When science is marketing

(Alec) #1

Just got this email from Chris Kresser. I thought it was an interesting insight into our trial and research industry.

Hi, Everyone,

In a perfect world, medical research would be free of commercial influence and bias.

Researchers would objectively and dispassionately pursue the truth, and the results of their work would be reliably reported regardless of the outcome.

Unfortunately, that’s not the world we live in.

Drummond Rennie, a nephrologist and deputy editor at JAMA , explains how drug trials are often more like marketing campaigns than scientific investigations:

Before the approval process, the sponsor [drug company] sets up the clinical trial—the drug selected, and the dose and route of administration of the comparison drug (or placebo). Since the trial is designed to have one outcome, is it surprising that the comparison drug may be hobbled—given in the wrong dose, by the wrong method?

The sponsor pays those who collect the evidence, doctors and nurses, so is it surprising that in a dozen ways they influence results? All the results flow in to the sponsor, who analyzes the evidence, drops what is inconvenient, and keeps it all secret—even from the trial physicians.

The manufacturer deals out to the FDA bits of evidence, and pays the FDA (the judge) to keep it secret. Panels (the jury), usually paid consultant fees by the sponsors [drug companies], decide on FDA approval, often lobbied for by paid “grass-roots” patient organizations who pack the court [that trick is called “astroturfing”].

If the trial, under these conditions, shows the drug works, the sponsors pay subcontractors to write up the research and impart whatever spin they may. They pay “distinguished” academics to add their names as “authors” to give the enterprise credibility, and often publish in journals dependent on the sponsors for their existence.

If the drug seems no good or harmful, the trial is buried and everyone reminded of their confidentiality agreements. Unless the trial is set up in this way, the sponsor will refuse to back the trial, but even if it is set up as they wish, those same sponsors may suddenly walk away from it, leaving patients, and their physicians, high and dry.

In short, we have a system where defendant, developers of evidence, police, judge, jury, and even court reporters are all induced to arrive at one conclusion in favor of the new drug. [emphasis added]

Does this seem like a good idea to you?

In health,

(Bob ) #2

It doesn’t sound like a good idea, but I don’t know of any other way to do it.

Running tests is outrageously expensive and the drug companies are probably the only groups with the money to do them. Even then, things we’d like to see done are arguably so expensive that they’ll never be done. Things like putting 200,000 people into randomized controlled experiments with 100,000 on keto and the other half on the SAD or vegetarian or something else - and keeping the the experiment going for 20 years or more. Providing their food, controlling for their activity and a hundred other things.


Sounds like america :upside_down_face: