Pulse Beat

Prof Dr BM Hegde 12 October 2016

Industry-Funded Studies in Medical Research
First came the great revelation that the sugar lobby had funded studies in the 1960s, to shift the glare from sugar to saturated fat as the main culprit for heart disease. Now, comes the proof that, in the 1990s, the tobacco industry funded many studies to show that secondary smoke is harmless. They did succeed in their nefarious game. Now, newer studies funded by soft drink majors have surfaced that are trying to shift the spotlight on sugary drinks as the leading cause of the obesity epidemic in the USA to sedentary living.

All of them systematically succeed in their game of making money at the cost of human misery and we have been watching this drama silently. My question is: Why do we need industry funding for research and why do we need industry funding for running the FDA (Food and Drug Administration), the watchdog body of drug control? My efforts did not get me any satisfactory answers! Come to think of it, it is an easy decision to ban industry research. In fact, in the area of cancer research, 85% of the studies are industry-funded and cannot be replicated. Yet, the rich cancer industry plays with people’s lives, day in and day out. Doctors, I understand, are trained to look after people’s health but what we do is to connive with the industry for our personal gains.

Cognitive Defects due to Poverty Even in Younger Age Group

Poverty is a curse. Now, new studies have shown that poverty in young people could adversely affect their cognitive functions. Even earlier studies, in the UK and USA, had shown that “not knowing where your next meal comes from could be the greatest risk factor for heart attacks.” The present studies are pointing to the possibilities of poverty adversely affecting one’s cognitive state. There needs to be a caveat here. The small studies (3,500 black and white men and women), by themselves, are not conclusive; but they could act as pointers. The second problem is the difficulty in long-term studies of poverty in the marginally poor segment of American public where these studies are done. The income levels fluctuate quite a bit and cast doubts on their reliability.

Be that as it may, the very foundation of these RCTs (randomised controlled trials) is now being seriously questioned. Human beings are not like molecules in a chemistry laboratory that can be compared. They are so disparate that comparing two cohorts by the simple initial parameters might not hold water, as time evolves. Most of these studies are done to write papers and fatten the CVs and not to find the truth. Sir Michael Rawlins, the chief of NICE (National Institute of Clinical Excellence) in his Harvey oration to the Royal College of Physicians, in London in 2008, did say that “the RCTs have been given an undeservedly high pedestal.” That was quite a bold statement; but is true.

With all this hype, RCTs can, at best, only be indicators of association and not cause & effect relationships. For our convenience, we have been attributing to them a cause & effect relationship. There is now demand for N-of-1 studies (single subject clinical trials) of outcomes which, in the long run, could give better directions for patient care.

NSAID Pain-Killers and Risk of Heart Failure

According to the research team led by Giovanni Corrao of the University of Milano-Bicocca in Italy, research has provided strong evidence that NSAIDs—including COX-2 inhibitors, a new generation of NSAIDs—can raise the risk of heart failure. A new study published in The British Medical Journal (BMJ) has uncovered a dose-response relationship between the use of non-steroidal anti-inflammatory drugs (NSAIDs) and increased risk of hospital admission for heart failure (published online 27 September 2016). As I had written several times in the past four decades, pain-killers are true killers—of the pain and the owner together, to get rid of pain for ever. The interesting part of the story is that new studies in animals are going on to find out newer pain-killers as anti-inflammatory drugs to prevent heart attacks!

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