[First, I have not blogged for a while due to a significant illness in a close family member, so my time has been rather squeezed to zero. It is also hard to write unless my mind is 100% clear. Thing are now looking a lot better, on the illness front. Thanks to those who enquired if I was all right]
Here is the title of a paper which has just come out in the European Heart Journal. ‘Negative statin-related news stories decrease statin persistence and increase myocardial infarction and cardiovascular mortality: a nationwide prospective cohort study.’ Sune Fallgaard Nielsen and Børge Grønne Nordestgaard.
I was sent it before publication date to see what I made of it. Well, my first thought was that it bore amazing relationship to a paper published the Medical Journal of Australia (MJA) which came out earlier this year1.
The Australian paper was written following two programmes aired on The Australian Broadcasting Corporation (ABC) in 2013, under the ‘Catalyst’ banner. The first programme criticised the diet-heart hypothesis of heart disease. The second was critical of statin over-prescribing. [I have written about this saga before a few times].
The Catalyst programmes were written and produced by Dr. Maryanne Demasi who was then attacked and hounded and virtually forced out of her job. I have an interest on this issue as I advised Maryanne on the programmes before they went out. I warned her that she would be amazed by the vitriol that would pour down upon her.
The most brutal attack came in the paper in the MJA called ‘The crux of the matter: did the ABC’s Catalyst program change statin use in Australia?’ Cutting through all the impenetrable statistical bollocks, and weird assumptions that were made by the authors, the key sentence is, as follows:
‘…this [the impact of the Catalyst programmes] could result in between 1522 and 2900 preventable, and potentially fatal, major vascular events.’
Taking this story down to its ineluctable essence, this is what happened
- Maryanne Demasi wrote and produced a documentary critical of the over-prescribing of statins
- The cardiovascular establishment in Australia was outraged and attacks rained down
- Researchers (if they can be called that) tried to establish how many people may have stopped taking statins as a result of the programme
- They concluded that tens of thousands of patients stopped, causing at least 1522 preventable deaths.
So, Maryanne Demasi killed at least fifteen hundred people? You think that too harsh a statement. Well that is the exact message these authors were trying promote, put into its starkest terms. This tale was commented on in ‘MJA insight’ a sister publication to the Medical Journal of Australia:
‘A SUSTAINED and significant decrease in overall statin dispensing, affecting more than 60 000 people, has been blamed on a 2013 episode of the ABC program Catalyst, which criticised statin medications.
Dr Jennifer Johns, a Melbourne cardiologist and president of the National Heart Foundation, told MJA InSight that while Catalyst was produced by a highly regarded and trusted network, the report on statins was “extremely misleading”.
“The program did get it wrong — and people believed it”, Dr Johns said.’ 2
Of course, the programme did not ‘get it wrong.’ The programme was balanced and… well, I am not going into all that again.
However, it seems that one statistically warped attack in an established medical journal is not enough. Now, a group of researchers in Denmark have gone one step further. They have looked at all the negative stories about statins over fifteen years and concluded that the 111 negative stories about statins resulted in a cumulative 9% increase in statin discontinuation. Resulting in, who knows, a million deaths? A billion. The entire population of the Earth?
‘The odds ratios for early statin discontinuation vs. continued use were 1.09 (95% confidence interval, 1.06–1.12) for negative statin-related news stories.’3
Of course, in the same time period, there were 731 positive statin studies (about one a week). So, how the hell they managed to disentangle the effect of a 111 negative studies against over seven hundred positive studies is anyone’s guess. I found the entire paper full of weird and completely unprovable assumptions. And, yet, still it got published.
However, despite its inherent nonsense, this study can now be used as ‘evidence’. Which means that anyone who dares to write anything critical of statins can be accused of killing people in their thousands, their hundreds of thousands. How long before any article critical of statins is banned? Not long, I suspect.
Scientific debate, dontcha just love it? ‘Love it, we are banning it. People will do as they are told!’
[The corresponding author of the Danish study was Børge Grønne Nordestgaard. Tel: +45 3868 3297, Email: firstname.lastname@example.org Perhaps you might like to write to him and ask him why he did this study, and what he wanted to happen as a result of it? What was its scientific purpose? Or you may have your own, far better, questions.]
3: European Heart Journal doi:10.1093/eurheartj/ehv641