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Results of medication studies in top medical journals may be misleading to readers
Eurekalert ^ | 08/25/11 | Enrique Rivero

Posted on 08/27/2011 12:20:05 PM PDT by TennesseeGirl

UCLA-Harvard study highlights 3 types of confusing outcome measures

Studies about medications published in the most influential medical journals are frequently designed in a way that yields misleading or confusing results, new research suggests.

Investigators from the medical schools at UCLA and Harvard analyzed all the randomized medication trials published in the six highest-impact general medicine journals between June 1, 2008, and Sept. 30, 2010, to determine the prevalence of three types of outcome measures that make data interpretation difficult.

In addition, they reviewed each study's abstract to determine the percentage that reported results using relative rather than absolute numbers, which can also be a misleading.

The findings are published online in the Journal of General Internal Medicine.

The six journals examined by the investigators— the New England Journal of Medicine, the Journal of the American Medical Association, The Lancet, the Annals of Internal Medicine, the British Medical Journal and the Archives of Internal Medicine — included studies that used the following types of outcome measures, which have received increasing criticism from scientific experts:

Surrogate outcomes (37 percent of studies), which refer to intermediate markers, such as a heart medication's ability to lower blood pressure, but which may not be a good indicator of the medication's impact on more important clinical outcomes, like heart attacks.

Composite outcomes (34 percent), which consist of multiple individual outcomes of unequal importance lumped together — such as hospitalizations and mortality — making it difficult to understand the effects on each outcome individually.

Disease-specific mortality (27 percent), which measures deaths from a specific cause rather than from any cause; this may be a misleading measure because, even if a given treatment reduces one type of death, it could increase the risk of dying from another cause, to an equal or greater extent. (excerpted)

(Excerpt) Read more at eurekalert.org ...


TOPICS: Culture/Society; News/Current Events
KEYWORDS: medical; medication; studies
Follow the money.
1 posted on 08/27/2011 12:20:11 PM PDT by TennesseeGirl
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To: TennesseeGirl

I worked as a pharma sales rep for ten years.

These studies are designed in order to produce specific outcomes that can be presented favorably. Everyone knows it - especially the docs. Peer-reviewed studies carried more weight IF the data was presented in a way that was statistically honest.

I have NOTHING but contempt for the pharma-generated marketing pieces, “Detail Aids” and “Leave Behinds”. The marketing departments used every dirty trick they could to present only what they wanted the rep to show to docs. Of, course there was “fair-balance” data in fine print...

I had DMs who would give me an unapproved piece to detail to the doc - problem was there is a sticker on the piece that said “NOT FOR USE IN DETAILING” - so the DMs would say,”See that sticker? That’s where your thumb goes”.


2 posted on 08/27/2011 12:36:27 PM PDT by dadgum (Overjoyed to be a Pariah)
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To: TennesseeGirl
If you don't know how to read the "Method" section of a scientific article (Most people can't) then you may as well save your time for something else. You won't know how to evaluate the "Results" section. If all you read is the Abstract and maybe the Conclusion, you are probably worse off than before you started.
3 posted on 08/27/2011 12:59:00 PM PDT by hinckley buzzard
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To: dadgum
There are two numbers that everyone should ask their doctor about EVERY therapy (medication or procedure) the doctor recommends. If the doctor doesn't know the answer, then the patient should find the answer before agreeing to the therapy. Those numbers are:

1. Number Needed to Treat (NNT) - the number of people who must receive a therapy (e.g., a medication) for one person to receive the expected benefit (e.g., prevention of a heart attack). Ideally, this number should be as close to 1 as possible, meaning that every person who receives the therapy also receives the hoped-for benefit.

2. Number Needed to Harm (NNH) - the number of people who receive a therapy (e.g., a medication) divided by the number of people who are harmed in a significant way (e.g., the medication causes a stroke). Ideally, this number should be very high, indicating that the therapy is very safe.

Based on these two numbers for the statin drugs, I have chosen not to take them to lower my cholesterol. It's a personal choice, but one you should consider. you might want to read this easy-to-understand article to help you decide whether or not you wish to continue or begin your medications:

http://www.thecholesteroltruth.com/tag=numbersneededtotreat

4 posted on 08/27/2011 1:12:17 PM PDT by StonyMan451 (As for me and my household, we will serve the Lord.)
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To: dadgum
There are two numbers that everyone should ask their doctor about EVERY therapy (medication or procedure) the doctor recommends. If the doctor doesn't know the answer, then the patient should find the answer before agreeing to the therapy. Those numbers are:

1. Number Needed to Treat (NNT) - the number of people who must receive a therapy (e.g., a medication) for one person to receive the expected benefit (e.g., prevention of a heart attack). Ideally, this number should be as close to 1 as possible, meaning that every person who receives the therapy also receives the hoped-for benefit.

2. Number Needed to Harm (NNH) - the number of people who receive a therapy (e.g., a medication) divided by the number of people who are harmed in a significant way (e.g., the medication causes a stroke). Ideally, this number should be very high, indicating that the therapy is very safe.

Based on these two numbers for the statin drugs, I have chosen not to take them to lower my cholesterol. It's a personal choice, but one you should consider. you might want to read this easy-to-understand article to help you decide whether or not you wish to continue or begin your medications:

http://www.thecholesteroltruth.com/tag=numbersneededtotreat

5 posted on 08/27/2011 1:12:25 PM PDT by StonyMan451 (As for me and my household, we will serve the Lord.)
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To: TennesseeGirl

I worked as a statistician on several published medical studies, chief statistician on two of them, and I wouldn’t trust ANYTHING published in the medical journals today unless it has been confirmed and independently published by several independent hostile investigators... Six, seven, eight of them.

The problem as I saw it was not dishonest investigators, but overenthusiastic ones, too invested in their hopes and dreams to ever allow anything so insignificant as correct statistical procedure to stand in their way. That, and a totally unrealistic demand that they “publish or perish” without any financial support whatsoever from the university.

I mean, you can’t do a serious study today without recruiting a large number of subjects and following them over a lengthy time. And that takes $$$$$$$!

The same distorting forces are at work at the drug companies.

Generally speaking, I think, 99% of the time, no one should get overly excited about any so-called “new cure” of his particular malady until lots of disparate researchers are on board, and talking about it on all channels.

Just my opinion.


6 posted on 08/27/2011 1:48:09 PM PDT by LibWhacker
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