Three Blind NICE

al_leister

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Greedy Humans.....greedy animals I don't mind. I do like meat and fish but choose not to eat it!
In their 40 years of practice after leaving medical school, doctors hear about what works ad hoc, from sales reps, colleagues and journals. But those colleagues can be in the pay of drug companies – often undisclosed – and the journals are, too. And so are the patient groups. And finally, academic papers, which everyone thinks of as objective, are often covertly planned and written by people who work directly for the companies, without disclosure. Sometimes whole academic journals are owned outright by one drug company. Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it's not in anyone's financial interest to conduct any trials at all.

And this data is withheld from everyone in medicine, from top to bottom. Nice, for example, is the National Institute for Health and Clinical Excellence, created by the British government to conduct careful, unbiased summaries of all the evidence on new treatments. It is unable either to identify or to access data on a drug's effectiveness that's been withheld by researchers or companies: Nice has no more legal right to that data than you or I do, even though it is making decisions about effectiveness, and cost-effectiveness, on behalf of the NHS, for millions of people.
In any sensible world, when researchers are conducting trials on a new tablet for a drug company, for example, we'd expect universal contracts, making it clear that all researchers are obliged to publish their results, and that industry sponsors – which have a huge interest in positive results – must have no control over the data. But, despite everything we know about industry-funded research being systematically biased, this does not happen. In fact, the opposite is true: it is entirely normal for researchers and academics conducting industry-funded trials to sign contracts subjecting them to gagging clauses that forbid them to publish, discuss or analyse data from their trials without the permission of the funder.

http://www.guardian.co.uk/business/2012 ... n-goldacre
 

Shaun IDD1970

Member
Messages
10
Remember too that NICE has a political objective: save costs.

They publicly ignored US research and US prescribing that identified 1 (new therefore expensive) drug as having very beneficial benefits in regressing breast cancer.

A year or 2 ago it was roundly concluded in the press that NICE's were driven by cost, as they defended the use of cheaper drugs in the UK that had significantly less benefit to patients.

This practice may be lifted when growth comes back into the economy and the country can afford to look after itself.


Shaun Leahy
IDD 1970
www.alphaenterprises.co.uk
 

dawnmc

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Non-insulin injectable medication (incretin mimetics)
In the news it says that doctors are going to have to undergo a test to see if they are still competant. It's about time, teachers have to do a maths and english test every now and again. Social workers have to go on regular courses to comply with BASW. Maybe others know of other professions that have to keep up to date.
 

Daibell

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Hi. It's interesting to compare the public versus the private world of work. I'm a professional engineer now retired. Although engineers don't have tests, they have to design and deliver products that are competitive, reliable, functional, safe etc and it's the pressures of the market-place that forced me to constantly keep up with current knowledge to be ahead of the rest as far as possible; the marketplace was my measure. It is more difficult for GPs to be measured although I know the government is trying to do what it can. If patients were able to change surgeries more easily it would help people to go to the better GPs. Most people rapidly find out who the 'good' and 'bad' GPs are in a surgery but it is not easy to visit the fully-booked good ones.
 

GraceK

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dawnmc said:
In the news it says that doctors are going to have to undergo a test to see if they are still competant. It's about time teachers have to do a maths and english every now and again. Social workers have to go on regular courses to comply with BASW. Maybe others know of other professions that have to keep up to date.

Doctors are already undergoing 'tests' to see if they are still competent, they're called GP Appraisals'' and I worked in the department that arranged those appraisals. It goes like this - Who does the testing? Other doctors in General Practice who have become 'assessors' and who are paid a fee for assessing their colleagues competencies. Can a GP choose who they wish to be appraised by? In some case, yes they can. It's not done by an outside body, it's done by other doctors - which I think stinks to high heaven.

Every time I see that abbreviation 'NICE' it makes my flesh creep.
 

dawnmc

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It's like anything Grace, the police 'police' themselves etc. I'ts not good enough really is it.
 

GraceK

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dawnmc said:
It's like anything Grace, the police 'police' themselves etc. I'ts not good enough really is it.

Nope, it isn't.