Friday, 17 September 2010
Evidence (or lack of it ) Driving Healthcare Objectives.
Science itself, has been corrupted in many ways. Studies are now undertaken almost exclusively by makers of drugs, prosthetics and diagnostic machinery. Very little 'peer review' of the outcomes or dangers is undertaken, except by those same makers. The manufacturers are now corporate entities that span the globe and have sales in excess of small (and not so small) countries. Their influence in our everyday lives has become both persuasive and pervasive and sadly, Medicine and Healthcare slavishly follows the hypotheses propounded by various segments of the Public Health Community, the Regulatory Bodies, the (so called) Charities, all, who stand to gain, from the perpetuation of a disease, condition or ailment, because elimination would hail their demise.
Each feeds on the other, perpetuating the appearance of scientific unanimity, about a health benefit for which there was probability, which becomes a certainty. Drugs only prescribed for seriously ill cohorts, then become beneficial for the 'worried well'. Protocols are invented to guide what we eat, drink, spend our leisure time embracing, all guided by dubious healthcare benefits, for which there is weak evidence of any good or useful outcome. Powerful tools and organisations promote goals for which there is no real opposition, because it is not brooked, even in the face of incontrovertible proof that it is of no benefit, or worse, that it does harm. Possibility, becomes probability, and then certainty. Everything is presented as such; rational discussion is absent. Advice becomes diktat and all dissent is marginalised.
National policy currently advises us all that;-
Fat makes you fat and causes heart disease - not proven.
Cholesterol gives you heart disease - not proven, in fact proven to be false.
Statin's lower the risk of heart disease, in everyone - proven to be false.
Statin's lower heart attack risk in men with heart disease - now viewed as unlikely.
Hypertension (high blood pressure) is caused by salt - contradictory evidence therefore not proven.
Regular Mammograms save lives - in fact they do more harm than good.
Cancer rates are falling - not true, we are just better at extending the lives of those with it.
Heart disease rates are falling - as above.
Five-a-day lowers heart disease risk - in fact no benefit accrues.
Five-a-day lowers cancer risk - in fact there is little to no benefit except a small one for the vegetables only.
Green leafy vegetables lower diabetes risk - very little benefit.
The list is becoming too long, so I will stop now to save boredom setting in, but I can prove everyone of these tenets of healthcare to be either wrong or of so little benefit as to be virtually worthless. So how come the public doesn't know this and the bodies for whom we look to guide our health continue to peddle this worthless drivel? Well it's complicated. 'Big Pharma' and the food and drink industry have permeated all the agencies of the state and Politicians are so busy perpetuating power that they are indifferent to reason or dissent. Conclusions about healthcare are presented to the public with such forceful conviction that no balance now exists with the strength of the evidence that guides them or any that opposes it. There is a view that only the Politicians and the professionals that guide them, can weigh the evidence and they often view these protocols as inherently benign. So no harm then? Well er .. yes, but let not the truth guide you, if you are a Politician or 'Big Pharma' or the Food Standards Agency etc.etc.