The Heartbreak of Medial Conspiracies

 

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The latest statistics on the world epidemic of AIDS & HIV were published by UNAIDS/WHO in July 2008, and refer to the end of 2007.

Estimate Range
People living with HIV/AIDS in 2007 33.0 million 30.3-36.1 million
Adults living with HIV/AIDS in 2007 30.8 million 28.2-34.0 million
Women living with HIV/AIDS in 2007 15.5 million 14.2-16.9 million
Children living with HIV/AIDS in 2007 2.0 million 1.9-2.3 million
People newly infected with HIV in 2007 2.7 million 2.2-3.2 million
Children newly infected with HIV in 2007 0.37 million 0.33-0.41 million
AIDS deaths in 2007 2.0 million 1.8-2.3 million
Child AIDS deaths in 2007 0.27 million 0.25-0.29 million

More than 25 million people have died of AIDS since 1981.

Africa has 11.6 million AIDS orphans.

At the end of 2007, women accounted for 50% of all adults living with HIV worldwide, and for 59% in sub-Saharan Africa.

Young people (under 25 years old) account for half of all new HIV infections worldwide.

In developing and transitional countries, 9.7 million people are in immediate need of life-saving AIDS drugs; of these, only 2.99 million (31%) are receiving the drugs.

Revealing Critical Conflicts of Interest Regarding DTP

One such journal, the Journal of the American Medical Association (JAMA) ran an article several years ago. [1] In an editorial run in the same issue, the writer sought to convince readers that pertussis vaccine encephalopathy was a "myth." [2] The editorial was authored by James D. Cherry, M.D., the leading defense expert witness in vaccine litigation. Dr. Cherry failed to disclose his significant financial ties to Lederle Laboratories, Wyeth Laboratories, Connaught Laboratories, Parke-Davis & Company, or Eli Lilly & Company -- the major DTP vaccine manufacturers in this country. Similarly, Dr. Edward Mortimer, of Case Western Reserve School of Medicine, failed to disclose his ties to the industry in the underlying article that appeared in the same issue. [3] JAMA authors must sign a statement that they have no financial interest in the subject matter, including "consultancies" between the author and the manufacturer of the drug being reported. There is an editorial policy of JAMA concerning ethical and financial conflicts of interest. In any publication, the integrity of the articles is a direct function of the integrity of the authors. As peer reviewers for JAMA, Drs. Cherry and Mortimer [4] have been entrusted to ensure the scientific integrity of the works they review for that journal. The obligation of a journal's editorial board members is to come forward with information concerning potential ethical violations prior to the publication of an article in the journal if they know of the existence of such conflicts.
http://tinyurl.com/r9o34t

Endnotes

1. M.R. Griffin et al., Risk of Seizures and Encephalopathy after Immunization with Diphtheria-Tetanus-Pertussis Vaccine, 263 JAMA 1641-45 (1990).

2. J.D. Cherry, Perussis Vaccine Encephalopathy: It is Time to Recognize It as the Myth That It Is, 263 JAMA 1687-96 (1990).

3. Drs. Griffin and Ray are Burroughs-Wellcome Scholars in Pharmicoepidemiology at Vanderbilt University School of Medicine. Burroughs-Wellcome is the major DTP manufacturers in the United Kingdom. Dr. Mortimer has long been the DTP vaccine consultant to Wyeth Laboratories, and Parke Davis, former DTP manufacturers and current litigants involving liability for their vaccine. In addition, Dr. Mortimer has long been a consultant to Lederle Laboratories and Connaught Laboratories, the sole commercial suppliers of DTP in the United States.

4. The 1989 JAMA Peer Reviewers List, 263 JAMA 1687-96 (1990).

5. C.L. Cody et al., Nature and Rates of Adverse Reactions Associated with DTP and DT Immunizations in Infants and Children, 68 PEDIATRICS 650-60 (1981).

6. Cherry, supra note 2, at 1680 (calling for a study free of the influences of "special interest groups" and calling personal injury lawyers a "uniquely destructive force".

7. National Institutes of Health, Status of Acellular Pertusis Vaccines & Swedish Trial Update (Feb. 8, 1988).

8. Deposition of J.D. Cherry, M.D. at 49, Hardaway v. Metropolitan Gov't of Nashville, et al., __________ (19__).

9. Deposition of E. A. Mortimer, M.D. at 11, Krause v. Aboussy, et al., No. 82-1232, (Stark Cty., OH, September 6, 1984). 10 Opening remarks at the Institute of Medical Division of Health Promotion and Disease Prevention, Committee to Review the Adverse Consequences of Pertussis and Rubella Vaccines, Public Meeting, January 10, 1990. (Emphasis added.)

Medical Journals

Assessing the Validity of Published Randomized Controlled Trials in Podiatric Medical Journals
Michael A. Turlik, DPM*, Donald Kushner, DPM*, and Dina Stock, DPM
* Private practice, Beachwood, OH.
Ohio College of Podiatric Medicine, Cleveland.

Corresponding author: Michael A. Turlik, DPM, Beachwood Foot and Ankle Center, 3690 Orange Pl Dr, Ste 415, Beachwood, OH 44122.

Abstract

The purposes of this study were to develop an instrument to assess the validity of randomized controlled trials and to report on the differences in the validity of randomized controlled trials between two podiatric medical journals and a mainstream medical journal. The study demonstrated that after adequate training, there can be agreement among reviewers evaluating the quality of published randomized controlled trials using an established instrument and guidelines. The results of the study indicate that randomized controlled trials published in podiatric medical journals are less credible than those published in a mainstream medical journal. (J Am Podiatr Med Assoc 93(5): 392-398, 2003)

http://tinyurl.com/r9o34t

Journal Reporting of Medical Errors*
The Wisdom of Solomon, the Bravery of Achilles, and the Foolishness of Pan
Joseph G. Murphy, MD, LeAnn Stee, BA, Marian T. McEvoy, MD, and June Oshiro, PhD
+Author Affiliations

*From the Section of Scientific Publications, Mayo Clinic College of Medicine and the Department of Dermatology, Mayo Clinic, Rochester, MN.

Medical errors may result from lapses in judgment or lack of prudent care by individual physicians, from system errors inherent in the medical-care delivery model or, more frequently, from a combination of the two. Medical error reporting is a sensitive topic for physicians, institutions, and patients. The veil of secrecy that surrounds medical errors deprives health-care practitioners of knowledge that may help prevent similar adverse outcomes for patients in the future. Although reporting individual medical errors to involved patients is obligatory by most professional codes of conduct for physicians, no laws or professional society guidelines mandate widespread reporting of errors to professional colleagues. Furthermore, reports of medical errors in peer-reviewed journals are extremely rare. In 2000, the Joint Commission for Accreditation of Healthcare Organizations described systemic medical errors as fundamentally an information problem and called for the development of programs to collect and analyze medical error data. In this review, we define medical errors and detail common motivations and barriers to publication of error reports. We propose a model for confidential error communication and describe US legislation designed to improve patient safety and establish nationwide programs for error disclosure and analysis.

On February 22, 2000, Dennis OLeary, MD, President of the Joint Commission on Accreditation of Healthcare Organizations, addressed the US Senate Committee on Health, Education, Labor, and Pensions8:
The frequency and gravity of medical errors is perhaps the most pressing health care quality issue of our time . We believe that the problem of medical errors is endemic to the way health care is carried out . I would like to stress that medical error reduction is fundamentally an information problem. The solution to reducing the number of medical errors resides in developing mechanisms for collecting, analyzing, and applying existing information. If we are going to make significant strides in enhancing patient safety, we must think in terms of the information we need to obtain, create, and disseminate.

 

Vested interests
January 2003

From Lancet

Drug advertising in medical journals can be misleading
Spanish authors of a study in this week's issue of THE LANCET highlight how drug advertising in medical journals can be inaccurate and potentially misleading to clinicians.
The pharmaceutical industry increasingly uses bibliographical references to clinical trials that endorse their products in advertisements-mainly due to pressure from the evidence-based medicine movement concerning the prescribing behaviour of doctors. Salvador Peir from the Valencia School for Health Studies, Spain, and colleagues assessed whether the references about efficacy, safety, convenience, or cost of antihypertensive (blood-pressure lowering) and lipid-lowering drugs included in advertisements supported the promotional claims.

All advertisements for antihypertensive and lipid-lowering drugs published in six Spanish medical journals in 1997 that had at least one bibliographical reference were assessed. Two pairs of investigators independently reviewed the advertisements to see whether the studies quoted to endorse the advertising messages supported the corresponding claims.

Nearly half-44%-of 102 promotional claims analysed were not supported by corresponding references. The most common error in advertising was the recommendation of drug treatment to a different group of patients to those assessed in the reference study.

Salvador Peir comments: "Doctors should be cautious in assessment of advertisements that claim a drug has greater efficacy, safety, or convenience, even though these claims are accompanied by bibliographical references to randomised clinical trials published in reputable medical journals and seem to be evidence-based."

In an accompanying Commentary (p 10), Robert H Fletcher from Harvard Medical School, Boston, USA, concludes: "Readers should not take claims in journal adverts, with or without credible-appearing references, on face value. Regulation of advertising claims is not strong or consistent enough to protect readers from misinformation. But then, neither should readers accept the conclusions of original research uncritically. Government regulators and editors do attempt to improve the accuracy of the content of medical journals, both articles and adverts. But readers must still take personal responsibility for judging the validity of assertions, especially those made in adverts."