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Nearly 400 medical devices, procedures and practices found ineffective in study

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Re: Nearly 400 medical devices, procedures and practices found ineffective in study

#91

Post by Macross8299 »

criley2 wrote: post #33
geggam wrote: post #22

Frankly, Me and most of America think the FDA approves things according to the highest bidder. This is one of the biggest contributing factors to the anti vax movement. | The trust in our govt and all govt agencies is simply gone.

Anti-vax comes from anti-intellectualism, just like your opinion does. Two sides of the same coin. It has nothing to do with "trust in agencies" and everything to do with intellectualism. We live in a society where academics, data, evidence, etc are all maligned. How can you trust in an agency if you aren't willing to trust anyone at all? The cancer is not trust in agencies, it's your culture of anti-intellectualism…

Anti-vax stuff aside, the attitude of

>Trust experts or die.

is not a scientific attitude, it is borderline scientism and an appeal to authority. Remember when the tobacco industry paid medical experts such as ENT Doctors to endorse smoking? [0]

The idea that "the rubes" don't have to or shouldn't be allowed to see the data behind FDA decisions and should just trust the experts blindly is completely condescending and is probably a key contributor to anti-vax sentiment and the anti-intellectualism movements you decry.

[0]: https://med.stanford.edu/news/all-news/2012/01/big-tobacco-l...

Re: Nearly 400 medical devices, procedures and practices found ineffective in study

#92

Post by Fomite »

geggam wrote: post #82
gumby wrote: post #66

Earlier quoted context omitted.

> Regardless of it actually happening or not it looks terrible. This should never happen I understand the problem you're describing, but consider what you're asking for: people with competence and experience should be barred from taking jobs that require competence and experience? Non-competes have the same problem.

Think of it like a judge. You should be recusing yourself of anything that looks improper. Public servants have a higher standard they need to adhere to and they simply aren't, it is endemic in the public space.

Public servants are not compensated for that higher standard.

Re: Nearly 400 medical devices, procedures and practices found ineffective in study

#93

Post by Fomite »

geggam wrote: post #85
evandijk70 wrote: post #68

Earlier quoted context omitted.

I am not in this field, but I guess that as an employee at the FDA you approve drugs for all the big pharma companies, which aside from the FDA are the major employers that value their skillset. It may be that if you prohibit FDA employees to transition to one of the big pharma companies, you're telling them that they can either work at the FDA forever or have to leave their field

Yes, there is a price to pay for being a public servant.

You realize they're not actually servants, right?

"Take a job with the Fed, sign up for a lifetime of lower income so that HN can nod sagely about avoiding the appearance of impropriety" is a recipe to get no one to ever work for the government.

Re: Nearly 400 medical devices, procedures and practices found ineffective in study

#94

Post by Fomite »

geggam wrote: post #86
addicted wrote: post #67

Earlier quoted context omitted.

This is nonsense. The anti vaxxers place far more trust on someone who is known to have falsified data, and committed egregious malpractice. The anti vaxxers lack of trust in the media has almost nothing to do with what the media may or may not have done to lose trust. The actual difference is that one side does not have a good explanation for what causes autism, and as a result admits that they don’t have the answer…

You dont need that falsified data to come to the conclusion vaccinations in the US are a problem. Remove it from the picture. Compare the US vaccination schedule to any other develop country. Compare our infant mortality rate. Aside from the differences in the vaccination schedules what is the US doing different from other developed nations. Keeping in mind infants do little but eat food, sleep and see a doctor. So i…

The NHS vaccine schedule is just as large as the CDC's: https://assets.publishing.service.gov.uk/government/uploads/...

We're worse at prenatal care. And post-natal care. And there's some serious income inequality problems "poor people qualify for free medical care" doesn't actually obviate things as much as you think it does.

Re: Nearly 400 medical devices, procedures and practices found ineffective in study

#95

Post by ims »

geggam wrote: post #31
ims wrote: post #28

Earlier quoted context omitted.

> Me and most of America think the FDA approves things according to the highest bidder. Why do you think this?

Here is one example https://ivn.us/2013/02/11/the-revolving-door-fda-and-the-mon...

Revolving doors between regulators and industry can raise conflict of interest concerns, but this is not at all the same problem that you alluded to above.

Re: Nearly 400 medical devices, procedures and practices found ineffective in study

#96

Post by skybrian »

chimeracoder wrote: post #89
skybrian wrote: post #40

Earlier quoted context omitted.

This is true, but there may be moderate reforms that would work. Could drugs approved by European regulators be allowed without FDA approval? Which regulators do a better job?

> Could drugs approved by European regulators be allowed without FDA approval? Why should they be? It's not like European regulators have a better track record than the FDA here.

As long as they're not worse, it could result in more approved drugs.

Re: Nearly 400 medical devices, procedures and practices found ineffective in study

#97

Post by throwayEngineer »

adam wrote: post #76
dannykwells wrote: post #18

Everyone yelling about how the FDA is corrupt or should only screen for safety are completely ignorant of history and basic facts. Medicine is not like trying out a new coding framework - in some cases, like cancer: i) There is no ability to "try it out for your self" - you are either all in or not ii) There are extreme risks to taking the drug (most cancer drugs are actually somewhat to extreme toxic...just less tox…

Thank you for this. So often we rip on government agencies from our perch on...Hacker News, when we really have no idea what's going on. We do work with the Government in a different context, and I've found nothing but professionalism and deep expertise. In fact the people I've met in the agencies we're working with are some of the smartest I've encountered in my entire career.

>often we rip on government agencies from our perch on...Hacker News, when we really have no idea what's going on.

In a single department, we don't know.

As a whole, it's been shown over and over that like any organization, government becomes corrupt.

Between defense and universities, I've heard depressing ancedotes as well.

It's lucky and temporary you had a good experience.

Re: Nearly 400 medical devices, procedures and practices found ineffective in study

#98

Post by Symmetry »

chimeracoder wrote: post #89
skybrian wrote: post #40

Earlier quoted context omitted.

This is true, but there may be moderate reforms that would work. Could drugs approved by European regulators be allowed without FDA approval? Which regulators do a better job?

> Could drugs approved by European regulators be allowed without FDA approval? Why should they be? It's not like European regulators have a better track record than the FDA here.

Well, Propranolol was available in Europe for its main indication about a decade earlier than it was allowed in the US saving 10,000s of lives. European drug regulation encourages competition in ways that provide for about a dozen EpiPen equivalents rather than just one provider that can jack up its price to $1000. You can buy sunscreen that blocks both UVA and UVB in Europe, though the FDA is thinking about maybe allowing those sunscreens in the US soon. They did miss Thalidomide, though.

Re: Nearly 400 medical devices, procedures and practices found ineffective in study

#99

Post by Symmetry »

hirundo wrote: post #4

I think it's bad policy for the FDA to screen medicines not just for safety but also efficacy. From this study it appears to be frequently unjustified but it gives the drug a seal of approval that has a tendency to replace the judgement of doctors and patients. It's not that the FDA decision makers are corrupt or incompetent. These are wildly complex issues that nobody can get right consistently. Better not to concea…

Also sometimes a medicine's most important uses end up being off-label anyways. E.g. http://nielsenhayden.com/makinglight/archives/007140.html

Re: Nearly 400 medical devices, procedures and practices found ineffective in study

#100

Post by gumby »

Fomite wrote: post #92
geggam wrote: post #82

Earlier quoted context omitted.

Think of it like a judge. You should be recusing yourself of anything that looks improper. Public servants have a higher standard they need to adhere to and they simply aren't, it is endemic in the public space.

Public servants are not compensated for that higher standard.

I’m not “compensated” financially when I pick up litter I encounter when walking around but that doesn’t dissuade me from doing so.
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