in

The illusion of evidence based medicine

The illusion of evidence based medicine

https://www.bmj.com/content/376/bmj.o702

https://www.bmj.com/company/the-story-of-bmj-2/

https://journals.bmj.com/home

Evidence based medicine has been corrupted by
corporate interests,

failed regulation,

and commercialisation of academia,

argue these authors

Jon Jureidini, research leader

https://www.adelaide.edu.au/directory/jon.jureidini

Research Leader, child psychiatrist Adelaide

Leemon B. McHenry, professor emeritus

Emeritus Professor, Cal State University

Not commissioned, externally peer reviewed

Solid scientific foundation for medicine

Validity of this new paradigm

Reliable data from clinical trials,

Mostly conducted by the pharmaceutical industry

THE JAPANESE JOURNAL OF ANTIBIOTICS
74―1 61( 61 )

http://jja-contents.wdc-jp.com/pdf/JJA74/74-1-open/74-1_44-95.pdf

Global trends in clinical studies of ivermectin in COVID-19

Morimasa Yagisawa, Patrick J. Foster, Hideaki Hanaki, Satoshi Ōmura

Kitasato University asked Merck & Co., Inc. to conduct clinical trials of ivermectin for COVID-19 in Japan.

This company has priority to submit an application for an expansion of ivermectin’s indications, since the original approval for the manufacture and sale of ivermectin was conferred to it.

However, the company said that it had no intention of conducting clinical trials.

The release into the public domain of previously confidential pharmaceutical industry documents,

valuable insight into the degree to which industry sponsored clinical trials are misrepresented

Until this problem is corrected, evidence based medicine will remain an illusion

Karl Popper

Critical rationalism,

advocated for the integrity of science and its role in an open, democratic society

A science of real integrity

practitioners are careful not to cling to cherished hypotheses,

and take seriously the outcome of the most stringent experiments

This ideal is, however, threatened by corporations,

financial interests trump the common good

Medicine is largely dominated by a small number of very large pharmaceutical companies,

that compete for market share,

but are effectively united in their efforts to expanding that market.

Scientific progress is thwarted by the ownership of data and knowledge because industry suppresses negative trial results,

fails to report adverse events,

and does not share raw data with the academic research community.

Patients die because of the adverse impact of commercial interests on the research agenda, universities, and regulators.

Hierarchical power structures, product loyalty,

and public relations propaganda over scientific integrity.

Universities, have adopted a neo-liberal market approach,

actively seeking pharmaceutical funding on commercial terms.

As a result, university departments become instruments of industry:

through company control of the research agenda,

and ghostwriting of medical journal articles and continuing medical education,

academics become agents for the promotion of commercial products.

The corporate university also compromises the concept of academic leadership.

Deans, (proper academics) have in places been replaced with fundraisers and academic managers,

who are forced to demonstrate their profitability or show how they can attract corporate sponsors.

In medicine, those who succeed in academia are likely to be key opinion leaders

(KOLs in marketing parlance),

whose careers can be advanced through the opportunities provided by industry,

physicians are selected based on their influence on prescribing habits of other physicians

KOLs are sought out by industry for this influence and for the prestige that their university affiliation brings to the branding of the company’s products.

KOLs present results of industry trials at medical conferences and in continuing medical education.

Instead of acting as independent, disinterested scientists and critically evaluating a drug’s performance, they become what marketing executives refer to as “product champions.”

While universities fail to correct misrepresentations of the science from such collaborations,

critics of industry face rejections from journals,

legal threats, and the potential destruction of their careers.

This uneven playing field is exactly what concerned Popper when he wrote about

Suppression and control of the means of science communication (Popper)

Regulators receive funding from industry,

and use industry funded and performed trials to approve drugs,

without in most cases seeing the raw data.

Drug companies, “mark their own homework”

Our proposals for reforms

liberation of regulators from drug company funding

taxation imposed on pharmaceutical companies to allow public funding of independent trials

anonymised individual patient level trial data posted,

along with study protocols,

Written by Dr. John Campbell

Hello Everyone,My name is John Campbell and I am a retired Nurse Teacher and A and E nurse based in England. I also do some teaching in Asia and Africa when time permits. These videos are to help students to learn the background to all forms of health care. My PhD focused on the development of open learning resources for nurses nationally and internationally.

Comments

Leave a Reply
  1. I have not been monitored in any way regarding a long term chronic viral infection. No looking at side effects of the drug I've been taking since 1997 14 years after being infected and going to a NMD
    No one monitoring the vaccine I took that saved my life. No one taking my blood for further research. Unconscionable

    No looking at my progress or failing in any way !!!

    CDC declares my illness a GLOBAL PANDEMIC and no doctor is officially monitoring me in any way.!!!!

  2. This isn't a new problem…nor does it start and stop with drug companies.
    "Once you recognize the system is corrupt, you only make yourself an accessory by continuing to support it." -ancient clown

  3. To be objective, no process of gathering and analyzing data is perfect. Leave it to a small number of people to find and exploit, with malice, vulnerabilities in any public information system. Unlike you John, I actually practiced family and emergency medicine relying on evidenced based medicine for over 25 years. Nowhere more than emergency medicine do we need to know what works, what doesn't and why. You can't just "shoot from the hip," when you have to make life-saving therapeutic decisions in seconds to minutes. It's inevitable that most people reading this will be under the care of someone that relies on evidence-based medicine to provide the best care possible to you. To this end, we employ various principals of statistical analysis to know when the evidence for a particular therapy or surgical procedure should be employed or not relying on evidence-based medicine. If you know of a more reliable method other than evidence-based medicine to guide us to make the right decisions, please explain it to me now. Thank you.

  4. I am heartened by this presentation and your acknowledgement that our health and welfare have been hijacked by the pharmaceutical industry. My only mild concern is your apparent surprise and shock that such things can happen, whereas in reality I could have told you all this 20 years ago. So much has been written about this by many well qualified people, but supressed by the voluntary imperatives created when a false world is constantly presented. More disturbingly will be revelations that this is but the tip of the iceberg and most of what people believe about many medical interventions, particularly vaccines, has been fabricated by years of propaganda. In answer to your uncertainty about whether or not propaganda is just misleading information or lies, it is far more than that. Propaganda consists of many lies on many levels and presents to its audience a completely false narrative from beginning to end. It is an artificial reality of complete fabrication, using hooks into small segments of truth periodically and misrepresenting those connections to reinforce the fantasy that's on show. The surprising reality is that academics, doctors, scientists, politicians and the like are so easy to buy. The thing is what to do about it, but that's another book, I'm afraid.

  5. Propaganda has most definitely been rife over the past two years.

    Big pharma, government and mainstream media have all been complicit with embellishing the truth, hiding data and the manipulation of data in order to reach the desired outcome.

    Great numbers of people have been misled by the above. Many have suffered not just physically but mentally while 1000s have died as consequences of lock downs, the injectable therapeutics

    Also the failure of medical institutions who turned people away and refused to see anyone face to face is a diacrace.

  6. People keep commenting how bad things have been over the last 2yrs, which they have, but the thing is it's been bad (but mostly behind the scenes) for quite some time. The last 2 yrs has brought it out into the light for all to see..well, at least those who choose not to cover their eyes. I've tried to tell anyone who would listen that "science" can be bought and manipulated to say whatever they wanted it to say.

  7. Courageous commentary, balanced and measured comment. Balanced comment from the outset, that leaves the viewer – to make their own determination. "Who pays the piper."? Up to the viewer to make that determination. The role of Deans' and their expected function? Is it, "commerce driven"? From experience, this is often the case – sadly, which works against, evidence based medicine – this is nothing new. There is also this notion, in universities, " user pays, user passes" and by this, I hope to illustrate how monetisation has increasingly driven the education system. It is more-so the case in Australia. Education used to be free in this country. What were the advantages of an education system where the government picked up the tab? It meant, as an educator – you could, "exact a standard". The point being, evidence based outcomes, can often be undermined by profit driven motives. What Dr. Campbell touches on – has deeper implications for institutions. There are serious implications for (purported democracies') society as a whole, when you undermine trust in public institutions. Medicine is a public institution. Dr Campbell continues to even handedly negotiated the thorny territory of deciding what, "the evidence" quite likely is.

  8. Highly qualified, experienced, and ranked and awarded doctor, Dr. Hegde has been telling same thing all the time, making common people aware of how healthcare industry works.

    Interested people should listen to what he says and reveals… Must to watch I would say as highly recommended would be an understatement.

  9. "The truth is being contaminated very often by short term commercial interests" Well put. The public's indifference/mystification means this madness will continue. What was is Stan Laurel used to say? …"You can fool most of the people some of the time". I'm reminded of HG Wells (The Time Machine) where the hapless Eloi are preyed upon by the Morlocks. This is where we're going. We're s*it and we know it.

  10. It seems absolutely fair and reasonable to me that pharmaceutical companies only do clinical trials of potential medicines that will make them money. It also seems absolutely fair and reasonable to me that pharmaceutical companies are more interested in pills that help when we get ill rather than stopping us getting ill in the first place as if nobody got ill, people don't need to buy medicine. The obvious beneficiary, in the UK at least, of a society that doesn't get ill rather than a society of ill people, is the NHS as their costs would drastically reduce if people weren't getting ill in the first place and didn't need expensive treatments. In turn, governments and we as tax payers, would save money as a result. This is NOT a case for privatising pharmaceutical companies…..competition and a desire for profit is what drives product improvements in the healthcare sector. But the NHS/government/we DO have the incentive to do research in preventative options like Vitamin D or other similar 'cheap' things and do proper clinical trials. There isn't profit in doing so but there is cost/tax saving in doing so which amounts to the same thing.

  11. So now what – turn to "natural" snake oil sold by the gallon? Boil my own mushrooms and tree bark?
    I'm fortunate to be healthy. But it seems that there's not much point in seeing a medical "professional" about anything anymore.
    Hope is dying. And we with it.

  12. I have seen so many scientists being funded by commercial interests, it makes my head spin and unfortunately there are many examples of advances slowed or stopped dead because of scientific research funded by commercial interests. Lead in petrol, tobacco, stomach ulcer treatments, the transition away from fossil fuels, etc etc etc. So what is the root of this problem? Well where do scientists go if there is no government funding. Do they throw their doctorates and life's dreams in the bin and drive a bus? No, they end up in an organisation that is funded by commercial interests. Much of fisheries research for example is funded by the commercial fishing industry sector that harvests wild fish as opposed to aquaculture. What are your chances of getting pure data out of that research? This is an old foe and fortunately many people are aware of it. Certainly the older heads in academia, the public service and the media. This is why freedom of speech, democracy and a free press are so important. Exposing, lies, political corruption and prosecuting criminals is an ongoing battle and always will be. Big Pharma and big everything, for that matter, must never have their private research presented as credible without extensive peer review. Never ever. Why big Pharma can keep their data secret is beyond me. All of it can be kept confidential and still can be peer reviewed via non disclosure agreements. Politicians should have all of their conversations and communications made public in real time also.

  13. In my opinion this is the most important video John Campbell has ever made. This subject is so basic to all kinds of research and science, it has to be free and non-commercial. You just cannot trust research made by drug companies who are supposed to sell the medicines they are researching on… You have to be neutral to be scientific. In my opinion..

  14. Sadly, since this appears to be an excellent paper on the external influences on evidence-based medicine, it loses ALL its credibility by CHOOSING to exclude politicians and governmental administrative organizations from its "root cause analysis". I would suggest that behind all of the bias discussed in this podcast, governments and politicians are to blame for creating and maintaining the incentive systems and threats of economic punishment that encourage the universities' and pharmaceutical companies' deceit.

  15. This is not exactly a new phenomenon. When I studied medicine in the 80s a book had been published called „Bitter Pills“. Our professor of pharmacology Hans Winkler was scientific advisor to the authors. This book was a devastating blow to the then popular belief that the foremost interest of drug companies is our health. Furthermore In the last 20 years we have had a major scientific crisis in social, psychological and medical sciences called the replication crisis: many published data simply couldn’t be reproduced by other scientists! I am very much afraid that the whole world is now subject to an all out propaganda war for financial, ideological and political gain, with truth seeming to be an outdated idea substituted by relativity.

  16. I have been in pharmaceutical industry and academic research for a long time and I agree with much of what is in the article but is light on solutions. Pharma scientists really do want to cure diseases. They don't go in to work each day saying "How do I get more money out of people for nothing?". I will also say that "pure" research in academia is anything but pure. Government funding is doled out by peer review of grant applications. These reviews are often heavily biased and many times ideas are stolen by the reviewers. There is much to be done to fix the problems of Science in general, but as long as we have capitalism, the profit motive will always win. If you want to take the incentive out of it, many of those brilliant people will move to tech or finance to make obscene sums of money. You have to make everyone feel the pain equally or companies will use politicians to get what they want. The first thing I would do is force pharma companies to submit protocols for publically available peer-review approval and this includes the analytical plan as well. Protocols could be rejected if not rigorous enough. Second, I would make all de-identified raw data from trials public after a short embargo. I would also allow the submission of alternative analysis of the data with a financial incentive to do so. Third, I would make all analytical methods and algorithms public. That would be a start on cleaning things up, but there would still be a lot to do.

  17. Of the 3.main factors cited by the paper … commercialization of academia is the #1 root cause.

    If you didn't have that, you'd see contrarian opinions and evidence coming out of Unis regularly which would create a counter balance to big pharma.

  18. People are losing their livelihood and health and their lives at the moment because of government bullying and pharmaceutical companies pushing their products onto the population…………they are criminals and should be held accountable. ,!!!!!!!

  19. I am a nurse Practitioner. I am fortunate to have always worked for Physicians at University Hospitals. However once many years ago, about 1996 a friend asked me if I would like to have an interview at one of the AGEdwards investment firms. I went out of curiosity. They wanted someone with a medical background to write reviews of medications to get investors for the drugs. To give me an idea of what they wanted they showed me a review that someone had written about a new drug. I read it it was for a anti inflammatory drug much like ones we were already using for years. I said this is ridiculous we already have a drug that has been around for years and is cheap and works well. That was when I saw the future and lost a great deal of respect for drug companies.

  20. A sad, true story from this week: My wife has early on set Alzheimer's. Three years ago we were involved in a trial for a new drug protocol. It didn't show the hoped for results. At the end , we asked the neurologist in charge of the trial if we should make an appointment to see him about other possible treatments. He said that there wasn't much we could do, so an appointment would be a waste of time. This year, he again wanted us in a trial. After the first month of the new drug, my wife was more depressed than she had ever been in her life. We decided to quit the trial. At the same time, internationally known, researcher, clinician, Dr. Steven Phillips, share an article about low dosage lithium being successfully used with early Alzheimer's. He said it was fun that it was being treated as new information, as he shared FIVE other successful studies on the protocol- in fact he had been using the treatment with his Alzheimer's patient since 2014…. Funny, the doctor from our local trials didn't seem to know about this OTC treatment as a possibility, but was VERY willing to use my wife as a guinea pig for his high dollar experimental with awful possible side effects….

Leave a Reply

Your email address will not be published.

Loading…

0