What doctors don’t know about the drugs they prescribe | Ben Goldacre

What doctors don’t know about the drugs they prescribe | Ben Goldacre


Translator: Joseph Geni
Reviewer: Morton Bast Hi. So, this chap here, he thinks he can tell you the future. His name is Nostradamus, although here the Sun have made him look a little bit like Sean Connery. (Laughter) And like most of you, I suspect, I don’t really believe that people can see into the future. I don’t believe in precognition, and every now and then, you hear that somebody has been able to predict something that happened in the future, and that’s probably because it was a fluke, and we only hear about the flukes and about the freaks. We don’t hear about all the times that people got stuff wrong. Now we expect that to happen with silly stories about precognition, but the problem is, we have exactly the same problem in academia and in medicine, and in this environment, it costs lives. So firstly, thinking just about precognition, as it turns out, just last year a researcher called Daryl Bem conducted a piece of research where he found evidence of precognitive powers in undergraduate students, and this was published in a peer-reviewed academic journal and most of the people who read this just said, “Okay, well, fair enough, but I think that’s a fluke, that’s a freak, because I know that if I did a study where I found no evidence that undergraduate students had precognitive powers, it probably wouldn’t get published in a journal. And in fact, we know that that’s true, because several different groups of research scientists tried to replicate the findings of this precognition study, and when they submitted it to the exact same journal, the journal said, “No, we’re not interested in publishing replication. We’re not interested in your negative data.” So this is already evidence of how, in the academic literature, we will see a biased sample of the true picture of all of the scientific studies that have been conducted. But it doesn’t just happen in the dry academic field of psychology. It also happens in, for example, cancer research. So in March, 2012, just one month ago, some researchers reported in the journal Nature how they had tried to replicate 53 different basic science studies looking at potential treatment targets in cancer, and out of those 53 studies, they were only able to successfully replicate six. Forty-seven out of those 53 were unreplicable. And they say in their discussion that this is very likely because freaks get published. People will do lots and lots and lots of different studies, and the occasions when it works they will publish, and the ones where it doesn’t work they won’t. And their first recommendation of how to fix this problem, because it is a problem, because it sends us all down blind alleys, their first recommendation of how to fix this problem is to make it easier to publish negative results in science, and to change the incentives so that scientists are encouraged to post more of their negative results in public. But it doesn’t just happen in the very dry world of preclinical basic science cancer research. It also happens in the very real, flesh and blood of academic medicine. So in 1980, some researchers did a study on a drug called lorcainide, and this was an anti-arrhythmic drug, a drug that suppresses abnormal heart rhythms, and the idea was, after people have had a heart attack, they’re quite likely to have abnormal heart rhythms, so if we give them a drug that suppresses abnormal heart rhythms, this will increase the chances of them surviving. Early on its development, they did a very small trial, just under a hundred patients. Fifty patients got lorcainide, and of those patients, 10 died. Another 50 patients got a dummy placebo sugar pill with no active ingredient, and only one of them died. So they rightly regarded this drug as a failure, and its commercial development was stopped, and because its commercial development was stopped, this trial was never published. Unfortunately, over the course of the next five, 10 years, other companies had the same idea about drugs that would prevent arrhythmias in people who have had heart attacks. These drugs were brought to market. They were prescribed very widely because heart attacks are a very common thing, and it took so long for us to find out that these drugs also caused an increased rate of death that before we detected that safety signal, over 100,000 people died unnecessarily in America from the prescription of anti-arrhythmic drugs. Now actually, in 1993, the researchers who did that 1980 study, that early study, published a mea culpa, an apology to the scientific community, in which they said, “When we carried out our study in 1980, we thought that the increased death rate that occurred in the lorcainide group was an effect of chance.” The development of lorcainide was abandoned for commercial reasons, and this study was never published; it’s now a good example of publication bias. That’s the technical term for the phenomenon where unflattering data gets lost, gets unpublished, is left missing in action, and they say the results described here “might have provided an early warning of trouble ahead.” Now these are stories from basic science. These are stories from 20, 30 years ago. The academic publishing environment is very different now. There are academic journals like “Trials,” the open access journal, which will publish any trial conducted in humans regardless of whether it has a positive or a negative result. But this problem of negative results that go missing in action is still very prevalent. In fact it’s so prevalent that it cuts to the core of evidence-based medicine. So this is a drug called reboxetine, and this is a drug that I myself have prescribed. It’s an antidepressant. And I’m a very nerdy doctor, so I read all of the studies that I could on this drug. I read the one study that was published that showed that reboxetine was better than placebo, and I read the other three studies that were published that showed that reboxetine was just as good as any other antidepressant, and because this patient hadn’t done well on those other antidepressants, I thought, well, reboxetine is just as good. It’s one to try. But it turned out that I was misled. In fact, seven trials were conducted comparing reboxetine against a dummy placebo sugar pill. One of them was positive and that was published, but six of them were negative and they were left unpublished. Three trials were published comparing reboxetine against other antidepressants in which reboxetine was just as good, and they were published, but three times as many patients’ worth of data was collected which showed that reboxetine was worse than those other treatments, and those trials were not published. I felt misled. Now you might say, well, that’s an extremely unusual example, and I wouldn’t want to be guilty of the same kind of cherry-picking and selective referencing that I’m accusing other people of. But it turns out that this phenomenon of publication bias has actually been very, very well studied. So here is one example of how you approach it. The classic model is, you get a bunch of studies where you know that they’ve been conducted and completed, and then you go and see if they’ve been published anywhere in the academic literature. So this took all of the trials that had ever been conducted on antidepressants that were approved over a 15-year period by the FDA. They took all of the trials which were submitted to the FDA as part of the approval package. So that’s not all of the trials that were ever conducted on these drugs, because we can never know if we have those, but it is the ones that were conducted in order to get the marketing authorization. And then they went to see if these trials had been published in the peer-reviewed academic literature. And this is what they found. It was pretty much a 50-50 split. Half of these trials were positive, half of them were negative, in reality. But when they went to look for these trials in the peer-reviewed academic literature, what they found was a very different picture. Only three of the negative trials were published, but all but one of the positive trials were published. Now if we just flick back and forth between those two, you can see what a staggering difference there was between reality and what doctors, patients, commissioners of health services, and academics were able to see in the peer-reviewed academic literature. We were misled, and this is a systematic flaw in the core of medicine. In fact, there have been so many studies conducted on publication bias now, over a hundred, that they’ve been collected in a systematic review, published in 2010, that took every single study on publication bias that they could find. Publication bias affects every field of medicine. About half of all trials, on average, go missing in action, and we know that positive findings are around twice as likely to be published as negative findings. This is a cancer at the core of evidence-based medicine. If I flipped a coin 100 times but then withheld the results from you from half of those tosses, I could make it look as if I had a coin that always came up heads. But that wouldn’t mean that I had a two-headed coin. That would mean that I was a chancer and you were an idiot for letting me get away with it. (Laughter) But this is exactly what we blindly tolerate in the whole of evidence-based medicine. And to me, this is research misconduct. If I conducted one study and I withheld half of the data points from that one study, you would rightly accuse me, essentially, of research fraud. And yet, for some reason, if somebody conducts 10 studies but only publishes the five that give the result that they want, we don’t consider that to be research misconduct. And when that responsibility is diffused between a whole network of researchers, academics, industry sponsors, journal editors, for some reason we find it more acceptable, but the effect on patients is damning. And this is happening right now, today. This is a drug called Tamiflu. Tamiflu is a drug which governments around the world have spent billions and billions of dollars on stockpiling, and we’ve stockpiled Tamiflu in panic, in the belief that it will reduce the rate of complications of influenza. Complications is a medical euphemism for pneumonia and death. (Laughter) Now when the Cochrane systematic reviewers were trying to collect together all of the data from all of the trials that had ever been conducted on whether Tamiflu actually did this or not, they found that several of those trials were unpublished. The results were unavailable to them. And when they started obtaining the writeups of those trials through various different means, through Freedom of Information Act requests, through harassing various different organizations, what they found was inconsistent. And when they tried to get a hold of the clinical study reports, the 10,000-page long documents that have the best possible rendition of the information, they were told they weren’t allowed to have them. And if you want to read the full correspondence and the excuses and the explanations given by the drug company, you can see that written up in this week’s edition of PLOS Medicine. And the most staggering thing of all of this, to me, is that not only is this a problem, not only do we recognize that this is a problem, but we’ve had to suffer fake fixes. We’ve had people pretend that this is a problem that’s been fixed. First of all, we had trials registers, and everybody said, oh, it’s okay. We’ll get everyone to register their trials, they’ll post the protocol, they’ll say what they’re going to do before they do it, and then afterwards we’ll be able to check and see if all the trials which have been conducted and completed have been published. But people didn’t bother to use those registers. And so then the International Committee of Medical Journal Editors came along, and they said, oh, well, we will hold the line. We won’t publish any journals, we won’t publish any trials, unless they’ve been registered before they began. But they didn’t hold the line. In 2008, a study was conducted which showed that half of all of trials published by journals edited by members of the ICMJE weren’t properly registered, and a quarter of them weren’t registered at all. And then finally, the FDA Amendment Act was passed a couple of years ago saying that everybody who conducts a trial must post the results of that trial within one year. And in the BMJ, in the first edition of January, 2012, you can see a study which looks to see if people kept to that ruling, and it turns out that only one in five have done so. This is a disaster. We cannot know the true effects of the medicines that we prescribe if we do not have access to all of the information. And this is not a difficult problem to fix. We need to force people to publish all trials conducted in humans, including the older trials, because the FDA Amendment Act only asks that you publish the trials conducted after 2008, and I don’t know what world it is in which we’re only practicing medicine on the basis of trials that completed in the past two years. We need to publish all trials in humans, including the older trials, for all drugs in current use, and you need to tell everyone you know that this is a problem and that it has not been fixed. Thank you very much. (Applause) (Applause)

100 Replies to “What doctors don’t know about the drugs they prescribe | Ben Goldacre”

  1. The drug companies get to select the studies they present to the FDA for drug approval and they regularly set aside negative studies and this is how they get their drugs approved and this is the foundation on which so-called evidence is based. It is fraud and no better than numerous groups within alternative medicine which those in mainstream medicine condemn.

  2. As long as scientific validation is the gold standard for stimulating a revenue stream, there will be "fake science".  Greedy bastards will do whatever it takes in order to get more.  Vaccines are a prime example.

  3. Doctors deceive and convince healthy (prior
    to 2014) people like me they are diseased then give them drugs that cause the
    EXACT same symptoms they claim to be treating.

  4. Misleading research is determined to provide sound statistical work that they choose problems easy to analyse, but a profound triviality.Orthodox western medicine not only won't cure you but may leave worse off than you were before.In fact, these days scientific medicine itself is responsible for a good percentage of diseases.With all the fancy chemicals and computerised testing equipment we have, chronic depression, asthma, diabetes cancer virtually all degenerative disease is known to mankind are thriving, and medicine hasn't affected their incidence one tiny bit.The common cold is not caught; is created with the feet under the dinner table, and no other way.The hope of humanity lies in the prevention of degenerative and mental diseases, not in the care of their symptoms.

  5. You preach about misleading but you my friend are just as guilty. 1) I’m a doctor and I’m well aware of publication bias, especially regarding antidepressants. 2.) there are times when side effect profile is small that I’ll consider a medicine knowing the research behind it because it is worth the possibility of improvement for the patient due to the placebo effect alone. 3.) unpublished studies aren’t necessarily good studies. Maybe they weren’t published because they had a small population, poor study design, etc.

  6. Ben pointed out what some may say the obvious. Its all down to incentives. If we live in a capitalist system where profit is the ultimate goal, how can anyone expect a different outcome (in medicine or any other field)? Let's be honest and admit we'd all do the same if we were chairing the FDA, SEC, CDC, FED or any other supervising institution. Not saying communism or socialism is the answer .. but this is the other side of capitalism we have to live with

  7. Veritasium has a video called "Is Most Published Research Wrong?" that does a much better job at describing all the various reasons for publication bias. This video takes slightly longer to say much less. Both these videos however, suffer from a huge degree of pessimism. Neither video properly accounts for successes. Extraordinary claims require extraordinary evidence. Anyone who claims their research is significant in a very impactful way will certainly have their experiments repeated. It's true most research isn't repeated, but that probably means most of the research isn't actually of much importance whether it's true or not. Secondly, scientific journals do a very good job at picking out the statistically significant studies that might actually be of great importance because they have a motive to do so. I think it's really the media to blame in that they tear through the titles of studies as fast as possible looking for something to turn into a catchy headline. In the same way, I think TED is somewhat guilty of this by hiring this presenter. Skepticism is good, but too much of it is equally bad as having none.

  8. Everyone knows they do not want you to know Dexedrine and klonopin and medical marijuana is the BEST and only real medication that can be prescribed.

    Not everyone needs or should have drugs though. Maybe most people should not. If doctors write prescriptions, it has to be for dexedrine, benzodiazapines, or medical marijuana to treat depression, anxiety, adhd, or especially bipolar.

  9. I want to see an explanation to why doctors prescribe overdoses when they don't know how to help you and you have been on about 50% of all medication. I mean Michel Jackson was overdosed and he died from it. I got overdosed and found out so I stopped in time. Monty oum got overdosed and died. How many more need to get overdosed before someone does something to stop this trend. Doctors either overdose you or refer you when they don't have a way to help you, or what to prescribe you.

  10. Governments should do the testing. Drug companies should pay for it. They might farm out the work. If a testing company is caught cheating it gets a fine and no more contracts. putting it out of business.

  11. But what if those studies about publication bias were only published because they showed publication bias was true, but infact publication bias was in play. Lol

  12. Thankfully some of us are intelligent enough not to just trust and accept the supposed complete wisdom of doctors in every situation. Lol, so I can be prescribed one of several drugs for the rest of my life or if the first one I choose doesn't work "enough" or causes unacceptable side effects then I can rotate between the others until I eventually end on the most effective and most dangerous drug that just kills people once in a while but is otherwise great. Oh, and it'll all only cost tax payers or insurance companies (many other patients premiums) a few million dollars over my life. No thanks. Sometimes patients are smart and rebellious enough to study it all for themselves and mitigate chronic disease affectivally alternatively.

  13. These biases in medicines is even worse if you happen to be female. Most human test trials are done on males because female bodies are more complicated with their hormones and the risks of pregnancy.

  14. "The world will end on 5/11/08 then how am I still typing this and alive watching this in 2018 lamo

  15. Medicine like all business is in it for the money. Drug companies drive medical protocols. Those protocols push drugs. Governments need to push back and do their own research where drugs are suspected of offering minimal positive effect or negative effects. Drugs only treat symptoms, there maybe other options that treat causes that would be more effective.

  16. Ben Goldacre makes reference to the biotech company Amgen who had a team of about 100 scientists over 10 years trying to reproduce the findings of 53 “landmark” articles in cancer research published by reputable labs in top journals. They were only able to reproduce 6 of those studies, about 11%!

    How many cancer treatments and drugs being used today are based on the 89% of studies that have no foundation in science?  
    http://www.economist.com/news/leaders/21588069-scientific-research-has-changed-world-now-it-needs-change-itself-how-science-goes-wrong

  17. The problem with medicine in the world if people have to pay their bills the thesis their grants from going to college so they keep their mouth shut and let the bad stuff go on instead of having integrity and dignity it's all about money My Worship doctor's letter that donate their time to give help for nothing humanity is a disgraced what's going on today it's all about taxes money doesn't matter about people's lives.

  18. This is just one part of the problem. There are so many ways trials themselves can be manipulated that will still lead to bad science even if we can see all trials. So many trials are also just poorly conducted, while scientists are considered smart it seems like most are not smart enough to make sure they design trials in a way where the results actually mean something. Then again, might also be on purpose so they can get grant money and collect the big pharma paycheck in some instances.

    Add to that the limited scope of how we are researching many drugs. The vast majority of studies for antidepressants for instance only look at if there is an improvement in mood within 3-6 week. Are we that short-sighted? What doctor would prescribe something that makes someone feel better for a few weeks at a huge risk of long-term and short-term damage?

    I feel like 99% of doctors are just not using their brain at all.

  19. I think we should invent a t- shirt that
    Says “ I ♥️data dorks “
    And make them available to general public. Maybe we could advertise his book on the bottom – bad science.
    We need to promote morals and integrity in our Doctor all over the world and this might be a good place to start .

  20. wow, I was addicted to valium about 8 months ago (when I took my last pill) but I was addicted for about 5 months, and I know ppl have been addicted for way longer, but what a hellish five months it was!! it was actually CBD oil which weened me off of the benzo's, so thankful for it!!

  21. I really think this problem transcends the medical field and is the most damaging variant in the political sphere, as well as every other aspect of the documented studies that supposedly present the working knowledge we base our understandings on.
    Seeing as how the majority of us aren't even capable of amounting said working knowledge on our own, the publishing of misleading data will never be remedied as long as self serving bias's go unchecked.

  22. Anybody any idea, how to minimize the effect of publication bias until the problem gets fixed? Even reading all published online papers wouldn't help since the neg. results aren't available…

  23. Fix is easy to find, but until money is at stake, via HUGE fines for withholding results, it simply won't happen.

    1: register BEFORE you start the trial or no publication possible.
    2: Conduct study
    3: if you do not publish the result, a fine so huge that it'll make refusing to publish the result a death sentence for the company.

    Sadly, this will never happen unless a LOT of pressure is put on politicians that are in the pocked of large pharmaceuticals. I'm not holding my breath.

  24. The doctors don't know the antidepressants and ADHD drugs create the bipolar symptoms, which is why a scientific journalist had to point out these iatrogenic pathways that led to America's doctor created, in other words completely iatrogenic, not genetic, "childhood bipolar epidemic."

    https://www.alternet.org/story/146659/are_prozac_and_other_psychiatric_drugs_causing_the_astonishing_rise_of_mental_illness_in_america

    Although, the doctors did used to know the antidepressants created the bipolar symptoms, because the DSM-IV-TR does state, "Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder." But this medical wisdom was taken out of the DSM5.

    And the doctors claim to be ignorant of the fact that the antidepressants and antipsychotics can make people "mad as a hatter," psychotic, and filled with hallucinations. Despite the fact the doctors were all taught about antidepressant and/or antipsychotic induced anticholinergic toxidrome in med school.

    https://en.wikipedia.org/wiki/Toxidrome

    The schizophrenia treatments, the antipsychotics (aka neuroleptics), can create – not just the positive symptoms, like psychosis, of schizophrenia via anticholinergic toxidrome. But they can also create the negative symptoms of schizophrenia, via neuroleptic induced deficit syndrome.

    https://en.wikipedia.org/wiki/Neuroleptic-induced_deficit_syndrome

    But since neither of these medically known psychiatric drug induced syndrome/toxidrome are listed in the psychiatrists' DSM billing code "bible," the doctors claim ignorance of these medically known, psychiatric drug induced illnesses. And they always get misdiagnosed as one of the "invalid" DSM billing code stigmatizations.

    https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

    In other words, both bipolar and schizophrenia are illnesses that are created with the psychiatric drugs, they are not real diseases with a genetic etiology, as the psychiatrists incorrectly assumed. Let's hope the doctors some day soon learn this.

    I'd like to see an end be put to modern day America's on going psychiatric holocaust, primarily of our society's weakest members, our child abuse survivors, according to the medical literature.

    https://www.naturalnews.com/049860_psych_drugs_medical_holocaust_Big_Pharma.html
    https://www.madinamerica.com/2016/04/heal-for-life/

    Let's hope the psychiatrists and other doctors get out of the – cover up rape of children by turning millions of child abuse survivors into the mentally ill with the psychiatric drugs – business soon, since such a business is actually illegal. And it also aids, abets, and empowers the luciferian pedophiles, which is a stupid thing to do.

  25. Learn to heal with Mother Earth fast medicine: with sodium bicarbonate, hormone plants, and blood group nutrition – www.med-etc.com – have a great day!

  26. idk what kind of doctors you guys have mine wont give me anything that actuallly works they have only ever given me the weak stuff

  27. Dr. Goldacre eloquently explains the disturbing reality that the studies we rely on in medicine are much less based in evidence than we might think. Publication bias doesn’t just lead to an exaggeration of the benefits of a drug, it leads to mortality, as Dr. Goldacre highlights with the staggering 100,000 deaths that could have been prevented if death rates for lorcainide trials were accurately reported. It’s hard to believe that this bias is not common knowledge, and that many patients, family members, and caretakers must make decisions about their health and lives with these gaps in information that not even a trusted physician can bridge. I believe the most startling problem that publication bias of human clinical trials introduces is the muddling of informed consent. For those who may not know, informed consent requires a physician to disclose all of the expected benefits, risks, likely outcomes, and alternative options for a patient before prescribing a treatment or performing a procedure. Dr. Goldacre used the example 37 of 38 FDA trials showing positive results for an antidepressant being accessible while only 3 of 37 negative results were accessible, deliberately misleading physicians who act as the conduit between the drug and the patient in favor of marketing. If the physician is informed of nearly all the benefits and less than 10% negative outcomes that occurred during trials, can they truly obtain informed consent from their patients? Because the published records are all that any other physician or patient can access, the prescribing physician is technically operating within the standards of disclosure; so technically yes. However, any reasonable physician or patient would want to put the evidence they have into context, and they would want to know how publication bias can affect care. Thus, it is a moral obligation for the physician to become aware of this pervasive research misconduct, as Dr. Goldacre called it, and be able to communicate this reality to their patients while still seeking to provide the best possible individualized care with the evidence-based information they do have. It must also be the physician’s responsibility to fight to change these standards as part of their duty to protect their patient’s right to being fully informed in any way they can, starting perhaps by signing a petition as suggested in this video. Not to mention the obligation to combat this injustice must extend to all of the physicians-scientists, researchers, pharmacists, the FDA, journals, and anyone who could potentially interfere with such foundational ethical principles.

  28. Dr. Goldacre brings up a very important point in the context of evidence based medicine. His whole presentation begs the question “if we are cherry-picking evidence is any medicine actually evidence based?” This alone is a frightening idea however, I was struck by the ethical implications of the lack of trial publishing. Particularly, I feel this interferes with the ethical topic of informed consent. The American Medical Association (https://www.ama-assn.org/delivering-care/informed-consent) states that informed consent a caregiver disclosing the benefits, risks, likely consequences, and alternative treatment options. The patient must understand everything and then volunteer to undergo the treatment. In a nutshell, this protects the patient from a caregiver willfully hiding information from them to promote the caregiver’s own agenda. By withholding negative drug trial information an argument can be made that all medications have been taken without informed consent. A cornerstone of informed consent is making sure the patient is told and understands the risks of a treatment. If the medical community as a whole are not being told or understanding the risks of a treatment, they cannot pass that along to patients. I am in no way trying to imply that medical professionals are constantly working unethically. On the contrary, individuals are working as well as they can in the scope of our knowledge. However, this possible baseline violation of informed consent raises uncomfortable questions about the ethics of healthcare.

  29. Dr. Ben Goldacre’s presentation of the current fraud in the world of prescription drugs via evidence based medicine brings up a very interesting ethical dilemma in regards to beneficence, and physician’s recommendations of medication to patients. When deciding on the best prescription medication for a patient, physicians utilize published studies, with both positive and negative results, to determine the safety and effectiveness of that drug. Depending on those findings, some medications are seen as dangerous or ineffective and subsequently avoided, or appreciated for their affects and prescribed. However, Dr. Goldacre shed light on the systematic flaw that is present in this system, misleading both doctors and patients alike. His argument that “ About ½ of trials go missing and positive findings are twice more likely to be published” was astounding as this system is supposed to be the “go to” for health care. A physician’s role is to do no harm, and that includes knowing all the side effects of medicine they prescribe, something that is impossible to know if they do not have access to all of the information. Just as it is seen unethical for drug companies to give gifts to physicians, since there is evidence that gifts from drug companies strengthen physician's recommendation of that product, and impairing objectivity-so is the “publication-bias” that Dr. Goldacre explains is occuring every day. If a physician can’t trust the information they are being given, due to the fact that negative studies are often “cherry-picked” out, leaving only a small percentage of original information, then a physician cannot give the best care and truly “do no harm” if they aren’t aware of the possible harm their prescription could be doing to their patient. Dr. Goldacre mentioned that over 100,000 Americans died from the antiarrhythmic agent Lorcainide, due to studies depicting the negative results of the original trial were never published. In that study, all 5 patients given the drug died, and 4/5 given the placebo also died-causing the drug to be pulled from the shelves due to its dangerous effects. However, since the study was never published, years later several drug companies made a similar drug since they had no negative results influencing this decision, and over 100,000 people died before the new studies could be published. Patients trust that their doctors have their best interest at heart, and that the medication they are being prescribed is both effective and safe. This parallels the ethical notion of beneficence-the moral imperative act for the benefit of others. Beneficence is something that all doctors swear to uphold in regards to their patients, and includes recommending treatment options and medications that would benefit the patient, not harm them. If the studies being used by physician’s to determine the “level” of beneficence of a particular drug, are misleading and fraudulent due to withholding and not publishing a majority of the negative results regarding that drug, then this ethical responsibility is being both breached and prevented.

  30. I completely agree with speaker Ben Goldacre and his informational talk on the issue of publication bias. Publication bias can be especially dangerous when viewed through the lens of medical ethics.

    When doctors look at prescribing medications, especially medications that are new to the market, most of them strive to be as informed as possible about the medication’s effectiveness, benefits, and risks. They operate under the premise of non-maleficence – to “do-no-harm” – and yet despite their best efforts, if the information that they need is not published, they will unintentionally have a skewed view of the medication they prescribe. This is worrying considering that the trials with negative results that do not get published are likely to be the most transparent and informational resource about the medication’s negative side effects. Even in the tragic situation that the medication’s risky benefits outweigh all the negative side effects, doctors are ill-equipped to monitor their patients for the appropriate warning signs of any serious complications, all because these journals favor positive results over negative.

    Publication bias also makes it impossible for doctors to protect a patient’s autonomy. Doctors strive to abide by the ethical principle of autonomy, where it is their duty to provide each patient with the best chance of making well-informed decisions about their health care. However, if accurate, transparent information is not available to inform a doctor of a medication’s risks and side effects, they in turn cannot give their patients a clear, well-informed choice either.

    While I understand the excitement of positive test results and the forward momentum of innovation they provide to the scientific community, our progress is meaningless if we ever let our strive for discovery outpace our sense of humanity.

  31. Plz, plz, plz never stop. How in the world can u not want this practice to end IMMEDIATELY. And a million thx for exposing this. We need more like u.

  32. Thank you, Sir, for exposing the FDA and Pharmaceutical Industries for the frauds they are, the efficacy and ethical violations, and the lie that beats throughout the center of their Corporate and Federal Heartless Policies. Heartless. Profit above people, and yet they are known for what and who they are. It's not okay to walk over you and trample your patients, and in consideration of recent doctor suicides? Well, this pervasive bias is a massive problem. Call them out….. and yet? Now, it's an even bigger problem with suicided doctors yes? It's absolutely terrifying. I appreciate your good conscience and honest disposition, but take care to protect yourself. More than one-hundred doctors are suicided now from these monsters, and we're free to speculate, perhaps it's coincidence, but I think not.

  33. There is great evidence that modern medicine extends lives and the quality of life. The problem with it is that along the way there is a significant group that isn't helped or even hurt.

    Any physician scientist knows that any single study (even one with a large sample size) proves nothing. Decades of study results have sometimes shown conflicting results. Many study designs are extremely flawed. Very few studies are exactly looking at the exactly the same things. 'Similar' things isn't the same as 'exact things'.

    The amount of data that medical studies produce each year is more than incomprehensible. Condemning physicians, science or drug companies because it isn't perfect is the same as telling them that they are causing a net negative impact on people's health. We know that is not true.

  34. This is so very important! Replication or REPEATABILITY is one of the cornerstones of science. I’m a PhD student in geoscience/engineering and I find it so frustrating when I read papers and am not able to replicate even elementary results in the lab. Unfortunately, full scale replication is a very technically complex, time consuming, and expensive process. It is going to be to be impossible to do replication without heavy incentives. And currently incentives are basically a BIG ZERO! All of the emphasis is on novelty! We need to fix this across the board. Not just in medicine.

    (And no, this doesn’t excuse people for being anti-science! Plenty of great work out there.)

  35. At the start of the video the guy is obviously highly biased however it is true that doctors do not know about the drugs they prescribe, yes they are dangerous and yes they should be reviewed especially when it comes down to health.

  36. I told my mom (a cardiologist) and she said that she knew this was going on. That’s why she tries to prescribe alternatives to medication.

  37. the Golden Age of medial quackery is modern bio-medicine. Goldacre will never bite the hand that feeds him so don't be mistaken by this little effort that he is on 'your' side when it comes to non-harmful medicine.

  38. The academic journals get a large part of their money from either pharmaceutical research or selling article reprints (to drug reps).

  39. doctors don't prescribe
    they push just like any street corner thug
    they are nothing more than sales reps for pharma
    i fear doctors like you wouldn't believe

  40. I love Capitalism. My beef with it is parents having to pay 500 to 7000$ per pill for their kids. I feel that every parent is entitled to take a baseball bat to the CEO's of these companies. If I was a parent and it was my kid, I would be looking up the address of a CEO or two.

  41. I'd love to see all the trials done on vaccines that the drug companies have hidden. That would stir up a hornets nest!

  42. When is this guy going to set his mind on vaccines and the appalling lack of placebo safety trials and objective research? He seems to have a blind spot. Same companies , same regulatory bodies, same processes but even worse.

  43. If you really have guts then tell us why Cancer is still incurable despite so much funding and researches.

  44. This Guy should try looking in his own Backyard, He is not on my side, he is on his own. he is against Conspiracy theorists, Against Big Pharma, Against Billy Meier, Against MUFON, Against Tommy robinson, and he will continue to be against everyone else apart from his own.

    He will point out "Your Mothers Mistakes and demand money for doing so" he is no Royal Hero, he is a C U N T "We need a cheerleader hear to spell it out for him"

  45. So he bashes alternative medicine and yet he seems to understand why there is a huge mistrust in the medical mafia and it’s twisted system of educating doctors.

  46. Diagnosed with Bipolar Disorder 1… well, no pharma! I will not be your client. Make exercise, eat well… Have Faith in Jesus… The healing of the mind is possible.

  47. That also speaks volume about the value of "there is no scientific evidence that * insert name of any ancient medicine or cheap natural therapy * has any effect on such and such problem". When said therapy is used by millions of people at any given time successfully.

  48. Do you people really think these sinister drug dealing corporations care who they kill? No they don't. If 20 jumbo jets per year fell down from the sky that were full of people, we would take notice. But no one cares that thousands of people die from taking these poisons every year. Their system is not better than natural health

  49. Ben Goldacre needs to watch his back? Because big dollar science, does not want anyone knowing what they are doing?

  50. vaccine as well: hide the results: https://www.telegraph.co.uk/news/2018/09/15/health-regulator-withholding-vaccines-results-making-impossible/

  51. Who in the WORLD are the 107 that hit the "thumbs down" on this vid/presentation. Pls, i beg u…email me, or comment back, and if there is something i missed in why this presentation is wrong/flawed in any way…well….

  52. I know you're wrong about predicting the future I stood next to 15 different individuals and knew they were going to die within a week and they did I stood next to one of them and told her not to do what she was going to do that night and she died in a trailer fire you can't tell me you don't know the future

  53. The further we get from nature more dangerous we as a species become. Vaccines are another example of this.

  54. Sure, the pharmaceutical companies are essentially evil – but its the doctors that look the other way because of their fat salaries that allow this fraud to happen

    Anyone that spent a day or two studying vaccines would know more than the majority of doctors – that's scandalous

  55. I think it's a REAL PROBLEM they just bought the BS they were TOLD by drug reps (shocker!) about Oxycontin. "It's not addictive!" Direct quote!

    Never EVER buy what they tell you. Even when they DON'T KNOW! They'll keep seeing you, and CHARGING YOU. Just tell them bluntly, to not even bother charging you the co-pay. If you had a car mechanic NOT find or fix the problem, would you pay them??

  56. This has got to be criminal what thes fuckers are doing how do they get away with it. I guess money is more important than health smh

  57. doctors,drugs mafias, and food companies have made the world more diseased than it was before. and all happening in the name if science.

  58. BEFORE YOU BECOME A PSYCHIATRIST. It should be REQUIRED for everyone of them to TRY one fucking psychiatric drug before they prescribe it to ANYONE! These psychiatric drugs are MURDER!! I promise you. You will suffer from these pharmaceutical companies making money off of people committing suicide BECAUSE of what the drugs do to their brains!!!

  59. Ben Goldacre is speaking a lot of truth. He's aware that big Pharma uses much deceit to reap vast profits, while damaging & killing people. & YET, he's unwilling to be open-minded to the possibility that the big Pharma Vaccine manufacturers are pushing lies about the historical consequences of vaccines, & the current consequences & frauds. That they are making huge profits, while putting the public in MORE danger, & causing MAJOR damage, while CAUSING viruses to mutate into more dangerous forms.
    https://youtu.be/gn8xiiZwdDE

    & watch YT, dr. Humphries on the history of vaccines.

    & Google "Vaxxed". Watch the documentary for free.

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