Aust N Z J Psychiatry. 2004 Nov-Dec;38(11-12):933-9.
http://www.ncbi.nlm.nih.gov/pubmed/15555028
"Pharma Collaboration", unreported in the Australian media, linked the Mental Health Council of Australia directly to global pharmaceutical giants
IN OCTOBER 2004, the nation's most influential mental illness advocacy group signed a deal that financially tied it to some of the world's biggest pharmaceutical companies.
The so-called "Pharma Collaboration", unreported in the Australian media, linked the Mental Health Council of Australia directly to global pharmaceutical giants Pfizer, Eli Lilly, Glaxo SmithKline, Bristol Myers Squibb, Lundbeck, Wyeth and Astra Zeneca.
It has been a good deal for the non-profit council, which promotes itself as Australia's peak mental health group, providing 8 per cent of its total income. It also seems to have benefited the drug companies, which have a strong financial interest in selling medication to treat mental illness, especially the "new epidemic" of depression.
http://www.theage.com.au/news/national/mental-health-takes-industry-pills/2006/08/07/1154802820416.html
The so-called "Pharma Collaboration", unreported in the Australian media, linked the Mental Health Council of Australia directly to global pharmaceutical giants Pfizer, Eli Lilly, Glaxo SmithKline, Bristol Myers Squibb, Lundbeck, Wyeth and Astra Zeneca.
It has been a good deal for the non-profit council, which promotes itself as Australia's peak mental health group, providing 8 per cent of its total income. It also seems to have benefited the drug companies, which have a strong financial interest in selling medication to treat mental illness, especially the "new epidemic" of depression.
http://www.theage.com.au/news/national/mental-health-takes-industry-pills/2006/08/07/1154802820416.html
extreme case of compensatory truncal hyperhidrosis and anhidrosis over the head and neck region which led to a heatstroke
Thoracic sympathectomy is a commonly performed surgical procedure for the treatment of palmar hyperhidrosis. However, one major complication of such a procedure is compensatory truncal hyperhidrosis. We describe an extreme case of compensatory truncal hyperhidrosis and anhidrosis over the head and neck region which led to a heatstroke.
http://icvts.oxfordjournals.org/content/early/2011/12/20/icvts.ivr121.abstract?sid=89a2ce71-1ea3-4573-9e63-17329e7c09cd
the fabled Hippocratic Oath:
for the good of the patient … never do harm to anyone … to please no one prescribe a deadly drug … preserve the purity of my life and my art … keep myself far from all intentional ill-doing and seduction … All that may come to my knowledge … I will keep secret and never reveal …
Medicine has become the playing field of politicians, bureaucrats and myriad associations representing doctors, nurses, scientists and other health professionals. All these bodies are actively involved in competition, driven by a different philosophy, which focuses on remuneration, work conditions and power.
http://www.mjainsight.com.au/view?post=martin-van-der-weyden-idealism-wears-thin&post_id=7367&cat=comment
Medicine has become the playing field of politicians, bureaucrats and myriad associations representing doctors, nurses, scientists and other health professionals. All these bodies are actively involved in competition, driven by a different philosophy, which focuses on remuneration, work conditions and power.
http://www.mjainsight.com.au/view?post=martin-van-der-weyden-idealism-wears-thin&post_id=7367&cat=comment
Forty percent of interviewed clinicians were clinically depressed.
In the past 10 years, the culture of medicine in California has changed radically. A study of 454 clinicians by the Sacramento Medical Society indicated that most had felt the effects of these changes deeply.1 Forty percent of those interviewed were clinically depressed. Most reported that they had thought about leaving the profession at least once in the past 12 months. Even more surprising, many would not want their children to go into medicine nor would they choose medicine as a career again.
This is not a California phenomenon. An unprecedented number of physicians nationwide, many of them young, are dropping out or seeking early retirement.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071213/
lobby group to pressure universities to close down alternative medicine degrees
MORE than 400 doctors, medical researchers and scientists have formed a powerful lobby group to pressure universities to close down alternative medicine degrees.
Bias in eye of beholder
There’s no doubt that doctors’ financial relationships with industry could be used — fairly or otherwise — to question their credibility.
In fact, this happened last week when Melbourne endocrinologist Professor Henry Burger and overseas colleagues published a re-evaluation of the results of the of the Million Women Study, disputing claims it showed a causal link between hormone replacement therapy (HRT) and increased breast cancer risk.
Predictably enough, the paper sparked a fiery debate. Some experts welcomed the finding; others disputed it and pointed to the authors’ financial relationships with manufacturers.
Dr Andrew Penman, of the NSW Cancer Council, told ABC radio the authors were “playing the game” of seeding doubt about well established scientific findings, “and you really do have to question their interest, given their association with the industry”.
No doubt, the HRT debate still has some distance to run, but the demand for greater public disclosure means doctors in all fields of medicine are likely to find themselves grappling with more of these kinds of conflict of interest allegations.
We humans are not very good at detecting our own biases, though we can be hyper-vigilant about those of others.
Studies in the past have suggested most doctors do not believe their own decisions are affected by industry gifts or payments — though they tend to be more sceptical about their colleagues’ ability to remain impartial.
http://www.mjainsight.com.au/view?post=jane-mccredie-bias-in-eye-of-beholder&post_id=7768&cat=comment
In fact, this happened last week when Melbourne endocrinologist Professor Henry Burger and overseas colleagues published a re-evaluation of the results of the of the Million Women Study, disputing claims it showed a causal link between hormone replacement therapy (HRT) and increased breast cancer risk.
Predictably enough, the paper sparked a fiery debate. Some experts welcomed the finding; others disputed it and pointed to the authors’ financial relationships with manufacturers.
Dr Andrew Penman, of the NSW Cancer Council, told ABC radio the authors were “playing the game” of seeding doubt about well established scientific findings, “and you really do have to question their interest, given their association with the industry”.
No doubt, the HRT debate still has some distance to run, but the demand for greater public disclosure means doctors in all fields of medicine are likely to find themselves grappling with more of these kinds of conflict of interest allegations.
We humans are not very good at detecting our own biases, though we can be hyper-vigilant about those of others.
Studies in the past have suggested most doctors do not believe their own decisions are affected by industry gifts or payments — though they tend to be more sceptical about their colleagues’ ability to remain impartial.
http://www.mjainsight.com.au/view?post=jane-mccredie-bias-in-eye-of-beholder&post_id=7768&cat=comment
Confidence in research shattered
A REANALYSIS of evidence supporting the anti-influenza drug oseltamivir has undermined confidence in published research for one of the review authors, who has called for an overhaul of the way systematic reviews are conducted.
Professor Chris Del Mar, professor of public health at Bond University, Queensland, was one of seven Cochrane researchers who reanalysed the evidence for oseltamivir (Tamiflu) using primary trial data, much of which was unpublished. (1)
They found several inconsistencies with published reports, such as that oseltamivir did not reduce hospitalisations. The reanalysis also showed a possible underreporting of adverse events, although the drug was found to reduce duration of influenza symptoms by 21 hours.
Governments globally had spent billions of dollars stockpiling oseltamivir after a previously published analysis, funded by Roche, found that the drug reduced complications and hospital admissions. However, eight out of the 10 trials used in the Roche analysis were unpublished and their data sets were not available from either the authors or Roche. (2)
The researchers postponed an analysis of zanamivir (Relenza) evidence because its manufacturer, GlaxoSmithKline offered to provide individual patient data.
The Cochrane researchers found that 60% of patient data from oseltamivir trials had never been published, a fact Professor Del Mar described as “disgraceful”.
The research has also raised questions about the mechanism of action of oseltamivir.
“One of our team has suggested that oseltamivir’s effect might not to be due to an antiviral action but to do with a general brain suppressant … if it is working that way, then it’s no better than paracetamol but a lot more expensive”, Professor Del Mar said.
http://www.mjainsight.com.au/view?post=confidence-in-research-shattered&post_id=7790&cat=news-and-research
Professor Chris Del Mar, professor of public health at Bond University, Queensland, was one of seven Cochrane researchers who reanalysed the evidence for oseltamivir (Tamiflu) using primary trial data, much of which was unpublished. (1)
They found several inconsistencies with published reports, such as that oseltamivir did not reduce hospitalisations. The reanalysis also showed a possible underreporting of adverse events, although the drug was found to reduce duration of influenza symptoms by 21 hours.
Governments globally had spent billions of dollars stockpiling oseltamivir after a previously published analysis, funded by Roche, found that the drug reduced complications and hospital admissions. However, eight out of the 10 trials used in the Roche analysis were unpublished and their data sets were not available from either the authors or Roche. (2)
The researchers postponed an analysis of zanamivir (Relenza) evidence because its manufacturer, GlaxoSmithKline offered to provide individual patient data.
The Cochrane researchers found that 60% of patient data from oseltamivir trials had never been published, a fact Professor Del Mar described as “disgraceful”.
The research has also raised questions about the mechanism of action of oseltamivir.
“One of our team has suggested that oseltamivir’s effect might not to be due to an antiviral action but to do with a general brain suppressant … if it is working that way, then it’s no better than paracetamol but a lot more expensive”, Professor Del Mar said.
http://www.mjainsight.com.au/view?post=confidence-in-research-shattered&post_id=7790&cat=news-and-research
Cosmetic surgery advertising ban urged by leading surgeons
The British Association of Aesthetic and Plastic Surgeons has proposed a ban on advertising for cosmetic surgery as part part of a six-point plan for tighter regulations on the industry.
more here:
http://www.guardian.co.uk...rtising-cosmetic-surgery
more here:
http://www.guardian.co.uk...rtising-cosmetic-surgery
up to $3 billion was spent inappropriately each year by by unscrupulous doctors
Dr Webber had told a recent senate inquiry that he would like the PSR to have a greater role in investigating corporate medicine. (2)
“I can certainly see PSR — and this may be somewhat controversial — having an own-motion ability to investigate scams and unacceptable corporate behaviour, of which I have seen significant examples”, he told the inquiry.
In the MJA article Dr Webber described the Medicare Safety Net as “one of the most poorly thought out pieces of health legislation”, saying it offered opportunities for exploitation by unscrupulous doctors.
Dr Webber told MJA InSight he repeatedly raised many of these concerns with the Department of Health and Ageing when he was director of the PSR but nothing changed.
“It was frustrating. The department would tell you that changes to chronic disease management were underway but nothing ever seemed to happen”, he said.
Health journalist Ray Moynihan, in the same issue of the MJA, said health authorities had so far found no meaningful mechanism to police the corporate medicine sector. He said it was time to assess “how well the private-for-profit corporate structure sits with the spirit of a publicly funded universal health insurance scheme”. (4)
http://www.mjainsight.com.au/view?post=billions-wasted-says-ex-psr-chief&post_id=7687&cat=news-and-research
“I can certainly see PSR — and this may be somewhat controversial — having an own-motion ability to investigate scams and unacceptable corporate behaviour, of which I have seen significant examples”, he told the inquiry.
In the MJA article Dr Webber described the Medicare Safety Net as “one of the most poorly thought out pieces of health legislation”, saying it offered opportunities for exploitation by unscrupulous doctors.
Dr Webber told MJA InSight he repeatedly raised many of these concerns with the Department of Health and Ageing when he was director of the PSR but nothing changed.
“It was frustrating. The department would tell you that changes to chronic disease management were underway but nothing ever seemed to happen”, he said.
Health journalist Ray Moynihan, in the same issue of the MJA, said health authorities had so far found no meaningful mechanism to police the corporate medicine sector. He said it was time to assess “how well the private-for-profit corporate structure sits with the spirit of a publicly funded universal health insurance scheme”. (4)
http://www.mjainsight.com.au/view?post=billions-wasted-says-ex-psr-chief&post_id=7687&cat=news-and-research
Bias in Medical Research by A. Indrayan
Bias are possible in many ways in a research activity. Please see some of the bias mentioned by A. Indrayan in the book, Basic Methods of Medical Research by AITBS Publishers, J-5/6, Krishan Nagar, Delhi - 110051.
Varieties of Bias:
bias in concept
bias in design
bias in selection of subjects
bias due to concomitant medication or concurrent disease
instruction bias
length bias
bias in detection of cases
lead-time bias
bias due to confounder
contamination in controls
Berkson's bias
bias in ascertainment or assessment
interviewer bias or observer bias
instrument bias
Hawthrone effect
recall bias
response bias
repeat testing bias
mid-course bias
self-improvement effect
digit preference
bias due to non-response
attrition bias
bias in handling outliers
recording bias
bias in analysis
bias due to lack or power
interpretation bias
reporting bias
bias in presentation of results
publication bias
Varieties of Bias:
bias in concept
bias in design
bias in selection of subjects
bias due to concomitant medication or concurrent disease
instruction bias
length bias
bias in detection of cases
lead-time bias
bias due to confounder
contamination in controls
Berkson's bias
bias in ascertainment or assessment
interviewer bias or observer bias
instrument bias
Hawthrone effect
recall bias
response bias
repeat testing bias
mid-course bias
self-improvement effect
digit preference
bias due to non-response
attrition bias
bias in handling outliers
recording bias
bias in analysis
bias due to lack or power
interpretation bias
reporting bias
bias in presentation of results
publication bias
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http://www.mjainsight.com.au/view?post=mental-health-funding-lacks-transparency&post_id=7889&cat=issue-3-30-january-2012