Book Review of Ben Goldacre's "Bad Pharma"

[HuckleB]

Lies, damn lies and drug trials: Bad Pharma: How drug companies mislead doctors and harm patients
http://www.newstatesman.com/sci-tech/sci-tech/2012/10/lies-damn-lies-and-drug-trials

"...

Goldacre made his name with the Guardian’s “Bad Science” column but it’s been clear for a while that statistics are what really energise him. Most politicians and journalists notoriously find numbers baffling; very clever and influential people get away with epic innumeracy where a slight verbal stumble would be ruthlessly derided. Contrast the sniggering over David Cameron not knowing the translation of “Magna Carta” with the finding from the Royal Statistical Society that 77 per cent of Labour MPs could not correctly answer the question: “If you spin a coin twice, what is the probability of getting two heads?” (It’s 25 per cent, by the way.)

Doctors do at least have some training in appraising evidence but as Goldacre shows, there are so many ways you can skew a clinical trial that it’s unrealistic to expect a GP or consultant to spot any dodgy data. For example, you could recruit patients to your trial who have no other medical conditions or drug prescriptions, making them more likely to get better. You can test a drug against a sugar-pill placebo, instead of the best current competitor. You can stop a trial early if it looks like it’s going well, or prolong it in the hope that the results will even out. You can find a fluke “clump” of encouraging results about one minor symptom and pretend that’s what the trial was going to measure all along.

Running alongside all of these practices – for which the researchers involved must take some responsibility – is the simple fact that the whole architecture of research publication is tilted towards new, exciting and positive results. There is currently no requirement for the results of every trial to be made public, so naturally academics only want to bother when they’ve found something interesting. Journal editors also worry that research which discovers a treatment has no benefit, or replicates a previous study, is boring. This flatters the drugs and helps their manufacturers reap billions from them.

...

But the real strength of Goldacre’s book is that he has answers. If poorly funded and easily swayed regulators can’t police the industry, then make the data available to everyone. Replace bewildering consent forms with shorter ones in plain English. Scrap the endless drug information labels that list every conceivable side effect (from heart attacks to bad breath) with simple checklists that show how common they are.

..."


Alas, the book is not available in the US until January. Still, Goldacre is a very legitimate source. I can't wait to dig into this one.

[xchrom]

1. Du rec. Nt

[SheilaT]

2. Thanks for this. I'll look forward to reading it.

While there are any number of good drugs out there, it seems to me, just as an observant layperson, that people are too readily persuaded to take drugs that may not do them any good, and often are discovered to do actual harm. It's one of the reasons I tend to avoid all doctors.

There ought to be some kind of a solution, but I suppose the real one would be a magically perfect world in which the profit motive simply didn't exist, and everyone actually had everyone else's best interests at heart.