truth in advertising

the truth hurts. recent ads for a medicine for gout picture a man carrying a big glass container of green liquid with him wherever he goes. he's got gout, caused by high levels of uric acid in his blood. along comes the medicine, uloric, and voila! he is now carrying around a smaller, though still substantial, glass container of green liquid. i'm sorry, but that's not reassuring. it would be like a cancer center ad showing people who added a couple of painful days to their lives instead of years of joyous living.
this truth alongside the 'two bathtubs on a deck' commercials for cialis. seems that cialis makes you go from mowing the yard or changing a lightbulb to having sex in a tent in your (now gorgeous manicured) back yard or a (where did that come from?) waterfall in the woods that just showed up in your living room. not so much truth there, i think.
give me the days of the PF Flyer shoes. they said they made you run faster and jump higher and by golly, i ran faster and jumped higher when i got a new pair, every time, as far as i knew. it sure felt like it. in the movie Sandlot, Benny "the jet" Rodriguez dons a pair of brand new PF Flyers before his monumental battle with/run from 'The Beast'. they worked for him, too. that 'truth' was a little easier to swallow than the previous examples. one is too much truth, the other pure fantasy (get inside and take a shower, you're all sweaty from mowing the yard!).
the most recent addition to the 'too much truth' category is the T mobile ad. and the worst part is, they are marketing the too much truth part and i don't know if they realize it.
in the ad a dad and mom and a kid are carrying huge piles of books, tv's, dvd players and dvds, computers, etc., etc.  they are bowing under the pressure of all that stuff and the pretty T mobile girl wonders why they don't have a phone that could have all that stuff inside it instead of carrying it all with them. well...if they get the phone, sure, no more big physical load of stuff, but still the same pile of junk, only now electronically stored for access whenever they want it. the irony of the whole thing to me is that they don't need to carry around all that junk all the time, even if they can (yes, i carry an iphone 4), and the fact that one can advertise as if being able to cram all that junk into a phone (smart phone is an oxymoron in my book) is a good thing that people should strive for, is an indictment of our culture and one that someday may be our undoing. we seem to think there is, or should be, an app for everything, and that by having that app we can do anything.
they need to make an app for the guy with the glass container of green liquid, maybe then instead of a lesser of two evils type of ad it could be just one more thing the guy has piled up on his junk pile of stuff that he's going to be able to put on his phone.

is anybody else reading this stuff?

it's funny when i set my mind on something, in this case looking for things for the 'duh' files or looking for things that disagree with the prevailing thoughts on medicine/healthcare, that something just jumps up at me from a sort of unlikely source. in this case it's newsweek magazine - the january 31, 2011, issue. under 'scope, health matters, science+: why almost everything you hear about medicine is wrong.
that's the headline of the article. so, of course i read it.
seems that 'the very framework of medical investigation may be off-kilter, leading time and again to findings that are at least unproved and at worst dangerously wrong'.
we used to think (or, let's say i used to think, as i had been trained to think, with most of my western medicine trained colleagues) that medical trials were rigorously controlled and that the outcomes couldn't be compromised by the authors or the companies paying for the studies of whatever drug or treatment or test was being studied. it was only 'those nonmedical, no fda-approved, non double blind placebo controlled studies' that were suspect. how stupid was that? apparently pretty stupid. i don't know whether to believe the ones i wasn't supposed to believe or just disbelieve the ones that were supposedly done right.
the effect on the practice of medicine in the western world, where drugs cost everybody so much, could be tremendous. tremendous in a good way, as far as i'm concerned. yes, pediatrics is 'safe' in many ways from the statins and the diabetes drugs and the antidepressants and psa tests, etc., but they are still used. and then, after all, pediatricians are people, too, and some are of an age where these medicines and tests are being recommended to us.
what if, instead of overhauling healthcare the way it is, it's overhauled pretty much from the inside out? cut about a trillion (a trillion is a million million, just for you math folks) in drug cost from the national healthcare bill and wow, it's not so bad! instead of figuring out how to pay for all those 'necessary' meds and treatments that studies show are good and safe and effective, and that we now know may not be any of those things, we just pay for the stuff that's really helpful. that should be easy to figure out...not. who's going to do the study to prove which treatments and drugs and tests are really needed? but at least it's not now in a rationing of care sense so much as in a safe/effective sense. until now (and maybe past now if i'm the only person who reads newsweek) it's been counted on that there will be somebody somewhere whose case requires drug A or treatment B and for some reason theirs is unique and therefore the drug or treatment should be available to everyone regardless of whether they meet the same criteria, because this is the u.s. of a and by golly we should be free to get treated in any way we want whether it makes sense of not, and by the way, our insurance should be forced to pay for it.
so now it can be said that nobody needs this medicine or this treatment. that the only effect that the antidepressant that so famously worked by fixing a chemical imbalance (i lost count of how many people wanted a chemistry test done to see if they were out of balance...there is no such test, though i guess i should have faked one and sold it and made a mint before this deal came out!) was a placebo effect. and now, God is so good in the order that He revealed these things to my tiny little mind, since we know that the placebo effect works even though we know it's a placebo, we can cut down our drug costs and side effects tremendously!
quick, someone open a drug company specializing in placebos...oh, wait, there are several, but they thought they were making real drugs!
so, a few quotes and i'll finish this parcel of radical thought.
from a guy who questions the doctor who is calling all this research into question: he worries that the 'most-research-is-wrong claim "could promote an unhealthy skepticism about medical research, which is being used to fuel anti-science fervor'". and on how statistical flukes affect studies: "when you do thousands of tests, statistics says you'll have some false winners(or, even a blind hog finds an acorn every once in a while - my words)...drug companies make a mint on such dicey statistics...by testing an approved drug for other uses, they get hits by chance, and 'doctors use that as the basis to prescribe the drug for this new use. i think that's wrong.'"
the caveat: the last paragraph. "of course, not all conventional health wisdom is wrong. smoking kills, being morbidly obese or severely underweight makes you more likely to die before your time, processed meat raises the risk of some cancers, and controlling blood pressure reduces the risk of stroke. the upshot for consumers: medical wisdom that has stood the test of time - and large, randomized, controlled trials - is more likely to be right than the latest news flash about a single food or drug.'
ok. nuff said. so, what are all those internal medicine/family medicine docs going to do with all those medicare patients on all those drugs? and what are we going to do about this information? be skeptical of medical research? look at the emperor's clothing real closely, he may need viagra.

the 'duh' factor

here are my first 2 duh factor entries.

TEENS WHO SAW TOBACCO ADS ARE MORE LIKELY TO SMOKE (DUH)

A study of German teens finds that those who were exposed to more cigarette advertisements during a nine-month observation period were more likely to take up smoking. The study is published in the journal Pediatrics.

Researchers looked at the role that any kind of advertising, including cigarette advertising, plays in influencing teens to begin smoking. Researchers showed advertisements to 2,102 German teens who had never smoked. The ads included six cigarette advertisements, and eight ads for other products including candy, clothes, cell phones and cars.

Students also answered surveys about how frequently they had seen each ad, as well as questions about smoking behaviors among their parents, peers, and their attitudes toward rebellious and sensation-seeking behaviors.

Initially, 47% of students reported one or more parents who smoked and 27% reported having peers who smoked.

During the nine-month observation period, 13% of students started smoking, the researchers reported.  Increased incidence of smoking was associated with increased exposure to cigarette advertisements, according to the study. Other factors tied to taking up smoking included older age, lower socioeconomic status, having friends who smoked, and higher levels of sensation-seeking behavior.

The study authors say their research shows that adolescent exposure to cigarette advertising, but not to other advertisements, is tied,at least in part, to the initiation of smoking. The study points out that while some countries, including Italy, Finland and New Zealand have strong anti-tobacco marketing regulations, other countries, including the United States and Germany, have “considerably weaker tobacco-marketing policies.”

Almost 90% of smokers began the habit when they were teens, according to theAmerican Association of Pediatrics. Each puff of a cigarette exposes the body to more than 400 toxic substances including cyanide, benzene, formaldehyde, acetylene, ammonia, carbon monoxide, as well as nicotine, the substance that makes smoking so highly addictive.

BOOSTER SHOTS: ODDITIES, MUSINGS AND NEWS FROM THE HEALTH WORLD

'Healthy' kids' foods usually aren't, study finds (DUH)

Just because a box of cereal claims to be nutritious doesn't mean it's actually healthy, researchers warn. (Photo courtesy of Marion Nestle)

297Share
2digg

By Karen Kaplan, Los Angeles Times

January 19, 2011, 4:30 a.m.

• E-mail
• Print
• Share
•   Text Size

If the foods we ate were actually as healthy as their packages would have us believe, Americans certainly wouldn’t be spending $168 billion a year on obesity-related healthcare costs. So it shouldn’t exactly be shocking to learn that yet another study has found that the front-of-package labels on processed food items are misleading (to put it kindly).

Even judging by these low standards, the new report out Wednesday from the Prevention Institute manages to evoke some distress.

The report focuses on the claims made on packages of certain cereals, meals, beverages and snacks that are marketed to kids. Researchers zeroed in on 58 products that were deemed healthy by an industry group and that also made nutritional claims on their front-of-package labels. Among the 58 items were such staples as Campbell’s Tomato Soup, Skippy Super Chunk Peanut Butter and Rice Krispies.

The researchers examined the "nutrition facts" panels of all 58 items to determine how much sodium and fiber they contained, and to calculate the percentage of total calories that came from sugar, fat and saturated fat. Then they checked to see how many of the items measured up to nutrient criteria derived from the federal government's "Dietary Guidelines for Americans." To qualify as healthy, foods had to:

• Derive less than 35% of their total calories from fat (exceptions were made for nuts, nut butters and seeds) and less than 10% from saturated fat;
• Get less than 25% of their total calories from sugar;
• Contain at least 1.25 grams of fiber per serving (milk products and 100% fruit juices got a pass); and
• Contain less than 480 milligrams per serving of sodium (for snacks) or less than 600 milligrams per serving of sodium (for meals).

Care to guess how many of the 58 items failed to meet at least one of these criteria and were judged “unhealthy” by the Prevention Institute researchers? Would you believe 49?

RELATED: The FDA should put an end to bogus health claims on packaged foods, experts say

That’s right -- 84% of the items declared healthy by an industry group called the Children’s Food and Beverage Advertising Initiative actually weren’t, including the tomato soup, peanut butter and Rice Krispies.

Among the other findings:

• 95% of all products in the study contained added sugars, including high fructose corn syrup and healthy-sounding alternatives such as honey and fruit juice concentrate.
• 17% of the items contained “no whole food ingredients.”
• Only one of the 58 products contained a green vegetable (peas).

The study concludes that it’s time to call in the food police -- otherwise known as the Food and Drug Administration -- to create a rational, uniform and honest system for conveying nutritional information on food packages, as is already done in Canada, Sweden and the Netherlands:

“Key nutrition information, including calories, saturated fat (and trans fat), added sugar, and sodium should be listed in easy-to-read type, on the front of packaging. Nutrients associated with health, including vitamins A, C, D, calcium, and fiber, should not be included since they have the potential to mislead shoppers into believing that foods with a poor overall nutritional profile are healthful.”

Those who disagree with this will probably point out that the study was commissioned by an advocacy group that calls itself the Strategic Alliance for Healthy Food and Activity Environments. Some may say that self-regulation by the food industry and greater parental responsibility can lead to healthier choices.

Just keep in mind, under this laissez-faire approach, added sugars and unhealthy fats have come to account for almost 40% of the calories eaten by kids and teens, according to a study published last year in the Journal of the American Dietetic Assn.

ok, sorry. tell me if you want the whole article posted or just the title. these just came across my desktop this week and are representative of the 'news' in healthcare these days, or at least some of it. 

people are getting money, money i say, to study these things. and both entries are pure advertising 101. 'let em see it, think it looks good or sounds good, and they'll buy it/do it'. 

we are so gullible. not sure which is more indicative of gullibility, the fact that people didn't know this already or that they paid people to study them!

healthcare rant

listening to intelligence squared u.s. debate on 'should obamacare be repealed?' and had to respond…my take on the healthcare debate is that they are all missing the point. People shouldn’t go to the doctor so much, shouldn’t be screened for so much that generates rx’s that are expensive and cause side effects for which more rx’s are given…this occurs in kids some, but big time in adults, and adults with the most access to healthcare easily get…more healthcare. Not better, just more. And more tests and more meds and more to talk about how bad they feel on fb and at coffee club or work and it’s a status symbol to be on the ‘you need to be wound up like a friggin doll’ medicine or the ed drug that could make your penis fall off…

Sorry, it’s just that more healthcare isn’t better healthcare. But if someone shows up in the office with anything as an adult they get everything screened increasing the stress level and therefore the blood pressure, etc., etc., and  instead of saying, ‘hey, fatso, lose some weight’ they say ‘here’s your medicine for your type 2 diabetes, hypertension, and high cholesterol, hope you don’t die of the side effects’ and when the government gets involved if the adult docs DON’T do that they will get in trouble.

just like the financial crisis (for which intelligence squared u.s. - npr - has an excellent debate from a couple of months ago) we want something we don't want to pay for. so we dump it off on the government. then we don't want our taxes raised and we don't want to go into debt with china any further but we...want our cake and we want to eat it too. we just can't have it like that. but the debate is about those people who can't afford healthcare or have preexisting conditions and whether they deserve better treatment by insurance companies. yes, they do. we all do. insurance companies are making the lives of doctors, hospitals, pharmacies, and patients miserable while they cash in because 'gasp' what if they didn't? 

Ok, I’m through. Thanks for listening.

sorry, i must have RDS

RDS, it sounds more official and takes less time to say than 'reward deficiency syndrome'. never mind that it also means 'respiratory distress syndrome', not to be confused with RSD, which is 'reflex sympathetic dystrophy'. it's also 'radio data system' or 'relational database system'. these acronyms DMC! (drive me crazy).
but i guess i'm addicted to blogging right this moment, i can't stop! i've been mindful of the fact that i sometimes feel the need to share my thoughts with other people, and for some reason, i think they should care. i guess that's a typical blogger mentality (TBM?). but then God shows me that the thing i thought was so important that had occurred to me or that i heard that i thought others should hear was just important to me and just for that one moment and that other people probably didn't really need that information filed away in their brains under 'things that somebody thought would be interesting' because that storage unit is already full and taking up space that could be used for things like, remembering directions (oh, wait, there's GPS) or phone numbers (oh wait, they're stored in my phone) or friend's names (oh wait, they're on facebook if they're really my friends) or important passwords to secure websites (now that one calls to mind a quandary -  can you store them safely in one place and if so, what if you forget that password?). so, i'm going to quit blogging now. someday, maybe i'll look back to all the blogs i've done, all the crap i've committed to the blogosphere and other digital media, and write a book. not that anyone would want to read a compilation of the stuff i thought was important any more than they would want it handed to them a piece at a time.

placebos revisited

can you get addicted to a placebo? i was searching for a definition of reward with google (easier than finding and thumbing through the dictionary) and one of the reasons i love and hate the internet popped up. when i put 'reward' in the google search box, 'reward deficiency syndrome' came up as an option. now i've seen it all. it's supposed to explain addiction by showing how people need positive strokes or rewards and when they don't get them they look to temporary 'cures' like alcohol, drugs, sex, gambling, etc., to help assuage the deficiency.
there's a diagnosis for everything.
and do you know why a diagnosis is important? other than that it gives people the ability to say 'i have reward deficiency syndrome' instead of 'i can't control myself'? it allows doctors to put its number in a box beside which said doctor can put an order for a medicine or a treatment for that diagnosis and then the insurance company is supposed to pay for it. no diagnosis, no payment.

put mercury back in vaccines

10 years ago thimerosal, the mercury-containing preservative used in many multiple dose vials of vaccines, was removed due to the thought (not proof, just idea of possibility) that it contributed to the rising incidence of autism. since then, thankfully, autism is now nonexistent....no, it's not, autism diagnoses are rising even faster. makes me wonder if we should put the mercury back into the vaccines?

beware of false studies

the temptation to jump on the bandwagon against andrew wakefield and his study about MMR and autism being false (pretty much proven already) and even (collective gasp) motivated by monetary gain is strong. but if that same critical eye is aimed at many pharmaceutical studies sponsored by the company who stands to profit, we find that it's easy to point fingers when the villain is our enemy but not so easy when they are feeding us lunch every day. ouch.

placebos

a new study shows that placebos work...duh...that's what they're supposed to do. but they work even when we know they are placebos. we always, at least i always, assumed that they worked as a tactic to fool people into thinking they were getting something that they really weren't getting, and that it proved that it was not the medicine that worked but that the person thought they were getting better so they did. and that may be true, but now it seems that we don't even have to be fooled to believe stuff works even without any reason to believe it will. this makes me think at several different levels.
first, it explains why babies get better with pretty much any kind of drop you put in their mouths when they are fussy. after a dose or two, just the touch of the dropper to their lips makes them calm down. sometimes. truly sick babies believe less in the placebo effect than others.
it explains why babies seem to get sleepy when given tylenol by their parents. seems that the placebo effect is transferable. if the parents believe it, the kid gets sleepy.
it explains why antibiotics work. and it explains why colloidal silver works. and ear drops with vinegar. and pretty much anything else you do with the belief that it's going to help. because usually the ear infection will go away in a couple of weeks regardless of what you do.
but it doesn't explain why people continue to take medicines whose list of side effects is longer than the list of good effects. why not just take a placebo? it's got about as good a chance as any to work, without the side effects.
so this study both explains why pharmaceutical companies are making so much money, and asks why? at the same time. maybe it's the side effects that make you know it isn't a placebo.