Skepticism about science and medicine

In search of disinterested science

“Cold fusion” never disproved, lives on under other names

Posted by Henry Bauer on 2015/03/29

“Cold fusion” began in 1989 as a claim that fusion of deuterium could be accomplished at room temperatures in electrochemical cells using palladium electrodes. The claim was quickly dismissed after quick and dirty attempts at replication, but hundreds of researchers have continued to look into that and similar systems, including activation by sound energy or lasers. Further claims of nuclear transformations followed, and the field is now being pursued under other names: ‘condensed matter nuclear science (CMNS)’;  ‘low energy nuclear reactions (LENR)’; ‘chemically assisted nuclear reactions (CANR)’; ‘lattice assisted nuclear reactions (LANR)’.

There is a dedicated professional society, the International Society for Condensed
Matter Nuclear Science (www.iscmns.org) and journal, the Electronic Journal of Condensed Matter Nuclear Science (http://iscmns.org/CMNS/publications.htm).

For an up-to-date review of the field, see Current Science 108 #4, pp. 491-659, freely available at http://www.currentscience.ac.in/php/toc.php?vol=108&issue=04.

 

Posted in funding research, resistance to discovery | Tagged: , , , | Leave a Comment »

Loch Ness Monsters

Posted by Henry Bauer on 2015/03/13

A book about “the Loch Ness Monster” by a man (Tim Dinsdale) who had filmed the back of a large creature swimming in Loch Ness had aroused my interest in 1961: Could the Loch Ness Monster be a real animal after all?

I was disappointed that I could find no authoritative discussion of the possibility in the popular or scientific literature. Encyclopedias had no more than a paragraph or two. On the other hand, Dinsdale’s book cited several earlier works, by Rupert Gould and by Constance Whyte, both of whom had quite impressive credentials. Why would science have nothing to say about a topic of such wide public interest?

That curiosity led me eventually to change my academic field from chemistry to science studies, with interest especially in scientific unorthodoxies. But I’ve kept my interest in Loch Ness, which remains an unexplained mystery. I’ve detailed elsewhere what my “belief” about Nessies actually is (Henry Bauer and the Loch Ness monsters).

Some of the most objective and compelling evidence for the existence of these creatures comes from sonar (“The Case for the Loch Ness Monster: The Scientific Evidence”Journal of Scientific Exploration, 16(2): 225–246 [2002]) and a few underwater photos taken simultaneously with sonar echoes, but such technical stuff is less subjectively convincing than “seeing with one’s own eyes”. For the latter, there is no substitute for the film taken by Tim Dinsdale in 1960. Recently Tim’s son Angus published a book, The Man Who Filmed Ness: Tim Dinsdale and the Enigma of Loch Ness, whose website  contains a link  that enables anyone to see the film itself on-line. Grainy as the film is, small as the Nessie’s back may seem at the range of a mile, you need to know only one thing to judge its significance:

The most determined debunkers, of whom there have been quite a few, have been able to suggest only one alternative explanation to this being a film of a large unidentified creature, of a species far larger than anything know to be in Loch Ness: That what seems to be a black hump, curved in cross-section and length, which submerges but continues to throw up a massive wake, is actually a boat with an outboard motor. Several magnified and computer-enhanced frames of the massive wake on my website show quite clearly that nothing material is visible above the wake after the hump has submerged.

If the most dedicated “skeptics” can offer no better explanation than this, then I feel justified in believing that Dinsdale filmed a genuine Nessie.
It reminds me of the Christian apologist, I think probably G. K. Chesterton or Malcolm Muggeridge, who remarked that the best argument for the truth of Christianity is the attempts by disbelievers to discredit it.
If there is one thing that the hump filmed by Dinsdale is certainly NOT, it’s a boat with an outboard motor.

Posted in resistance to discovery, science is not truth, unwarranted dogmatism in science | Tagged: , | Leave a Comment »

How (not) to measure the efficacy of drugs

Posted by Henry Bauer on 2015/02/19

Innumerable books and articles have described the flaws of contemporary drug-based medicine, notably the way drugs are approved: the Food and Drug Administration requires only 2 successful trials of 6 months duration — even if there have been many unsuccessful trials as well. Accordingly, drugs have had to be withdrawn from the market because of their toxicity sooner and sooner after their initial approval (p. 238 ff. in Dogmatism in Science and Medicine, McFarland 2012). It is becoming quite common to see a drug being advertised by its manufacturers at the same time as a law firm is canvassing for patients harmed by the drug to join their class-action suit (today, for example, with Xarelto, approved in 2008 and for extended uses in 2011).

Not widely noted or understood is that the statistical criterion for efficacy of a drug is inappropriate. What concerns patients (and ought to concern doctors) is how big an effect a drug has; but the approval process only requires that it be better than placebo, or than a competing drug, at “statistical significance” of p≤ 0.05. The latter is already a very weak criterion, allowing the result to be wrong once in 20 trials. But even more inappropriate is that the effect size need not be large. If one uses a large enough number of guinea pigs, even a tiny difference can become “statistically significant”. For instance, clopidogrel (Plavix) is prescribed for prevention of stroke, and a study found it better at 75 mg/day, at statistical significance of p = 0.043, than aspirin at 325 mg/day. But it took nearly 20,000 trial subjects to reach this conclusion, because the reduction in risk of an adverse event was only from 5.83% (per year) to 5.32% *. One might judge this as trivial and not worth the extra cost and extra danger of side effects compared to aspirin, one of the safest drugs as demonstrated by decades of use.

Moreover, meaningful for patients is the change in absolute risk brought about by an intervention, not the relative reduction in risk compared to something else. The occurrence of an adverse (stroke) event is about 5% per year in older people; the absolute reduction brings it to perhaps 4.5%, about 1 in 22 instead of 1 in 20. Trivial, especially considering that such small differences, even from large trials, may actually be artefacts of some flaw or other in the trial protocol or practice.

The easiest measure of efficacy to understand, but almost never shared with patients or doctors, is NNT: the number of patients that needs to be treated in order to achieve the desired result in 1 patient. These numbers reveal an aspect of drug treatment that is not much emphasized: no drug is 100% effective in every patient.
Even less commonly shared is NNH: the number of patients who must receive a drug in order to have 1 patients harmed by that drug. This reveals an aspect of drug treatment that is not at all emphasized, indeed deliberately avoided: every drug has adverse effects to some degree.

A fine exposition of this appeared in the New York Times: “How to measure a medical treatment’s potential for harm”: to prevent 1 heart attack over a 2-year period, 2000 patients need to be treated (NNT = 2000 — the benefit is 1 in 1000); but aspirin can also cause bleeding, NNH = 3333. So the chance of benefit — very small to start with — is only about twice the chance of harm. In other cases — mammograms are mentioned, and antibiotics to treat ear infections in children, NNH is large compared to NNT; yet current medical practice goes against this evidence.

More examples are given by Peter Elias.

Statins show up very badly indeed when evaluated in this manner:

StatinsNNT

 

For other critiques of using statins, see “STATINS are VERY BAD for you, especially FOR YOUR MUSCLES”;  “Statins weaken muscles by design”;  “Statins are very bad also for your brain”;  “Statins: Scandalous new guidelines”.

——————————————————————
* Melody Ryan, Greta Combs, & Laroy P. Penix, “Preventing stroke in patients with Transient Ischemic Attacks”, American Family Physician, 60(1999) 2329-36

Posted in fraud in medicine, medical practices, prescription drugs | Tagged: , , , | 4 Comments »

R. I. P., Ivory Tower

Posted by Henry Bauer on 2015/02/15

There was a time, well within living memory, when academic institutions expected their faculty to teach conscientiously and to do research with the resources provided by the institution. Freedom to follow one’s hunches was aided by tenure.

Then governments started to support research through separate agencies, and faculty could obtain support from them; whereupon academic institutions increasingly came to view their faculty as geese bringing in golden financial eggs from those government agencies. At my first job in the USA, the Research Director at my university tripled the budget I had estimated in a grant application, in order to increase what the university could rake off the top for “overhead”, “indirect costs”, and even reimbursement of part of my salary.

For a decade or so, everyone loved this arrangement, because the funding sources had enough goodies to distribute to satisfy almost everyone asking for them. But then more and more people wanted to feed at that same trough, and things became competitive and then cutthroat. For instance, if you were an engineer at my university 30 years ago and wanted tenure, you needed to bring in about $100,000 annually, and if you wanted to be a full professor your target was $300,000 annually.

I’ve described how The Science Bubble has continued to bloat and become increasingly dysfunctional in EdgeScience #17.

Faculty as milch cows for their institutions was invented in the USA, but the innovation has become viral. Here  is a description of one of the consequences in England.

As I was beginning my career in Australia more than half a century ago, academe seemed and largely was an ivory tower in which one could pursue scholarly and scientific interests sheltered from the hurly-burly rat-race of industry with its single-minded pursuit of commercial profit. So I was surprised in the mid-1950s in the USA when a newly minted chemistry PhD told me that he was planning to enter industry in order to get out of the academic rat-race. How prescient he was.

Posted in conflicts of interest, funding research, scientific culture | Tagged: , , | 3 Comments »

Probabilistic causation, misinterpreted probabilities, and misdiagnosing mental illness

Posted by Henry Bauer on 2015/01/25

Some people want everyone to accept what “science” says, even when they cannot really justify that from the actual evidence and facts.

For instance, Donald Prothero in Reality Check (Indiana University Press, 2013), spends countless words saying things like “nothing in real science is 100% proven” (italic emphasis in original) mixed in with “if something has a 99% likelihood of occurring, or being true, then this level of confidence is so overwhelming that it would be foolish to ignore it” (p. 32). He illustrates this by the high likelihood of injury or death if one jumps off a building.
Then comes a typical piece of misdirection about the likelihood of getting cancer if one smokes, because “the link between cancer and smoking is about 99%”.
In the first place, the evidence for jumping off a building and for cancer causing smoking are of an entirely different order. In the second place, no source is given for the claim of “about 99%” for the cancer-smoking link.
The observable evidence about jumping off buildings is quite direct, no inferences needed. On the other hand, the link between cancer and smoking is based on inferences from data that are probabilistic: analyzing records from people who have smoked varying amounts for varying lengths of time and applying statistical tests of significance.
But most subtly misleading or deceitful is that “about 99%” assertion. A similar point crops up in a number of quite different matters. Probabilities cannot be turned around, one might say they are not “commutative”. (A + B is commutative because it equals B + A. There are many operations in mathematics that are not commutative.)
If someone dies of lung cancer, there is a high likelihood that smoking may have been a causative factor; but that is not the same as saying that smoking is highly likely to cause death by lung cancer, and the second statement does not follow from the first. The commutated probability that a smoker will die of lung cancer is not very high:
“Smoking accounts for 30 percent of all cancer deaths and 87 percent of lung cancer deaths” but “fewer than 10 percent of lifelong smokers will get lung cancer”
(Christopher Wanjek, “Smoking’s many myths examined”).

I. J. Good discussed this general issue in relation to the trial of O. J. Simpson for the murder of his wife, given the acknowledged circumstance that Simpson was an habitual wife-batterer. Alan Dershowitz, assisting the defense, had pointed out that only about 0.1% of wife-batterers go on to actually kill their wives. But this was misleading. The pertinent probability must be calculated as follows: Given that a wife is murdered, and given that the husband is an habitual wife-batterer, what is the probability that the husband did it? Good showed that it was greater than about 1 in 3 (Nature 375 [1995] 541). In a later piece, Good reported that Dershowitz’s 0.1% was itself misleading, and the correction raised the pertinent probability from >1/3 to about 90% (Nature 381 [1996] 481).
The probability that the murdered wife of a battering husband was killed by the husband is high. The commutated probability that a wife-batterer will actually kill his wife is very small.

It is quite damaging to public and personal health that such basic issues concerning probabilities are so little understood among doctors. For example, what is the probability that a woman between 40 to 50 years of age and with no manifest symptoms or family history of breast cancer actually has breast cancer if her mammogram is “positive”? A survey of doctors yielded estimated probabilities of >50%, many of them at about 90%; but the actual probability is only 9% (Steven Strogatz, “Chances are”).
A fundamental point is that no test is 100% specific and 100% accurate. All tests have some probability, even if only small, of yielding a false positive. If a particular condition is rare, then the likelihood of a positive test being false can be quite high: in low-risk populations, a high proportion of “positives” are actually false positives (Jane M. Orient, Art & Science of Bedside Diagnosis, 2005).
The probability that a woman with breast cancer will have a positive mammogram is very high. The commutated probability that a woman with a positive mammogram has breast cancer is not high.

This sort of issue is very damaging when it comes to diagnosing mental illness, discussed at length in Saving Normal by Allen Frances and The Book of Woe by Gary Greenberg (both 2013; see my essay review in Journal of Scientific Exploration, 29 [2015] 142-8). The critical problem is that there exists no objective diagnostic test for a mental illness, diagnosis has to be gauged on the basis of observable symptoms. One classic procedure for diagnosing depression is the Hamilton Depression Rating Scale (HAM-D). It was evolved in the 1950s by British doctor Max Hamilton, who was seeking a way to measure efficacy of anti-depressants, using his depressed patients as guinea pigs (see for example Gary Greenberg, The Noble Lie, 2008, p. 55 ff.). Hamilton came up with 17 items — for instance insomnia, feelings of guilt, sleep, appetite — rated on scale of 0 to 4 or 0 to 2, with a possible maximum total of 52. There is nothing objective here since the assigned points depend on what the patient says and what the tester concludes; and the diagnosis also uses arbitrary cut-off points: 0-7 = normal, 8-13 = mild depression, 14-18 = moderate depression, 19-22 = severe depression, ≥23 = very severe depression. But the point here is not about subjectivity or arbitrariness of the diagnosis, but the fact that HAM-D was evolved by looking at patients who had already been diagnosed as depressed severely enough to require treatment, even hospitalization. However, the fact that depressed patients frequently accumulate high scores on this questionnaire does not entail the commutated reverse, that anyone who scores more than 7 is to some extent “depressed” or at ≥18 severely depressed.

Confusion about what statistics and probability mean, about interpreting such data with their seemingly accurate numbers, is a hazard in public discourse on a host of matters in science and in medicine. Misinterpretation is common and damaging.

Posted in consensus, media flaws, medical practices, science is not truth, scientism, unwarranted dogmatism in science | Tagged: , | 1 Comment »

Sea-Level-Rise Hysteria

Posted by Henry Bauer on 2015/01/15

Human-caused global warming, and even more terrifyingly human-caused climate change, is blamed for all sorts of things: more frequent and more extreme tornados and hurricanes and tsunamis, proliferation of viruses, shortage of fresh water, and of course rising sea levels that will submerge coastal cities. For example (from Reuters via Sydney Morning Herald):

“Sea level rise in the past two decades has accelerated faster than previously thought in a sign of climate change threatening coasts from Florida to Bangladesh, a study said on Wednesday. . . .

IPCC scenarios . . . range from a sea level rise of 28 to 98 cm this century . . . .

the rise has accelerated, with the most recent rates being the highest on record . . . .

Sea level rise is gnawing away at shores from Miami to Shanghai”.

All this is based on a letter, just published on-line by Nature, that used some mathematical techniques to re-evaluate, from admittedly incomplete data, what the sea-level rise actually was from 1901-1990; concluding that it was a bit less than formerly thought, at about 1.2 mm per year rather than 1.5 mm; and leapt to 3 mm per years in the last two decades. A terrifying acceleration!

Human activities apparently threaten us with between 28 cm (11 inches) and 98 cm (39 inches) in this century. That wide range of expectation should make obvious how uncertain these projections are; but what is altogether missing is an assessment of how this expectation compares with what one might expect from purely natural causes.

During the last Ice Age, which ended about 15,000 years ago, sea level was 400 feet lower than now. Quite naturally, sea level must rise as things warm up after the Ice Age and glaciers melt. But how rapidly?

On average, from purely natural causes, sea level has risen in the past, following an Ice Age, by about 5 inches per century. However, the rate varied tremendously during different eras; for example, pulses of as much as 100 inches per century for 5 centuries (Vivien Gornitz, “Sea level rise, after the ice melted and today”).

In other words, purely natural causes have in the past produced rates of sea-level rise considerably greater than the merchants of doom and gloom are now projecting as being caused by human actions, projecting on the basis of computer models that failed to predict the present decade-and-a-half lull in “global warming”.

Posted in global warming, media flaws | Tagged: | 1 Comment »

Contemporary science and medicine are losing credibility

Posted by Henry Bauer on 2014/12/31

“The Demise of Science? Hundreds of computer generated studies have been published in respected scientific journals” describes more problems than just the publication of fake articles generated by computer programs.

“Independent research, where funding is unrelated to findings, has become a rarity, and the end result is a dramatic deterioration of credible science” is spot on. What used to be the place for independent purely truth-seeking “basic” research, the “ivory tower” of academe, has become a place where budding researchers must find their own research support from outside sources if they are to have a career — see e.g. Science has become another Bubble; Science rewards hucksters and spin artists, not soundly tested science; The business of for-profit “science”;  and links in those articles.

“The Demise of Science?” cites the increase in articles retracted because of falsification and other breaches of proper conduct.

Clinical trials are biased, and prescription drugs are now responsible for more deaths than anything but cancer and heart disease (David Healy, Pharmageddon, University of California Press, 2012; Peter C. Gøtzsche, Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare, Radcliffe, 2013).

A large proportion of published studies in medical matters cannot be reproduced.
Inveterate defenders of the mainstream will seek to discount the facts discussed in “The Demise of Science?” by noting that it is an Internet publication on a website that favors alternative medicine; but the same critique was made years ago by Marcia Angell, a former editor of the New England Journal of Medicine:

It is simply no longer possible to believe
much of the clinical research that is published,
or to rely on the judgment of trusted physicians
or authoritative medical guidelines

Drug companies and doctors: a story of corruption
New York Review of Books, 15 January 2009

Posted in fraud in medicine, fraud in science, funding research, science is not truth, scientific culture | Tagged: , | 2 Comments »

Corrupt “science” publications and meetings

Posted by Henry Bauer on 2014/12/20

The “publish-or-perish” syndrome, together with the low cost of “publishing” on-line, has brought an endless spate of new “journals” put out by entrepreneurs ready to cash in; and quality control is not a consideration, even as some of the “publishers” pay lip-service to peer review.

A correspondent  to my HIV/AIDS blog  contributed a link to a story at Retraction Watch  that shows how the urge to make money by “publishing” is not restricted to new entrepreneurs, it is alive and well at corporate giants like Elsevier, whose prime interest in proliferating publications means that they do not even exercise ordinary care in overseeing how they accept articles: they had to retract a number of published articles that had been accepted after faked “peer review” because the article authors were allowed to choose who the “peer reviewers” would be.

Elsevier, of course, also published advertisements for drug companies under the pretense that they were journals (Corruption in medical science: Ghostwriting), and emasculated the innovative Medical Hypotheses after unfounded initiatives by HIV/AIDS vigilantes (see Chapter 3 in Dogmatism in Science and Medicine).

A related phenomenon to fake and shoddy “journals” is the proliferation of “conferences” whose only purpose is self-promotion by individuals, institutions, or even perhaps countries, since China is a prominent venue for these occasions; again see Fake, deceptive, predatory Science Journals and Conferences. The invitations to pseudo-conferences are often so incompetently composed that they remind one of the emails from Nigeria that one has won a huge prize at a lottery or inherited a huge amount from a previously unknown relative. Below is a just-received specimen; note that I never responded to earlier invites as well as other signs that this is an unedited from letter; note the poor written expression and syntax; but above all, browse the list of “Keynote Speakers” and “Part” listing of “renowned speakers”; a number of academics are quite happy to enjoy a grant-paid sightseeing vacation in China at an event organized primarily by Big Pharma and an entrepreneurial pseudo-conference-arranging outfit. Don’t neglect the link to the organizational home to note the huckstering of sponsorships, exhibition space, and the registration fees that range from $1300 to $2000; as well as the list of eight other concurrent “conferences” .

—————————————————————————————–
Dear Henry H. Bauer,

How are you? I wish everything goes well with you!

This is an email to follow up my previous invitations. I have not heard from you for a couple of weeks since my first letter. Now we have received well responding from worldwide experts in planned sessions, in case you won’t miss it, we’ d like to extend our invitation again. I am writing to confirm whether you would like to attend this grand congress and present a speech. Would you please give me a tentative reply? Thank you very much.

I apologize for the inconvenience if the letter disturbed you more than once. On behalf of the Meeting Organizing Committee, it is my pleasure and privilege to invite you to be the Session speaker in the 7th Annual International Congress of Antibodies (ICA-2015).

The conference with the theme “Innovations from Defending Surface to Penetrating the Membrane” will be held during April 25-28, 2015 in Nanjing, China. If the suggested thematic session is not your current focused core, you may look through the whole sessions and transfer another one that fits your interest. We sincerely wish your participation.

Keynote Speakers:

Dr. Brian E. Harvey, Vice President, Pfizer Inc., USA
Dr. Liangzhi Xie, Founder & CEO, Sino Biological Inc., China
Dr. Andrew Wang, Chairman, Taiwan Antibody Association, Taiwan
Dr. Jonathan Milner, CEO, Abcam, UK
Dr. Chien-Hsing Ken Chang, Vice President, Research and Development, Immunomedics, Inc., USA
Dr. Michael Yu, Presidert, Innovent Biologics, Inc., China

We look forward to seeing you in Nanjing in 2015 for this influential event.

If you need any assistance about the conference, please do not hesitate to contact us at any time!

For more information, please visit: http://www.bitcongress.com/ica2015/default.asp
Sincerely yours,

Dannie
Organizing Commission of ICA-2015
East Area, F11, Building 1,
Dalian Ascendas IT Park,
1 Hui Xian Yuan,
Dalian Hi-tech Industrial Zone,
LN 116025, China
Tel: 0086-411-84575669-860
Email: dannie@bit-ica.com

PS: Part of Renowned Speakers:
Mr. Homan Chan, Investigator, Novartis Institute of Biomedical Research, USA
Dr. Tao Wu, Principal Scientist, Boehringer Ingelheim, USA
Dr. Liming Liu, Merck Research Laboratories, USA
Dr. Joshua DiNapoli, Senior Scientist, Sanofi Pasteur, USA
Dr. Ostendorp Ralf, Vice President, MorphoSys AG, Germany
Dr. Abdul Wajid, Senior Director, XOMA, USA
Dr. Ernesto Oviedo-Orta, Clinical Sciences Expert, Novartis Vaccines Diagnostics Siena, Italy
Dr. Guohong Wang, VP, Immunalysis Corporation, USA
Dr. Rong-Rong Zhu, Senior Scientist, EMD Millipore, USA
Dr. David P. Humphreys, Senior Group Leader, UCB-New Medicines, UK
Dr. Jian Li, Principal Scientist, Pfizer Inc., USA
Dr. Bing Kuang, Principal Scientist, Pfizer, USA
Dr. William Haseltine, Founder, Chairman of the Board and CEO, Human Genome Sciences, USA
Dr. Martin Lemmerer, Principal Scientist, Novartis Institutes for BioMedical Research, Inc., USA
Dr. Jijie Gu, Senior Principal Research Scientist, AbbVie Pharmaceuticals, Inc., USA
Dr. Ronald C. Desrosiers, Professor, Harvard Medical School, USA
Dr. Eva Kimby, Professor, Karolinska University Hospital, Sweden
Dr. Joseph F. John, Professor and Chief, Medical University of South Carolina, USA
Dr. Dongfeng Tan, Professor, the University of Texas M. D. Anderson Cancer Center, USA
Dr. Paul Fisch, Group leader and Professor, University of Freiburg, Germany
Dr. Koshi Mimori, Professor & Director, Kyushu University Beppu Hospital, Japan
Dr. Peggy Hsieh, Professor, Florida State University, USA
Dr. Rudiger Schade, Professor, Charité-University Medicine of Berlin, Germany
Dr. Tae Young Jang, Professor, Inha University, Korea
Dr. Oddmund Bakke, Professor, University of Oslo, Norway
Dr. Rajat Sethi, Chair, California Health Sciences University, USA
Mr. Tim Bernard, CEO, Pivotal Scientific Limited, UK
Dr. Dan Zhang, Chairman and CEO, Fountain Medical Development Ltd., China
Dr. Kaia Agarwal, President, Regulatory Compass, LLC., USA
Ms. Sandra Frantzen, Shareholder, McAndrews, Held Malloy, Ltd., USA
Dr. Seth D. Ginsberg, President, Global Healthy Living Foundation, USA
Dr. James R Harris, CEO, Healthcare Economics LLC., USA
Dr. Martin Gleeson, CSO, Genalyte Inc., USA
Dr. Mingjiu Chen, President and CEO, biosynergics Inc., China
Dr. Jane Dancer, Chief Operating Officer, F-star, UK
Dr. Xiaodong Yang, President and CEO, Apexigen, USA
Dr. Wenzhi Tian, President and CEO, Huabo Biopharm Co Ltd, China
Dr. Ralph V. Boccia, Director, Center for Cancer and Blood Disorders, USA
Dr. Jun Bao, Senior Vice President, Shenogen Pharma Group, China
Dr. Francesc Mitjans, Chief Scientific Officer, Lykera Biomed, Spain
Dr. Fiona Greer, Director, SGS M-Scan, UK
Dr. Albrecht Gröner, Head Pathogen Safety, CSL Behring, Germany
Dr. Chung-Chou Lee, CEO of Medigen Vaccinology Corporation, Taiwan
Dr. Chengbin Wu, President of RD, Shanghai CP Guojian Pharmaceutical, China
Dr. Ni Jian, General Manager, National Engineering Research Center of Antibody Medicine, China
Dr. Ian Q. Li, Chief scientific Officer, ATGCell Inc., Canada
Dr. Terry Dyck, President, CEO, IGY Immune Technologies Life Sciences Inc., Canada
Dr. Vijay E-Bionary, CEO, E-Bionary Technologies, India
Dr. Allan Riting Liu, Vice President & Senior Advisor, Wanbang Biopharmaceutical Group, China
512

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All I can say is, FOR SHAME, to everyone associated with such scams.

Posted in conflicts of interest, fraud in medicine, fraud in science, peer review, scientific culture | Tagged: , , | Leave a Comment »

Public health VERSUS individual health

Posted by Henry Bauer on 2014/11/23

“Public health and individual health”  pointed out that “public health” deals in statistics and averages, and some public-health policies and practices can bring actual harm to some individuals unless physicians recognize the danger and treat each patient as the unique individuals that they are.

It seems that things are even considerably worse than I knew.

“How medical care is being corrupted”  reveals that some insurance companies have taken it on themselves to reward doctors for choosing particular drugs and treatments and penalizing them for not doing so. The article is no outsiders’ radical rant: it is by two physicians at Harvard Medical School and is published in the New York Times.

The insurance companies have financial considerations as their prime motive, and their criteria are inevitably statistical and “on the average”. To drive doctors into practicing by the insurance company guidelines means driving doctors not to treat their patients as unique individuals.

Half a century ago already, health-insurance considerations brought into being the damaging belief that “high” blood pressure represents a risk of cardiovascular disease or adverse events, because blood pressure correlates with such events. But it correlates only because both blood pressure and risk of cardiovascular problems both increase with age, naturally and inevitably. No correlations ever prove causation, furthermore. For half a century, medical practice has continued the absurd practice of defining “hypertension” independently of age, thereby classifying as “illness” levels of blood pressure that are perfectly normal at a given age. Something like 75% of American seniors are being exposed chronically, lifelong, to the continuing negative “side” effects of blood-pressure-lowering drugs for no good reason and with no expectable benefit.

The present direct incentives to doctors to harm their patients seems a natural, normal, progression of allowing health-care policies to be determined by the financial marketplace.

You get what you pay for.

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Damning psychiatric drugs with very faint praise

Posted by Henry Bauer on 2014/11/13

The effectiveness of psychiatric drugs has been questioned in innumerable books and articles, see for example What’s Wrong with Present-Day Medicine.

It would actually be surprising if psychiatric drugs did work reliably and with high efficacy, since psychiatric diagnosis is itself an art, certainly not a science. Saving Normal by Allen Frances (William Morrow [HarperCollins], 2013) and The Book of Woe by Gary Greenberg (Blue Rider Press [Penguin], 2013)document in exhaustive detail the lack of sound basis for the classification of mental illnesses used in the Diagnostic and Statistical Manual of Mental Disorders (DSM), specifically in its latest version, the DSM-5.

The insurmountable problem is that no distinct cause has been found for any of the peculiar or unusual behaviors and symptoms that are described as mental illness, insanity, craziness, psychosis, or the purportedly more specific labels manic-depression (bipolar), schizophrenia, etc.

Applying the label “mental illness” presupposes an understanding of what is not mental illness. However, human behavior and mentation vary enormously, and there are distinct cultural influences. Some things are regarded as crazy in some societies but not in others, and in a given society what is regarded as crazy may change over time; for example, early DSMs labeled homosexuality a mental illness but recent ones do not.

In absence of identified causes, all mental illnesses are defined on the basis of collections of symptoms that are matters of degree and not specific to any one label. The criteria for the “Inattention” part of attention-deficit disorder (ADHD) (DSM-5, p. 59 ff.) describe behavior quite typical of teenagers, for instance. DSMs are replete with loose criteria that call for satisfying only several of some set of listed symptoms, for more than some specified period of time, to degrees that are judged excessive. Diagnoses are therefore inescapably subjective and thereby arbitrary. A given individual is often given different diagnoses by different psychiatrists.

Treatment can hardly be more specific than diagnosis, and the labeling of psychiatric drugs is no sounder than are the diagnostic labels. It is criminally misleading to describe these medications as anti-anxiety pills, anti-depressants, anti-psychotics, atypical anti-psychotics, mood stabilizers, selective serotonin re-uptake inhibitors (SSRIs), etc., because they do not have the specific influences implied by those labels. Anti-depressants cause suicide in some people; anti-anxiety drugs in one culture are used as anti-depressants elsewhere; SSRIs are not selective in their effects even though they are designed to target a particular neurotransmitter, and so on.

All psychiatric drugs are mind-altering. They are distinguished from “street” drugs like Ecstasy or LSD only in their legality, not in being better understood or more specific in their action.

This not to deny that psychiatric drugs can be useful at times. But so have been insulin-shock and electric-shock treatment and surgical lobotomy. The point is just that these are all purely empirical treatments. Employing them successfully requires a background of experience and good diagnostic intuition; applying them routinely on the basis of formulaic diagnosis à la DSM can be highly damaging. That is perhaps the main theme of Saving Normal, which deserves to be given considerable respect since the author, Allen Frances, is a distinguished psychiatrist who was the lead organizer of DSM-IV (Arabic numeration supersedes Roman numbers with the fifth edition).

Frances’s book attempts a tightrope path, on the one hand acknowledging the lack of scientific basis for labeling and on the other hand not wishing to undercut the authority of the psychiatric profession. One consequence of attempting this impossibility is that he defends the use of psychiatric drugs by asserting that drugs used in general medical practice often have no better record of success than those applied in mental illness. The latter contention cites “Putting the efficacy of psychiatric and general medicine medication into perspective: review of meta-analyses” by Stefan Leucht et al., British Journal of Psychiatry, 200 (2012) 97-106.

But that review shows only that many drugs don’t do what they’re claimed to do. It isn’t much incentive to taking an anti-depressive, for example, if you’re told, “Of course it doesn’t work, but then your anti-cholesterol drug doesn’t prevent heart disease either”. The data cited by Leucht et al. report, for example, that blood-pressure-lowering drugs overall reduce mortality by 4% although “significant reduction of mortality has not been shown for all of them”. Aspirin reduced stroke mortality by 1%, but heparin did not. Statins reduced 5-year mortality by 1.2%. Digitalis reduced hospital admission by 8% but did not reduce mortality.
But those numbers don’t even take into account possibly unpleasant “side” effects: for example, some 10% of people taking statins experience muscle weakness within a few years; aspirin causes internal bleeding in some people.
What Leucht et al. have documented is that medications used to prevent illness, by contrast to medications used to treat actual illness, have such a poor record of success as to make their use very doubtfully recommendable.

The claim that psychiatric drugs are no less effective compares apples and oranges: the data given for the psychiatric drugs is for treatment, not for prevention. In general medicine, of course there are conditions for which there is simply no really good treatment, namely, conditions brought on by aging — cardiovascular disease, cancer, organ failures — and it is hardly worth pointing out that drugs attempting to treat those don’t do a very good job; but that is no reason to use psychiatric drugs that are no better.

The authors’ Declaration of Interest is worth noting:
“In the past 3 years S.L. has received fees for consulting and/ or lectures from the following companies: Bristol-Myers Squibb, Actelion, Sanofi-Aventis, Eli Lilly, Essex Pharma, AstraZeneca, MedAvante, Alkermes, Janssen/Johnson & Johnson, Lundbeck Institute and Pfizer, and grant support from Eli Lilly. W.K. has received fees for consulting and/or lectures from Janssen-Cilag, Sanofi-Aventis, Johnson & Johnson, Pfizer, Bristol-Myers Squibb, AstraZeneca, Lundbeck, Novartis and Eli Lilly. All authors work in psychiatry.”

The authors have a clear bias toward the use of drugs to treat mental illness, and that alone already brands their article as biased. This is hardly a reliable assessment of the efficacy of psychiatric drugs or a recommendation for their use.

Posted in conflicts of interest, medical practices, prescription drugs | Tagged: , | 4 Comments »

 
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