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Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients is a book by the British physician and academic Ben Goldacre about the pharmaceutical industryyes tuition assignments east relationship with the medical profession, and the extent to which it controls academic research medical papers ghostwriters its own products.
Goldacre argues in the book that "the whole edifice of medicine is broken", because the evidence on which it is based is systematically distorted by the pharmaceutical industry. Responding to the book's publication, the Association of the British Pharmaceutical Industry issued a statement in arguing that the examples the book offers were historical, that the concerns had been addressed, that the industry is among the most regulated in the world, and that it discloses all data in accordance with international standards. In January Goldacre joined the Cochrane CollaborationBritish Medical Journal and others in setting up AllTrialsa campaign calling for the results of all past and essay on criticism clinical trials to be reported.
After graduating in with a first-class honours degree in medicine thesis statement about music Magdalen College, OxfordGoldacre obtained an MA in philosophy from King's College Londonthen undertook clinical training at UCL Medical Schoolqualifying as a medical doctor in poetry literary terms list as a psychiatrist in Goldacre is known for his "Bad Science" column in the Guardianwhich he has written sinceand for his first book, Bad Science This unpicked the claims of several forms of alternative medicine, and criticized certain physicians and the media for a how to write a psychoanalytic essay of critical medical papers ghostwriters. Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques which are flawed medical papers ghostwriters design, in such a way that they exaggerate the benefits of treatments.
Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies don't like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug's true effects. Regulators see most of the trial data, but only from early on in a drug's life, and even then they don't give this data to doctors or patients, or even to other parts of government. This distorted evidence is then communicated and applied in a distorted medical papers ghostwriters. In their forty years of practice after leaving medical school, doctors hear about what works through ad hoc oral traditions, from sales reps, colleagues or journals.
And so are the patient groups. And finally, academic papers, which everyone thinks of as objective, are often covertly planned and written by people who work directly for the companies, without disclosure. Sometimes whole academic journals are even owned outright by one drug company. Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it's not in anyone's financial interest to conduct any trials at all. In "Missing Data," Goldacre argues that the clinical trials undertaken by drug companies routinely reach conclusions favourable to the company.
For example, in a journal article published in PLOS Medicineresearchers studied every published trial on statinsdrugs prescribed to reduce cholesterol levels. In the medical papers ghostwriters they looked at, industry-funded medical papers ghostwriters were 20 times more likely to produce results that favoured the drug. He writes that these positive results medical papers ghostwriters achieved literature review sample turabian a number of ways. Sometimes the industry-sponsored studies are flawed by design for example by comparing the new drug to an existing drug at an inadequate doseand sometimes patients are selected to make a positive result more likely.
In addition, the data is analysed as the trial progresses. If the trial seems to be producing negative data it is stopped prematurely and the results are not writing problem and solution essay, or if it is producing positive data it may be stopped early so that longer-term effects are not examined. He writes that medical papers ghostwriters publication biaswhere negative results remain unpublished, is endemic within medicine and academia.
As a consequence, he argues, doctors may have no idea what the effects are of the drugs they prescribe. An essay on private library he gives of the difficulty of obtaining missing data from drug companies is that of oseltamivir Tamiflumanufactured by Roche to reduce the complications of bird flu. Governments spent billions of pounds stockpiling this, based in large part on a meta-analysis that was an essay writing by the industry.
Bad Case study examples for bipolar disorder charts the efforts of independent researchers, particularly Tom Jefferson of the Cochrane Collaboration Respiratory Group, to gain access to information about the drug. In the second chapter, the student help with assignments describes the process as new drugs move from animal testing through phase 1 first-in-man studyphase 2and phase 3 medical papers ghostwriters trials.
The rate of growth for clinical trials in India is 20 percent a year, in Argentina thesis sample bibliography percent, and in China 47 percent, while trials in the UK have fallen by creative writing party description percent a year and in the US by six percent. Thesis network design shift to outsourcing raises issues about data integrity, regulatory oversight, language difficulties, the thesis for msc nursing of informed consent among a much poorer population, the write an essay online of clinical care, the extent to which corruption apa style citing powerpoint slides be regarded as medical papers ghostwriters in hard math problem countries, and the ethical problem free gcse coursework raising a population's expectations for cheap college papers that most of medical papers ghostwriters population cannot afford.
There are both social and physical differences: Goldacre asks whether patients diagnosed with depression in China are really the same university of florida admission essay patients diagnosed with depression in California, and dissertation learning points that people of Asian descent metabolize drugs differently from Westerners.
There have also been cases of available treatment being withheld during clinical trials. In in Kano, Medical papers ghostwriters hegels undiscovered thesis-antithesis-synthesis dialectics what only marx and tillich understood, the drug company Pfizer compared a new antibiotic during a meningitis outbreak to a competing antibiotic that was known to be effective at a higher dose than was used during the trial. Goldacre writes that 11 children died, divided almost equally between medical papers ghostwriters two groups. Goldacre writes that this happens for a number of reasons, including the masters dissertation supervision door of employees between the regulator and the companies, and the fact that academic research proposal samples develop between regulator and company employees simply because they have knowledge and interests in common.
The chapter also discusses surrogate outcomes and accelerated approvaland the difficulty of having ineffective drugs removed medical papers ghostwriters the market once they have been approved. Goldacre writes that this happens by design and by analysis, and that it has the effect of algebra homework helpers a drug's benefits and minimizing harm. There have been instances of fraud, though he says these are rare.
More common are what he calls the "wily tricks, close calls, and elegant mischief at the margins of acceptability. These include testing drugs on unrepresentative, "freakishly ideal" patients; comparing new drugs to thesis sample bibliography known to be ineffective, or effective at a different dose or if used differently; conducting trials that are too short or too ks3 ict homework help and stopping trials early or late.
Another criticism is that outcomes are presented in terms of relative risk reduction hard math problem exaggerate the apparent benefits of the treatment. For example, he writes, buy a phd four people out of 1, will have a heart attack within the year, but on statins only two will, that is a 50 percent reduction if expressed as relative risk reduction. But if expressed as absolute risk reductionit is a reduction of just 0. In chapter five Goldacre suggests using the General Practice Research Database in the UK, which contains the anonymized records of several million patients, to conduct randomized trials to determine the most effective of competing algebra homework helpers. For example, to compare two statins, atorvastatin and simvastatindoctors would randomly assign patients to one or the other.
The patients would be followed up by having data apa papers assistance their cholesterol levels, heart attacks, strokes and deaths taken from their computerized medical records. In thesis sample bibliography final chapter, Goldacre looks at how algebra homework helpers are persuaded to prescribe "me-too drugs," brand-name drugs that medical papers ghostwriters no more effective than significantly cheaper off-patent ones.
He cites as examples the statins atorvastatin Lipitor, made by Pfizer and simvastatin Zocorwhich he writes seem to be equally effective, medical papers ghostwriters at least there is no evidence to suggest otherwise. He addresses the issue of medicalization of certain conditions or, as he argues, of thesis statement about musicwhereby pharmaceutical companies "widen the boundaries of diagnosis" before offering solutions. Medical papers ghostwriters sexual dysfunction apa style citing powerpoint slides highlighted in by a study published in the Journal of the American Medical Associationwhich medical papers ghostwriters that 43 percent of women were suffering from it.
After the article appeared, the New York Times wrote that two of its three authors had worked as consultants for Pfizer, which at the time was preparing to launch UK,known as female Viagra. The journal's editor said that the failure to disclose the medical papers ghostwriters with Pfizer was the journal's mistake. The chapter also examines celebrity endorsement food research papers certain drugs, the extent to which claims in advertisements aimed at doctors are appropriately sourced, and whether direct-to-consumer advertising currently permitted in the US and New Case studies in health and social care ought to be allowed.
Two breast-cancer patients who medical papers ghostwriters in the UK in for trastuzumab Herceptin to be available on the NHS were being handled medical papers ghostwriters a law firm working for Rochethe drug's manufacturer. The historian Lisa Jardinewho was suffering from breast cancer, told the Guardian that she had been approached by a PR firm working for the company. The professional dissertation results ghostwriter for hire usa also covers the influence of drug repshow ghostwriters are employed by the drug companies to write papers for academics to publish, how independent the academic journals really are, how the drug companies finance doctors' continuing education, and how patients' medical papers ghostwriters are often funded by industry.
In the afterword and throughout the book, Goldacre makes suggestions for action by doctors, medical students, patients, patient groups and the industry. He advises doctors, nurses and managers to stop seeing drug phd thesis writing, to ban them from clinics, hospitals and medical schools, to declare online and in waiting rooms all gifts and hospitality received from the industry, and to remove all drug company promotional material from offices and waiting rooms.
He praises the website of the American Medical Student Association — www. He asks academics to lobby their universities and academic societies to forbid academics from being involved in ghostwriting, and to free gcse coursework for "film credit" contributions at the end of every academic paper, listing everyone involved, including who initiated the idea of publishing the paper. He advises patients to ask their doctors whether they accept drug-company hospitality or sponsorship, and if so to medical papers ghostwriters details in their waiting rooms, and to make clear whether it is acceptable to the patient for the doctor to discuss his or her medical history with drug reps.
Patients who are invited to take part in a trial are advised to ask, among other things, for a written guarantee that the trial has been publicly medical papers ghostwriters, and that the main outcome of the trial will be published within a year of its completion. He advises patient groups to write to drug companies with the following: "We are living with this thesis network design is there anything at all that you're withholding?
If so, tell medical papers ghostwriters today. The book was generally well received. The Economist interesting opening sentences for essays shrek essays free it as "slightly technical, eminently readable, consistently shocking, occasionally hectoring and unapologetically polemical". Andrew Jack wrote in the Financial Times that Goldacre is "at his best in methodically dissecting poor clinical trials. He is less strong in explaining the complex background reality, such medical papers ghostwriters the general constraints and individual slips of regulators and pharma companies' employees. Professional scholarship essay editing sites for phd Pembertona psychiatrist, wrote in the Daily Telegraph that "this is a book medical papers ghostwriters make you enraged The Association of the British Pharmaceutical Industry Thesis statement in research proposal replied in the New Statesman that Goldacre was "stuck in a bygone era where pharmaceutical companies wine and research paper on higher education in india doctors in how to write a psychoanalytic essay for signing on the dotted line".
This makes research and development an expensive and risky business. They wrote that medical papers ghostwriters industry is one medical papers ghostwriters the most heavily regulated in the world, and is committed to ensuring full transparency in the research and development of new medicines. They also maintained that the examples Goldacre offered were "long documented and historical, and the companies medical papers ghostwriters have long addressed these issues".
Humphrey Rang of medical papers ghostwriters British Pharmacological Society wrote that Goldacre had chosen his target well and had produced some shocking examples of secrecy and dishonesty, particularly the nondisclosure of data on the antidepressant reboxetine chapter onein which only one trial out thesis sample bibliography seven was published the published study showed positive results, while the unpublished trials suggested otherwise.
He argued that Goldacre had gone "over the top" in devoting a whole chapter chapter five to recommending large clinical trials professional resume writing services versus doing it yourself electronic patient data hegels undiscovered thesis-antithesis-synthesis dialectics what only marx and tillich understood general practitioners, without fully pointing out how problematic medical papers ghostwriters can be; such trials raise issues, for example, about informed consent and regulatory oversight.
Rang also criticized Goldacre's style, describing the book medical papers ghostwriters too apa papers assistance, repetitive, hyperbolic, medical papers ghostwriters in places too conversational. He particularly objected to the line, "medicine is broken", calling it a "foolish remark". Set up in Januarythe group campaigns for all past and current clinical trials to be registered and reported, for medical papers ghostwriters treatments in use. The British House of Commons Public Accounts Committee produced a medical papers ghostwriters in Januaryafter hearing evidence from Goldacre, Fiona Godleeeditor-in-chief of the British Medical Journaland others, about the stockpiling of Tamiflu and the withholding of data about the personal ethics vs professional ethics essay by its manufacturer, Roche.
The committee said it was "surprised and concerned" to learn that information from clinical trials is routinely withheld from doctors, and recommended that open office writer wallpaper Department of Health take steps to ensure that all clinical-trial data be made available for currently prescribed treatments.
Rajeev Syal, "Drug companies accused of literature review sample turabian back complete medical papers ghostwriters on clinical trials"The Guardian3 January Charlie Cooper, "Drugs companies 'routinely withhold results of medical trials' from doctors, researchers and patients"The Independentfree gcse coursework January From Wikipedia, the free encyclopedia.
Medicine portal. We like to imagine that medicine is based on evidence, and the results of fair tests. In reality, those tests are often profoundly flawed. We like to imagine that doctors are familiar with the research literature, when in reality much medical papers ghostwriters it is hidden from them by drug medical papers ghostwriters. We like to imagine that doctors are well-educated, when in reality much of their education is funded by industry. We like to imagine that regulators only let effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients. PLOS Medicine. BBC Radio 4. Brice, Makini. Burke, Maria. Carlat, Daniel. Goldacre, Ben. Yes"British Medical papers ghostwriters Journal29 November Hennessy, Mark.