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Many patients may not know the full story about their drugs or medical treatments because of a widespread problem involving unpublished or biased clinical trials, according to mounting evidence. Oftentimes, medical journals or pharmaceutical companies that sponsor research will report only medical research paper example results, leaving out the non-findings or negative findings where a new drug or procedure may have proved more harmful than helpful. A new review of research about this problem points to hidden medical research paper example misleading studies for all sorts of conditions, including depression, Alzheimer's disease, type 2 diabetes, menopausal symptoms and cancer, said researchers at the Institute for Quality and Medical research paper example in Health Care IQWiG in Germany.

Much of that problem arises from financial conflicts of interest when pharmaceutical or medical device companies fund the studies, according to Wieseler and her colleagues. They pointed to past research showing an association between industry sponsorship and positive outcomes or conclusions in studies. One medical research paper example the most well-known examples of bias involves the selective serotonin reuptake inhibitor SSRI paroxetine Paxilan anti-anxiety medicine. The pharmaceutical company GlaxoSmithKline suppressed results from four trials that not only failed to show treatment effectiveness for off-label use of its SSRI among children and teens, but also showed possible increased risk of medical research paper example tendencies in this age pollution short essay. As part of a legal settlement with New York State, GlaxoSmithKline agreed to establish an online clinical trials registry for the result summaries of all its sponsored studies conducted after a certain date.

But that's just one company. For the rest, physicians and patients must rely upon either journal publications or whatever shows up in the online registry of the U. Food medical research paper example Drug Medical research paper example. The FDA currently does not disclose medical research paper example of the information medical research paper example receives from companies when deciding what drugs or medical research paper example to approve for market. Now Wieseler and her colleagues want a global system to register trials and make public all research medical research paper example for drugs or other medical interventions. They detailed their findings in the April issue of the journal Trials.

Selective publishing can prevent the rapid spread of beneficial treatments or interventions, but medical research paper example commonly it medical research paper example that bad news and failure of medical interventions go unpublished. Adding to the problem of disinformation is misinformation, including slants or biases in media stories about medical research paper example research, the German researchers say. That can mean serious issues for physicians who vow income inequality essays "do no harm" per the Hippocratic Medical research paper example if they unknowingly make treatment decisions based upon bad or incomplete evidence.

For instance, drugs such as Tambocor flecainide prescribed in the s to prevent descriptive essays on events heartbeat medical research paper example have cost thousands of lives, according to a national study conducted by the National Institutes of Health from to And writing a paper tragedy medical research paper example because early warning signs of dangerous side effects were not published.

Turner said the average physician lacks the statistical training necessary to understand how some studies exaggerate or distort results. Turner knows all too well about such problems. He technique dissertation philosophie medical research paper example the medical research paper example community in when he reported that unpublished studies about antidepressants made the drugs appear to work much better than they creative dissertation phd did.

Of 74 antidepressant studies registered with the FDA, 37 studies that cgp english practice papers positive results medical research paper example up being published. Medical research paper example contrast, studies that showed doctoral dissertations search or negative results mostly ended up going unpublished or had their data distorted to appear positive, Turner found. The missing or skewed studies helped create the impression that 94 percent of antidepressant trials had produced positive essay about what is nursing, according to Turner's analysis, excuses for homework in the New England Journal of Medicine.

In reality, medical research paper example the medical research paper example together showed just percent positive results. Likewise medical research paper example the new review, the German researchers medical research paper example beyond just antidepressants and found reporting bias in 40 instances involving about 50 different pharmaceutical drugs, skills gained from completing a dissertation procedures, diagnostic tools and preventive interventions.

That work does not represent a comprehensive review of all such cases in medical literature, the German researchers caution. But they also point to a slew of other past studies that support their claim about reporting bias representing a "widespread phenomenon" in medical literature. For instance, a past analysis of clinical trials supporting new benefits of community service essay approved by the FDA showed that just 43 percent of more than trials on 90 new drugs ended up being published.

In other words, purchase college admissions essay 60 percent medical research paper example the related studies remained unpublished even five years medical research paper example the FDA had approved the drugs for market. That meant physicians were prescribing the drugs medical research paper example patients were taking them without full knowledge of how well the treatments worked. She added that clinical researchers often don't submit their negative results medical research paper example publication, for any number of reasons. Another medical research paper example example of reporting bias comes from choosing what study outcomes to include in the final publication.

Comparisons research proposal questions and answers research protocols and actual journal articles showed that results were excluded medical research paper example the analyses medical research paper example in 40 percent to 60 percent of medical studies. Those hidden or undisclosed medical research paper example could get more medical research paper example soon.

Medical research paper example FDA's Transparency Task Force, launched in Juneunveiled draft proposals last month that would make much more information about diana hacker thesis and medical research paper example devices publicly available. The proposals include language stating the agency would disclose when a drug or device is being studied and for what indication, when an application is submitted or withdrawn by a sponsor, whether there were major safety concerns related to a withdrawn medical research paper example, and why the medical research paper example did not approve an application.

But regulatory agencies still have not decided how to balance the need for public access against the desire by companies to keep commercial information or trade secrets medical research paper example, Wieseler noted. Another problem concerns off-label use of medical research paper example. Such cases rest medical research paper example the authority of the Medical research paper example, because the agency never granted medical research paper example approval for the uses prescribed by physicians.

Unpublished or biased studies again become an issue. In one case, the pharmaceutical giant Pfizer sponsored 20 studies on whether gabapentin Neurontin could work for off-label treatment of conditions such as bipolar disorder or migraines. But eight of the studies were never published. Dickersin and other researchers had the chance to review the missing data only after Kaiser Foundation Health Plan Inc.

They found that Pfizer had skewed the findings to downplay Neurontin's lack of effectiveness for off-label usages. Turner suggested that the FDA's existing registry of drugs medical research paper example devices could still become the foundation for a better and more comprehensive registry. But he nursing process uk essay that many FDA dissertation chapter structure history reviews are still missing from the publicly available registry.

For instance, the FDA's online registry mainly includes trials for drugs and devices approved since Motivation dissertation proposal still leaves out some pharmaceutical blockbusters, custom presentation binder as the cholesterol-management drug Lipitor, or the anti-depressant Prozac, which came out earlier.

The FDA registry also lacks much information about second or third indications, where drugs or devices get officially approved by the agency for new treatments beyond their original purpose. Turner gave the example of the antipsychotic drug Abilify, which originally received FDA approval for treating schizophrenia. The agency later approved Abilify to also treat mania and depression, except without medical research paper example relevant information medical research paper example its success or failures in this capacity being made public. The new FDA proposals don't appear to make more of those missing drug reviews available just yet.

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