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Is Your Doctor's Continuing Ed Funded by Pharma?

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Raise your hand if you've breathed a sign of relief seeing your doctor had a CME certificate next to the medical school diploma on the wall. 

Did your doctor pass, Bipolar Disorder: Individualizing Treatment to Improve Patient Outcomes, Part 2 "taught" by Trisha Suppes, MD, PhD and offered by CME Outfitters? 

Suppes is a Professor in Stanford's Department of Psychiatry and Behavioral Science and funded by Abbott, AstraZeneca; GlaxoSmithKline, Janssen, Novartis, Pfizer, Wyeth, Bristol-Myers Squibb, Eli Lilly, Shire and four more pharma companies. 

Maybe your doctor passed Quadrivalent HPV Vaccine May Be Effective in Women 24 to 45 Years Old --which sounds like a sales pitch for Gardasil because it is--which "studies" a Lancet article written by Nubia Munoz, MD, two Merck employees and other authors. 

Sample question: "What was the main conclusion of the current study by Munoz and colleagues of HPV vaccine among women between the ages of 24 and 45 years?" (Italics CME's) Hint: the answer is in the title. 

Upon "completion on this activity" offered by CME giant Medscape--still available for credit if you hurry--"participants will be able to: "Specify the currently recommended age range for the administration of the quadrivalent human papillomavirus vaccine" and "Describe the effects of the quadrivalent human papillomavirus vaccine among women between the ages of 24 and 45 years." 

CMEs, continuing medical education courses, are sponsored by pharma, "taught" by pharma funded specialists and bracketed by pop-up drugs ads which sometimes occlude the text you're reading. ("Which of the following manic symptoms are most seriously impacting your bipolar patients' lives?" asked a disease-baiting ad for Geodon, direct-to-consumer style, when we looked at a CME.) Yet doctors are required to sit through the canned message like a time-share presentation and answer a quiz just to keep their state licenses and sometimes insurance policies. 

In fact the only good thing doctors have to say about CMEs is they are hard to fail--"second chance" questions pop up if you miss the first ones; whew!--and they are often free. Why? 

CMEs are supposed to be monitored by the Accreditation Council for Continuing Medical Education (ACCME) but like Standard and Poor's and Moody's stock ratings funding comes from the client side so buyer beware. 

Last year Bernard Carroll, MD a former chairman of psychiatry at Duke, challenged the objectivity of a CME Outfitters course called Atypical Antipsychotics in Major Depressive Disorder: When Current Treatments Are Not Enough  (what are they trying to say?) funded by Seroquel maker AstraZeneca and taught by disgraced Emory University psychiatrist Charles Nemeroff, MD who lost his department chairmanship from unreported pharma income. 

Two doses of Seroquel were tested but only the results of one were "statistically significant," writes Carroll on a blog called Health Care Renewal. "One of the junior presenters stated very clearly that there was 'significant improvement in both response and remission with both doses' of Seroquel. That is a falsification of the scientific record." 

In October AstraZeneca agreed to pay $520 million to settle Seroquel suits and investigations of "physicians who participated in clinical trials involving Seroquel," presumably on which safety was established, and a JAMA article red flags Seroquel's metabolic proclivities in which studied children gained a pound a week and more. Yet AstraZeneca still seeks FDA approval to market Seroquel to kids. 

Nor did the April 2009 article about Seroquel, Maintenance Treatment For Patients With Bipolar I Disorder: Results From A North American Study Of Quetiapine In Combination With Lithium Or Divalproex in the American Journal of Psychiatry (AJP) by CME presenter Trisha Suppes fare well. 

Why were two-thirds of pre-randomization patients discontinued because of "lack of therapeutic response, developing an adverse event" and being lost to follow-up ask Debasish Basu, MD, and Kaustav Chakraborty, MD from Chandigarh, India in the October AJP? "Could it be possible that the remaining patients, who did eventually proceed to the randomization phase, represented a group favorably predisposed to the quetiapine combination?" 

A second letter in the same AJP echoes the methodology questions. "Only one-third of the patients were selected for maintenance therapy, which raises the possibility of selection bias," write Bettahalasoor S. Somashekar, MD, DPM, Ashok Kumar Jainer, MD, MRCP and Wajid Shafi, MD from Coventry, UK. "In this regard, Healy [David Healy, MD, Cardiff University professor] stated that company sponsored clinical trials invariably recruit samples of convenience, which by definition do not actually sustain extrapolation to normal clinical practice." 

Similar methodology questions are raised about the "science" behind Medscape's  Quadrivalent HPV Vaccine May Be Effective in Women 24 to 45 Years Old CME in the October 10 Lancet. 

Why did Munoz et al exclude women "with pre-existing infections and women who do not complete the full course of the vaccine," ask six researchers with US National Cancer Institute. Is this also a sample of convenience? And why was "infection of 6 month duration or longer" used as an endpoint for showing a public health cancer benefit asks a different set of researchers, Stefanie Schenk and Jutta Halbekath from Berlin--when no "differentiation" between infection and cancer is given? 

Clearly the letter writers need to do their CMEs. 
 
By Martha Rosenberg

 
 

Subscribe to comments feed Comments (3 posted):

Rosemary Mathis on 03/11/2009 10:40:21
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My 13 year old daughter was injured by Gardasil and completely disabled for the past year. Merck got it right when they used the slogan "One Less" for Gardasil. Because of Gardasil, my daughter was "One Less". She was "One Less Student", "One Less Active Child", "One Less in every aspect of her life". Take it from a mother who has spent the past year sitting by my child's bedside wondering if she would die in her sleep. INVESTIGATE BEFORE YOU VACCINATE. DO NOT trust your doctor to make this decision. If you want to understand Merck's role in the medical community, investigate some of their former wonderdrugs such as VIOXX and then marvel at how many people died from it before it was pulled off the market. The CDC AND FDA need to do their job and get this off the market before more children are harmed. The public is not aware of VAERS and the #'s are grossly understated. I have had to tell my child's doctors about VAERS and make them file reports or she would not be one of the current statistics in VAERS. Even then, her information has not been entered correctly so I know that VAERS is not what it should be. Please do not let this happen to your child. There is NO WAY that I will get my son this vaccine. My doctor clearly didn't do his research on this vaccine or maybe he did. Maybe the research material was written by Merck. Gardasil needs to be taken off the market. It is destroying the health of America's young women.
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Teresa Allen on 03/11/2009 16:42:20
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For any person that got the Gardasil vaccinations and did NOT have any side effects or symptoms, PLEASE go and have a pap test done immediately! We are getting reports of these girls that had no side effects to the vaccine that are now getting cervical lesions and cervical cancer. So if you know of anyone that received Gardasil with NO side effects, PLEASE tell them to get a pap test done immediately!

My 16 yr old daughter was also injured by Gardasil. She had 2 of the 3 injections (Jan 9th and March 9th, 2009). Before Gardasil, she was a happy, healthy and vibrant teenager. Since Gardasil she is sick every day of her life. She has dizziness, overall weakness, numbness and tingling in both legs and left arm, back pain, neck pain, pressure headaches, vision problems, breathing problems, chest pains, racing heartbeats, brain fog, stomach problems, nausea, diarhea, weight loss, hair loss, jerking all over spells...the list goes on and on.

She was an A/B student but failed her 10th grade year because she was too sick to retain what she was trying to learn (brain fog). She no longer has the energy to go off with her friends. Most days she lays in bed, in pain.

This just doesnt happen to a healthy teenager!! And it just doesnt happen to THOUSANDS of other girls with no connection except they all had the Gardasil vaccine.

It doesnt take a rocket scientist to figure this one out.

Please educate yourself as much as you can before you allow anyone to push this unproven and unsafe vaccine on your daughter! The guilt is overwhelming from a mothers' standpoint! I thought I was doing something to protect my daughter. Instead, I allowed the doctor to inject poison into my child and take away her life!

These 'side effects' are NOT rare! They are happening every day to literally hundreds of thousands of young girls after receiving Gardasil. The numbers in VAERS is estimated to only be between 1-10% of the true numbers! Try asking some of us moms who have to deal with these horrible side effects every day if we consider it to be RARE!

Everyone should look at the other side of the fence and research this. There are thousands of girls that are coming down with strange illnesses, paralysis, gran mal seizures, etc. after receiving Gardasil.

We are now getting reports of girls as young as age 9 that are breaking out with genital warts and severe cases of cervical cancer AFTER receiving Gardasil. Some of these girls/women did not initially have any side effects from the vaccine.

There are perfectly healthy girls all of a sudden come down with all of these strange sicknesses (some that I cant even pronounce) after getting jabbed with Gardasil. All within hours/days/weeks?

Just like Merck's 'wonderful' Vioxx...what will it take? How many dead/injured before someone takes notice?

The doctor that literally pushed this vaccine on us at a routine doctor visit told us that there were no side effects except for soreness or redness at injection site.

She also told us that it would protect her from a whole LIST of things! I had seen the commercials but had not researched it.

As a matter of fact, I never really THOUGHT about vaccines until my daughter suddenly started having all of these strange health issues.

She was ALWAYS a healthy child, happy and outgoing, active and just a joy to be around.

Now, she is a totally different child. She is always sick..always in pain..and cries a LOT, so scared that she will die in her sleep from the breathing problems. She describes it as breathing through a blanket or that an elephant is sitting on her chest.

She has SO many of the exact same symptoms as all of the other girls that have been injured.

It is NOT a coincidence! All of these Gardasil girls have the same symptoms, some worse than others, but the bottom line is the one thing they all have in common is Gardasil.

These symptoms are NOT in their heads!

My daughter started having dizziness, overall weakness, pain and numbness in both legs and left arm BEFORE we found out about any of these other girls having the same issues.

When I called her doctor that gave her the vaccine (as soon as she started with these symptoms) she said it was NOT the Gardasil vaccine that is causing it. How could she be so sure? This is such a NEW vaccine...a DANGEROUS and UNNECESSARY vaccine!

HPV is not an STD (research this!).

Cervical cancers have gone down 70% since the PAP smear came along.

This is NOT an epidemic! Why are they mandating this vaccine for as young as 9 year old girls for a vaccine that doesnt even do what they claim it will do?

Girls are now coming down with cervical lesions and HPV AFTER receiving Gardasil! I'm talking about healthy young girls that did NOT have these things BEFORE getting Gardasil.

Young girls dropping dead within hours of getting the vaccine and they think we are all stupid enough to believe it was a huge tumor that was in her heart and had spread to her lungs? (I'm speaking of the 14 yr old that just recently died after receiving Cervarix).

If that young and healthy and active young girl really DID have this so called huge tumor, she would have had symptoms. A tumor like that doesnt just up and kill it's host without a 'wasting away and painful period'.

That is a complete cover-up!

Just like the young girl that has been paralyzed and hospitalized for the last year, Ashleigh Cave. Because her mother was trying to speak out and find out what exactly happened to her daughter, they have now placed that child under protective orders! To shut the mother up?

This is all about $$$$$ at the expense of our young daughters (and now sons) health and lives!

It is an outrage!!!

Please see my posts at www.injuryboard.com/Teresa-Allen

And this website:

http://wbx.me/l/?u=http://lecafpolitiquedecamusdecaf.blogspot.com/2009/09/gardasil-and-how-it-has-affected-lives_14.html

There, you can see other girls' stories and their pictures..there is also a memorial document with pictures and stories of young girls that have died after receiving Gardasil.


Educate Before You Vaccinate!!
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Denise Melton on 04/11/2009 15:43:21
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“ONE LESS” has been mentioned by one of the writers. Our family is also “ONE LESS”. Jessie had all three shots of Gardasil. After the second shot she and her mother notices the headaches, Muscle aches, and fatigue. Jessie was taken to the doctor that gave her the Gardasil. The doctor said it was just stress. Jessie was a cheerleader; a member of the National Honor Society, Played many sports and was practicing for softball, which was about to start.
Jessie went with her mother on February 20, 2008 for the third shot of Gardasil. The next night she told her mother that the headache was back and went to bed. Her mother went to work early the next day and upon returning home from work found Jessie dead. She had been dead for several hours. The medical examiner said, “She was dead before she hit the floor”. Still he could find no cause for her death.
Gardasil was typed into the computer and the nightmares that came up were shocking. We have been in contact with several families that have also lost their daughters to the vaccine that was to protect them. If we had only known that there were other side effects other than the few that were listed by Merck. Jessie would NEVER have received this wonder vaccine that is killing and maiming our girls.
Since Jessie’s death we have been researching and cannot believe that the FDA and the CDC have not pulled this product off the market. There are so many unanswered questions. The GRAY ZONES of risk were mentioned. They are calling all of the deaths (48 plus) just in the U.S. that we know of, sheer coincidences. There have been 15,000 adverse reactions also reported just in the U.S. Statistics show that only 1%-10% is ever reported to VAERS, which is a very small percentage. Many families do not know to report the reactions or how to report them. It is not mandatory for doctors to report the adverse reactions so many doctors do not report them.
Should I go on? YES!!!
Gardasil trials by Merck brought many new medical conditions to many of the girls and women that were being used for the studies. This information is found on the FDA web site dated September 11, 2008. If you would like to look at it the information is on page 132 table 73 titled “New Medical Conditions.
HPV is a virus that the body can fight off over a period of time. The virus COULD cause cervical cancer, NOT WOULD cause cancer. In the U.S. cervical cancer is on the decline with the Pap test and other forms of detection. We do not have an epidemic of cervical cancer so why is Merck pushing to have every girl vaccinated. YOU GUESSED IT!!!! The answer is MONEY. Merck lost a lot of money with the drug VIOX. This drug was also killing people and had to be removed from the market. This is why my family and many others are fighting so hard to remove gardasil from the market. We do not want other families to suffer the loss of a child or have a daughter that is unable to function a normal life because of something that was suppose to keep her safe.
Please do not have your daughter vaccinated without researching Gardasil.
A grandmother who knows.
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