[johnt]

Ben Goldacre in the Guardian

http://www.guardian.co.uk/commentisf...ence-new-drugs

makes an interesting point:

"So it turns out that, out of all the 197 new drugs approved in the past decade [by the FDA], only 70% had data to show they were better than other treatments (and that's after you ignore drugs for conditions where there was no current treatment)."

Goldacre doesn't mention Parkinson's explicitly, but let's set it in our context. Consider a test (finger tapping, for instance) in which a well person would score 40, a PwP on existing medications score 30 and a PwP on no medications scores 10.

Now a new drug comes along claiming a 50% reduction in symptoms. Good news? Possibly. It could be a number based on the present treatment which still leaves the PwP with a deficit of 10 (40 - 30), the new drug halves this, leaving a score of 35. Alternatively, it could be based on the untreated score. In which case the deficit will be reduced from 30 (40 - 10) to 15, leaving a score of 25, which is worse than what we have now.

And we haven't even looked at issues surrounding the suitability of the metric, who is tested, etc., which could make the new drug even less useful.

John

[paula_w]

Originally Posted by johnt

Ben Goldacre in the Guardian

http://www.guardian.co.uk/commentisf...ence-new-drugs

makes an interesting point:

"So it turns out that, out of all the 197 new drugs approved in the past decade [by the FDA], only 70% had data to show they were better than other treatments (and that's after you ignore drugs for conditions where there was no current treatment)."

Goldacre doesn't mention Parkinson's explicitly, but let's set it in our context. Consider a test (finger tapping, for instance) in which a well person would score 40, a PwP on existing medications score 30 and a PwP on no medications scores 10.

Now a new drug comes along claiming a 50% reduction in symptoms. Good news? Possibly. It could be a number based on the present treatment which still leaves the PwP with a deficit of 10 (40 - 30), the new drug halves this, leaving a score of 35. Alternatively, it could be based on the untreated score. In which case the deficit will be reduced from 30 (40 - 10) to 15, leaving a score of 25, which is worse than what we have now.

And we haven't even looked at issues surrounding the suitability of the metric, who is tested, etc., which could make the new drug even less useful

John

and how does one stop the madness of statistics in an illness that changes every hour? i recently went to the NIH and received a score of 32 stage 3.

i finally remembered to ask! The doctor then said, "that's your score today - right now". i fully understood.