This example below shows the dangers of cherry picked and buried data. It shows how great news and joy can be reported from rancid results, and the only protection against this is open access. When the taxpayer funds research that is not fully and transparently public, and immediately available, the people are funding PR rather than science. “Peer review” does little to stop this, little to clean up the mess after it happens, and the truth can take years to be set free.
Ten percent of teenagers taking an anti-depressant harmed themselves or attempted suicide. This was ten times the rate of the teens on the placebo. The results of this clinical trial were published in 2001, but those alarming statistics were not reported. The drug went on to be widely used. A new reanalysis of the data, reported in the BMJ, revealed the dark and hidden dangers. The company that funded the research, Glaxo Smith Kline, has already faced record fines of $4.2 billion. The Journal of the American Academy of Child and Adolescent Psychiatry won’t retract the paper.
There are many ways to hide data. In this case, the results of the trial include 80,000 records which were [...]
Was that a half-truth or a lie by omission? Trick question…
Malcolm Kendrick reports on a new study that he says should “shake the foundations of medical research” but laments that it almost certainly won’t.
In the year 2000, the US National Heart Lung, and Blood Institute (NHLBI) insisted that all researchers register their “primary aim” and then later their “primary outcome” with clinicaltrials.gov. This one small change in the way medical studies were reported transformed the “success” rates in peer reviewed papers. Before 2000, fully 57% of studies found the success they said they were testing for, but after that, their success rate fell to to a dismal 8%. When people didn’t have to declare what their aim was, they could fish through their results to find some positive, perhaps tangential association, and report that as if they had been investigating that effect all along. The negative results became invisible. If a diet, drug or treatment showed no benefit at all, or turned up bad results, nobody had to know.
The world of peer reviewed climate research: like a universe of dark matter
It’s not like climate science suffers from unpublished “negative results” — no, it’s more [...]
If the “leech” doctors circa 1000AD were able to treat superbugs that modern doctors struggle with, I wonder what other knowledge has come and gone and had to be rediscovered?
How many lives have been lost because information was not there when they needed it?
Image: © The British Library Board (Royal 12 D xvii)
Judith Curry posted a link this week to a story about a medieval recipe for an “eyesalve” that rather surprised researchers when it worked against the ghastly MRSA superbug, which is resistant to almost all modern antibiotics.
The book is one of the earliest known medical texts, called Bald’s Leechbook. The recipe called for garlic, onion, wine, and bile from a cow. It was very specific — the mix had to be brewed in brass and then left for nine days. The researchers at the University of Nottingham followed it closely, then it was tested in the lab. Will it work on people, and what are the side-effects?
The word revolution is overused and done to death. But in the case of medicine, we are in the midst of one. Here are three stories just out this week. It’s possibly none of these will end up being useful clinically, but the sheer volume of results like these mean that sooner or later getting a diagnoses of cancer will mean something very different. It’s time for good news stories. Let’s redirect the gravy train of pointless climate and renewables research. (Sell the ABC and use the money to double our medical research budget. How many lives might we change?*)
These are not instant miracles, but potential ones. The bladder cancer drug ultimately helped about a quarter of all patients. It was a small trial. Two patients of 68 appeared to reach the holy grail: to be tested free of cancer (though it doesn’t mean they are). The second news report talks about a small study targeting a similar mechanism to stop melanoma that only helps about 30% of patients — the study successfully predicted which ones. In both cases the idea is to stop the cancer from hiding from the immune system. Some cancer cells produce molecules called PD-1 [...]
The New Yorker has the best article I have read yet on the Ebola outbreak. Finally we get human story and details of how this outbreak started and spread, along with the outstanding heroic efforts of those on the front line. The article has details on everything, the genetics, the virology, the story of escalating fear as health workers started to get infected, and the hard decisions.
Who would get doses of ZMAPP, and which other experimental therapies would be tried? ZMAPP is the genetically engineered copy of antibodies against Ebola, and it does appear to be useful, even though it has not been properly tested. Kent Brantly, the US doctor who contracted Ebola, improved within hours of receiving ZMAPP. His recovery was so fast his medical staff wondered if it were possible, but his colleague Nancy Writebol did not show the same progress.
Know thy enemy: only six proteins and one line of code, yet so incredibly deadly. The virus is not one virus, but a swarm of particles — an evolving population.
Since Ebola makes errors as it replicates, each genome was like a hand-copied text, and detectable differences would emerge among the genomes; there isn’t [...]
In case you’ve missed this — stem cells have been used to partially restore movement in a 38 year old man who had his spinal cord completely severed by a knife attack in 2010. The cells came from his nose, and are technically olfactory ensheathing cells (OEC). They are unique cells — the only nerve fibres we know of that grow and make connections with the central nervous system. It’s no magic instant bullet, but a first step. It’s taken 19 months of intensive rehab after the transplant, but he is now able to drive. It’s not known if this procedure can help with paralysis caused by other, more messy causes of spinal breaks. The stab wound was a very clean cut.
It is almost 30 years since Prof. Geoffrey Raisman first identified the potential of OEC’s to repair nerve damage in mice. In November 2012 researchers in Edinburgh were able to restore a dogs ability to move hind legs.
Speaking earlier today Geoffrey Raisman described the results as “more impressive than man walking on the moon”. — speakingofresearch
There are at least three different methods of possibly curing paralysis which have all made announcements this year. In May [...]
I am glad that Nigeria is officially free of Ebola now. The story is reassuring. New outbreaks of Ebola are stoppable. But the numbers are sobering. They show how far gone the situation is in West Africa.
The index patient (as the source of the outbreak is known) arrived in Lagos, a megacity of 21 million people, on July 20th — a recipe for disaster. Over the next six weeks 19 further people were diagnosed with Ebola. The death toll was eight people, many of them health workers. Those infected generated 989 contacts, and it took 18,500 in-person, follow up visits to make sure that the virus did not spread further.
Translate those ratios to West Africa, where the latest WHO situation report shows there were 2,638 new cases between September 26 and October 17. In Nigeria, each infected person on average generated 50 contacts, and each contact generated 18 follow-up visits. This is only the roughest of ballpark estimates, but if the ratios were similar, it means that solving the spread in Liberia, Sierra Leone, and Guinea would generate 130,000 contacts and require 2.4 million follow-ups in the next three weeks. By mid November that will double. Obviously things [...]
Compare the response of The Firestone Rubber Plantation in Liberia to the Hospital in Dallas, Texas.
The rubber plantation has 8,000 workers with 71,000 dependents. It is an hour north-east of Monrovia, surrounded by Ebola outbreaks. The virus arrived on the plantation in March. Knowing that the UN and the Liberian government were not going to save them, the managers sat around a rubber tree and googled “Ebola” and learned on the run instead. They turned shipping containers into isolation units, trucks into ambulances, and chemical cleaning suits into “haz-mat” gear. They trained cleaners, and teachers, they blocked visitors, and over the next five months dealt with 71 infections, but by early October were clear of the virus. There were only 17 survivors (the same 70% mortality rate as elsewhere). But without good management, there could have been so many more deaths.
In contrast, the nanny-state takes a good brain and stops it thinking. In Texas, trained health professionals were caught unprepared, following inadequate protocols they assumed were good enough, and even risking their own lives. A nurse who cared for a dying Ebola patient — and knew how bad Ebola could be — still needed to phone someone to [...]
The bad news -Medecins Sans Frontieres (MSF) said the disease was still out of control. Thanks to the mistake with a plane, a few US schools have closed, and whole neighborhoods are being roped off. How fast does a 19Kb string of information spread? Outside Africa, Norway has one case, Germany has had one death, one survivor, and one case. Spain has lost two, and is treating one. France and the UK have a survivor each. Today, at least, Senegal has been declared free of Ebola.
The WHO organization has admitted it botched the Ebola outbreak in West Africa.
“In a draft internal document obtained by The Associated Press, the agency says “nearly everyone” involved in the response failed to notice the potential for Ebola’s explosive spread.
The agency acknowledged that its own bureaucracy was a problem, pointing out that the heads of WHO country offices in Africa are “politically motivated appointments” made by the WHO regional director for Africa.”
The good news – CSL have said they will develop a plasma product from survivor’s blood. At the moment this is the most pragmatic possible treatment. There are 3000+ survivors who have antibodies, which [...]
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