This study supports my position. 12.9 vs 14.7. From taking my statins I get a measly 1.8% lower chance of dying over a five year period, and that's a shaky assertion. It costs a fortune, I'm impotent, and my short term memory is screwed up, but hey, the doc says to take it for that 1.8%. And I suspect the 1.8% is misleading. The profile of the people who died in both groups was probably distinctly identifiable, so in effect the vast majority probably got no benefit.
And I think I've seen this methodologically refuted elsewhere. Some studies have definitely got the opposite result.
Dude, I've worked as an ER/Critical care nurse for years. I push a drug, a person's heart rate changes. I tweak a drug on an IV pump, a person's blood pressure comes out of shock and normalizes. The idea that pharmacology doesn't help people is quite simply wrong.
Sure, the protocol for Advanced Cardiac Life support changes every 2 years, because some therapies that we use to thing were very effective, are proven to be less effective than new ones. But, there is a strong self-corrective factor in Medicine. The ideal isn't to do what the pharma companies push the doctors to do. The ideal is to do whatever the best science says increases lifespan, quality of life and decreases morbidity and mortality.
At times, studies are funded by pharma companies, and the research is tainted. Current best practices are a moving target, because the science changes. But, over all, good medical practice is a big plus.
Sure there are drugs that have great promise, are pushed through FDA approval and then are found to have bad side effects and/or not as effective as once thought... (e.g. Vioxx, Celebrex... both recalled several years after approval).
But, for every drug that isn't effective, or has bad complications, there are dozens that do work. And, many more are found to have other beneficial uses. For example, mucomyst is a drug that was developed to help break up mucous plugs in people's lungs. Then, is was found to work as the antidote for one of the most common and toxic poisonings: tylenol. It's also used to protect people's kidney's during IV contrast injections.
I'm sorry but the anti-pharma, anti-vaccination stuff that flies around the internet is one of the clearest examples of FUD I've seen, and it's very harmful. I've seen a number of people die because they didn't trust medicine and they didn't trust doctors. Please, check what you are saying before someone gets permanently hurt by your ideas.
Key words are ER and Critical Care. That stuff works great and makes progress all the time. It's also somewhat irrelevant to the bulk of medical practice and health care costs, which pertain to chronic conditions and lifestyle disease.
If people don't manage their chronic diseases with medication, where do they end up? The ER.
If a diabetic doesn't take insulin or their anti-high-blood-sugar pills, where do they end up? The ER in a diabetic coma. A daily dose of insulin is like $1 a day. An ER visit/ICU hospitalization for a diabetic coma is around $20-50k depending on the severity.
If an asthmatic doesn't manage their chronic condition with the appropriate inhalers, where do they end up? The ER. IF they let it go too long, they end up on life support in the ICU.
Pneumonia used to be a leading cause of death, now it's not. Why? Antibiotics and oxygen therapy. People used to get polio all the time. I haven't seen an active case of polio every in my 15 year nursing career. Why? The polio vaccine.
The incidence of tetanus has dropped from 600,000 deaths in '92 to less than 150,000 deaths world wide. Why? The tetanus vaccine. Ref: http://www.emedicine.com/emerg/topic574.htm
Please, stop saying the pharmacology doesn't work. It does. It saves lives. Are there problems with the system? Sure. But please stop spreading FUD about "Big Pharma".
I have zero doubt that this is true. I have been around a lot of those medical errors, and I have seen people who have been killed by medical errors and malpractice. It's tragic.
But, just because there are problems, that doesn't mean that the system doesn't work.
In the article that you posted, they mentioned 10's of millions of unnecessary antibiotics. The reason that antibiotics are prescribed for viral infections is twofold. And, it's primarily because people want them. If I take my child who has been sick for 1 week to the ER, spend 3 hours waiting in line for a 5-10 minute visit with an ER doc. I want to go home with a prescription in hand. If not, I'm going to be very angry. So, it's easier for the MD to prescribe an antibiotic than deal with the 5-10 minute conversation convincing the parents that it's only 2008 and we haven't found a cure for the common cold yet.
As for unnecessary medical procedures... That pretty much speaks to 95% of plastic surgery cases and 80% of dermatology practices.
Our society also has very high expectations of the medical community. We used to go to a shaman, priest or pastor when our family was dying and looked for answers or expected miracles. Now, we take then in a ambulance to the hospital and expect answers and miracles from our doctors and medical systems.
Doctors feel those expectations and generally work very hard in very difficult circumstances. They also are trying to make a decent living to pay for the 12-15 years of schooling they suffered through. So, the average MD will work 70-110 hours a week. When you work that much, you're bound to make mistakes.
There's no doubt about it, there are a lot of problems with the system, but that doesn't mean that we should throw the baby out with the bath water.
Tips to getting better health care:
#1 Bar none, go to the rich people's hospital. Go to the neighborhood with the most expensive homes, and find a doctor in that neighborhood. You get much better medical care in those areas because that's where the good doctors go to practice. After working in 35 different hospitals in 15 years, I settled on working at an upper class/upper middle class hospital in Silicon Valley. That was deliberate. I can give better care here than any where else I've ever worked.
it's 1.8% percentage points which is not the same as 1.8% lower chance. It's a 13% lower chance. And that's just from dying. It prevented many others from having a heart attack or stroke which can be pretty bad to.
You can dismiss it if you like, but what these numbers mean in more practical terms is this:
Over 5 years on treatment, it will prevent up to 1 person out of 10 from dying, having a stroke, or heart attack.
And there may be a negative study here or there, but there are many more positive studies. It's like flipping a coin 100 times in a row. There will be times when you get 70 heads, 30 tails, and times you will get 30 heads, and 70 tails. If you do it enough, it will average around 50% heads and tails. This is the "true" result or chance over time of getting heads or tails.
If you do a single study, you might get a negative result (no improvement), if you do another study you might get a really positive result (huge improvement). If you do it enough, the results with trend towards the "true" result... which for statins is that it saves a significant number of lives and prevents heart attacks and strokes in certain patients.
Semantics. I change my odds by 1.8% in the naive assumption that these numbers are applicable to myself at face value. If you like these odds I would like to sell you some lottery tickets.
Your thinking is fundamentally flawed. 1.8 people out of 100 are prevented from dying, and not for free: there are side effects and financial costs. How many died in year six as opposed to year five is also unclear. We're talking about drugs they want to keep people on for the rest of their lives.
The cumulative arithmetic of how many escaped cardiovascular "events" and death cannot be computed clearly from the numbers presented, as you seem to allude.
I agree that the cost is not free. The point being is that these medications do do something. They aren't sugar pills.
You're first assertion was that these medications don't actually do anything. I simply am pointing out they do do something.
It comes at a cost of $$, possible side effects, sure. But if you are arguing that point, then you have to concede that if the price is low enough or the side effects are low enough, then it's worth it.
If it's not personally worth it to you to take the statin because you have side effects from it... that's fine. don't take it. But you can't use it as a blanket to say all medications don't do anything, just because you had a bad experience with one or don't agree with the cost/benefit analysis.
Personally, I'd say 1.8% over five years is nothing, and as I mentioned I've seen the abstract read closer to 0% or -X%. Think of it as 0.36% per year. Expect big lawsuits next decade about the side effects.
> you have to concede that if the price is low enough or the side effects are low enough, then it's worth it.
Not quite so simple, because there are lifestyle treatments that do work and are generally not pursued. The drug options are pursued at the opportunity cost of much more efficacious, much simpler, much less profitable options.
Again, I believe you simply don't understand percentages, or statistics.
The numbers were statistically significant, which means the differences were not likely related to random chance.
The statin prevented 1079 people from having a stroke, dying, or having a heart attack. It helped 10% of the people in a non-trivial way in this study.
(and lifestyle changes are typically pursued alongside these medical treatments. Certainly in these studies, of course your individual doctor's mileage may vary.)
I understand statistics just fine, asshole. You're saying I should bank with XYZ Bank because their savings account interest rate is 100% higher than my current bank! Or, .5% vs 1%. I'm saying the interest rates are .5% and 1% respectively.
As for the 10 out of 100 total winners claim, it looks fudged up to me on quickly scanning the abstract. I'd have to use a calculator and read the study. That cute little bit about a compliance adjustment smells like fudge. And, as I've said, there are other studies with other conclusions.
1) Your continued comments are way off topic. In what way do they relate to doctors being overworked? None that I can see.
2) You really don't seem to have a good grasp of what the statistics are telling you. Take the statins example. As others have tried to explain to you quite politely, the statistical improvement of statins vs placebo are both significant, and even impressive. Your response? 'Asshole'. Nice work.
Nice try, but your argument doesn't hold up for society at large.
It doesn't matter to you as an individual if you are prescribed heart medicine when you need it. However, it truly does save lives in society. How do you propose we scale back the system of medicine? Should doctors no longer prescribe statins?
You have some time now to find those opposing drug study citations. Your claims interest me and I'd like to subscribe to your newsletter, but the rubber will start hitting the road for me if this conversation progresses from accusations to evidence.
Here's an example of the kind of thing that interests me: a recent meta-study of FDA trials of SSRIs (antidepressants) showed little to no benefit over placebo, below statistical significance in some important cases. So there's a fair chance that most people shouldn't get SSRIs because they just don't work.
"Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication."
And I think I've seen this methodologically refuted elsewhere. Some studies have definitely got the opposite result.