, 26 tweets, 50 min read Read on Twitter
@tombarr26816936 Right, I've got the book. So I reckon it's time to tag in @therealrthorat and @SmutClyde (because you usually enjoy a laugh) and @michaelghead and @KevinEienstrand @Tuffmann & @stinuslindgreen & @gorskon
This claim that PCG makes that drugs are the 3rd leading cause of death...
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon Scroll up the thread to see him making the same claim at GoFundMe.
The source of this claim:
**A book what he wrote**
He likes to publicize this book, with >900 references...
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon 900 references!
Well, not really.
One thing I always wondered was how many of those were actually germane to the 3rd greatest cause of death claim.
Well, thank you wonderful local #library #Ilovemylibrary
The book arrived today:
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon So I have the book.
The relevant chapter seems to be 21 "General system failure calls for revolution".
He starts off by saying "Good data are available..."
And has three (3) references for this.
I'll link to them in the next tweet...
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon So they're:
Weingart et al 2000

Starfield 2000 which is actually a commentary;
"Is US health really the best in the world?"*
And Lazarou 1998:
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon *No. Did anyone suggest it was? Certainly not anyone I've heard talking about global health? Actually US health seems appalling, with gross inequality and the most abysmal value for money I have ever seen:
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon But back to the refs (not 900):
First up is Weingart:
It's errors
Errors often due to inexperienced clinicians and new procedures being introduced.
Risk factors: extremes of age, complex care & prolonged hospital stay.

Medical errors should be reduced, no mistake.
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon Next is Starfield (great name), which isn't a research paper and actually refers to an IOM report...
It's again completely US based in its outlook.
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon So, so far so deeply unimpressed.
This just doesn't support Peter's claims.
I hope one of Peter's fans will rush in and tell me how I have it all wrong? And point me to other bits in the book with references which actually show prescribed drugs to be the third leading caused 💀
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon Lazarou 1998 is more interesting as it is actually a research paper.
But again it's USA and it's hospitalized.
And, yes, I did read the full paper. But the abstract is valid:
"CONCLUSIONS: The incidence of serious and fatal ADRs in US hospitals was found to be extremely high."
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon But, it was hospitals and:
"While our results must be viewed with circumspection because of heterogeneity among studies and small biases in the samples, these data nevertheless suggest that ADRs represent an important clinical issue."
I agree, who wouldn't?
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon So those are the first three refs, described by PCG as "good data".
Lazarou says his results should be regarded with circumspection and concludes drugs are about 4th to 7th as cause of death.
In hospitalized patients.
In the US.
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon So that's Gøtzsche's "good data"...
He then moves on to a "careful Norwegian study", thank god it's not American is all I can say:

@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon And what does Ebbensen find with his 732 patients (by the way, I applaud Ebbensen this sort of research is vital):
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon CONCLUSIONS: Fatal ADEs represent a major hospital problem, especially in elderly patients with multiple diseases. A higher number of drugs administered was associated with a higher frequency of fatal ADEs..."
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon "is unsettled. Autopsy results and the findings of premortem and postmortem drug analyses were important for recognizing and excluding suspected fatal ADEs."

And he didn't say it was the third leading cause of death either.
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon Actually, none of the papers cited so far have.
So where does Peter get his confidence?
Oh, next up is the European Commission which has apparently estimated adverse reactions kill 200,000 annually.
What's his reference?
Weirdly it's a letter from K Archibald to D Cameron...
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon It also doesn't support the idea that drugs are the third leading cause of death.
I'm not sure of the population of Europe? 500+million? Deaths each year? 5 million?

But it doesn't stop dear old Peter...
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon And there the references in Chapter 21 end for now.
And Peter triumphantly declares:
"drugs are the third leading cause of death after heart disease and cancer"

Er, no mate?
You were supposed to demonstrate that, and show your workings.

This is pathetic.
Truly pathetic.
@tombarr26816936 @therealrthorat @SmutClyde @michaelghead @KevinEienstrand @Tuffmann @stinuslindgreen @gorskon Oh, and by the way:
I'm pretty sure lots of people die due, finally, to the drugs they're taking.
We have to die of something. Personally I'm all for palliative care which may hasten death when life becomes a burden, rather than a blessing.
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