Facts are stubborn things, but statistics are more pliable. ~Author Unknown
During a recent health seminar a rather astute visitor cried out?
“Fat is good…fat is bad, my cardiologist tells me one thing and you tell me another!”
I and my fellow presenters then jumped into a long discussion of the difficulty determining “Quality Advice” from current research.
Doctors and patients find themselves frustrated by the near daily contradictory research findings. Examine current nutrition studies for instance. 70% polled doctors, according to a Credit Suisse report, do not know what current research clearly shows about nutrition.
Low fat, Paleo, Vegetarian, Atkins, all have their darling studies but the research clearly indicates quality fat is necessary in the diet for optimal health.
What are we to do?
One could spend every waking moment pouring over data and conflicting research but that’s unrealistic even for doctors.
How do we know what to believe? Bias, conflict of interest, personal/corporate agendas, and the status quo combine to produce often worthless or misleading information.
One should however, caution oneself not to believe everything read regardless of how credible on the surface.
ENTER RIAT (Restoring Invisible & Abandoned Trials)
I recently found an article in the American Academy of Family Practice reporting research from 2001 on a common drug called Paxil (Paroxetine)was inaccurate. Rather than Paroxetine (Anxiety/depression) benefiting teenage patients, re-analysis revealed greater harm and no efficacy as compared to placebo.
In fact, a new initiative from the British Medical Journal (BMJ) known as RIAT (Restoring Invisible & Abandoned Trials) re-analyzed data from this often cited study and found multiple discrepancies. For starters, the original trial appears “Ghost written” by GlaxoSmithKline (Manufacturer of Paroxetine) on behalf of the scientists. Breaking scientific methodology, end points and variables were changed during the study. Instead of benefit, the data showed increased risk when teens were treated with drug studied.
Only 14 years later do we see this study likely misled countless physicians and patients alike.
Read the summary from AAFP if you like.
My take is one I’ve had for a long time. I was taught in medical school to use caution reviewing studies if commercial interests were at stake. Though quality studies do exist and many drug medication trials have a high level of integrity–many do not. Transparency, reproducibility, and accountability are still woefully lacking.
I have written on this topic before and I am greatly angered by the difficulty in obtaining quality guidelines for patients. (See here for similar topic)
In the end, the patients I talk with have the same frustration. The traditional medical care community need to refocus efforts on efficacy and safety. I have long believed that we “MD’s” are losing credibility by blindly and gullibly following every guideline/intervention/vaccine/drug company study that comes down the pipeline.
Regaining confidence from those we serve will require addressing health problems with actions that actually modify disease–not simply treat symptoms.
I have hope that the tide has already begun to turn. RIAT and other similar initiatives will hopefully begin chipping away at some of the more blantantly fabricated medical research hopefully clarifying best care practices in the coming years.
Until then….keep your eyes open and think critically.
As always, leave comments, ask questions, share ideas!