Bad Bad Bad: how drug companies mislead doctors – Ben Goldacre

bad scienceDr Ben Goldacre is a physician, psychiatrist and epidemiologist; writer, broadcaster and really fast TEDtalker.

He was in Toronto publicising his new book Bad Science in Feb, here he is in interview with Anna Maria Tremonte on CBC’s The Current from Feb 2012.

Bad Science: Bad Pharma, Bad Medicine, Bad Academia

Ben Goldacre’s aim is to recruit everyone – including you and me to help change the Bad Science that’s killing medicine and killing people by making it impossible to know which medicines work best, and which don’t work.

We’ve known about the problem for almost thirty years: but we’ve left it to panels of experts – doctors academics and bureaucrats  to fix but it’s failed. In fact it’s gotten worse.

“Some of these problems have been documented for three decades and we’ve failed as a profession to fix them.”

Ben Goldacre focusses us on the fact that half of all drug trials never get published – yet trials with results showing drugs in a good light are twice as likely to be published as those that don’t.

He likens this to a coin toss: if I asked you to predict the results of a series of coin tosses then run a trial, from which I hide half the results – those results for “tails”, you’d likely say I cheated. Well that’s like what’s happening with drug trials.

What you can do

all trials logoyou can go to to sign the petition,  and support, even donate to the international campaign to have all trials registered and published, and to learn more.

Listen to the podcast here

 cbc podcast audio player clipid=2336303058&position=93599&

From the podcast…

Ben Goldacre:

Medicine Is Broken

“There are very well documented flaws in the way we measure the risks and benefits of the treatments that we use, but also in how we bring that evidence together, disseminate it to decision makers – doctors and patients –  and how we implement it in practice.

“I wanted to take all these technical flaws, which are well documented and discussed in the professional academic literature. and share them with the public.

“Some of these problems have been well documented for three decades and we’ve failed as a profession to  fix them so I want to recruit the Public and policymakers in helping to fix them.”

“We know that unflattering results can be buried, with held from doctors and patients.

“We also know that trial results can be flawed by design such that they are no longer a fair test of which treatment is best.

“We need to be cautious about industry sponsored research – but also we need to be cautious about all research because all the problems that I describe in the design and reporting of results also apply to academic studies as to industry studies.

“I think by far the biggest issue is the problem of trial results being with held.

“systematic review reveals

      • about half of all the trials that have ever been conducted oo all the medicines that we use today have never been reported: never been published in academic journals.
      • clinical trials with positive results are about twice as likely to be published as trials with negative results.

“This is very serious business: we need these results to make decisions about which treatment is best. And if half those results are being withheld from us then we cannot know the true effects of the treatments that we’re given.

“And this is a problem that’s been demonstrated in medicine since at least 1986.

“And though there have been several interventions that are supposed to have fixed it they ‘ve all failed and not only have they all failed but we’ve been lulled into a false sense of security that they have worked, when they have failed.

“If you withhold half the evidence from all the drug trials that have been conducted, then you pollute the well.

…You pollute the well of evidence that all of us use to make decisions – and that means that nobody can know which treatment is best.”

CBC Feb 2012

How drug companies mislead doctors

Bad Pharma author explains on The Current

Drug companies are misleading doctors by withholding important information about the effectiveness of their products, says epidemiologist Dr. Ben Goldacre.

In his new book, Bad Pharma, Goldacre points out flaws reported in medical literature in the way drugs are tested and approved for use and illustrates some of the deadly consequences.

The biggest problem, he says, is that only half of all clinical trials are published, and often the trials that are not published are the ones showing the drug is ineffective.

“If you withhold half of the results of all the clinical trials that are conducted, then you … pollute the well of evidence that all of us use to make decisions,” he told CBC’s The Current.

“And that means that nobody can know which treatment is best.”

Goldacre outlined a couple of examples, including one case in which 100,000 people may have died prematurely because the results of an early trial were never shared in the academic literature.

Testing against a placebo

Another way in which drug approvals are flawed, Goldacre said, is that they allow drug companies to test against a placebo instead of the best possible existing treatment.

“If you don’t get the best treatment, then as far as you’re concerned as a patient, then I think you’ve been failed.”

Goldacre also discussed problems with the way clinical trials are designed and run.

Many of the problems with drug testing and approvals have long been known and discussed in the academic literature, Goldacre said. But he thinks the discussion should also be shared with the public.

“Some of these problems have been documented for three decades,” he added, “and we’ve failed as a profession to fix them.”


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