Medical science is in trouble.

Overdo$edAmerica is a great read. The author Dr Abramson was a family gp for 20 odd years a few ks outside Boston. He was involved with the university teaching medical students. He gave up Gp work to find out why the medical journals he was used to relying on were publishing stuff that seemed to have the welfare of the drug companies in mind rather than the well being of people.

With his research training he was able to spot, for example, a claimed significant relative benefit which was in fact no better than placebo. Why would a journal of such repute publish this stuff? Something is going on.

The claim - a statin - lipid lowering medication - WonderDrug gives a 18% reduction of stroke. Sounds good!! (The real figure was 16%, not 18%, and 16% in this context wasn't statistically significant) Anyway over 6 years 4.5% of people who took placebo had strokes compared to 3.7% who took Wonderdrug. There is an 18% reduction from 4.5 to 3.7. I think this is how it works!! In absolute terms this means if 100 people take WonderDrug for six years 0.8 of them won't have a stroke - keep in mind that maybe this finding is a matter of chance. The cost of saving this eighth of a life was 1.2 million dollars!!!

The average age of the people in the above study was 62. In the real world the average age of men having strokes is 71 and for females it's 79. What Abramson found - patients in this study aged over 70 taking WonderDrug had 21 percent more strokes than those on placebo. WonderDrug causes more strokes in the at risk population!!! That's cool.

How about his next little goodie - for all the women in this study those taking WonderDrug had 26 percent more strokes than women taking placebo!!! That's cool too.

Abramson states that other studies show that eating fish once a week reduces risk of stroke by 22%. Controlling blood pressure reduces risk by 35 to 45 percent. Less than two hours a week of moderate exercise reduces risk of stroke by about 60%.

He takes a look at Celebrex and Vioxx, HRT and other drugs and slams how evidence is spun and twisted out of shape. Are Celebrex and Vioxx safer than good old voltaren?? The information your doctors rely on has become more and more promotional. Follow the money. Where there should be objectivity there is $$$$$$$$$$s?? It's a scary book. Buy it and find out. You thought your doctor was a front man for the drug companies - looks like he os she is!

Years ago a drug rep told me over a beer that he was working on getting the consultants in my local hospital to use drug X. They don't listen to you I told him. Those illustrious men and women have IQs way up there in the clouds. They are independent thinkers. They get their information from the journals. Maybe they do he said but we influence their prescribing habits.

He pulled out of his brief case some flashy looking graphs. These showed a steady uptick over time as he and his mates plied their skills on the doctors in various regions of England.

They think they are free thinkers, he said. But they aren't. We repeat this trick wherever we go.