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April 28, 2006

Times writer exposes fraud in clinical trials

At least 70 pharmaceutical drugs are on the market after passing clinical trials based on fraudulent data provided by a California doctor, said Kurt Eichenwald, an investigative reporter for The New York Times.

Eichenwald, author of "Conspiracy of Fools: A True Story," about the Enron scandal, spoke Tuesday night at Williams College on "Clinical Trials in the Era of Corporate Medicine: Promise and Benefit, Betrayal and Fraud," focusing on how corporate interests influence clinical trials for new medicines.

He gave an as example a Southern California doctor who became the largest medical researcher with a private practice in the western United States, but ended up in jail after his fraudulent practices were revealed.

"After four or five years in the business, he and his wife lived in a mansion. They both drove Mercedes and they were building their dream home in the Caribbean," Eichenwald said.

The problem was, he said, the doctor had figured out how to lie and cheat and get the money he wanted. In one drug study, people with a particular protein level in their urine were needed. This doctor found one person with that level of protein in her urine and gave her $25 a bottle to be used to admit those who were not qualified into a study, he said.

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April 27, 2006

What's Triggering Your Migraine?

There are a lot of prescription painkillers that relieve migraine headaches. But neurologist David Buchholz of Johns Hopkins University takes his headache patients off the drugs.

"I tell people to use the power they have in their own hands to control their headaches," says Buchholz.

Many headache doctors advise their patients to avoid certain foods and beverages. Caffeine, MSG and chocolate are usually at the top of the list. But Buchholz' list includes many more food products.

Donna Sees first made an appointment to see Buchholz three years ago. At the time, she was suffering with daily headaches. Many of them left her holed-up in her dark bedroom.

"I was in bed. I couldn't stand the light or noise. I couldn't stand to be out in the sun," says Sees. "My head was ready to blow up."

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Why Most Published Research Findings Are False

John P. A. Ioannidis

John P. A. Ioannidis is in the Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece, and Institute for Clinical Research and Health Policy Studies, Department of Medicine, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts, United States of America.

Summary
There is increasing concern that most current published research findings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance. Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias. In this essay, I discuss the implications of these problems for the conduct and interpretation of research.

The rest of the essay can be found here.

April 26, 2006

Fact

When doctors test, they have criteria that determine if something is a placebo. It needs to be effective more than 30 percent of the time. Interestingly enough, using chemotherapy for one cancer is beneficial less than 1 percent of the time, which would make it one of the biggest placebos in history. Yet, they recommend it when anyone has lung cancer.

Chemotherapy: The Good, the Bad, and the Ugly

For those of you who are new to the debate, let me explain some of the pros and cons of chemotherapy. Unfortunately, there is a high probability that you or someone you know will have to face the decision on how to treat cancer.

Before we get into how chemotherapy works, it’s probably worth a little digression to talk about its history. The first drug used for cancer chemotherapy was not originally intended for that purpose. Mustard gas was used as a chemical warfare agent during World War I and was studied further during World War II. During a military operation in World War II, a group of people were accidentally exposed to mustard gas and were later found to have very low white blood cell counts. It was reasoned that an agent that damaged the rapidly growing white blood cells might have a similar effect on cancer. Therefore, in the 1940s, several patients with advanced lymphomas (cancers of certain white blood cells) were given the drug by vein, rather than by breathing the irritating gas. Their improvement, although temporary, was remarkable. That experience started researchers studying other substances that might have similar effects against cancer.

Chemotherapy is used to kill cancer cells anywhere in the body, including cells that have broken off from a main tumor and traveled through the blood or lymph systems to other parts of the body. Many doctors have successfully slowed cancer cells by using chemotherapy after a tumor has been surgically removed . How does it work? Chemotherapy drugs are cytotoxic, meaning they poison the cells in our body that multiply the most rapidly, which is how the majority of cancer cells perform. So, if your cancer cells are rapidly multiplying, you may find chemotherapy effective.

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Beware - High Fructose Corn Syrup

Until the 1970s most of the sugar we ate came from sucrose derived from sugar beets or sugar cane. Then sugar from corn—corn syrup, fructose, dextrose, dextrine and especially high fructose corn syrup (HFCS)—began to gain popularity as a sweetener because it was much less expensive to produce. High fructose corn syrup can be manipulated to contain equal amounts of fructose and glucose, or up to 80 percent fructose and 20 percent glucose.2 Thus, with almost twice the fructose, HFCS delivers a double danger compared to sugar.

(With regards to fruit, the ratio is usually 50 percent glucose and 50 percent fructose, but most commercial fruit juices have HFCS added. Fruit contains fiber which slows down the metabolism of fructose and other sugars, but the fructose in HFCS is absorbed very quickly.)

In 1980 the average person ate 39 pounds of fructose and 84 pounds of sucrose. In 1994 the average person ate 66 pounds of sucrose and 83 pounds of fructose, providing 19 percent of total caloric energy.3 Today approximately 25 percent of our average caloric intake comes from sugars, with the larger fraction as fructose.4

High fructose corn syrup is extremely soluble and mixes well in many foods. It is cheap to produce, sweet and easy to store. It’s used in everything from bread to pasta sauces to bacon to beer as well as in “health products” like protein bars and “natural” sodas.

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