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Healthy Skepticism Library item: 16968

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Godlee F, Clarke M
Why don’t we have all the evidence on oseltamivir?
BMJ 2009 Dec 8;
http://www.bmj.com/cgi/content/extract/339/dec08_3/b5351


Abstract:

The full data from drug trials must be available for scrutiny by the scientific community

This week the BMJ publishes an updated Cochrane review on neuraminidase inhibitors in adults with influenza.1 The review and a linked investigation undertaken jointly by the BMJ and Channel 4 News2 cast doubt not only on the effectiveness and safety of oseltamivir (Tamiflu) but on the system by which drugs are evaluated, regulated, and promoted.

In the process of updating their review, Jefferson et al found several important inconsistencies. Prompted by a reader of their previous update,3 they attempted to reconstruct the evidence from a much cited analysis on which they had based their previous conclusions. The analysis, by Kaiser et al,4 looked specifically at the effects of oseltamivir on the risk of hospital admission and complications (pneumonia and other lower respiratory tract infections) in people with influenza. Jefferson et al noted that the Kaiser analysis was funded by the drug’s manufacturer Roche and was based entirely on 10 trials . . .

 

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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963