1. The vast majority of clinical trails performed are ones that test one chemotherapeutic regimen against another. Single arm clinical trials provide the tumor response evidence that is the basis for approving new cancer drugs. The randomized, controlled clinical trial may likely remain the standard for evidence of clinical decision-making in cancer medicine, however, observational methods and systematic reviews are clearly useful. Even with the importance of clinical trials, it is crucial to work on reducing their inherent limitations, including uncertain generalizations, and to expand the use of the randomized clinical trial paradigm to areas beyond proving biological activity.

Evidence based medicine, since the 1970's, depended upon the randomized, controlled trial. It rests upon the assumption that evidence should be determined and applied as a basis for medical decision-making. Evidence is based upon quantities, similarities, populations, and averages, rather than qualities, idiosyncracies, individualization, and specifics. It would be surprising if the most ardent supporter of evidence based medicine would ever advocate a randomized trial for an intervention in which an observational study showed remarkable efficacy in preventing a near death situation. Many major medical advances have never been subjected to a prospective randomized study before being introduced into routine management because their beneficial effects have been obvious.

Recognizing the reliability of the evidence upon which clinical practice has increasingly come to depend, the time has come for physicians to reassess the value of direct observation, and to trust more readily both the empirical and intuitive discoveries they make each day in their personal experience, even if those discoveries are contradicted by the best available evidence. There could be nothing more serious than the call for physicians to reconsider what it means to be authentic and true.

Posted at 1:12AM on Sep 24th 2006 by Gregory D. Pawelski

2. D. Entenmann states, "The next time a reader comes by and extols the virtues of scientific medical research as the gold standard to which all else should be validated, I am simply pointing them to this investigative outcome."

I can cetainly agree that the "tentacles of drug companies" (as Re. Stupak has indicated) should be cut, but to infer from this that this invalidates in some way scientific medical research is what's called the "shooting the messenger" logical fallacy.

First expressed by Shakespeare and even by Sophocles:
("No one loves the messenger who brings bad news.")this fallacy is still made today. "Shooting the messenger" is a phrase describing the act of lashing out at the bearer of bad news. It's a subdivision of an ad hominem attack where one attacks the individual instead of the data. This Washington Post article had nothing at all to do with the validation of the scientific method.

That's been left to Mr. Pawelski.

"It would be surprising if the most ardent supporter of evidence based medicine would ever advocate a randomized trial for an intervention in which an observational study showed remarkable efficacy in preventing a near death situation."

We've heard this before about no one testing a helmetless child as he rides his bike into an oncoming car as we comapre that to a helmeted child. This is a ridiculous comparison and a red herring or a distraction from the seriousness of the subject.

"Many major medical advances have never been subjected to a prospective randomized study before being introduced into routine management because their beneficial effects have been obvious."

Perhaps. But, you can't compare one advance to another and how it should be tested. They must be examined individually.

"The time has come for physicians to reassess the value of direct observation, and to trust more readily both the empirical and intuitive discoveries they make each day in their personal experience, even if those discoveries are contradicted by the best available evidence. There could be nothing more serious than the call for physicians to reconsider what it means to be authentic and true."

This is an appeal to emotion. An appeal to emotion is a type of argument which attempts to arouse the emotions of its audience in order to gain acceptance of its conclusion. Despite the example of Mr. Spock from the original Star Trek television series, emotion is not always out of place in logical thinking. However, there is no doubt that strong emotions can subvert rational thought, and playing upon emotions in an argument is often fallacious.

If this emotional appeal encourages a patient to act, perhaps to get a second opinion, to read up on the realities of say alternative medicine and cancer, then I applaud it. So a motivation to act through emotion is good, but to appeal with emotion to influence a belief may very well be fallacious.

When physicians are instructed to simply trust their gut feelings, their intuition, to be true, authentic, then I suspect we open a monstrous can of worms with everyone putting a shingle outside his or her doorway and declaring "I'm a healer and I am open for business."

Posted at 12:07PM on Sep 24th 2006 by Michelle

3. There are a number of scientists from respected research facilities across the United States that say much of what is known to be true about cancer is false. Many of the basic assumptions and theories that are driving most of today's cancer research are false. There has been almost no improvement in the cure of most types of metastatic cancers over the last thirty years.

Despite the media hype about the breakthroughs, clinical trials of cancer drugs are failing with painfully predictable regularity. "Chronic control" has replaced "cure" as the goal of many in the research community. Some researchers say insufficient consideration has been given to the requirements for the "cure" of cancer without significant toxicity to the patient and without severe side effects. They say the problem is tumor cell evolution.

Most cancer research has focused on discovery of the differences between cancer cells and normal cells. The hope has been that these differences can provide a basis for understanding and targeting cancer cells. Drugs have been made to target and kill cancer cells. But the truth is that despite these drugs, patients continue to suffer and die of cancer at virtually the same rate. The conventional approach is not working, we can do better.

Posted at 7:18PM on Sep 24th 2006 by Gregory D. Pawelski

4.
Eli Lilly 3Q 10% profit rise is nearly all from psyche drugs including zyprexa.

How have they schemed to squeeze more money from their zyprexa cash cow when pill production has actually gone down?

ANS-Eli Lilly profiteers have jacked up the price of zyprexa to the federal govt,from the Medicare D payouts.

Eli Lilly is a big drug company that puts profits over patients.

They covered up findings that their Zyprexa has a TEN times greater risk of causing type 2 diabetes

Only 9% of Americans trust big pharma,right around the same rating as tobacco companies.

Daniel Haszard Eli Lilly zyprexa drug caused my diabetes www.zyprexa-victims.com

Posted at 8:17AM on Oct 22nd 2006 by Daniel Haszard