In reply to Reach>Talent:
> (In reply to Shani)
> A simple understanding of the different kinds of trials is appropriate for most of the population and would help them in discussion with their GP when assessing claims made by drug manufacturers.
>
> No it isn't. Knowing what a double blind placebo controled trial is does not enable you to make a value judgement of the outcomes.
I was thinking of a case where an "off-label" prescription might be made.
> Pharma companies are auditted dozens of times a year, auditors can ask to see anything they want. They have access to trial details and are totally at liberty to disect the data. Several pharma companies already publish all their trial data.
Simply not true to imply that data is not gated and controlled selectively by the pharmaceutical industry. There is good research available on the problem of publication bias.
> You seem unaware of both the lethal consequences of the current status quo and the scale of the problem.
>
> I'd really like to know what the 'problem' is. I'd take a list of current "lethally ineffective" drugs as a starter.
Paroxetine (an antidepressant) prescription in children is a case in point. Found to be ineffective with a side effect of increase risk of suicide. Glaxosmithcline new about this problem but sat on the evidence allowing a further 300000 prescriptions to be made to children in the UK alone.
> We are paying pharma millions for some drugs that are at best worthless and at worst harmful.
As above.
> More testing would be nice, but would require a method of reducing the unit cost of trials. As animal methods are increasingly proving inneffective we need to engage in a much greater program of human trials. The problem is that we can't afford it. More research to reduce subjectivity in trials would also be beneficial, but doesn't work with a lot of common conditions (depression being a good example).
>
> We've already got a healthcare system that we can't afford, as a result there is a limited scope for introducing larger and more complex safety nets into the system. I'm all for transparency but you can't solve everything by throwing lots of data into the public domain, if a million monkeys can't turn out a work of Shakespeare they certainly won't turn out a meta-analysis.
Saying "we can't afford it" exposes us to quackery and woo. It doesn't matter whether the claimed cure is coming from a new-age hippy or pharma - if it isn't evidence based then we should be skeptical about prescribing it. 'Throwing lots of data into the public domain' solves the problem in that appropriate organisations like Cochrane can peer review. This is the scientific method.