What causes disease

[Buckeyefan 1]

Don't wait. Do as the voodoo peddlers are marketing. You do have a choice. We all do. That is why there is such a huge market for these voodoo products, both medical and audio. How is it different from audio voodoo? Exactly the same. Gullible people buy into it thinking that there must be a conspiracy, or the voodoo peddlers know more than the whole of science.

Ignorance and denial is bliss for some of us. Are you assuming RJ's sister who has her PhD doesn't qualify in the "whole of science?" Big words backing science who's funding is many times dependent on big business with interests more on the lines of maximizing shareholder profits. No one mentioned audio here. It's not the same because lives aren't at stake.

Voodoo peddlers??? I don't see anyone selling and making profits on healthy foods that can be purchased in a local grocery store. And .99 cents for a bottle of h202 - no one is making a killing off of this either. Bad analogy.

You'll always have those in life who refuse to be pioneers, to independently do their own research, and only trust their forefathers (and things published in professional journals) for advice.

 

[Buckeyefan 1]

Where did you get the other notion about H2O2?

Do a google search on the "benefits of h2o2." There have been published books and articles dating back to the 20's on it's benefits. You may be surprised at what you find.

 

[Tomorrow]

Gullible people buy into it thinking that there must be a conspiracy, or the voodoo peddlers know more than the whole of science.

You're speaking for a mighty large group, here, mtry. The "whole of science" suggests you know a lot about this matter. Can you be more specific as to what is and isn't nutritional voodoo?

 

[Rock&Roll Ninja]

Are labs being paid not to release cures? There's astronomical money in cures, but even more in treating and proloning the disease.

In a purely capitalist society, yes, drug companies would only treat the symptoms. But in todays world pharmecutical economy, scientists from all backgrounds are working on cures. Government studies are probably the single largest source of new treatments/cures, and the majority of those come from overseas. A "free healthcare" country is not going to waste millions of dollars treating cancer/AIDS over the course of decades is a $200 cure is to be had. That is why there are more than just one drug-company doing research, to prevent this kind of medicine monopoly.

And western medicine can cure people of most kinds of cancer. The downside is that we have to do it with radiation. And radiation poisoning is oftentimes worse than the cancer.

 

[Rock&Roll Ninja]

Can you be more specific as to what is and isn't nutritional voodoo?

Theres another problem: "science" is not a governing body. Many scientists come to very different conclusions. Every year a new docotr or scentist comes up with a new diet-regime that promises to make you shed fat and live forever. Only to undue all the science that came befor eit, and will be undone by new science later.

In truth "healthy diet" is determined by a few factors:
*Folklore/superstition
*Political climate
*product availablity
*advertising
*nutritional science du-jour.

The political climate has the largest impact in this country, Just look at Atkins and the "scientific" backlash from the agricultural community. Vegans/vegitarians don't eat animal meat, not because it has any factual health claims (at least not any claims that can't be refuted 50:1), but due to a "moral problem" with killing (morals don't provide vitamin c). There aren't going to be any asparagus every -day dets is asparagus isn't available year round (which it isn't in most areas).

And finally people want "testimonials" from other people who lost 100lbs. It doesn't matter if they really did or just straved themselves and ha da photoshop makeover, but people won't ever be the first to try a new diet.

 

[Buckeyefan 1]

Government studies are probably the single largest source of new treatments/cures, and the majority of those come from overseas.

I will say the Human Genome project headed up by our government (with the help of other countries and private businesses) is one of the most amazing achievements in human history. Just check out the "Research Milestones" a third of the way down the page.

http://www.ornl.gov/sci/techresources/Human_Genome/project/progress.shtml

 

[philh]

Wow, what a great discussion

I'm disturbed by the amount of money spent by the pharmaceutical companies selling their products to the Md's. Really miss my retired Dr, because he tended to avoid the new drugs and stick with the old ones. In his words, "they are way too expensive, most of the time don't work any better, and sometimes are less effective." My latest doc's employer does not permit drug reps to speak directly to the docs. He's actually fine with that.

Dan,
One of the questions I'm having trouble resolving is relative v absolute statistics. Reviewed a lot of material on Statin's and found it interesting that side effects are presented in absolute terms and benefits are presented in relative terms. When does the sample size become large enough on a relative basis to make it useful information? For example, on a study of 20,000 people, if two people died on a placebo, and one died on the new drug, it would be advertised as a 50% improvement, where in absolute terms it made no diff.

 

[Dan]

Phil-
I'm no biostatisics whiz but I'll do my best. Absolute risk is the risk of developing a disease over a certain period of time for a given population. For example you might say that you have a 3 in 10 or 30% chance of having heart disease in your lifetime. RELATIVE risk is used to compare the absolute risks of two different populations (eg smokers and non smokers). The relative risk is the ratio of the absolute risks of the two groups.

Let's say that the incidence of bladder cancer in smokers is 6/100 and in nonsmokers is 4/100. The absolute risks are 6% and 4%. The relative risk is 1.5 or a 50% increased relative risk. The absolute risk is only increased 2%. Thus the number can be made to sound bad when the risk is only mildly increased. The opposite is true if the numbers are higher. Try it again with a disease that is 40 and 60%. RR=1.5, absolute risk 20% higher. The media and drug companies do use this to their advantage.

Deciding what to do depends upon the disease, how likely you are to get it and the costs, risks, side effects of the treatment. To reduce a disease that is a 4/million risk to 1/million is a 75% relative risk reduction but really won't help very many people.

Also when looking at statistical data the N (number of subjects) is critical. A small sample population may not accurately reflect the true population being considered. A Chi test measures the liklihood that two different measurements are in fact truly different or reflect random variations. Five straight coin flips of heads might be luck with a fair coin but 500 straight heads is alomost certainly a twoheaded coin. The Chi test expresses the value p as the chance that two numbers are in fact the same. The maximum commonly accepted value is .05 which means that 95% of the time two different measurements are in fact different and not due to random variation.

I hope this helped some. The statin effects are not great but there were, I believe, fairly large population samples inolved so the numbers are probably valid. I also have been told the dside effects are few with certain key exceptions (heat failure, liver disease, certain idney diseases). I am not intimatly acquainted with the statistics, perhaps you know something I don't. Statins aren't my field.

I referred to the following web sites which might add more or explain things more clearly: www.patient.co.uk/showdoc/27000849/ and www.medcalc.be/manual/mpage08-08.php

And to Buckeye, I am sorry you don't feel like waiting for clinical trials. I wonder how you feel about thalidomide and DES. These were disasters that were missed due to inadequate clinical trials. Perhaps you felt better about the scam artists in Mexico who pushed Laetrile in 70s to desperate cancer patients without any backing studies. When studied the crap was totally useless. Sure, drug studies can be cooked. It looks like Merck cooked the numbers about Vioxx now. But at least the data is available so that they are now held accountable which they wouldn't if trials weren't done. Without trials there would be no accidental discoveries like minoxidil grows hair, sadly no help to me. People are quck to blame the FDA for being too slow to approve drugs and then are the same ones to scream when a Vioxx slips through. Can't have it both ways.

 

[philh]

Dan,

Thank you for the detailed reply. I have some statistical knowledge, being an engineer and performed some research. What amazes me with the Statins, is they are very very good at lowering cholesterol, BUT have very little impact on total mortality numbers. The Heart Prevention Study is generally held up to be one of the ideal models, until you start analyzing the detail data. It raised an eyebrow to find out a full third of the initial participants did not even make it through the startup process. 25% reduction in heart attacks is typically a quoted number, although there was some rounding "liberty's" taken with that number. While that 25% is relative risk reduction, in absolute values, it was about 1.5%. Side effects are reported to be 5% in absolute values, and off the top of my head believe it's something like 65% relative. The process of saying this (or any other drug) works is confusing with such small absolute numbers. If I attempted to use the same statistical process in automotive engineering, we'd be fighting more lawsuits then there are lawyers. My uneducated study has made me considerably more skeptical (cynical?) on the whole medical field and process. Especially with the extensive use of kickbacks. I'm prevented from literally accepting any gift of any value, to prevent abuse and swaying of opinion. Yet Drs are allowed to accept vacations, boondoogles, gifts, etc worth thousands of dollars. The office staff of the Dr I fired, complained to me, a customer, about how there was no way he could provide correct treatment with all the "information" he was given. It was his insistence I read the studies and not just misinformation on the internet. It was reading the actual studies and looking at the data that led to more questions and his eventually being fired as my physician.

Thanks again for the info!

Phil

 

[chicagomd]

OK, this is a long one...sorry.

Better late than never, eh rjbudz?

Great discussion, although I admit I didn't get to all the posts. One of the main problems I have with the "alternative" medicine industry is essentially there is no one watching them. They were removed from FDA over-sight thanks to a certian Congressman from Utah, and now they can make whatever claim they want to about their products without having to prove any benefit. As long as they don't kill anyone they can keep pumping out products and people will keep buying them. I am not a huge fan of the FDA or large pharm. companies, nor is the process of drug approval without some pretty big issues, but at least it is something.

Do things like H202, St. John's Wart, etc work? Some people will swear up and down that they do, and some of them have pretty good studies backing them up. I personally don't have a problem with patients using these therapies, as long as they are not at the expense of treatments that are proven to work.

I think the bottom line is if people are really interested in increasing their health, nothing beats a good diet and regular exercise. If you have those two things covered, from a general health concern knock yourself out with whatever other therapies you want. But don't think for a second that taking H2O2 is going to help reduce your risk of a heart attack in a statistically significant way if you are 400 lbs., have diabetes, and smoke 2 packs a day.

And to Phil:
The relationship between physicians and the drug companies should leave you more than cynical. It should leave you somewhat ill and with a very bad taste in your mouth. Many docs get to much information from studies that really amount to marketing propaganda. Although I will say now that the companies are recruiting more ex-college cheerleaders, it is at least tolerable when the come to sell their snake oil.

 

[Buckeyefan 1]

But don't think for a second that taking H2O2 is going to help reduce your risk of a heart attack in a statistically significant way if you are 400 lbs., have diabetes, and smoke 2 packs a day.

Very well put.

The relationship between physicians and the drug companies should leave you more than cynical. It should leave you somewhat ill and with a very bad taste in your mouth.

It's a sad day when the pharmaceutical reps and chem-e's from major drug companies are making more than the docs they sell drugs to. The industry should require the drug reps to maintain malpractice insurance, just like physicians.

Dan: And to Buckeye, I am sorry you don't feel like waiting for clinical trials.

What I said was "does our generation really have time to wait for clinical trials?" If your wife, daughter or whomever close to you is on their deathbed and your physician writes them a death notice of 6 months of life, I guess you'll just write them off rather than looking for alternative ways to save them. Never once did I say eliminate clinical trials. Some don't have time to wait for clinical trials based on the disease they're fighting. You're putting words in my mouth.

 

[Dan]

Dan,

Thank you for the detailed reply. I have some statistical knowledge, being an engineer and performed some research. What amazes me with the Statins, is they are very very good at lowering cholesterol, BUT have very little impact on total mortality numbers. The Heart Prevention Study is generally held up to be one of the ideal models, until you start analyzing the detail data. It raised an eyebrow to find out a full third of the initial participants did not even make it through the startup process. 25% reduction in heart attacks is typically a quoted number, although there was some rounding "liberty's" taken with that number. While that 25% is relative risk reduction, in absolute values, it was about 1.5%. Side effects are reported to be 5% in absolute values, and off the top of my head believe it's something like 65% relative. The process of saying this (or any other drug) works is confusing with such small absolute numbers. If I attempted to use the same statistical process in automotive engineering, we'd be fighting more lawsuits then there are lawyers. My uneducated study has made me considerably more skeptical (cynical?) on the whole medical field and process. Especially with the extensive use of kickbacks. I'm prevented from literally accepting any gift of any value, to prevent abuse and swaying of opinion. Yet Drs are allowed to accept vacations, boondoogles, gifts, etc worth thousands of dollars. The office staff of the Dr I fired, complained to me, a customer, about how there was no way he could provide correct treatment with all the "information" he was given. It was his insistence I read the studies and not just misinformation on the internet. It was reading the actual studies and looking at the data that led to more questions and his eventually being fired as my physician.

Thanks again for the info!

Phil

The problem with these studies is that it is believed that the benefits of reducing cholesterol etc. occur over the long haul. No drug company wants to wait 20 years to show a benefit before releasing the drug. Thus a small short term benefit must be extrapolated. The long term studies will be done and maybe the supposed benefits won't pan out in the long run. Unfortunately I don't see a way around this as the drug companies are not going to wait that long. Besides, perhaps a drug is wonderful over the long haul, would you want it withheld for years just to be sure?

As far as the drug co.-MD relationship it has improved. The old days of paid trips to the Caribbean etc. are long gone. Anyone giving a lecture at a conference or writing a paper is now required to diclose all ties to such companies. Not that it is now clean by any means. But compare it to the lobbyists here in DC with the Congressmen. That is truly obscene and it goes on at all levels of government. Me, I'm a radiologist so I don't prescribe many drugs and almost all are generic. If I want to buy a CT scanner it's gonna cost 1.5-2 million large and a free pen or even a night out ain't gonna cut it. I need the best price for the best gear and nothing else matters. It's more like buying a car (or audio gear) than anything else.

Buck, sorry but I think I quoted you pretty close. Perhaps I misunderstood you in which case I apologize. I never suggest writing anyone off who wants to give something a go no matter how dim the outlook. For them clinical trials ARE A SHOT. For example, my brother's father in law had a rare lymphoma which was misdiagnosed for some time by his local GP. He eventually wound up in a trial of a new chemo regimen. The first 13 of 15 people in the trial died but he was number 14 and lived to see it cured, in part thanks to the experience gained by the first 13. So even if you aren't helped the knowledge gained may help someone else. Remeber those first 13 had no hope otherwise anyway.

The alternative medecine types certainly make profits too. While I hear a lot about drug companies suppressing cures I never seen any evidence of it. When they are guilty of something it is overcharging or INFLATING the value of a new drug like Vioxx. Knowledge is hard to supress. Look at how nuclear devices have spread despite America's concerted effort to prevent it.