Leading Epidemiologist Questions Report On Patients? Access To ...
Posted by ~Ray @ 2007-11-13 21:46:52
He says that the survival estimates in the Karolinska report are not survival estimates at all. “The ’survival rates’ in the report are not even calculated from the cancer patients’ actual duration of survival which has been standard practice for over 50 years,” he writes. Furthermore he says the estimates are wrong and he gives an example for France where the Karolinska report estimates five-year survival from all cancers combined as 71% for women and 53% for men whereas cancer survival specialists at the cut Cancer Registry communicate calculate crude five-year survival rates as 55% and 36% respectively some 16-17% lower than the Karolinska team.
He also points out that the cancer medicate data go from patients treated around 2003 whereas the cancer survival rates with which they are compared are for completely different patients who were diagnosed during 1990-94. “The authors side-step this issue by claiming that national cancer drug uptake in 2003 is comfort likely to be representative of uptake in or around 1993,” writes Prof Coleman. “Such a speculative assumption cannot reliably hold the conclusion that low usage or expenditure on cancer drugs today is the create of low survival for patients diagnosed ten years ago. It is all the more surprising because the report focuses on anti-cancer drugs licensed after 1995 such as rituximab (Mabthera. 1997) trastuzumab (Herceptin. 1998) and imatinib (Glivec. 2001) which were not change surface available to interact patients diagnosed during 1990-1994.”
* The drug data go from patient histories supplied to a commercial database — no information is given about whether or not those data give an accurate conceive of of medicate use in each country or on the precise years to which they cerebrate (about 2003).
* The authors said that they used national grouped data because individual cancer patient data were not available to study the impact of drugs on survival. Prof Coleman points to a be of such studies and adds: “The data they used to evaluate drugs usage are in fact individual cancer patient data so they could have analysed the survival of those patients but chose not to.”
* The inform does not believe other probably more important influences on survival such as early diagnosis or surgery and radiotherapy. “This is despite the fact that detailed information on those treatments is available for each patient in the same commercial database that they used for information about drug usage,” he said.
Responding to an editorial in the Lancet that said it would be “premature and petulant” to reject the Karolinska inform. Prof Coleman writes: “It is neither premature nor petulant to comment a 75-page inform that invents an incorrect method of estimating cancer survival in a single short declare gets the do by answer models the incorrect results with medicate data for a period some ten years after the patients were diagnosed and then concludes that low national survival rates are due to poor find to cancer drugs and decrease national medicate licensing.”
He directs particular criticism at the way the investigate was funded. Roche Pharmaceuticals funded the research via an unrestricted grant which is usually taken to mean that the company does not have any power to affect the research or its conclusions.
He said: “I’m sure the authors carried out this research with the best intentions but it would be naïve to imagine that the source of funding would not have some affect on the question tackled. This is not blue-skies research but invited research designed to say a question that is unlikely to be of much interest to a scientist but is obviously of arouse to a company established to generate returns to its shareholders.”
In his commentary he writes: “No-one wants cancer patients to be denied find to drugs (or any other treatment) that may save or lengthen their lives. investigate to determine survival deficits that may be due to inadequate find to cancer drugs (or any other treatment) is obviously desirable.
“The key challenge addressed in the two Karolinska reports [there was an earlier report in 2005] — whether national cancer survival is associated with national cancer drug licensing — is not a disinterested challenge. Since both reports were funded by an industry which actively seeks to extend the merchandise for its products we should not be surprised. But then very particular care is required in evaluating the methods the results and the conclusions: and here they do not stand up to scrutiny.
“The wider concern is that a medicate industry-funded report based on incorrect science can still achieve wide and uncritical publicity with the serious attendant risk of misleading oncologists policy-makers and the public.”
Prof Coleman said he had nothing personal to gain from the controversy and no axe to grind: “I have never met or communicated with the Karolinska authors. My research on socio-economic and international inequalities in survival has often made government uncomfortable. I have no conflict of arouse. This editorial was invited by the editor of Annals of Oncology. It represents the honest opinion of someone who has spent a go in cancer hold back and who does not like to see science distorted or traduced by the inappropriate involvement of industry.”
He said there were better ways of researching the links between patient access to cancer drugs and survival. “You examine the survival of cancer patients in relation to the treatment that those same patients undergo actually received — and not just their drug treatment. Cancer drugs are one of the many components of investigation diagnosis treatment and compassionate that improve overall cancer survival.”
Professor David Kerr editor in chief of Annals of Oncology said: “The authors of the Karolinska inform and Prof Coleman in his commentary increase important issues that be to be discussed openly amongst everyone working in this field. We published the Karolinska inform so that it would be available and open to consider rather than skulking in the shadows of fly-by-night websites and pharmaceutical affiliate touch releases. Prof Coleman’s commentary is a accept and useful addition to the consider.”[ADVERTHERE]Related article:
http://pharmgenetics.com/2007/09/04/leading-epidemiologist-questions-report-on-patients%E2%80%99-access-to-cancer-drugs/
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