I just got your book today; started reading it after dinner; and kept on going until I was done. It has inspired me to enhance my efforts to reduce the influence of big pharma on the clinical practice guidelines, clinical research, and prescription habits of pulmonary specialists. During my 20 years of practice, I have seen all of this first-hand. Thanks for taking the time to research and write this superb book. P.E., MD
Dear Dr. P.E.,
Thanks for your comments. Even after spending 4 years in front of a computer what feels like 24/7 trying to unravel the commercial bias intruding into medical care, I am constantly surprised. Like this example that I missed the first time around from the recent JAMA meta-analysis about statins and cancer:
The article concluded:
"CONCLUSIONS Statins have a neutral effect on cancer and cancer death risk in randomized controlled trials. We found that no type of cancer was affected by statin use and no subtype of statin affected the risk of cancer.
But this is just not true. The following table, from the same article shows a 33% statistically significant increase in the risk of breast cancer:
Table 2. Subgroup Analysis
____________________No. of Events/ ______________________
_________________Total No. of Participants __________________
Outcome____No. of___Statin___Control____Odds Ratio ___Q Stat__
Measures___Studies___Group___Group____(95% Conf) ___P Value_
Breast cancer __ 5 ___ 81/16875 __ 64/16901 __ 1.33 (0.79-2.26) ___ .047
This is a particularly important finding, given the lack of evidence of benefit of statins for primary prevention. And even for secondary prevention in women, statins reduce further CV events and mortality, but have not been shown to reduce overall mortality.
You are doing a great service to your patients by your dedication to real scientific evidence. But, I know this is a real challenge because the commercial and sociological currents are strong going in the other direction.
Wishing you all the best,
Overdosed America Paperback Edition Available
"Some of the nation's worst drug dealers aren't peddling on the street corners, they're occupying corporate suites. Overdosed America reveals the greed and corruption that drive health care costs skyward and now threatens the public health. Before you see a doctor, you should read this book." - Eric Schlosser, author of Fast Food NationBuy on Amazon | Buy on Barnes & Noble