I know too, I would take the 12million from homeopathy and put it into genetic research into what alleles cause adverse reactions to what substances so that patients can be screened before prescribing. But hold on, such work is already being done, funded as is proper, by the likes of the MRC. The NHS does fund some research but you don’t seem to realise that research is not its primary purpose and the system in this country is that the right people should do the research, which is what happens.

The results are coming in, for eg knowing your cytochrome p450 profile determines the dose of a number of anti cancer drugs like cisplatin. If you metabolise the drug quickly you need a higher or more frequent dose, if you metabolise it slowly you need a smaller dose. This means everyone gets the same dose in the tissue where it is required.

This work was funded iirc by CRUK. I was not involved, I just worked in the dept where it was done here in Dundee.

The work is ongoing as the genome is large and not only p450s are involved and there are a lot of drugs but pharmacogenetics is a growth area. So your criticism is premature. Also criticising a doctor for prescribing something that helps the large majority when she has no way of telling in advance who are the minority it will harm is more than harsh. You try that job for a while and see how you like it.

But since you raised it, I deplore as much as you the commercial pressures to overprescribe statins. There is a good review by NICE. I have fairly low risk of CVD despite my age so I wouldn’t take them. I should pont out that the evidence for sardines being useful is hardly strong either.

Would I take homeopathy,no. Would I take simvastatin 40mg with an NNT of 22 in very high risk individuals? Nah, I’ll stick with the sardines.And this is a drug with gold standard primary end point data. I wonder what would happen if they took 84 simvastatin tablets in one go. I hope they’re not lactose intolerant.

Always livens things up to get some sniping from you, though I’m not quite sure what your point is this time.

I suspect you should be asking Mary English, rather than me, about her understanding of Number Needed to Treat (NNT) and Number Needed to Harm (NNH). They are pretty standard terms these days, though I don’t think they were around at the time I wrote my textbook on statistics.

They do involve an assumption of causality of course, and for some reason that baffles me alt. med enthusiasts seem to have a particularly weak grasp of that. Hence their disdain for RCTs

So what’s your knowledge of evidence-based medicine? When I’ve raised the NNTs and NNH of conventional medicines the only thing I’ve heard is the sound of one hand clapping.

Lovin’ it.

-r.c.

Oh – and I got to be in one of the videos!

Of course if you are doing things that are actually dangerous, as many homeopaths do, the fact that you honestly believe it is not a sufficient excuse.

@lecanardnoir. I hope that response is sufficient to prevent me from having to use your defence (hehe I love it). Also love the post that presumably gave rise to it, at http://www.quackometer.net/blog/2007/07/what-our-nhs-money-is-being-spent-on.html

Mary English once wrote to me saying you have “24 hours to remove all mention, links, comments, writings and/or articles about me or my sites or I will be instructing them to sue for libel”

If I remember, my response was roughly along the lines of the Private Eye classic,

“We would therefore be grateful if you could inform us what [your] attitude to damages would be, were [you] to learn that the nature of our reply is as follows: fuck off”

Great post, anyway.

Regarding Mary English & treatment of Croup.

She claims in the audio clip that conventional medicine has no treatment for croup. Simply not true. As someone who has had to rush kids to Hospital with croup, treatment is either a salbutamol nebuliser or an oral dose of steroids. Which, in my experience, works very quickly.

Shame there wasn’t time in the interview to take her to task!