{"id":34712,"date":"2013-03-28T19:27:24","date_gmt":"2013-03-28T23:27:24","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=34712"},"modified":"2013-03-28T19:31:35","modified_gmt":"2013-03-28T23:31:35","slug":"there-its-solved","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2013\/03\/28\/there-its-solved\/","title":{"rendered":"there, it&#8217;s solved&#8230;"},"content":{"rendered":"<div align=\"justify\">I had already thought about doing this, but reading <strong><font color=\"#200020\">David Healy<\/font><\/strong>&#8216;s most <a target=\"_blank\" href=\"http:\/\/davidhealy.org\/not-so-bad-pharma\/?utm_source=feedburner&#038;utm_medium=email&#038;utm_campaign=Feed%3A+DrDavidHealy+%28Dr.+David+Healy%29\">recent post<\/a> means that I&#8217;ll probably go through with it. The &quot;it&quot; is to read <strong><font color=\"#200020\">Ben Goldacre<\/font><\/strong>&#8216;s <a target=\"_blank\" href=\"http:\/\/www.amazon.com\/Bad-Pharma-Companies-Mislead-Patients\/dp\/0865478007\">Bad Pharma<\/a> and <strong><font color=\"#200020\">David Healy<\/font><\/strong>&#8216;s <a target=\"_blank\" href=\"http:\/\/www.amazon.com\/Pharmageddon-David-Healy\/dp\/0520270983\">Pharmageddon<\/a> in tandem, one right after the other. I like both of them, but their takes on this topic are not so much just different, but maybe from different planets. In his recent post, Dr. Healy makes the case that Dr. Goldacre is playing into the hands of the pharmaceutical industry by suggesting that the true path is reforming clinical trials. His take is that clinical trials themselves are the problem. Something like once you accept randomized clinical trials [RTC] as the gold standard, you&#8217;re finished, and PHARMA has you in their clutches. Says <a target=\"_blank\" href=\"http:\/\/davidhealy.org\/not-so-bad-pharma\/?utm_source=feedburner&#038;utm_medium=email&#038;utm_campaign=Feed%3A+DrDavidHealy+%28Dr.+David+Healy%29\">Healy<\/a>:<\/div>\n<blockquote>\n<div align=\"justify\"><sup><strong><em>Bad Pharma<\/em> calls for more regulations but the more  regulations there are the stronger industry becomes. The Chinese sage  Chuang Tzu caught the dilemma beautifully in 323 BC:<\/strong><\/sup><\/div>\n<div align=\"justify\">\n<ul>\n<div><sup><strong><em>&ldquo;For  security against robbers who snatch purses, rifle luggage, and crack  safes, one must fasten all property with ropes, lock it with locks, bolt  it with bolts. This is elementary good sense. But when a strong thief  comes along he picks up the whole lot, puts it on his back, and goes on  his way with only one fear; that ropes, locks and bolts may give way.&rdquo;<\/em><\/strong><\/sup><\/div>\n<\/ul><\/div>\n<div align=\"justify\"><sup><strong>The problem for healthcare worldwide goes back to a set of  regulations &ndash; the 1962 amendments to the US Food and Drugs Act put in  place following Thalidomide.<\/strong><\/sup><\/div>\n<\/blockquote>\n<div align=\"justify\">The stimulus for Dr. Healy&#8217;s post was a request that he write a review of <a target=\"_blank\" href=\"http:\/\/www.amazon.com\/Bad-Pharma-Companies-Mislead-Patients\/dp\/0865478007\">Bad Pharma<\/a>. When he did, they turned it down:<\/div>\n<blockquote>\n<div align=\"justify\"><sup><strong>The invitation from the London Review of Books to review Ben Goldacre&rsquo;s <em>Bad Pharma<\/em>&trade; reads:<\/strong><\/sup><\/div>\n<ul>\n<div align=\"justify\"><sup><strong>&ldquo;We were  unsure, at first, what a review could add that isn&rsquo;t already in the book  &ndash; scrappy summaries and bits of praise are not for us. The book is of  sufficient importance that the main thing is to get someone who knows  what they&rsquo;re talking about to present the material confidently.. frame  the discussion&rdquo;.<\/strong><\/sup><\/div>\n<\/ul>\n<div align=\"justify\"><sup><strong>My head said it was inconceivable that the LRB wouldn&rsquo;t take a  review, even if it was at odds with the invitation to praise Bad Pharma.  But my gut told me the inconceivable was about to take flesh.<\/strong><\/sup><\/div>\n<p align=\"justify\"><sup><strong>Sure enough LRB turned down the review.&nbsp;Because, they said, their  readers would be baffled by it &ndash; piquant given that LRB specializes in  complex reviews of the esoteric and the obscure.<\/strong><\/sup><\/p>\n<div align=\"justify\"><sup><strong>Now it is unfair to say that if Ben Goldacre didn&rsquo;t exist, Andrew  Witty, the CEO of GlaxoSmithKline, might have had to invent him.&nbsp;But it  needs something like this to flag up how perilous our position is and  how paradoxical &ndash; seemingly beyond the capacity of the editors of LRB to  follow.&nbsp;This rejected review will puzzle some, and perhaps annoy those  it doesn&rsquo;t puzzle because it leaves answers for another day.<\/strong><\/sup><\/div>\n<\/blockquote>\n<div align=\"justify\">His review follows in his post, and you&#8217;re on your own here. Having read his book, I sort of get his point, but I&#8217;m only on the edge, not totally <em>un&middot;puzzled<\/em>, thus my resolution to reread both books. There is some dialog between the two in the comments to the post.   <\/div>\n<p align=\"justify\">I don&#8217;t have any problems personally with their disagreements. I agree with both Ben&#8217;s determination to make the clinical trial world play things straight and David&#8217;s point that RTCs aren&#8217;t the do-all and be-all of scientific truth [being a case study person all on my own]. But I still think the right thing to&nbsp; do is read their books back to back. Can two right-thinking people who are approaching the same problem but have radically different approaches to the solution both be right?<\/p>\n<div align=\"justify\">Sure. And this, to me, is a fine example of a case where that seems to be true. Make the clinical trial world play it straight, and, by the way, don&#8217;t over-value clinical trials. There, it&#8217;s solved&#8230;<\/div>\n","protected":false},"excerpt":{"rendered":"<p>I had already thought about doing this, but reading David Healy&#8216;s most recent post means that I&#8217;ll probably go through with it. The &quot;it&quot; is to read Ben Goldacre&#8216;s Bad Pharma and David Healy&#8216;s Pharmageddon in tandem, one right after the other. I like both of them, but their takes on this topic are not [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-34712","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/34712","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=34712"}],"version-history":[{"count":5,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/34712\/revisions"}],"predecessor-version":[{"id":34717,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/34712\/revisions\/34717"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=34712"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=34712"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=34712"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}