The statistical games behind “off-label” drug use.

Oh, but there are a lot of clever pharma people who know how to manufacture data to convince docs who usually don’t know much about statistics and love being told about the “latest more effective drug.”  

In this article in Slate, Darshak Sanghavi teaches us a few of the tricks.  Be sure to read the whole article; it is short and enlightening.  May many doctors read this.

Three years ago, Stanford researchers found that 20 percent of all prescriptions are written for “off-label” use, such as using an anti-seizure drug to treat attention-deficit disorder, and the vast majority of such uses “had little or no scientific support.” By one conservative estimate, the annual U.S. market for off-label prescription drugs is about $44 billion, or about one-fifth of the value of all domestic automobile sales.

According to a remarkable analysis of the Neurontin documents, published last month, many clinical trials of the drug took a shotgun approach. Study patients took the drug, and researchers measured tons of possible outcomes (like pain with touch, pain with cold, excessive pain with pinpricks, more than a dozen different scales for psychiatric symptoms, and so on). By random chance, if you measure enough outcomes, at least some of them will appear better after drug treatment. When the time came to report the findings, however, the researchers systematically omitted the outcomes on which the drug had no effect—and presented only the data showing benefit. That’s like dealing dozens of hands of poker to yourself but showing only the hand with good cards.

via The statistical games behind “off-label” prescription drug use. – By Darshak Sanghavi – Slate Magazine.


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