We Told You The Important Parts!
“Evidence-based medicine is valuable to the extent that the evidence base is complete and unbiased. Selective publication of clinical trials — and the outcomes within those trials — can lead to unrealistic estimates of drug effectiveness and alter the apparent risk–benefit ratio.”
“Medical decisions are based on an understanding of publicly reported clinical trials….If the evidence base is biased, then decisions based on this evidence may not be the optimal decisions.”
“Overall, the studies that the FDA judged as positive were approximately 12 times as likely to be published in a way that agreed with the FDA analysis as were studies with nonpositive results according to the FDA.”
“We found a bias toward the publication of positive results. Not only were positive results more likely to be published, but studies that were not positive, in our opinion, were often published in a way that conveyed a positive outcome.”
“According to the published literature, the results of nearly all of the trials of antidepressants were positive. In contrast, FDA analysis of the trial data showed that roughly half of the trials had positive results.”
“Selective reporting…waste resources and the contributions of investigators and study participants, and they hinder the advancement of medical knowledge.”
“By altering the apparent risk–benefit ratio of drugs, selective publication can lead doctors to make inappropriate prescribing decisions that may not be in the best interest of their patients and, thus, the public health.”
I think it’s safe to say that when making the decision to prescribe or use a particular drug, in this case of the so called anti depressant variety, one needs to take into consideration the possibility that not all of the relevant information has been made available to you.
Many doctors today rely upon meta analysis to justify their decisions, without looking at the methods used in the individual studies included, and often not taking into consideration the vast number of studies that may have failed to make it to publication due to a bias against negative results, which exists for variety of reasons, protection of highly profitable new products likely being one.
Have you ever questioned the basis upon which your doctor has made the decision to prescribe one particular drug over another?
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Image “Week Five-Face of depression..,” by Jessica B, via Flickr