http://www.usna.edu/ethics/publications/documents/GehmanPg1-28_Final.pdf

Think of it this way. If you are working for a pharmaceutical corporation, and you know there is this big effort to make this amazing, blockbuster drug, and your data is suggesting that maybe it’s not all it’s cracked up to be, what will you do? Your data may represent a threat to your department. Will you do what, years later, will seem to be the right thing, and tell people? Or do you do what might seem like the right thing now, and keep digging until the data stops looking like a problem? That’s more or less what he describes NASA doing with the information that foam shedding had very nearly destroyed Atlantis on ascent, two flights before Columbia’s final flight, when it missed a critical electronics box on an SRB by just a foot. That should’ve been a “ground the fleet” finding, but somehow good engineers who consider the astronauts family gradually massaged it until it became an acceptable anomaly rather than the very narrow escape from disaster that it actually was. If it happened there, it can happen in any organization. Normalizing anomalies so they go away and stop being a threat to your organization. I’m sure it happens in clinical trials too.

I bet you don’t even know what a rose smells like.

I assure you that I’ve used too much rose in a sherbet in just the past couple of months.

Oh, and Enovid looks to have taken about two and a half years.

How is that ‘ignorant criticism’ weing?

I’m not weing, but the assertion that “back in the 1950′s a drug was tested for 15+ years before put on the market” is nonsensical. The polio vaccine took about three years from initial testing to rollout. Mycostatin, about four years from isolation to production.

As has been pointed out, it is simply false to say that CAM works, because these problems exist in the pharmaceutical industry. Or vice-versa. One does not imply the other, even though otherwise very intelligent people that are dedicated to science and truth will seemingly make that leap with very little consideration as to what they are claiming.

I think it is incredibly important not to compromise ourselves by ever insinuating for a moment that the practice of medical research and the ways of the pharmaceutical industry are without fault. If we do, we commit a similar error to the one I described above, i.e. because CAM is quackery, then medical science is always a clear, unbiased and effective system for the treatment of patients. There are gaps in our knowledge not just because we haven’t made certain scientific discoveries yet. They exist, because of the less than ideal cultural and economic settings in which real practical medical science takes place.

That doesn’t mean that we give up on science-based medicine any more than it means that we turn to CAM for “cures” when medical science offers none. But I think people like to fit everything within a nice, neat narrative of “how the world works” when the world is simply messy and sometimes there are no good answers, at least not in the present moment.

Question: are antibiotics meant to be in our bodies without harm? If Rusty’s child were dying of bacterial pneumonia, would she reject antibiotics? If she accepted them, would it matter which one had been shown superior by clinical trials?

“now it is out of the factory today and tomorrow people are the “testors” not rats or guinea pigs.” etc. illustrates ignorant criticism.

“I’m glad to see that SBM isn’t ONLY bashing alternative medicine.”

You could have seen that a long time ago. In fact, my post from 3 days ago doesn’t mention anything about alternative medicine, and there are many, many other examples. We “bash” anything that is not good science, wherever we find it. It’s just that we find so much more of it in CAM!

Another point: there is less need to criticize mainstream medicine because it is already self-critical: the studies I cited in my article were all from mainstream medical journals. There is more of a need for criticism of CAM because it doesn’t criticize itself.

This is totally unacceptable. I have worked in the health care field for over
50 years, and back in the 1950′s a drug was tested for 15+ years before put on the market. As years passed the years shortened and now it is out of the
factory today and tomorrow people are the “testors” not rats or guinea pigs.
This is ludicrous and must stop. We need to make a statement to congress, who
by the way get paid to “look the other way”!!!!

Sorry, to be redundant, but, I just wanted to say also, it’s nice to see SBM actually bringing this out in topic! I wasn’t coming back for a while to give you all and myself a rest but, just thought I’d mention this here

I really can´t see supressing information as being the right way forward here. Mainly because the entire SCAM/Conventional-thing is a useless division (well, not in law). What we need to know is what works, and shoddy trials and literature should be exposed and picked to pieces no matter where it might come from.

As to the effects on the SCAM-community, I very much doubt anything will change most of their minds. THey´re already throwing around their conspiranoia, and all information like this does is show that the EBM and sceptic communities actually take fraud in the medical industry seriously. In addition it can be a handy way of introducing critical thinking to true believers.
I had a fellow student who was an acupuncturer and aromatherapist, and who “hated” big pharma and homeopathy (why on earth she chose our profession I´ll never know). I avoided the acupuncture for some time, feeding her with non-conspiranoia criticism of the pharmaceutical industry and gave her information on trials of homeopathy. It only took a term before she was coming to me asking why on earth I hadn´t shown her that acupuncture was bunk, and that her attacks on BP had been misguided. But of course, she was one of very few exceptions in my experience.

“However useful it will be as a critique, the sCAM believers will use this book as a pitchfork of fear to drive throngs of ill-informed consumers to their quasi-relgious belief system and away from real medicine–some of which has saved many lives and improved the quality of life for millions.”

I do hope you are not suggesting that the truth be suppressed because if its supposed adverse consequences.

Besides, it’s unknown what the consequences might be. It might actually result in a complete revamp of the pharmaceutical industry’s marketing arm. And a more ethical pharmaceutical inductry could result in a further marginalising of sCAM.

It is hardly ever bad move to tell the truth.

It seems to me that many of Goldacre’s concerns are even more problematic for psychosocial interventions where things like blinding and the accurate measuring of meaningful outcomes are often much more difficult, even for researchers unaffected by any bias or self-interest.

Case in point: early in the book Goldacre describes how Pharmacia/Upjohn successfully marketed reboxetine has safe and effective, when it had suppressed data that showed there was neither. This much of the story Goldacre got right. However, what he doesn’t say is that this drug company enlisted gadfly psychiatrist David Healy to promote reboxetine as safer and more effective than SSRIs. Healy conducted the dubious Normal Volunteers study with a handful of his his clinic staff serving as research participants. He claimed that a number of them became suicidal when switch from reboxetine to an SSRI. The article was published without any conflict of interest disclosure. The odds ratio for the link between SSRIs in suicidality in this study is absurdly high.

http://davidhealy.org/wp-content/uploads/2012/05/2000-Healy-Healthy-Volunteer-Suicide.pdf

Goldacre is far too cozy with uncritical of David Healy and got defensive when I posted on Twitter my account of David Healy and reboxetine. You can read it here.

https://dl.dropbox.com/u/23608059/martyrdom%20of%20healy.pdf

Although not perfect, Bad Pharma is still a damn good book.