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Healthy Skepticism Library item: 6915

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

Redelmeier DA.
Drug dependence in a journal club.
ACP J Club 1999 Nov-Dec; 131:(3):A13-4


Abstract:

Redelmeier expressed concern that, by running a journal club for hospital house-staff, he has unwittingly given a large amount of promotion to the pharmaceutical industry. The problem is that reliance on staff preferences resulted in disproportionate attention to therapeutic studies, the desire for rigor created an affinity for RCTs, and drug trials dominated because of their desirable methodological characteristics such as large sample sizes and double-blinding. These three factors favoured studies funded by drug companies. The problem will not go away soon. Regulatory and commercial interests conspire to perpetuate it. Redelmeier encouraged clinician-teachers who run journal clubs to guard against this trend and sometimes choose less popular articles, including studies other than drug trials. More generally, he expressed concern that the appeal of rigorous evidence may tempt people to only ask questions that are easily answered.

Keywords:
*editorial/Canada/United States/ Drug Therapy* Education, Medical, Continuing*

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909