I like how the veteran health journalist Andrew Holtz once explained the interesting concept of surrogate or intermediate endpoints for us dull-witted patients. He cites, for example, studies on patients with diabetes that included aggressive control of blood sugar, high blood pressure and cholesterol in people considered to be at very high risk for heart attacks. But oddly enough, this research showed that:
strict management of blood sugar did not reduce heart attack deaths
reduction in high blood pressure levels did not reduce heart attack deaths
controlling high LDL cholesterol numbers with the use of statin drugs did not reduce heart attack deaths
Holtz explains that lab results may not actually be accurate predictors of mortality – they are merely intermediate or surrogate endpoints along the way.
And just because a drug improves lab test results doesn’t mean it saves lives – despite the efforts of Big Pharma to convince drug prescribers otherwise. Continue reading →
According to a trio of widely published American researchers, many of us are “over-diagnosed” by being labelled with a medical condition that will never cause us any symptoms or premature death. We are, they tell us, mistakenly swallowing the popular conviction that early detection of everything is always for the best.
Their book, Over-diagnosed: Making People Sick in the Pursuit of Health, claims that over-diagnosis is in fact one of medicine’s biggest problems, causing millions of people to become patients unnecessarily, producing untold harm, and wasting vast amounts of resources in the name of disease mongering. Continue reading →