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The results show that in about half of the cases where researchers were able to closely mimic the design of the corresponding RCT using RWD, the RWE study came to a similar conclusion as the analogous RCT. In many cases where RWE and RCTs did not come to a similar conclusion, the RCT design itself did not align with real-world clinical practice, creating a challenge for emulation of the trial using RWD. In these instances, RWE and RCTs may both be reaching meaningful conclusions, but to subtly different research questions.
Exercise Is Even More Effective Than Counselling or Medication for Depression - Neuroscience News
When comparing the size of the benefits of exercise to other common treatments for mental health conditions from previous systematic reviews, our findings suggest exercise is around 1.5 times more effective than either medication or cognitive behaviour therapy.
FDA vaccine advisers 'disappointed' and 'angry' that early data about new Covid-19 booster shot wasn't presented for review last year | CNN
It found that 1.9% of the study participants who received the original booster became infected. Among those who got the updated bivalent vaccine – the one that scientists hoped would work better – a higher percentage, 3.2%, became infected. Both versions of the shot were found to be safe.
This infection data was far from complete. The number of study subjects who became infected was very small, and both the patients and the researchers were aware of who was getting the original shot and who was getting the new booster.
Despite these imperfections, the data was included in a preprint study that was posted online in June, again in September in an FDA document and then later that month in a top medical journal – and advisers to the FDA and the CDC said the data should have been shared with them, too.
FDA vaccine advisers 'disappointed' and 'angry' that early data about new Covid-19 booster shot wasn't presented for review last year | CNN
“I was angry to find out that there was data that was relevant to our decision that we didn’t get to see,” said Dr. Paul Offit, a member of the Vaccines and Related Biological Products Advisory Committee, a group of external advisers that helps the FDA make vaccine decisions. “Decisions that are made for the public have to be made based on all available information – not just some information, but all information.”
How Some Parents Changed Their Politics in the Pandemic - The New York Times
Ms. Longnecker and her fellow objectors are part of a potentially destabilizing new movement: parents who joined the anti-vaccine and anti-mask cause during the pandemic, narrowing their political beliefs to a single-minded obsession over those issues. Their thinking hardened even as Covid-19 restrictions and mandates were eased and lifted, cementing in some cases into a skepticism of all vaccines.
Nearly half of Americans oppose masking and a similar share is against vaccine mandates for schoolchildren, polls show. But what is obscured in those numbers is the intensity with which some parents have embraced these views. While they once described themselves as Republicans or Democrats, they now identify as independents who plan to vote based solely on vaccine policies.
Why are antidepressants so overprescribed? And what to do about it? - HealthSense
Withdrawal symptoms are most likely to occur when medications are stopped abruptly, after prolonged use, and at higher doses. Withdrawal can be very unpleasant and scary, causing lethargy, sadness, anxiety, irritability, trouble concentrating, sleep problems, nightmares, ’flu symptoms, nausea, dizziness, and strange sensations. They can also go on for a long time. Twenty-five per cent of users are still experiencing some symptoms after 3 months, and for some withdrawal can last 6 months.(4) Withdrawal occurs when doctors fail to deprescribe slowly enough or patients stop on their own. Partly because of the widespread misconception that antidepressants don't cause withdrawal, patients and doctors routinely misinterpret the symptoms as relapse – triggering what is often unneeded long term treatment.
BMJ fights back against Facebook fact-checkers - The Post
Despite being fully evidenced and error-free, Lead Stories, a company that conducts around half of all fact-checking on Facebook, said the article was “missing context” and stated that a whistle-blower at the heart of the investigation failed to “express unreserved support for covid vaccines”. The fact-checking company later commented that it was concerned about who was sharing the article online. In other words, the documentation of research and investigation in some areas is not permitted if it risks causing the infantilised public to stray from their designated path.
Matt Taibbi’s TK News Joins the List of Media Outlets Alarmed at Facebook Censorship
Then I went to the “fact check,” and it was just insane. It looked like it’d been written by high school students. It describes the British Medical Journal as a “blog.” I was joking with my editors about how they work. They pick some proposition out of the blue and then they debunk it, and it’s like, “Aha, win!” Bullshit. It’s like, “Did the BMJ prove that the vaccine kills Martians? No! Fact check: wrong.” And you’re thinking, “Wait, what?”
Here’s what they do. They’re not fact checking facts. What they’re doing is checking narratives. They can’t say that your facts are wrong, so it’s like, “Aha, there’s no context.” Or, “It’s misleading.” But that’s not a fact check. You just don’t like the story.
By the mid-1950s, Lazarsfeld’s group had extended their argument into medicine, through a study contracted by Pfizer about the factors that influenced doctors in the USA to adopt a new drug. In this landmark study5, the authors asked the fundamental question that continues to drive every pharmaceutical marketing operation to this day: “What were the social processes that intervened between the initial trials of the drug by a few local innovators and its final use by virtually the whole medical community?” The simple answer: the implementation of a new drug is all about promoting and expanding “the effectiveness of interpersonal relations at each stage of the diffusion process”.
A moratorium on strong recommendations is needed | The BMJ
Medicine is addicted to so-called hopium, an unwarranted confidence in the value of its tests and treatments. Clinicians overestimate their value,1 while experts on guideline panels make strong recommendations about care backed by untrustworthy evidence.2 Rigorous guideline methods can highlight this problem, but they are far from a perfect antidote—it is time for a moratorium on strong recommendations.
In a linked paper (doi:10.1136/BMJ-2021-066045),3 Yao and colleagues report that almost half (1246 of 2528) of the recommendations issued by the leading American cardiology and oncology professional societies were strong, “just do it” recommendations.4 About a quarter (354 of these were based on low certainty evidence. Compared to a consensus process, an evidence based guideline process reduced the risk of issuing such inappropriately strong recommendations, but not completely: the evidence based approach produced about a third (105 of 354) of the inappropriately strong recommendations in this study. Most of them simply conveyed the panels’ overconfidence in the benefit of following their recommendation.
Looking to Tackle Prescription Overload - The New York Times
One way is for patients themselves to combat polypharmacy, by regularly asking their doctors to reassess their medications — sometimes bringing every pill bottle, including supplements, to an appointment for a “brown bag review.” A short list of potentially inappropriate drugs, published by the American Geriatrics Society, can help them spot problems.
That is essentially what Leslie Hawkins did for her mother, Dr. Nothelle said. “Every time she had a health care interaction, she asked, ‘Do we need this? Can we lower this? Can we stop this?’”
Ten months passed before Ms. Harrison could see her geriatrician again, and by then, “she was a completely different person,” Dr. Nothelle said. “She was awake, she answered my questions. It was night and day.”
Ms. Harrison’s score on the 30-question cognition test jumped from three to 25. She is starting physical therapy to improve her mobility. And she is taking four drugs — insulin, a blood pressure medication and two anti-depressants — instead of 14.
How Big Pharma Finds Sick Users on Facebook – The Markup
Ads for Latuda, an antipsychotic from the company Sunovion used in the treatment of bipolar depression, were shown to users with an interest in the Depression and Bipolar Support Alliance, a nonprofit support group. We also found it targeted at users interested in therapy and the National Alliance on Mental Illness.
Patient Advocacy Groups Take In Millions From Drugmakers. Is There A Payback? | Kaiser Health News
The financial ties are troubling if they cause even one patient group to act in a way that’s “not fully representing the interest of its constituents,” said Matthew McCoy, a medical ethics professor at the University of Pennsylvania who co-authored a 2017 study about patient advocacy groups’ influence and transparency.
Notably, such groups have been silent or slow to complain about high or escalating prices, a prime concern of patients.
This story also ran on The Daily Beast. This story can be republished for free (details).
“When so many patient organizations are being influenced in this way, it can shift our whole approach to health policy, taking away from the interests of patients and towards the interests of industry,” McCoy said. “That’s not just a problem for the patients and caregivers that particular patient organizations serve; that’s a problem for everyone.”
A Million-Dollar Marketing Juggernaut Pushes 3D Mammograms | Kaiser Health News
On average, 3D screenings may slightly increase cancer detection rates, finding about one extra breast tumor for every 1,000 U.S. women screened, according to a 2018 analysis in the Journal of the National Cancer Institute. Most studies also show that 3D screenings cause fewer “false alarms,” in which women are called back for procedures they don’t need, said Dr. Susan Harvey, a Hologic vice president.
Why is it so hard to review the Johnson & Johnson vaccine? Data. | MIT Technology Review
Without a national health-care system, there’s no comprehensive way to assess risks and benefits for different groups that have received the vaccine. There is no routine federal capability to connect patient data with vaccine records. Instead, regulators hope clinicians will hear about the pause and proactively report cases they hadn’t previously connected to vaccinations.
“It might stimulate some clinician to say, ‘Oh my God, Mrs. Jones had that three weeks ago,’” says Reingold. In addition, he says, “there’s still quite a few people who have gotten a dose within the last two weeks, and some of them could develop this rare side effect.”
The voluntary system may seem archaic, but that is how the six cases under review came to the attention of the authorities. They were reported to the CDC through an online database called the Vaccine Adverse Events Reporting System, or VAERS. It is an open website that medical staff, patients, and caregivers can use to notify the government about potential vaccine side effects.
Because the system is so open, and requires opt-in participation, it’s impossible to calculate exact risks using VAERS data. Epidemiologists generally think of it as a place to look for hypotheses that tie vaccines to side effects, rather than a source that can be used to confirm their suspicions.
Related Story
The CDC’s $1.75 billion sequencing boom may be throwing money at the wrong problem
Experts say trying to stop covid variants without better data is “insanely difficult.”
“It’s a messy system. Anyone can report anything, whether it’s biologically plausible that it’s related to the vaccine or not,” says Mark Sawyer, a member of the FDA’s Vaccines and Related Biological Products Advisory Committee, which reviewed the covid-19 vaccines for public use. “Then the job is to sort through and figure out, is there really a signal here?”
The next best thing to a national health-care system is the CDC’s Vaccine Safety Datalink, a consortium of American health insurers that provide medical care to patients in-house. The system includes records of about 10 million patients. Unfortunately, only 113,000 Johnson & Johnson vaccines have been captured by that system so far.
How IBM's audacious plan to 'change the face of health care' fell apart
But former employees said IBM’s approach made it all but impossible to answer those questions. It touted multiple studies, for example, that showed the recommendations of Watson for Oncology, its cancer treatment adviser, closely matched those of hospital tumor boards. However, those studies were carried out with IBM clients, not outside and objective researchers, and didn’t prove the tool could actually improve outcomes. That was a far cry from the claim that Watson could help “outthink cancer,” which IBM was suggesting in national advertisements.
“It was all made up,” one former employee said of the marketing without robust data behind it. “They were hellbent on putting [advertisements] out on health care. But we didn’t have the clinical proof or evidence to put anything out there that a clinician or oncologist would believe. It was a constant struggle.”
On Randomized Trials and Medicine - Insight
If we had more proper randomization and tracing of these various approaches, we’d have more dexamethasones at hand. The WHO is leading some randomized trials at the moment, but we have little to none going on in the United States.As we learn more about some effective clinical practices, it’s getting harder to do novel ones: ethically, we cannot withhold known best practices from patients. It’s possible that we have found ourselves stuck at a local optimum, but much less than the upside potential we might have had, had we tried proper randomization from the beginning, when we had little to no idea what worked anyway, we could have conducted randomized trials. We should have.. This oversight will go down as yet another major failure of our health infrastructure and response to this pandemic.
On Randomized Trials and Medicine - Insight
Clinical trials for non-pharmaceutical interventions in health are relatively rare because there is little to no money to be made from recommending them. Conversely, drugs which require trials to go on the market are sponsored heavily by pharmaceutical companies.
Scientists find neurochemicals have unexpectedly profound roles in the human brain: Dopamine, serotonin involved in sub-second perception, cognition -- ScienceDaily
"An enormous number of people throughout the world are taking pharmaceutical compounds to perturb the dopamine and serotonin transmitter systems to change their behavior and mental health," said P. Read Montague, senior author of the study and a professor and director of the Center for Human Neuroscience Research and the Human Neuroimaging Laboratory at the Fralin Biomedical Research Institute at Virginia Tech Carilion. "For the first time, moment-to-moment activity in these systems has been measured and determined to be involved in perception and cognitive capacities. These neurotransmitters are simultaneously acting and integrating activity across vastly different time and space scales than anyone expected."
Better understanding of the underlying actions of dopamine and serotonin during perception and decision-making could deliver important insight into psychiatric and neurological disorders, the researchers said.
"Every choice that someone executes involves taking in information, interpreting that information, and making decisions about what they perceived," said Kenneth Kishida, a corresponding author of the study and an assistant professor of physiology and pharmacology, and neurosurgery, at Wake Forest School of Medicine. "There's a whole host of psychiatric conditions and neurological disorders where that process is altered in the patients, and dopamine and serotonin are prime suspects."
INHN: Daniel Kanofsky’s comment on Edward Tobe’s comment
"The emphasis on prescribing drugs as the major psychiatric contributor to treatment without knowing the patient has become an unfortunate consequence of insurance industry control of medical care initially through the formation of HMOs. Today, psychiatrists perform a 'med check' that may range from 10 minutes to 30 minutes during which a patient, often not in remission, is psychiatrically evaluated to determine medical and psychological changes and current mental status, response to pharmaceuticals, changes in their life, compliance, and ability to function vocationally and avocationally. The psychiatrist writes prescriptions for drugs with minimal knowledge of the patient. Drug sales benefit."
The Corruption of Evidence Based Medicine — Killing for Profit | by Dr. Jason Fung | Medium
“The medical profession is being bought by the pharmaceutical industry, not only in terms of the practice of medicine, but also in terms of teaching and research. The academic institutions of this country are allowing themselves to be the paid agents of the pharmaceutical industry. I think it’s disgraceful”
Coca-Cola’s work with academics was a “low point in history of public health” | The BMJ
An analysis of thousands of emails has shown the extent to which Coca-Cola sought to obscure its relationship with scientists, minimise perception of its role, and use researchers to promote industry friendly messaging. The findings represented a “low point in the history of public health,” said one of the authors.
Academics the UK and Italy worked with US Right to Know, an investigative public health and consumer group, to obtain and analyse more than 18 000 pages of email correspondence between the Coca-Cola Company, West Virginia University, and the University of Colorado.1
Both universities were part of a “front group” funded by Coca-Cola called the Global Energy Balance Network (GEBN), a global network of scientists1 said to have been created by Coke to downplay links between obesity and sugary drinks.2
Covid-19 Vaccines With ‘Minor Side Effects’ Could Still Be Pretty Bad | WIRED
The press release for Monday’s publication of results from the Oxford vaccine trials described an increased frequency of “minor side effects” among participants. A look at the actual paper, though, reveals this to be a marketing spin that has since been parroted in media reports. (The phrases “minor side effects” or “only minor side effects” appeared in writeups from The New York Times, The Wall Street Journal and Reuters, among other outlets.) Yes, mild reactions were far more common than worse ones. But moderate or severe harms—defined as being bad enough to interfere with daily life or needing medical care—were common too. Around one-third of people vaccinated with the Covid-19 vaccine without acetaminophen experienced moderate or severe chills, fatigue, headache, malaise, and/or feverishness. Close to 10 percent had a fever of at least 100.4 degrees, and just over one-fourth developed moderate or severe muscle aches. That’s a lot, in a young and healthy group of people—and the acetaminophen didn’t help much for most of those problems.
Screening + Drug Treatment = Increase in Veteran Suicides - Mad In America
There is clear evidence that SSRIs and SNRI antidepressants can provoke suicidal impulses and acts in some users, and the reason is well known. SSRIs and other antidepressants can stir extreme restlessness, agitation, insomnia, severe anxiety, mania and psychotic episodes. The agitation and anxiety, which is clinically described as akathisia, may reach “unbearable” levels, and akathisia is known to be associated with suicide and acts of violence, including homicide.
DEMAND CHEMICAL IMBALANCE RETRACTION: Round One: The Most Absurd "Chemical Imbalance" Quote
There's almost 200 quotes on this page so far.
In efforts to find the most preposterous I need your help.
Over the next few weeks I'll be wanting you to vote.
There will be a cut-off point for each post.
I have included the Twitter/Facebook link for each of the individuals. If you want to ask them to join in then please feel free to contact them. This will give them an opportunity to retract their claim or not, as the case may be.
Richard Smith: Psychiatry in crisis? - The BMJ
Dutch psychiatrists, it was explained to me, are feeling vulnerable because there are too many of them. They have two treatments to offer–drugs and psychotherapy. But the Netherlands has many clinical psychologists, and they have taken over the psychotherapy. Psychiatrists are left with drugs and anxiety about their future.
