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Aspirin debate confuses me totally. The researcher who is now
opposing the use of aspirin for prevention is the one who wrote: “The
worldwide meta analysis of anti-platelet trials shows that low dose
aspirin reduces non fatal myocardial infarction, non fatal stroke and
vascular deaths in a wide range of patients.(1) ” He was highly critical
of John Cleland’s articles on aspirin in the BMJ and The Lancet.(2) (3)
(4) Today I am surprised that he thinks that aspirin might not be safe in
elderly people for prevention of vascular events as the risks might
outweigh the benefits.
Meta-analysis is the worst kind of statistical science that we could
rely on. I had written earlier about the mix-master technique of meta
analysis in the BMJ rapid responses.(5) Recently, a well known Professor
of solid state at the Penn State U’sity in the US, was telling me that we
doctors rely too much on a science that is unreliable-statistical science.
He was of the opinion that it is not the real science. In his book SCIENCE
WITHOUT SENSE, Dr. Steven Milloy, a well known statistician-
epidemiologist, was of the same opinion.(6) Based on meta analysis
treating “otherwise well persons” with drugs may not be good practice.
To interfere in human life when they are well definitely needs
stronger evidence. Treating them when they are ill is a different cup of
tea altogether. At the end of the day aspirin might only change the label
on the death certificate without altering the date. My gut feeling is that
this kind of intervention might even advance the date on the death
certificate for the unfortunate victim of intervention.
References:
1) Baigent C, Collins R, Peto R. Article makes simple errors and could
cause unnecessary deaths. BMJ 2002; 324: 167.
2) Cleland JGF. Preventing atherosclerotic events with aspirin. BMJ 2002;
324: 102-103.
3) Cleland JGF. No reduction in cardiovascular risks with NSAIDs-including
aspirin. Lancet 2002; 359: 92-93.
4) Cleland JGF. Chronic aspirin could be effective if data are massaged.
BMJ 2002; 324: 295.
5) Hegde BM. Mix master technique. BMJ.com/cgi/eletters/330/7492/0.
6) Milloy S. Science without Sense. 1997. Cato Institute, Washington DC.
Men trip not on mountains, they stumble on stones
Dear Editor
Aspirin debate confuses me totally. The researcher who is now
opposing the use of aspirin for prevention is the one who wrote: “The
worldwide meta analysis of anti-platelet trials shows that low dose
aspirin reduces non fatal myocardial infarction, non fatal stroke and
vascular deaths in a wide range of patients.(1) ” He was highly critical
of John Cleland’s articles on aspirin in the BMJ and The Lancet.(2) (3)
(4) Today I am surprised that he thinks that aspirin might not be safe in
elderly people for prevention of vascular events as the risks might
outweigh the benefits.
Meta-analysis is the worst kind of statistical science that we could
rely on. I had written earlier about the mix-master technique of meta
analysis in the BMJ rapid responses.(5) Recently, a well known Professor
of solid state at the Penn State U’sity in the US, was telling me that we
doctors rely too much on a science that is unreliable-statistical science.
He was of the opinion that it is not the real science. In his book SCIENCE
WITHOUT SENSE, Dr. Steven Milloy, a well known statistician-
epidemiologist, was of the same opinion.(6) Based on meta analysis
treating “otherwise well persons” with drugs may not be good practice.
To interfere in human life when they are well definitely needs
stronger evidence. Treating them when they are ill is a different cup of
tea altogether. At the end of the day aspirin might only change the label
on the death certificate without altering the date. My gut feeling is that
this kind of intervention might even advance the date on the death
certificate for the unfortunate victim of intervention.
References:
1) Baigent C, Collins R, Peto R. Article makes simple errors and could
cause unnecessary deaths. BMJ 2002; 324: 167.
2) Cleland JGF. Preventing atherosclerotic events with aspirin. BMJ 2002;
324: 102-103.
3) Cleland JGF. No reduction in cardiovascular risks with NSAIDs-including
aspirin. Lancet 2002; 359: 92-93.
4) Cleland JGF. Chronic aspirin could be effective if data are massaged.
BMJ 2002; 324: 295.
5) Hegde BM. Mix master technique. BMJ.com/cgi/eletters/330/7492/0.
6) Milloy S. Science without Sense. 1997. Cato Institute, Washington DC.
Competing interests:
None declared
Competing interests: No competing interests