Honestly, I am glad to see these things come to light in specialties other than psychiatry. There have been many times I felt that others blow off the psychiatry scandals with one of two excuses: either the patients are "making it all up" (like withdrawal symptoms, etc.) because what can you expect from mental patients (sarcasm alert!), or they discredit the doctors by saying "well, of course psychiatrists would do underhanded things--they'll do anything that might help them prove they are REAL doctors, even to making up research data etc., or we all know psychiatrists are all nuts that's why they went into psychiatry to begin with, so who wouldn't expect them to do stuff like this, with the power trips and narcissism, etc." (sarcasm alert again). I don't believe either of those things as a generalization, but I know many people who do, and they have been the foundation for many rationalizations about why the "general public" doesn't need to care all that much about the psychiatry scandals.

To see this happening in other specialties brings welcome credibility to what is happening in psychiatry. Yes, we've seen things like the Vioxx scandal, the Vitorin mess, and the HRT debacles. I hate to see any of this happening at all, because first and foremost it all hurts the patients, and the scandals hurt the medical professionals too, the honest ones who are trying to help, who depend on journals and CME for their livelihood, the ones who CARE. And yes, they are out there. I hate to see it happening, but the more this stuff comes to light across specialties, the more chance I see that something can be done to make it stop. I wish I knew what that was, but at least a shake up might make it come faster.

So in a sad, weird way, it is comforting to me to know that we (who see what is happening in psychiatry and despise it) are not alone. In the long run, I think that will help our causes.

If you think this is big news? Someone should take a serious look at the research defining the risk of second hand and now third hand tobacco smoke. Its like a traveling medicine show with all the familiar confidence racket plugs built into the process.

Who funds it all? Well Pfizer had a certain amount of inspirational following, but Johnson and Johnson's ad agency they like to call the Robert Wood Johnson Foundation has not only grabbed at the brass ring they laid claim to the whole amusement park.

The anti-smoker [not smoking] campaign; if targeting any other identifiable group on the planet, would inspire lengthy jail sentences, but hell who could lower themselves to fighting for a smoker? They aren't even considered human any more. Entirely reminiscent of the Jews in post war science. You remember the eugenics system of "protecting us from them", that thing we blamed on Hitler?

Here is an example of modern wisdom at work and beyond the grasp of peer review;

http://www.bmj.com/cgi/content/full/315/7114/980

This one is rich;

"There was no evidence of publication bias against negative studies. "

Can you find a published negative study?
I know of just one, the largest one to date, and look at the comments, especially aimed at the Editor, no publication bias indeed.

http://www.bmj.com/cgi/content/full/326/7398/1057?ijkey=a7fce859b1b499e3151f3b860bd59fd7465bf026

It would be like telling someone Global warming was a fraud...
http://www.youtube.com/watch?v=FfHW7KR33IQ

The paper goes on in raising the bar to make this statement;

"Overall estimate of risk of lung cancer
Adjustment of the observed relative risk of 1.24 (1.13 to 1.36) for misclassification bias reduced it to 1.18 (1.07 to 1.31); adjustment for dietary confounding further reduced it to 1.16 (1.04 to 1.27), but adjustment for exposure to environmental tobacco smoke in the reference group increased it to 1.26 (1.06 to 1.47). The effects tend to cancel, and the unadjusted (observed) pooled relative risk is a valid estimate of the true risk."

Slight of hand?
The reference group was expossed so we can increase the risk from 1.16 to 1.26.

Does it fall to anyone's intelligence we are comparing the differences between two groups here. Both groups had exposure to second hand tobacco smoke, so how would this not, at most, cancel out the common exposures? The referenced group was given credit and where is the offset to balance that credit?

It seems without the crafted increase, the result risk [at 1.16] would fall below the controversial Enstrom and Kabat research findings [At 1.19] declaring the risk of second hand smoke was largely over blown.

More recently we were treated to this gem along side published research in a medical journal;
Authored by anti-smoker advocates Paschal Diethelm and Martin McKee.

http://eurpub.oxfordjournals.org/cgi/eletters/19/1/2

"scientists who have challenged the causal connection between secondhand smoke and lung cancer are comparable to Holocaust deniers"

And now this;

"sending smokers to work with indigenous people was like allowing convicted pedophiles to work with children."

http://www.ntnews.com.au/article/2009/02/26/35731_ntnews.html

How much is enough?

This is not science, this is theological imposition.

Another, out-of-psychotropic, area, is cardiology. I believe I read somewhere that Grassley is going to train his laser eyes on that field - most likely to uncover the same fraud and abuse both in pharma and surgical procedures and devices.

It's everywhere, have no doubt. But I will still with psychotropics - there is plenty, if not way too much, to do right in this field.

Most of us think of anesthesiologists as the guys and gals who knock us out for surgery. These days, they're just as likely to specialize in "pain management" for folks with chronic ailments and unfixable injuries. The scramble to write scripts for expensive, on-patent drugs is intense; the profits are huge, and the dangers are many. Celebrex just barely escaped being yanked from the market along with its fellow Cox-2 inhibitor Vioxx. It probably should have been. Lyrica is a close cousin of Neurontin, which came into its own just when Neurontin was going off patent and its massive irresponsible off-label marketing was finally being exposed. Cymbalta is also being prescribed in bushels by these pain specialists -- generally with NO warning or awareness of its psychoactive properties and risks.

"Multimodal analgesia" is just a fancy phrase meaning "treating pain with a variety of things." In other words, with cocktails of pills whose effectiveness is overhyped and whose risks are skilfully underplayed -- but which can be relied on to cost a bloody fortune. If you think depression and anxiety are big juicy markets, how about arthritis and back pain?

It's not only in psychiatry that for-profit medicine is draining our bank accounts and threatening our health. It's just a tad bit easier to do in psychiatry, because the patients' reports of their own experiences are, by definition, not to be listened to. If only unwilling arthritis patients could be medicated by court order! The profits would be awesome...