I’d like to see a public survey of comprehension of the recent splash of news about new guidelines for heart disease prevention and statin drug use. Heads must be spinning.
Here are some of the pieces that I found noteworthy:
“The chairman and one of two additional co-chairs of the working panel that wrote the controversial cholesterol guidelines on reducing cardiovascular risk, released last week, had ties to the drug industry at the time they were asked to lead the panel. And, in all, eight of the 15 panelists had industry ties.”
“The process by which these latest guidelines were developed gives rise to further skepticism. The group that wrote the recommendations was not sufficiently free of conflicts of interest; several of the experts on the panel have recent or current financial ties to drug makers. In addition, both the American Heart Association and the American College of Cardiology, while nonprofit entities, are heavily supported by drug companies.
The American people deserve to have important medical guidelines developed by doctors and scientists on whom they can confidently rely to make judgments free from influence, conscious or unconscious, by the industries that stand to gain or lose.
We believe that the new guidelines are not adequately supported by objective data, and that statins should not be recommended for this vastly expanded class of healthy Americans. Instead of converting millions of people into statin customers, we should be focusing on the real factors that undeniably reduce the risk of heart disease: healthy diets, exercise and avoiding smoking. Patients should be skeptical about the guidelines, and have a meaningful dialogue with their doctors about statins, including what the evidence does and does not show, before deciding what is best for them.”
“even if these guidelines were not written by people in the pay of the drug industry, they could just as well have been. And somehow, while important new evidence against the routine use of statins, and suggesting that we really don’t know much about the true mechanism by which these drugs work in the cases where they do, crept into the guidelines for the first time, the bottom line is largely unaffected by such enlightened thoughts. We’re back to putting statins in the water supply.”
“…amidst all the late-breaking clinical trial presentations and ask-the-expert sessions, what I didn’t hear were the speakers’ financial conflicts of interest….
Don’t get me wrong — the AHA mandates that all speakers present a disclosure slide at the beginning of every talk, and this rule was reliably followed by all presenters … in the following manner: “Here are my disclosures” — PowerPoint slide flashes on screen with a list of pharmaceutical/device companies. Yet, by the time the speaker finishes speaking those four words, the slide deck has already advanced to the next slide. I, and my fellow audience members, didn’t even have enough time to read the disclosures, let alone process them.
Now, I have no problem with pharmaceutical sponsorship of biomedical research. Nor do I wish to criticize physicians for accepting industry funds. However, I do feel strongly that all such financial relationships must be completely transparent.
Personally, I feel that transparency is not achieved by quickly flashing a slide in front of an audience. No, transparency requires not only that each speaker’s financial relationships be read out loud, but that any connection between these relationships and the subject matter being discussed should be EXPLICITLY stated. We as audience members should not have to connect the dots and look up which pharmaceutical companies manufacture which drugs; rather, we should expect that these connections will be made for us.”
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