We have to give the best currently available treatment. We will kill people when we continue to practise with a veil of ignorance. - Dr Ben Goldcare, Centre for Evidence Based Medicine, University of Oxford
Better evidence and communication are needed to avoid worrying harms in healthcare, according to a distinguished group of speakers from Oxford University's Nuffield Department of Primary Care Health Sciences.
The failure to deliver the best treatment, the risks of overdiagnosis, and the proliferation of rogue online pharmacies were all emphasised during the talk during Oxford University's Alumni Weekend.
Dr Ben Goldacre – a medical researcher at Oxford University and the author of bestseller Bad Science – was the first speaker at the packed Harms in Healthcare session at Oxford's Museum of Natural History. The fast-talking and passionate academic emphasised the importance of evidence-based medicine and the need for doctors to be frank when communicating the risks and benefits of medicines to patients, all of whom have different perspectives on mortality, especially at different stages in their lives.
During his presentation on Saturday 19 September, Goldacre explained how 100 million people take statins worldwide (including around 10 million in the UK) to reduce the risk of heart attack, stroke and death. Yet there remain significant knowledge gaps about the cost-effectiveness of low and high cost statins. Goldacre spoke of the need for a randomised controlled trial of statins and the disclosure of full data, as well as the obstacles to medical trials sometimes put in place by ethics committees.
Goldacre said: "We have to give the best currently available treatment. We kill people when we continue to practise with a veil of ignorance."
The other speakers, also from Oxford University, were equally forthright in their conclusions. Dr Kamal Mahtani, Academic Clinical Lecturer in General Practice and Deputy Director of the Centre for Evidence Based Medicine, warned patients to challenge the health claims of medicines and products, and to be critical of any so-called miracle cure.
Dr Bethany Shinkins, Research Fellow in Medical Statistics, spoke of the trend for more and more medical tests when people do not have symptoms. She said this leads to overdiagnosis, increased anxiety and harmful overtreatment for conditions unlikely to cause harm.
Obesity was discussed by Dr Jeff Aronson, Reader in Clinical Pharmacology. He explained how slimming drugs have repeatedly been removed from the market because of adverse reactions. His advice was very simple: "Keep calm and stop taking the tablets. Drugs are not the way forward."
DPhil student Tim Muntinga shared mind-boggling statistics to show how the internet is awash with rogue pharmacies peddling unregulated and dangerous drugs.
Professor Carl Heneghan, Director of the Centre for Evidence-Based Medicine and Senior Tutor at Kellogg College, focused on the mass of unpublished evidence about Tamiflu and its side effects, and how he warned the British Government not to spend more on the drug. He concluded the lively session by advising the audience to make informed decisions and to balance the risks and benefits of healthcare.
Harms in Healthcare was organised by Kellogg College and the Nuffield Department of Primary Care Health Sciences' Centre for Evidence-Based Medicine.
By Guy Collender, Head of Alumni Communications and Marketing, Alumni Office, Oxford University