Spin in Medical Results

This ABC piece by John Paulos points out how the public is misled about the magnitude and significance of medical results.

That being said, imagine that a headline announces that screening for cancer X reduces deaths from it by 25 percent. Imagine as well that another headline announces that screening cuts deaths from cancer X by about 1 in 1,000, reducing the rate from 4 in 1,000 to 3 in 1,000.

25% is much more impressive than a drop of 4 in 1,000 to 3 in 1,000

See this in a British newspaper touting the results of the Jupiter study. This article reads like a PR release from AstraZeneca the makers of Crestor.

The Jupiter study showed heart attacks were cut by 54 per cent, strokes by 48 per cent and the need for angioplasty or bypass was cut by 46 per cent compared with a placebo. Levels of ‘bad’ cholesterol were halved.

Experts say the results would not necessarily be found with other statins because some work differently.

But in another interpretations of the Jupiter study published in the New England Journal:

The relative risk reductions achieved with the use of statin therapy in JUPITER were clearly significant. However, absolute differences in risk are more clinically important than relative reductions in risk in deciding whether to recommend drug therapy, since the absolute benefits of treatment must be large enough to justify the associated risks and costs. The proportion of participants with hard cardiac events in JUPITER was reduced from 1.8% (157 of 8901 subjects) in the placebo group to 0.9% (83 of the 8901 subjects) in the rosuvastatin group; thus, 120 participants were treated for 1.9 years to prevent one event. (Medicynical emphasis)

Not nearly as impressive as the 54% reported in the news article.

This type “interpretation” of results is common. PhARMA companies maximize the “benefit” by using relative rather than absolute values. In addition to overemphasizing the medical benefit their interpretation also doesn’t factor in toxicity and cost. Somewhere, somehow in our “reformed” health care system we need to look at this.

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