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Educating the layperson about treatments and how to judge what is useful can be a minefield. Having now been living in India for 6 months, I can see how easy it is to part with randomised controlled trials and research initiatives and depend on pharma for education in new therapies and medicines. I dread to think of the potential harm we could be doing to patients and the public by taking this approach.
This book is an ideal follow-on from Ben Goldacre's highly acclaimed book Bad Science, and a good one to read before Goldacre's Bad Pharma. It highlights the ups and downs faced in evaluating treatments and the time it can take for effective treatments to reach the layperson. It also talks about the difficulty that clinicians often have in judging which treatment to choose for their patients and how local administrative regulations can get in the way. The various ways in which we have managed to highlight problems with treatments and medications, including the Yellow Card Scheme, are discussed and the layperson's role in making such problems known is acknowledged. That there is great need for transparency in pharma, publishing and regulation is without doubt. There are several ways in which these phenomena have been addressed in recent years including the CONSORT Statement and the need to register trials and publish all trial data and results. However, in many countries, doing good research and accessing research data is difficult, to say the least. The Cochrane Collaboration and a number of other academic websites that offer synthesised evidence play an important role in contributing to research information and evaluation that can be accessed anywhere on a smartphone provided you know where to look.
I recommend Testing Treatments highly to all my medical colleagues as well as to any patients I meet who want to educate themselves about what medical treatment today is all about and how they can deal with the vast amount of information they are inundated with every day. I have also recommended this book and those by Ben Goldacre to marketing individuals who approach innocent citizens in market squares here in India and attempt to lure them into investing money in schemes involving network marketing of herbal medicines and nutraceuticals. Aside from big pharma, these are the current money spinners in the market everywhere in the world. Until recently, medical professionals have been slow to take an interest in products that prevent illness and disease. The industry in nutrition and nutraceuticals has identified this gap and cashed in on the mass hysteria that obesity, diabetes and polycystic ovary syndrome have caused. The task is huge, and I do sincerely hope that readers of these books will both appreciate and embrace the greater sense of responsibility for their treatment choices for patients in the same way that I have. Whether we can follow through with what is right is the subject for another book.
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