We Told You The Important Parts!

'Science' 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.” (Turner, EH, et al., 2008)

I think it’s safe to say that when deciding to prescribe or use a particular drug, in this case, the so-called antidepressant variety, one needs to consider the possibility that not all of the relevant information has been made available to you.

Many doctors rely upon meta-analysis to justify decisions without looking at the methods used in individual studies. And they need to consider the vast number of studies that do not get published, perhaps due to a bias against negative results, which exists for various reasons, the protection of highly profitable new products likely being one.

What is the basis upon which most doctors make decisions regarding prescribing one particular drug over another?

Copyright 2021, by Dan M @ CowsEatGrass. All rights reserved (except for quotations and images having their own protected copyrights). This copyright protects author-publisher Dan M’s right to future publication of his work in any manner, in any and all media — utilizing technology now known or hereafter devised — throughout the world in perpetuity. Everything described in this publication is for information purposes only. The author-publisher, Dan M, is not directly or indirectly presenting or recommending any part of this publication’s data as a diagnosis or prescription for any ailment of any reader. If anyone uses this information without the advice of their professional health adviser, they are prescribing for themselves, and the author- publisher assumes no responsibility or liability. Persons using any of this data do so at their own risk and must take personal responsibility for what they don’t know as well as for what they do know.

See more here

Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R. Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med. 2008 Jan 17;358(3):252-60.

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#prescriptionpotluck

Image “Week Five-Face of depression..,” by Jessica B, via Flickr

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