So what's really going on here?
 

I was telling my friend about the thread on "so called specialists" and she mentioned that just that morning she was listening to the Diane Rehm show and they had a Neuroscientist on talking about his latest book and he got onto the subject of modern medicine for a bit and here's what came out. And if true this is why I'm very concerned with all the meds being thrown about and recommendations of surgeries etc. Take a look.

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Daniel Levitin, Neuroscientist
The Organized Mind: Thinking Straight in the Age of Information Overload




When making decisions with your physician concerning recommended treatment, it is important to ask two questions. E.g. - if your cholesterol is high and the doc recommends a statin, ask these questions first, then discuss your odds.

1. "What is the number needed to treat," ie how many people have to undergo a treatment in order for one person to benefit.
This statistic is a known in the med. prof.
When using statins to treat high cholesterol: for every 300 people given the statin, 299 will show no benefit, while one patient will benefit.

2. "What are the side effects?"
Statin use: 5% of the people taking the statin will develop debilitating gastrointestinal and/or joint/muscle disorders
5% of 300=15.
Therefore, you are 15X more likely to become debilitated by the above than to be helped by the statin..

Example 2: doc recommends prostate surgery
The number needed to treat is 49 (for every 50 men having the surgery, 1 will benefit). Therefore, any one guy has a 2% chance he will be helped by the surgery.
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I'm so glad I refused a prostate biopsy many years back when a doc said he felt a lump. I knew that a biopsy could deposit cancer cells into my bloodstream. Seven years later I had it checked by the emergency room doc and he said it was small, smooth and felt very healthy. Prostate surgeries are prone to side effects. With a 2% chance of success against a much higher risk of failure I know what a gambler would do. This guy said your doctor will not likely be happy about you asking such questions but you better.

I may not be a fan of statins, but I don't believe this "known in the med. Prof." statistic that only 1 for 300 treated will benefit. I'd like to see where this 'known' fact came from...any link to it's source?? Even in his book, he would have to site this in his sources.

This is one explanation of "number to treat":
http://www.thennt.com/nnt/statins-fo...heart-disease/

and another explanation:
http://www.thennt.com/nnt/statins-fo...heart-disease/

http://www.docsopinion.com/2014/05/1...-statinistics/

http://www.bloomberg.com/bw/stories/...gs-do-any-good

You can find many articles on NNT (needed to treat) on line.
Try to find the more recent ones...as the old ones accept potentially flawed/fraudulent studies.

There is a petition out there now to have Big Pharma make public all their studies ..ALL ... showing the negative ones.
It should be very revealing. As in what happened to Paxil and its negative studies showing no effects in teens and children.

No, I don't and I didn't hear the program. My friend sent me this. I'm going to try it out on my next dr. visit. Then I'll find out for myself.

Please let us know how that goes.

Will do. Unfortunately my last app. was yesterday so it may be some time before I see him. Or I'll see him next week. I never know these days. :confused:

This an area that I work in, so I guess I'll offer my one or two cents. I will say up front that I'm not a biostatistician (and I'm glad that I'm not one because they are a weird bunch). Statistics are mostly up over my head, but I know a tiny bit about it.

If you bring up the number needed to treat (NNT) for any given drug with your physician, they will likely explain that summarizing all the trial data through any one single number might be problematic and have limitations (and they would technically be correct). Or they might just shrug their shoulders and scratch their head because they don't really know. There are even some crazy doctors out there that would love to put statins in the water supply. And this is why it is good for all of us patients to have a bit of knowledge to be able to protect ourselves from harm.

Data calculations on large clinical drug trials are very complex. First, the stats people will do hypothesis testing on the data. Maybe you've even heard of terms like p-value or null hypothesis or t-test. They are just trying to answer some simple questions - Does the drug work? Is treatment A better than treatment B? Is there a dose response? Are treatments A and B clinically equivalent?

At this point they know to what extent there is a treatment effect. But there are other ways to measure treatment benefit and harm, so they will calculate odds ratios (odds of a patient suffering one or more serious adverse events), relative risk, relative benefits, and NNT. There are advantages and disadvantages to each of these calculations, which is beyond my understanding.

Most people would find the NNTs for statin drugs shocking. The data for statins really only points to helping middle-aged men who have already experienced a heart attack (secondary prevention). The other group that might want to consider a statin are those with familial hypercholesterima who have a genetic defect with their LDL receptor. So if people fall into those two categories, by all means, take a statin. But if you are outside of those categories, definitely consider things like number needed to treat or absolute reduction in risk.

Many studies like to put their numbers in terms of relative reduction of risk and not absolute reduction of risk because it makes them look more impressive. I find this to be very annoying and dishonest. For example, if you take a drug and it reduces the risk of having a disease from 2% to 1%, well then the absolute reduction in risk = 1%; this number is not very impressive sounding. But if were to use relative reduction in risk, then the number would be 50% reduction in disease risk. This sounds way more impressive. So always check the fine print on any study - did they use absolute risk or relative reduction in risk.

I found this neat little website that gives the NNT by medical specialty and organ system. I haven't totally vetted it out, but lists sources for all the numbers that it gives.

http://www.thennt.com/home-nnt/

Sorry I rambled, but I enjoy this topic.:) Have a good, pain-free weekend everyone!

HAHAHAH! Nice work mrsD! I just realized that I linked to the same website as you.

This is a huge, enormous problem.