Margaret McCartney's Blog, page 6

Review: What magazines don’t tell you

Free link to BMJ article here

Breastlight – not for earlier detection

as per their misleading adverts, up held by ASA, here.

Not the first time their adverts have been problematic, see these informally resolved cases here.

VERY EXCITING NEW WEBSITE

made with lots of friends.

It’s here, called http://privatehealthscreen.org/ and we hope you find it useful. Please pass it on, I hope practice websites might find a place for it, we hope it’s a resource to add to, and we would love to include anyone who shares our concerns – send me photos and words.

There was a blog in the guardian to launch it, here.

 

Ecstasy trial on TV – BMJ review

Free link to BMJ review ‘A Show Trial’ ,

also a smaller piece about overtreatment and overdiagnosis in the UK – yes, we have some of the US’ problem too. http://www.bmj.com/content/345/bmj.e6617

 

 

 

 

 

 

Quietish self promotion (apologies)

The Patient Paradox is on kindle for 1.99 for the next week.

thank you, Pinter and Martin

http://www.amazon.co.uk/The-Patient-P...

References for tonight’s Inside Health

Gardiasil

 

http://www.whatdotheyknow.com/request/mhra_reports_for_gardasil?unfold=1#incoming-260466

 

http://www.cdc.gov/vaccinesafety/vaccines/HPV/Index.html

 

http://www.cdc.gov/vaccinesafety/Vaccines/HPV/jama.html

http://www.biomedcentral.com/1741-7015/9/54

http://www.bmj.com/content/337/bmj.a769

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=PubMed&Cmd=ShowDetailView&TermToSearch=17993361

Sunscreens and cancer

http://news.mst.edu/2012/05/sunscreen_ingredient_may_pose.html

http://www.sciencedaily.com/releases/2012/05/120507131951.htm

http://www.sciencedirect.com/science?_ob=ArticleListURL&_method=list&_ArticleListID=2126870568&_sort=

 

Hearing and vitamins

http://oto.sagepub.com/content/143/6/826.full.pdf+html

http://www.unboundmedicine.com/evidence/ub/citation/8484483/Vitamin_B12_deficiency_in_patients_with_chronic_tinnitus_and_noise_induced_hearing_loss_ http://www.ncbi.nlm.nih.gov/pubmed/20534742

 

acne

http://www.sgm.ac.uk/news/releases/DUB12_MGE.cfm

and the unbelievable press release. here. It’s nonsense. We need good information to make choices, not nonsense statistics and scaremongering.

Press Release: For immediate release

 

The “world’s most dangerous vaccine” now being offered to our teenage daughters

[PRESSWIRE] London, United Kingdom – 01.10.12 – From last month (September), British schoolgirls from the age of 12 upwards are being offered a new vaccine to protect against cervical cancer. Gardasil is replacing Cervarix as the NHS’s vaccine of choice to combat HPV (human papillomavirus), which causes the cancer.

But research by the health magazine, What Doctors Don’t Tell You (WDDTY), reveals that Gardasil is officially the world’s most dangerous vaccine. And the UK government isn’t telling parents the truth about a vaccine that has been responsible for at least 100 deaths and thousands of life-destroying disabilities in the US.

WDDTY challenges the government to answer:

• why the UK has so readily embraced Gardasil when take-up has slumped by a third in the US following thousands of reports of adverse reactions, including death

• why our drug regulators are being so lax when America’s Food and Drug Administration (FDA) has enforced stronger warnings on the vaccine’s packaging, and is investigating a new reaction known as ‘immunotoxicity’ where the whole immune system is affected

• why the UK has accepted a vaccine that has been rejected by India after an early trial, funded by Microsoft billionaire Bill Gates, led to the deaths of seven young girls and another 120 suffered debilitating side effects

• why the UK government is wasting NHS resources and money on a vaccine that may save just 40 lives in the UK. Overall, an HPV vaccine may protect against 137 new cases of the cancer. Despite the publicity, especially following the death of Big Brother star Jade Goody, cervical cancer is a rare disease, and one that doesn’t even feature in the list of the 10 most common cancers.

Gardasil is officially the world’s most dangerous vaccine, according to figures collated by the US Vaccine Adverse Event Reporting System (VAERS). Of the 75 vaccines monitored, Gardasil is responsible for 20 per cent of all side effects reported by doctors. By the end of 2011, VAERS had recorded 18,727 adverse events, 1,498 of them serious, and 68 deaths related to Gardasil. Parent groups put the figures higher: one group, Sanevax, claims adverse events total 27,023, while the website www.truthaboutgardasil.org claims more than 100 girls have died after being vaccinated.

“The government is playing fast and loose with British parents and their daughters. They are not being given all the facts so they can make a proper informed decision”, says WDDTY editor Lynne McTaggart.

NOTES TO EDITORS:

WDDTY is a new magazine, available every month on news-stands, including Sainsbury’s, Tesco, Waitrose, WH Smith, and independent newsagents. Its editorial panel includes 12 leading doctors and experts. Price: £3.95.

Website: www.wddty.com and www.wddtysubscribe.com

oxygen and cancer cells

http://jmcb.oxfordjournals.org/content/4/3/174.full

A show trial

Review of Channel 4′s Drugs Live, for the BMJ,  in which I conclude that it didn’t help people understand how to do a clinical trial.

Baby helmets and misinformation

Inside Health tonight had a piece about about baby helmets for so-called ‘flattened head’ syndrome. I think the evidence of benefit for these helmets – costing 2K upwards – simply isn’t there, and I think parents are being misled. My complaint – with all components upheld – with the ASA is here. The ASA point out that the aggressive marketing tactics may put off parents going to their GP, and that there isn’t RCT evidence of benefit. This is crucial because most children will develop a less flattened skull as they get older anyway – so without comparing children using helmets with ones who don’t, we don’t know they are any good.

Some of the references I used are here

RCT that the helmets aren’t needed

Review saying helmets aren’t needed

Natural history of head shape study

It’s worth pointing out that synostosis can also cause a misshapen baby’s head – but this is very rare, and should be diagnosed and treated through medical specialists, not via commercial baby helmets.

What works; homeopathy and Big Pharma

Ben Goldacre’s excellent piece in the Guardian this weekend outlines clearly why it is that we can’t trust much of the data we have about pharmaceuticals. Data gets buried, the wrong questions get asked about what works, and we end up prescribing things that are later shown not to be useful, or even harmful.

Meantime, Des Spence wrote in the BMJ that homepathy is ‘bad science but good medicine’. While making it clear that homeopathy doesn’t work at a cellular level, he said that “The homeopathic doctors I know are caring people, disillusioned with the crudeness of conventional medicine, not your typical aggressive alpha medical type. They are not in the pay of big pharma, whose drugs potentially kill 100 000 people a year in the United States alone.1 They listen, spend time, and offer some explanation for the unexplainable—and their patients like them. The effect of homeopathy is the positive effect of a therapeutic relationship that is reassuring, accepting, and supportive. Society should never underestimate the healing effect of a kind word or the value of a holistic approach. These consultations genuinely improve wellbeing. Homeopathic pills are placebos, but the placebo response is great, maybe even as high as 80%.”

Here we have the crux; the massive dilemma in modern medicine. We have pharmaceuticals which we hope are evidence based but may, if we take into account the poor quality of the evidence, actually not be. Then we have doctors saying that actually, the drugs won’t work for a subset of people anyway; homeopaths are not prone to the excesses of Pharma, and thus homeopathy, with it’s kindness and concern, works. In other words, homeopathy is the best way to protect patients and care for them.

I think this is wrong, hugely and utterly and inescapably wrong.

First: it would be a scandal if the homeopathic consultation were the only way to talk, listen, support and be kind. But it’s not. It is true that the GP consultation has become owned, via the GP contract, to politicians more than patients (the whole of the last bit in The Patient Paradox is all about this.) The answer to this is not homeopathy, but in making the GP consultation about the patient, not about ticking boxes via the GP staring at the computer screen. We must address the GP contract, not add an unethical placebo like homeopathy. As I’ve written about before, there are many things which good general practice can ethically offer that improve outcomes for patients – like continuity of care – and which are not unethical deception.

Second: Some drugs do work. Treatments for HIV, meningitis, organ transplantation, heart failure, stroke. Ben knows this, he writes about this; he is certainly not arguing for non evidence based medicine (like homeopathy). The answer is not to give up on pharmaceuticals. It is to make the way we test and research treatments better. We have to  make the questions researchers ask more useful to patients. This is already happening. The James Lind Alliance works to do just this – to make sure that patients are telling researchers are asking the questions which are important to them, and then taking part in trials which they have ownership of. We need legislation to ensure that clinical trial results are not hidden. This can be done.

Third; It is of huge importance that we get back to the importance of unbiased assessments of the evidence. This  is what Cochrane was set up to do. Biased, bad evidence should be dismissed – which is how Cochrane operates – but good evidence stops us killing people – and here’s the crux -not just by prescribing, but also by not prescribing. So we know that MMR saves lives. But we also know that paroxetine prescribed to young people raises the risk of suicide.

More than ever, doctors, patients, carers, citizens and researchers have to work together. We have to acknowledge and reduce uncertainties about treatments when we can. But we also have to do this ethically; and caring well for patients without deception can  and should be our priority.

 

 

new things

Free link to Statins for all? in the BMJ

and

a column on why Emma’s Diary should be ditched, here.