I went to hospital today.....

[Sifu Ben]

This got very heavy all of a sudden, for a moment I thought I was on the Badscience forum.

[Twinfan]

As for trials,well structured large multi-centre RCTs are indeed strong evidence, but unless they went on forever and considered every conceivable variable and ruthlessly tracked down every possible confounding variable, they always have some scope for error or misinterpretation. Indeed, there's a saying that goes "you only really learn about a drug after it's been used in practice for a while".

Well that's blindingly obvious isn't it?  No trial, or collection of trials, can cover every single patient type in enough numbers to make a meaningful analysis that exactly represents the global population.

So would you like the pharms companies to run even bigger and longer studies, examine all the data every which way, and THEN sell the drug?  You'd like them to be hideously more expensive than they are now?  :?

Drugs are toxic by their very nature, and there's always a risk of nasty events happening when you take ANY of them.  It's for you and your doctor to assess that risk before taking any  :)

[Sifu Ben]

No, RCTs aren't perfect but they're the best we can come up with. However, the point is that for medical applications systematic review is the gold standard of evidence. This isn't particularly useful when assessing new drugs however, and yes, you need to assess a treatment on it's merits, which is why it's such a scandal that so often in the past the companies have milsed over efficacy and suppressed side effect data.

[Twinfan]

I think you're over-egging the "misled" part, as I don't believe it's a widespread problem in the pharms industry.  We all have our own opinions though  :)

Anyway, back on topic(!), how's the foot Ian?

[mikeluke]

Ian - are you up to entering any ar$e kicking competitions yet?

[Ian Price]

Cheers all - the foot is on the mend. I can walk pretty much without any pain, will start doing a bit of swimming next week and maybe some running again a few weeks after that. The swelling has gone pretty much completely - I used the old fashion methods of compression, ice and elevation.

[Jonny]

Speaking of walking, three days ago I botched my foot up and I haven't the foggiest what's wrong with it and I can't walk properly. Hooray.

So really I'd rather have a bust up ankle right now it's so annoying :P