Saturday, June 17, 2017

Fake News, Medical Edition

There is something that’s not quite fake news, but possibly more dangerous, in the world of medicine.

First, what would you think if you had chronic knee pain and came across this intriguing item?
High quality (pharmaceutical grade) chondroitin sulfate is as good as a widely prescribed non-steroidal anti-inflammatory drug (celecoxib) for the treatment of painful knee osteoarthritis, according to a British study published in the Annals of Rheumatic Diseases.
Your reaction might be something along the lines of “Sign me up for that!” Especially when, upon doing a little investigating, you discover that chondroitin sulfate is an over-the-counter supplement – much cheaper and easier to obtain than celecoxib. What’s more, it’s naturally found in cartilage.

The problem is, high-quality studies have found it’s basically useless, just like glucosamine.

So what’s going on with this new study? I was curious and tracked down the full write-up here. But I wasn’t looking for details such as the number of people who took part, the methodology, confidence intervals for the results, etc.

This time, I was looking for something different: a certain taint that is increasingly a problem with published clinical studies. It took me a lot of – I mean, a LOT of – scrolling to find it. But at the end, neatly dropped in like an insignificant afterthought, there it was:
The study was sponsored by IBSA Institut Biochimique SA, Pambio-Noranco, Switzerland, a pharmaceutical company marketing Chondroitin Sulfate. The manuscript was entirely written by the first Author (JYR) who received an editorial assistance from IBSA. However, IBSA has no influence on the content of the manuscript. The editorial assistance was limited to the final editing of the manuscript and the submission process through the ARD website.
Which raises a host of questions: (1) If the study happened to find that chondroitin sulfate was useless, or even worse, harmful in some way, would the results have just been quietly quashed? (2) How exactly was this study “sponsored”? How much money did the principal researchers receive? Are we to believe that the knowledge of who is writing their paychecks really has no influence on how this study is conducted and reported? (3) What exactly was the nature of this “editorial assistance” that was provided?

Upton Sinclair once wrote wisely: “It is difficult to get a man to understand something, when his salary depends on his not understanding it.”

This study is not quite that kind of situation. But it’s a cousin to that kind of situation.

1 comment:

  1. Well written, Richard. It's been dawning on me how prevalent such irresponsible and biased publishing has become, and how readily the public accepts it because they lack the critical and analytical thinking skills to properly evaluate what they read. The media is of no help either when they cherry-pick data in order to produce their stories. As my husband is fond of saying with more than a hint of sarcasm, "It's on TV. It must be true!" The public seem to accept most of what they read without questioning the motivation of the author, or conversely, without stopping to wonder if there might be conflicting information out there that someone had a vested interested in burying.