Ben Goldacre on Avandia – Bad Science

This drug has been on the market since 1999, and it has seen billions of dollars of sales every year. There has been plenty of real patient experience of this treatment, but we have failed to capture it for analysis. Most of the trials included in these meta-analyses weren’t specifically designed to look at heart problems, and so the data on these, collected incidentally, is unpredictably inaccurate.

In an ideal world, for every patient, wherever possible, we could be gathering anonymised outcome data and comparing this against medication history, making exceptions only for those who put their anxieties about privacy above the lives of others (I will have this argument with you any time). In an ideal world, wherever a patient is given any treatment, and there is genuine uncertainty about which treatment is best, they would be simply and efficiently randomised to one treatment, and their progress monitored. In an ideal world, these notions would be so routinely embedded in our notion of what healthcare looks like that no patient would be bothered by it.

This isn’t fanciful, or difficult, or disproportionately expensive. Instead we have unsatisfactory hotchpotch of incomplete monitoring systems and unforgivable secrecy. Medical successes and failures are one of the biggest factors impacting on whether people live or die. Living and dying matter a lot. We have a failure of vision.

via badscience.net

Posted via email from Jack's posterous