Health experts with pharma links more likely to talk up risk

"A number of scientists on the World Health Organization’s (WHO) flu advisory committee, which monitors pandemics and provides guidance for governments, for example, have disclosed links with the pharmaceutical industry.

But given that the media can influence demand for pharmaceutical products and perceptions of risk, we set out to examine whether health experts commentating on swine flu more generally were also more likely to have links to drug companies.

Analysing UK newspaper coverage of the swine flu pandemic between April and July 2009 – the period in which the UK government was taking decisions on how best to respond to the emerging pandemic, including providing the public with vaccine and antiviral drugs – we looked for how often scientists were quoted in articles on the pandemic from a wide range of publications.

We then looked at these comments in more detail to see if scientists made an assessment of the risk to the public from swine flu, and if so, we compared these against assessments made by official agencies such as the Department of Health."

"We found that half of the health experts that commentated on the use of antiviral drugs or vaccine had competing interests. And scientists promoting the use of antiviral drugs were eight times more likely to have a competing interest than those that didn’t comment on their use. We also found that health experts with competing interests were six times more likely than those without to predict a higher risk to the public compared to official assessments."

https://theconversation.com/health-experts-with-pharma-links-more-likely-to-talk-up-risk-20108

Attention-deficit/hyperactivity disorder: are we helping or harming?

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f6172 (Published 5 November 2013)

Cite this as: BMJ 2013;347:f6172

http://www.bmj.com/content/347/bmj.f6172

Making all clinical data public is vital for better medical care

Making all clinical data public is vital for better medical care: "An article published in the journal of the British Medical Association, BMJ, earlier this week illustrates a devastating problem with the “evidence base” in the academic medical literature.

A large proportion of drug trials, particularly those sponsored by pharmaceutical companies, never get published, skewing our picture of drugs' effectiveness and safety."

'via Blog this'

Any sensible person or scientist knows that the drug laws are not based on the science of drugs

David Nutt: 'I was sacked, I was angry, I was right': "Any sensible person or scientist knows that the drug laws are not based on the science of drugs. And it’s a collusion among scientists, politicians, and to some extent the public, to ignore that. It is anti-establishment, but also not, in that it’s such an obvious thing. It’s like the emperor’s new clothes – someone needed to speak up."

'via Blog this'

Medical Students Examine Unconscious Patients Without Consent | Fox News

Medical Students Examine Unconscious Patients Without Consent | Fox News: "Australian and UK medical students carried out intrusive procedures on unconscious and anesthetized patients without first gaining consent, news.com.au reported Friday.

The unauthorized examinations included genital, rectal and breast exams, according to Australian women's magazine Madison, and raised serious questions about the ethics of future doctors.

The research, to be published in international medical journal Medical Education, describes -- among others -- a student with "no qualms" about performing an anal examination on a female patient because she did not think the woman's consent was relevant.

Another case is of a man who was subjected to rectal examinations from a "queue" of medical students after he was anesthetized for surgery.

The author of the study, Professor Charlotte Rees, voiced concerns about senior medical staff ordering students to perform unauthorized procedures, leaving the students torn between the strong ethics of consent in society and the weak ethics of some medical staff."

'via Blog this'

Epidemiology of medical error | BMJ

Epidemiology of medical error | BMJ: "The Harvard and Australian studies into medical error remain the only studies that provide population level data on the rates of injuries to patients in hospitals and they identified a substantial amount of medical error

In the United States medical error results in 44 000–98 000 unnecessary deaths each year and 1 000 000 excess injuries"

http://www.bmj.com/content/320/7237/774

Pharma giant fined billions for fraud

GLOBAL healthcare giant Johnson & Johnson will pay more than $2.3 billion to settle allegations that it fraudulently promoted drugs and used kickbacks to promote sales.

In one of the largest healthcare fraud settlements in US history, J&J's criminal and civil fine covers allegations the company marketed risperidone (Risperdal) and other prescription drugs for uses not approved as safe and effective by the Food and Drug Administration (FDA).

The settlement further covers kickbacks J&J allegedly paid to physicians and pharmacies for prescribing and promoting those drugs, the US Justice Department said yesterday. 

Medical Observer

5tov 2013

MORE than 25% of large randomised clinical trials registered with ClinicalTrials.gov have not published

MORE than 25% of large randomised clinical trials registered with ClinicalTrials.gov have not published any results in medical literature or in the registry database, according to research published in the BMJ. The researchers examined 585 registered trials with at least 500 participants and which had been completed by 2009. They found 171 trials with a total of almost 300 000 participants had not been published. Industry-sponsored trials were the most likely to remain unpublished. Of unpublished trials, 78% had no results available in ClinicalTrials.gov. For trials where the recruitment status was listed as “completed”, 26% (132/513) remained unpublished, and 29 trials were described as “active, not recruiting”; with 10 of these unpublished. The BMJ authors said trial investigators and sponsors had an ethical obligation to study participants to publish trial results. “The lack of availability of results from these trials contributes to publication bias and also constitutes a failure to honor the ethical contract that is the basis for exposing study participants to the risks inherent in trial participation”, they wrote. “Additional safeguards are needed to ensure timely public dissemination of trial data.”
http://www.bmj.com/content/347/bmj.f6104

Scientists voice fears over ethics of drug trials remaining unpublished

Almost a third of large clinical trials in the US still not published five years after being finished, scientists write in BMJ

http://www.theguardian.com/science/2013/oct/29/scientists-fears-over-unpublished-drug-trials

there are three main conditions which could impair the autonomy of a patient's medical decision: insufficient information, irrational beliefs/desires, and influence of different framing effects

http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8519.2012.01973.x/abstract