Sep 07 2009
Doug Bremner has a blog. That blog stinks.
Bremner is an apparently well-regarded psychiatrist, and takes a refreshing look at the influence of industry not just on pharmaceuticals but on the conduct of science itself. His outspoken views have led to attempts to squelch his academic freedoms. But his sometimes-heroic record does not excuse dangerous idiocy.
I can understand how wading into the cesspool that is conflict of interest can leave one cynical. But cynicism and suspicion turned up to “11″ is no longer bravery—it’s crankery. It’s not his snarkiness that burns—it’s his inability to separate his biases from the facts.
It’s not like the pharmaceutical industry doesn’t deserve to be taken to the wood shed. Examples of unethical and downright immoral practices abound, such as ghost-writing, fake journals, and a host of other sins. But the industry has also helped develop a most remarkable pharmacopeia which saves and improves countless lives. There is good, and there is bad. And telling the two apart, well, that makes all the difference.
He tends to go for headlines that hit hard, but miss the point entirely. Examples:
- Angioplasty Found to be Useless Waste of Money: he cites a journal article which he says concluded that “not useful for patients with stable coronary artery disease (CAD). ” His title would be accurate if angioplasty were used only in stable CAD—it is not.
- Should I Take Aspirin or Put a Gun To My Head?: here, he sort of gets the difference between primary and secondary prevention, but not really. He also likes to admit that the data contradict his conclusion but he’s nice enough to say, “screw the data”:
Although technically the risk of stomach bleeding is outweighed by the heart benefits of aspirin (which can only be shown when large numbers of patients are studied), in terms of what that means to you the differences are clinically meaningless.
- This Just In: Breast Cancer Screening Essentially Useless: yes, Doug, breast cancer screening doesn’t benefit everyone equally. For example, the prevalence of breast cancers in men is low enough that recommending it for you would be stupid—like your article.