tag:blogger.com,1999:blog-14743001.post3164420824852692862..comments2024-01-02T02:45:17.328-06:00Comments on Notes from Dr. RW: Accusations of disease-mongering and medicalization---are they evidence based?Robert W Donnellhttp://www.blogger.com/profile/16944231400440786271noreply@blogger.comBlogger11125tag:blogger.com,1999:blog-14743001.post-19979682684042235452007-02-19T16:35:00.000-06:002007-02-19T16:35:00.000-06:00THE OLD SYSTEM IS COMING DOWN. I can hear the Drum...THE OLD SYSTEM IS COMING DOWN. I can hear the Drums beating. Bugs are outpacing Drugs. The next epidemic is here. Go to www.wsvn.com and Look at the Brilliant, Patrick Frazier (great journalist) he wrote a segment called: "Body Bugs" this says a lot and also look at the video. <BR/>www.wsvn.com scroll to "Body Bugs".<BR/>We have all been delusional and people are now screaming loudly. They want Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-14743001.post-15241027665233702102007-02-10T12:07:00.000-06:002007-02-10T12:07:00.000-06:00Anonymous said "In my understanding, the accusatio...Anonymous said "In my understanding, the accusations disease-mongering usually apply to primary prevention i.e. labelling people who were considered 'healthy' yesterday as 'sick' today because of the lowered guidelines and thus increasing the number of people who are considered to have a disease." <BR/><BR/>That's what the video implied, and that's what everybody is screaming about, and it's not Robert W Donnellhttps://www.blogger.com/profile/16944231400440786271noreply@blogger.comtag:blogger.com,1999:blog-14743001.post-9702927504803901862007-02-10T10:50:00.000-06:002007-02-10T10:50:00.000-06:00Concerning "As far as lowering the targets -- so h...<I>Concerning "As far as lowering the targets -- so how many people do you need to treat whose numbers are above these new targets but below the old ones to prevent one heart attack or stroke?" In the converting healthy people as sick, i.e. primary study I cited the NNT was 45, over about 5 years.</I><BR/>Please correct me if I am wrong, but this was the study of secondary prevention for the Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-14743001.post-85231254002988444202007-02-09T19:58:00.000-06:002007-02-09T19:58:00.000-06:00Primary prevention in women has not been the focus...<I>Primary prevention in women has not been the focus of industry promotion, and the evidence is pretty slim.</I><BR/>Is this reflected in the guidelines?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-14743001.post-81114971814113175242007-02-09T14:26:00.000-06:002007-02-09T14:26:00.000-06:00To anonymous #3---Concerning "My 10-year risk of h...To anonymous #3---<BR/>Concerning "My 10-year risk of heart attack given my age, weight and risk factors (including cholesterol) is under 1%. So, tell me please, how come my doctor wanted to give me statins for LDL 4 points above threshold for my risk factors (btw - my triglicerides were low and my HDL high)."<BR/><BR/>So you want me to somehow explain why your doctor didn't practice EBM? If youRobert W Donnellhttps://www.blogger.com/profile/16944231400440786271noreply@blogger.comtag:blogger.com,1999:blog-14743001.post-8522042543006205812007-02-09T14:25:00.000-06:002007-02-09T14:25:00.000-06:00To anonymous #3---Concerning "My 10-year risk of h...To anonymous #3---<BR/>Concerning "My 10-year risk of heart attack given my age, weight and risk factors (including cholesterol) is under 1%. So, tell me please, how come my doctor wanted to give me statins for LDL 4 points above threshold for my risk factors (btw - my triglicerides were low and my HDL high)."<BR/><BR/>So you want me to somehow explain why your doctor didn't practice EBM? If youRobert W Donnellhttps://www.blogger.com/profile/16944231400440786271noreply@blogger.comtag:blogger.com,1999:blog-14743001.post-1812593145672218882007-02-09T12:49:00.000-06:002007-02-09T12:49:00.000-06:00And what about cholesterol? I don’t see anyone def...<I>And what about cholesterol? I don’t see anyone defining high cholesterol or making it into a disease. The disease is atherosclerosis. We moved beyond worrying about what’s defined as high or low years ago in favor of setting treatment targets appropriate for the patient’s risk.</I><BR/>Yes, right... My 10-year risk of heart attack given my age, weight and risk factors (including cholesterol) Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-14743001.post-21840170474882955182007-02-09T12:09:00.000-06:002007-02-09T12:09:00.000-06:00Primary prevention in women has not been the focus...Primary prevention in women has not been the focus of industry promotion, and the evidence is pretty slim.Robert W Donnellhttps://www.blogger.com/profile/16944231400440786271noreply@blogger.comtag:blogger.com,1999:blog-14743001.post-76896317301294677822007-02-09T12:01:00.000-06:002007-02-09T12:01:00.000-06:00These treatment targets have been lowered not beca...<I>These treatment targets have been lowered not because of any re-definition of high cholesterol by industry, but because it’s supported by evidence.</I><BR/>Would you care to demonstrate this evidence with regard to primary prevention in women?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-14743001.post-21362527938340293492007-02-09T11:21:00.000-06:002007-02-09T11:21:00.000-06:00To anonymous---All research is tainted by conflict...To anonymous---<BR/>All research is tainted by conflict of interest in one form or another. The fact that a drug company (or any other interested party) pays for a study should cause us to look critically at the results and methods, not reject the conclusions out of hand (the *ad hominem* fallacy of rejection by affiliation). I'd be more than happy for you to challenge the new targets based Robert W Donnellhttps://www.blogger.com/profile/16944231400440786271noreply@blogger.comtag:blogger.com,1999:blog-14743001.post-36740352512818534102007-02-09T10:15:00.000-06:002007-02-09T10:15:00.000-06:00Just let me ask you one thie:Who exactly finances ...Just let me ask you one thie:Who exactly finances the studies to define the threshold for cardiovascular risk? The drug companies do.Is this not a conflict of intrest and does it not introduce a hefty dose of bias into the supposedly objective scientific basis for the changes in BP and other targets? Not everybody who comments on this phenomenon is a conspiracy theorist.Anonymousnoreply@blogger.com