Re: Lack of evidence for LDL treatment targets

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David Rind wrote:

This just isn't a fair comparison. The evidence on HRT was entirely from observational studies. The evidence on statins and secondary prevention in patients with CHD is from randomized trials. That is, the same sorts of trials that eventually showed that HRT is not good for secondary prevention. Why do you trust those sorts of trials for HRT, but not for statins?

I don't trust trials by those with a financial stake in the outcome, no matter how they're designed, unless there's other, corroborative research where no such conflicts exist.

I've been in trials. I've signed "informed consent" while overeager investigators assured me that none of the risks were real, that the lawyers just make them put all that stuff in there. I've reported adverse reactions that were never recorded for the final investigational report. I've lived with life threatening sequelae once the chickens came home to roost.

If you believe in pure love of science as the driving force behind what gets publised, particularly in the U.S., I want some of what you're having, because you're probably having a much better time than I am. :-)

People are constantly posting here about this or that latest study showing in observational studies that statins are good for something (cancer prevention, cataract prevention) or bad for something (cause cancer). This sort of evidence, like the evidence for HRT, is extremely weak and generally shouldn't be believed. The evidence that statins are good for patients with CHD is nothing like this.

I understand that you feel comfortable that the evidence you've seen is an accurate depiction of what took place during trials. You probably understand at this point that I remain very skeptical. Not unwilling to be convinced, but skeptical and irriated that safer alternatives that may have potential for real benefits without the toxicity (and PROFITS) are ignored.

Susan
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Relevant Pages

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