Lying, Twisting and Manipulating: The Statistics Game Drug Companies Play
Faced with high insurance rates, long hours, endless paperwork, and high-pressure demands, doctors don’t have an easy time of it. If you’re blessed enough to have a thoughtful, proactive, cautious M.D., let them know, by all means. Doctors are inundated with free drug samples, bonuses and perks from Big Pharma, and even the most well-intentioned practitioner can face dilemmas.
Case in point: even the most careful doctors are getting misleading information from many medical journals.
It’s one of the most serious problems facing healthcare and medicine today. Scientists and medical experts are expressing increasingly loud concerns about the ethical standards of medical publications. Some journals and publications have essentially become an extended limb of advertising for drug companies.
The problem isn’t just in the expensive pharmaceutical ads that provide a means of financial survival for scientific and medical news publications.
Many of the studies themselves are funded directly by pharmaceutical companies, making the journals de facto supporters of such companies. Or, doctors participating in the studies also serve positions in various companies.
It’s troubling enough that independent news sources, supposedly impartial and peer-reviewed by other scientists and medical experts, are vulnerable. But even government agencies aren’t immune. The CDC, FDA and NIH have all faced huge criticism in recent years for obvious conflicts of interest.
How is Big Pharma getting away with this? Simple: we let them.
Here is what frequently occurs:
For starters, when companies fund studies of their own drugs – big shock – there are almost never unfavorable results.
When there are, they’re simply omitted, or a new study is funded. A fairly recent review found that when a study is funded by the company producing the drug, positive results happen four times more often than when impartial studies by independent researchers are conducted.
According to the Public Library of Science, an impartial public access resource (check it out in my Daily Reads at right), “between two-thirds and three-quarters” of the studies reported in the top journals are paid for by pharmaceutical companies.
According to the Library, companies aren’t bold enough (or unwitting enough) to skew the results. They simply ask questions they know will yield the “right” results. How convenient.
Another problem: even though journals are usually reviewed by colleagues, if companies are using the same study again and again, but presenting it in different ways, editors have no way of knowing. Editors try to maintain strict ethical integrity, but it can be next to impossible to know the origin, conflicts or “right questions” involved in some studies.
Before I started Primal Nutrition, I served a stint as an editor of a large national health magazine, and I certainly empathize with editors – as my staff knows all too well, information is always changing and getting to the truth is a ceaseless quest that demands constant vigilance. Of course, the truth is worth it. The stakes – Americans’ health – are too high.
Clearly, this is frustrating for anyone who’s even remotely health-minded and trying to arm themselves with the right information about health. If drug companies are paying for studies in order to get certain results, how safe, really, are these drugs? (Yet stevia must be sold as a skin-care treatment.)
There are several ways pharmaceutical companies get around the suspicions of journals and experts:
- They often test their new drug against an old one already proven to be useless or inferior.
- They test their drug against a weaker dose of the competitor’s drug (or a stronger dose, if there are side effects).
- They sponsor ongoing trials and pick information at points where results are most favorable.
- They sponsor tiny trials that only study a few people or a specific group of people.
My biggest contention is what I call the Statistics Game. Crass manipulation of statistics happens more than any of us wants to know. For example, a drug company will study 1,000 people with a particular illness or disease. Let’s say 6 of the 1,000 died. The company then creates a drug that reduces that number to 3. You can guess what the headline will say (because the company will provide the media with it): “Deaths cut by 50% with new drug!” when the real headline should say: “.3% die instead of .6%” or, better yet, no headline at all, because three people out of 1,000 is not even close to being statistically significant. Statistical significance is a benchmark standard in all science. In medicine, 15% is typically what’s required to be considered worthy of any attention, funding or recommendation. You can see where the Statistics Game gets manipulated here.
In other words, using my example (which, unfortunately, is all too real), what doctors should say is:
“If you don’t take this drug, you will be among the 994 of 1,000 that still live regardless. If you do take this drug, you will suffer a loss in quality of life, put up with side effects and complications and will be among 997 of 1,000 that live.”
What can you do?
First and foremost, seek a preventive lifestyle that avoids the need for possibly harmful medications. Vitamins, antioxidants, a fiber-rich diet, and daily exercise are proven, in hundreds upon hundreds of ethically-conducted studies, to be the best course in your journey towards good health.
Every month, new research from prevention-minded resources like the American Journal of Clinical Nutrition and the Public Library of Science reveal that simple lifestyle changes like exercise, diet, supplements and stress management are the true keys to unlocking great health.
Simply losing weight can halve your risk of diabetes, heart disease and other common health concerns. Doctors say the majority of arthritis sufferers would benefit if they just exercised on a daily basis. The vast majority of heart attack victims could help avoid these life-threatening incidents by simply reducing inflammation. (Ways to do this include taking Omega-3 fish oil supplements and exercising, in addition to cutting out alcohol, stress, smoking and high salt intake.)
Of course, I’m on a relentless mission to help you get started in the right direction. One way I can do that is to share my knowledge of studies with you. Here’s what I personally look for: studies that are reasonably controlled, have a variety of patients, and examine a large enough number of individuals over a long enough time period. I watch for drug company sponsorships in the hundreds of studies published every month, and my goal is always to separate the health from the hype. (One of my favorites: the big dairy campaign that claims three daily servings of milk or cheese will help you lose weight. Want to know what that was based on? A University of Tennessee study, funded by the Dairy Industry. The results? Even with Big Dairy backing the study, the average difference in weight loss between dairy-dieters and non-dairy participants was two pounds. Yes, two whole lb’s, folks. Unless you’re a five-year-old, I think many of us could lose that by skipping a dinner or two.)
Finally, you are your own best judge. Only you can decide what is best for your health. If something seems too good to be true, or appears to be a band-aid solution, it probably is. There’s no short-cut, drug or device that can give you good health. On the other hand, good health isn’t about deprivation or misery, either. It’s about smart daily decisions over a lifetime.
To do this, you don’t need to be a scientist or doctor – as this post shows, even the experts are vulnerable to biased influence. Let common sense be your guide and a positive, preventative lifestyle, your approach. And tell me what you think.
Technorati Tags: Big Pharma, pharmaceutical, medical journals, medical studies, medicine, FDA, pharmacology, reduce risk, diabetes, heart disease, arthritis, prevention, inflammation, obesity, CDC, Public Library of Science, PLoS
Something I read in the New York Times the other day got me steamed faster than fresh spinach. Apparently, fish oil prescriptions are not only standard practice in Europe – they’re handed out like candy corn on Halloween – but heart patients who don’t get a prescription can actually sue for malpractice.
Pure fish oil is so clearly supported by the international body of science that European doctors who don’t prescribe the stuff to anyone worried about their cardiovascular health are considered grossly incompetent.
Hundreds of peer-reviewed studies support fish oil for great health. Some of the healthiest peoples in the world – from Japan to the Mediterranean – rely heavily on fish fats for great health. Fish oil = better body is not some radical new idea, but try telling that to the American health business. Er…health establishment.
Now, this doesn’t really surprise me; after all, the safest, longest-lasting, most effective, non-drug form of birth control favored in Europe and tested safe for decades is also basically nonexistent here in the Fabulous 50. America may have the best life-saving surgery techniques in the world, but when it comes to basic illness recovery or health maintenance, one would think fish oil must be some risky, mind-altering substance right up there with caffeine and alcohol. The difference being those are both substances prescribed by doctors.
I’m not asking a lot of our federal government. I know they have lobbyists to cuddle. But would it kill anyone over at the FDA or the N.E. Journal of Medicineyness to admit that fish oil has excellent therapeutic properties for people in general and heart patients in particular, and – gasp – recommend prescribing the stuff? They accept the data. Why not recommend?
Here’s the part of the article that really burned my mocha:
“For example, on Solvay Pharmaceutical’s Web site for Omacor (a Euro fish oil supplement), the first question a user sees is ‘Are you a U.S. citizen?’
If the answer is yes, the user is sent to a page where heart attacks are not mentioned.”
I’m so thrilled with our government for censoring accurate scientific information about cardiovascular health on a European company’s website so we citizens can remain both ignorant and unhealthy. Fish fat in its pure form is vital to cardiovascular health, brain health, and the strengthening of the linings of cells. Considering the damage that free radicals and inflammation whack cells with every day, and the difficulty in getting low-mercury fish filets at the local market, wouldn’t recommending and even prescribing fish oil be a prudent thing for the medical “establishment” to do?
Thanks to Elisabeth Rosenthal at the Gray Lady (the Times) for this piece. To the rest of you, get thee to a fish oil supplement, stat!
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