“Evidence-based medicine has been hijacked”: John Ioannidis (2016) • Hacker News Board

Re: “Evidence-based medicine has been hijacked”: John Ioannidis (2016)

#71

Post by jdietrich » Fri, Jul 05, 2019, 4:18 PM UTC

tomp wrote: post #41

ekianjo wrote: post #28

Earlier quoted context omitted.

But it is the necessary step to highlight the problem so that actions can be taken. Also, you can safely assume that the large majority of outcomes that were not published were:\ - negative - worse than negative (i.e. safety issues?) - not properly designed So if you compare the number of trials disclosed/not disclosed for each drug/each company that gives you a pretty good picture of who is doing what already. With…

My assumption is that most unpublished trials were "no effect". Be a drug company. Develop a "drug" that is really a placebo (has no effect). Do 10 trials. 8 are "no effect", 1 is positive (by chance), 1 is negative (by cance). Publish the positive drug. Market the drug as having positive effect. Sell the drug, make billions. It would take decades for enough other research (mostly "no effect") to accumulate before it…

A drug that genuinely has no effect is actually pretty good; most drugs have some sort of risk and many are seriously dangerous. Rofecoxib is believed to have caused around 100,000 heart attacks and 30,000 deaths. Market approval for rofecoxib was based on misleading data and its withdrawal from the market was substantially delayed by misleading data.

https://en.wikipedia.org/wiki/Rofecoxib

Re: “Evidence-based medicine has been hijacked”: John Ioannidis (2016)

#72

Post by lez » Fri, Jul 05, 2019, 4:26 PM UTC

He is a spiritual brother of Dr. Peter Gøtzsche, who is also very clearly describing the corruption going on in the medical sciences.

He made simple statistical analysis to prove certain drugs like antidepressants causing side effects / death. His findings ignored, he was removed from his leading position from Cochrane Collaboration.

Videos: https://youtube.com/watch?v=dozpAshvtsA

https://youtube.com/watch?v=UVHSpQ9PbSs

https://youtube.com/watch?v=G2mFHHWyTrc

Re: “Evidence-based medicine has been hijacked”: John Ioannidis (2016)

#73

Post by dalbasal » Fri, Jul 05, 2019, 4:44 PM UTC

hef19898 wrote: post #45

dalbasal wrote: post #34

Earlier quoted context omitted.

As a sales and marketing person... I'll admit to a lot of blame for a lot of bad things... definitely playing with words to they point where they mean very little. Selective publishing and "p-hacking" though, these are research/academia pathologies not marketing ones.

I understand why you are getting downvoted. Yet I think you make a valid and important point. Sure marketing and sales are putting a lot of pressure on, in that case RandD. But then RandD is, at some point, deciding to publish or find what is wanted. And, at least in my experience, good marketing people would rather not have falsified results and even if it is just for PR reasons. Just blaming someone else, like mark…

Well said. In fairness to the downvotes, I was bey tongue-in-cheek.

Whether for reasons of communist 5-year plans, capitalist pharmaceutical industries or even just the personal desires of an academic to prove a pet theory, publish or whatnot.. incentives and pressure to cheat exist. That's one reason why replication is so important.

Re: “Evidence-based medicine has been hijacked”: John Ioannidis (2016)

#74

Post by astazangasta » Fri, Jul 05, 2019, 4:51 PM UTC

Nasrudith wrote: post #17

RobertRoberts wrote: post #4

Earlier quoted context omitted.

> If it were meaningless, FDAs and other regulatory bodies would not even accept it during the clinical trial design review phase. Go look up how many corporate stooges are in the place in the FDA over the years. A good starting point is the history of Aspartame, I'd link some articles, but I suspect the sources would be shot down and evidence ignored. The people at the FDA were complicit in its approval, despite sci…

Aspartame is ironically a substance we are most sure of its safety because of how fixed many were on the idea it was dangerous. Few substances were given such exhaustive testing. The sources would be shot down for a reason and not some vast conspiracy but because the hill they chose to die on wasn't even real. I would draw the opposite conclusion - safety analysis by whatever becomes a cause is a very poor way to bot…

Err, have you acually read the studies they used to approve? They are not unequivocal, and the final approval of it as a drink additive was thanks to Donald Rumsfeld, who was CEO of Searle at the time and had a hand in selecting Arthur Hull Hayes Jr. to head the FDA.

Re: “Evidence-based medicine has been hijacked”: John Ioannidis (2016)

#75

Post by darkpuma » Fri, Jul 05, 2019, 6:13 PM UTC

ben_w wrote: post #19

Alex3917 wrote: post #7

Earlier quoted context omitted.

The tl;dr is that the same guys who fabricated the evidence about Saddam Hussein having WMDs also fabricated evidence for aspartame being safe. https://www.huffpost.com/entry/donald-rumsfeld-and-the-s_b_8...

Did Donald Rumsfeld also convince the European Union, who have their own interests and a similar sized economy, that it was safe? https://www.efsa.europa.eu/en/press/news/131210 or the “more than 90 countries worldwide” [1] that the Canadian government refers to on their own website? https://www.canada.ca/en/health-canada/services/food-nutriti... There are certainly cases where I don’t trust USA regulations. This jus…

Perhaps they consulted with somebody who's an expert at lying to Europeans, such as Tony Blair. ;)

Re: “Evidence-based medicine has been hijacked”: John Ioannidis (2016)

#76

Post by RobertRoberts » Sat, Jul 06, 2019, 5:31 AM UTC

andreareina wrote: post #18

RobertRoberts wrote: post #4

Earlier quoted context omitted.

> If it were meaningless, FDAs and other regulatory bodies would not even accept it during the clinical trial design review phase. Go look up how many corporate stooges are in the place in the FDA over the years. A good starting point is the history of Aspartame, I'd link some articles, but I suspect the sources would be shot down and evidence ignored. The people at the FDA were complicit in its approval, despite sci…

> I'd link some articles, but I suspect the sources would be shot down and evidence ignored Why would you say that? This is a serious accusation made without offering evidence and the only effect it can have is to greatly diminish the probability of having a productive debate.

If you feel like it, look at my previous comments, I post something with evidence and ad hominem attacks ensue. It's exhausting.

I figure some people don't know about this, so they will look it up.

People who are reactive will vote me down regardless of what I say or proof I provide.

There is so much evidence of corporate manipulation of the high level government posts is nauseating.

Re: “Evidence-based medicine has been hijacked”: John Ioannidis (2016)

#77

Post by RobertRoberts » Sat, Jul 06, 2019, 5:32 AM UTC

ekianjo wrote: post #30

RobertRoberts wrote: post #4

Earlier quoted context omitted.

> If it were meaningless, FDAs and other regulatory bodies would not even accept it during the clinical trial design review phase. Go look up how many corporate stooges are in the place in the FDA over the years. A good starting point is the history of Aspartame, I'd link some articles, but I suspect the sources would be shot down and evidence ignored. The people at the FDA were complicit in its approval, despite sci…

Assuming the FDA is corrupted is one thing, assuming regulatory bodies ACROSS the world are all corrupted at the very same time is just very close to being a ridiculous claim.

Humans are the same everywhere. Corruption is universal.

Re: “Evidence-based medicine has been hijacked”: John Ioannidis (2016)

#78

Post by andreareina » Sat, Jul 06, 2019, 9:42 AM UTC

RobertRoberts wrote: post #76

andreareina wrote: post #18

Earlier quoted context omitted.

> I'd link some articles, but I suspect the sources would be shot down and evidence ignored Why would you say that? This is a serious accusation made without offering evidence and the only effect it can have is to greatly diminish the probability of having a productive debate.

If you feel like it, look at my previous comments, I post something with evidence and ad hominem attacks ensue. It's exhausting. I figure some people don't know about this, so they will look it up. People who are reactive will vote me down regardless of what I say or proof I provide. There is so much evidence of corporate manipulation of the high level government posts is nauseating.

I suspect that the sort of person who would be convinced to look it up and decide for themselves would be less likely to do so after reading the sort of comment I replied to.

Re: “Evidence-based medicine has been hijacked”: John Ioannidis (2016)

#79

Post by fuzz4lyfe » Sat, Jul 06, 2019, 2:45 PM UTC

jdietrich wrote: post #70

dalbasal wrote: post #34

Earlier quoted context omitted.

As a sales and marketing person... I'll admit to a lot of blame for a lot of bad things... definitely playing with words to they point where they mean very little. Selective publishing and "p-hacking" though, these are research/academia pathologies not marketing ones.

Study 329. GSK paid a PR company to ghostwrite a misleading paper, with the intent of concealing the fact that a) paroxetine is no more effective than placebo in the treatment of adolescent depression and b) paroxetine significantly increases the risk of suicide in adolescents. GSK knew that their drug was worse than useless, they knew that children would die as a result, but they deliberately withheld damning data a…

"Why is youth suicide skyrocking since we starting giving them all anti-depressants that have a suicide as a side effect?"

"Sounds like they need more anti-depressants"