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Digital Subscriptions > Skeptical Inquirer > Skeptical Inquirer March/April 2018 > Drug Therapy Hype: The Misuse of Data

Drug Therapy Hype: The Misuse of Data

There are several flagrant examples of hype from cancer and cardiac therapy. The drugs Avastin and Opdivo, which have serious problems, have been greatly overhyped. Statins, which are effective in saving lives from heart attacks and stroke, have been subjected to negative hype meant to discourage their use.

Hype is promotion of an intensive extravagant nature that is often deceptive and frequently meant to stimulate the recipient to do or not do something. There is both positive hype (meant to stimulate action) and negative hype (to discourage action). Hype can be differentiated from hyperbole (and what in advertising is called “puffery”), an exaggerated statement or claim not meant to be taken literally. Complicating matters is the imprecision of language; ambiguity and vagueness abound.

We should separate hype from lies, although in many cases extreme hype tends toward lying. But to define lies we must first define truth. Truth applies to statements (propositions). A statement is true if:

1) The statement corresponds to reality;

2) The statement is coherent with other facts;

3) The statement has pragmatic implications, e.g., predictions based on the statement have not been falsified.

Lies are statements that are not true and may be told with or without intent to deceive.

In America and much of the developed world, hype is present everywhere: on the Internet and in advertisements, television, newspapers, and books. Most of the time, educated persons can separate hype and lies from the truth, but there are situations where hype is often “effective” and harmful or can cause great uncertainty, e.g., in medicine, government, or the law. Before I discuss some medical examples of hype, some important background information is in order.

Background

Physicians, including pediatricians, radiologists, and surgeons, have five main objectives:

1) Whenever possible, physicians try to prevent disease (e.g., with vaccines);

2) If disease occurs, they try to cure it with medicine, surgery, or radiation;

3) If a cure is not possible, they try to prolong and improve the quality of life;

4) Physicians often give patients support to normalize troublesome symptoms (e.g., remedies for insomnia and constipation);

5) Physicians try to achieve these objectives at reasonable cost (value).

To accomplish these goals, physicians must often deal with variabilities among individuals, especially in prognosis and their response to therapy. It is true that in some cases (e.g., vaccination against hepatitis A and B or papilloma virus) there is a 100 percent response and complete protection against the viruses in the vaccine. However, in many situations, the responses to drugs and vaccines are variable. To overcome this variability in drug response and the inability to identify in advance which patients will respond, regulatory bodies (e.g., the U.S. Food and Drug Administration [FDA]) have generally required the application of scientific methods, which include replicative randomized controlled trials (often blinded) comparing the new treatment versus a placebo or appropriate control for licensure and sale of prescription drugs. If there are enough patients in the trials and they correspond to the patient population to be treated, these trials allow a reasonable estimate of efficacy (e.g., whether the patients will live or die) and toxicity (although rare severe toxicity may occur post-marketing when large numbers of patients are treated).

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The War on Science, Anti-Intellectualism, and ‘Alternative Ways of Knowing’ in 21st-Century America