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"Undue industry influences that distort healthcare" – some thought provoking articles
I found a handful of thought provoking papers and articles that I thought I would share, these are broad in nature, potentially relevant to nearly every person, patient, provider, ailment, condition, treatment, etc. I think a reasonable conclusion is that having a degree of healthy skepticism about industry claims is warranted by patients and doctors alike.
“Undue industry influences that distort healthcare research, strategy, expenditure and practice: a review”
“We located abundance of consistent evidence demonstrating that the industry has created means to intervene in all steps of the processes that determine healthcare research, strategy, expenditure, practice and education. As a result of these interferences, the benefits of drugs and other products are often exaggerated and their potential harms are downplayed, and clinical guidelines, medical practice, and healthcare expenditure decisions are biased.”
https://onlinelibrary.wiley.com/doi/full/10.1111/eci.12074
“Why Most Published Research Findings Are False”
“Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias. ”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/
“Lies, Damned Lies, and Medical Science”
“Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors—to a striking extent—still drawing upon misinformation in their everyday practice? Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science.”
https://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/308269/
“The Dawn of McScience”
“Science in the Private Interest: Has the Lure of Profits Corrupted Biomedical Research?”
https://www.nybooks.com/articles/2004/03/11/the-dawn-of-mcscience/
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6 Replies
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The American College of Surgeons does pretty well but still implies that chronic pain is a short-term issue, “pain one year after surgery”, not really exploring what happens after that. But they do give a value of 10-12% and address it directly. More promising. They also show that the recurrence rate is higher for laparoscopic than open, which is surprising. Overall, they seem to have compiled current study results and are facing them directly. Just not going far enough with chronic pain. “Pain” is the original reason for going to the doctor. It should be of the highest priority.
https://www.facs.org/~/media/files/education/patient%20ed/groin_hernia.ashx
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The US FDA tries to address the issue but still falls back on the lack of understanding, thereby perpetuating the problem. Blaming chronic pain on previously recalled products. Still making very vague statements, “many complications”, and taking no action. At least they’re getting closer.
“Many complications related to hernia repair with surgical mesh that have been reported to the FDA have been associated with recalled mesh products that are no longer on the market. ”
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These two links illustrate the huge disconnect between some hernia repair surgeons and general surgeons, at least in Great Britain. Even though supposedly they are the same type of surgeon, and hernia repair is a skill within general surgery skills, somehow the hernia specialists in Great Britain are on a completely separate page from the rest of the surgical community. I say apparently, I haven’t read the whole article, it’s a pay-per-view article.
It seems that the hernia mesh repair surgeons in Great Britain, or at least their representative, are using the “no firm relationship” view to keep on doing what they do. It’s shocking to see it in print. The first article is about caring for your patients, the second one is about caring for your business. Some of these surgeons must know each other, it’s hard to see how they can coexist. And this is after many years of published studies showing that there is a correlation between mesh hernia repair and chronic pain, higher than pure tissue repairs, where chronic pain was so low that it was not an issue. The chronic pain issue has developed in step with mesh repair.
Hate to be so negative but these are recent results. Strange how the industry seems to be paralleling American politics.
From the article – “Around 570 0000 hernia mesh operations have taken place in England over the past six years, figures from NHS Digital show. Leading surgeons think that the complication rate is between 12% and 30%, meaning that between 68 000 and 170 000 patients could have been adversely affected in this period.”
Hernia mesh complications may have affected up to 170 000 patients, investigation finds
BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k4104 (Published 27 September 2018)https://www.bmj.com/content/362/bmj.k4104.full
From the British Hernia Society – “Some patients can develop chronic pain after surgery. There is no firm relationship with the use of mesh and chronic pain, and non-mesh repairs can equally result in this problem.”
Mesh and your Hernia Repair “helping you to make an informed choice”
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The NIH should be one of the organizations involved in solving the hernia repair mesh problem.
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Here’s a story I came across a while ago, similar but a bit different. It’s from last year. Our government really seems prone to corruption. These people don’t seem to understand their purpose.
https://www.nytimes.com/2018/03/17/health/nih-alcohol-study-liquor-industry.html
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Now this posted twice, my apologies.
Anyway, some food for thought.
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