you over the fact that drug companies, as with nearly all other companies, misrepresent and deceive in their advertising and public relations. I do not dispute that they attempt to influence the medical profession and the consumer. This is irrelevant to concerns over the media’s handling of science though.
        Scientific evidence behind theories and in support of hypotheses is made public and open to scrutiny by all (subject to journal subscription in most cases). This transparency is necessary for scientists to be able to work together. It ensures that mistakes and lies are unearthed as people try to repeat experiments, it ensures that theories correctly interpret data and so on. Sadly the general public seem unaware of this transparency and the media and bloggers like yourself have to accept some responsibility for that. You have fed the impression that science is devious, bad results are covered up, and that there is no transparency by reporting opinion as fact and not scrutinising press releases from individuals and organisations for valid scientific content. You also portray scientists as acting in unison and being of one opinion when in fact there is much diversity out there. Contentious issues are resolved through experimentation and evidence based debate rather than on rhetorical device, personal slurs and misrepresentation of opinion as fact that is common in media reporting.
        Why do you not emphasise the transparency and meticulous nature of science? It is important that people understand that we know that some drugs are dangerous precisely because of that transparency and attention to detail.

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      5. Your idealism is refreshing Richard,
        “Scientific evidence behind theories and in support of hypotheses is made public and open to scrutiny by all”

        Unfortunately this is not true. The vast majority of scientific breakthroughs are kept under close secrecy until patents have been filed and even then such details as are released will be vague and misleading. In the early 1980s I was working for Philips Industries and one of my projects was on process control computers for a Philips / Sony joint venture, the laser disc.

        Had details of research been issued in scientific journals, rival companies would have been able to bring out competitive products. I remember being in a meeting when discussion was on the prototype product, a 12″ video disc. I said, “I can’t really see a big market, but if it was used for recorded music it would take off.” I thought they were going to throw me into the dungeons but I left that meeting with the understanding that I must never mention a new music technology outside that room. Yet the laservision system was known to the media and surely someone else would have the nous to think “hmm, more potental as a music medium.” Corporate paranoia is much more acute today.

        I also had three years in the nuclear industry. Many things that go on are just not known outside the industry. I am still covered (for life) by the official secrets act of course.

        Are you sure you are not making the same mistake as Ben Goldacre and using the word “science” when you mean “medical research.” Even in that field there is a lot of secrecy, as I told you I did projects for three drug companies.

        So perhaps you can see now why the media misrepresent, as you put it, science.

        Also scientists do themselves no good by affrecting high mindedness. In one of my earlier discussions I had someone going on about how I did not understand why Wakefield’s research was wrong. It was due, the commenter said, to the measles virus having RNA rather than DNA. As my specialist field was information technology I could have said I found it amazing that the Measles virus contained a Router Negotiation Algorithm. I did not need to look RNA up, knowing vaguely what it was, but as the writer did not have the courtesy to expand his TLA for the benefit of a non medical person I could only conclude he was trying to be patronising. Never a good approach.

        This was an attitude I kept coming across in responses to my previous posts.

        Contrast that attitude in medical research with the open attitude of the people at CERN and MIT as they race to b e first to identify the Higgs boson and hopefully unravel a little more of the secrets of matter.

        So in short, no I do not think the media and bloggers have a responsibility to science, I think science has a responsibility to itself to learn to communicate. Oh and scientists would do well to lose the whitewash bucket, us mere mortals are not stupid. If members of any scientific commmunity behave like Estate Agents and Pensions Advisers in constant;ly trying to obfuscate the issues, they will enjoy the same levels of trust and respect.

        Ben Goldacre constantly patronises readers and that is why, outside his own community, he has so many hostile responses.

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  3. “That alternative, already widely used elsewhere, is a drug called Avastin which was developed to treat bowel cancer. Avastin, in eye sized doses, would cost around £10 per shot. Very affordable, yet NHS Doctors cannot prescribe it because nobody will fund the clinical trials that must be done before the drug is licensed for such use in the UK.”

    Not strictly true. Unlicensed treatments can and are prescribed, including Avastin for macular degeneration.

    The bigger problem is that without trials the treatment won’t be approved by NICE and so people a currently faced with a lottery as to whether their PCT will agree to fund such treatment. Without NICE approval most will probably shy clear.

    Although there was something on the radio today about the NHS funding the necessary trials.

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  4. I was only pointing out that just because Avastin isn’t licensed for the treatment of AMD doesn’t necessarily mean Doctors can’t prescribe it, although it does make it more difficult to obtain funding from PCTs. And the lack of clinical trials clearly means there is an unknown element of risk in the treatment that needs to be made clear to ensure informed patient consent. There is evidence it is effective so should these NHS funded trials go ahead it will hopefully become more readily available as a treatment.

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