Step Right Up and Play the Statin Lottery

An article published on Medscape yesterday caught my eye. The article, Should Clinicians Change How They Talk Statins with Patients? New Study Says Yes, reports on a new statin study and in doing so, echoes the argument put forth in the study that patients would be more responsive to statin usage if the gains were presented “in the language of lotteries,” and patients were enticed by “the possibility of a bigger payoff.”

The Medscape article discusses a study in the medical journal Open Heart, which argues that even though research show a trivial “mean lifespan gain,” on average, among groups of people taking statins, there are some patients who benefit greatly from statin usage. To reach this conclusion, the researchers looked at a large population of statin users and divided the participants into two groups:

  • Group 1: the 93% of statin users who have the worst gain in lifespan (7.4 months on average)
  • Group 2: the remaining 7%, who show an average of 99 months extended lifespan.

By dividing the group of statin users in this way, researchers argue that practitioners can present statins in a more exciting and appealing way.

Quoting the lead researcher of the study, Dr. Darrell Francis of the National Heart and Lung Institute in London,

“Many patients want to know ‘What’s the size of the jackpot?’ So when talking to patients, maybe we really should use the language of lotteries.”

Yes, lotteries! You know, that game where most everyone spends their money and gains nothing and some statistically insignificant few win big? Yeah, that’s what medicine is becoming, all in the name of selling statins. Only in this “lottery,” the losers suffer more than the loss of a few dollars: statin users lose their memory funding a multi-billion dollar industry, increase their risk of cancer and diabetes, and suffer a host of other complications that are readily downplayed by the statin-fueled medical establishment that’s hell bent on selling more statins.

And, of course, as is common when the medical establishment discusses statins, this “lottery” approach comes complete with a way to obfuscate reality. According to the researchers, practitioners should consider saying only that there is a “chance of a 10-year* life-expectancy extension” from taking a statin but physicians should not reveal the actual chance of seeing any benefit unless the patient asks, because “…most people are very interested in the size of the payoff and not the probabilities,” Dr. Francis observes.

Psychology researchers describe lottery gambling as “paradoxical behavior” because those who buy lottery tickets are compelled to “go for the win” even though it’s obvious that the odds overwhelmingly favor the house. Many others aren’t so kind when describing the growing practice of state sponsored gambling, calling it “predatory” because it plays upon the public’s desire to win big, no matter the odds. Psychologists have coined the term “lottery mindset,” to describe the average person’s common propensity for ignoring the odds while focusing only on the payoff.

I find it deplorable that these predatory tactics are now being advocated to sell more statins. It appears that this is the new practice of medicine: If the science doesn’t hold water, resort to deplorable, predatory psychological manipulation.

When I weigh the statin risks and side effects against the statistically insignificant benefits that statins offer (benefits that are easily duplicated by lifestyle changes to control inflammation, glycation, and oxidation), I think equating taking statins to playing the lottery is not the ideal analogy. Russian Roulette seems more accurate to me.

 

 

 

 

* The study cited a 99 month average life extension for those select few who were “winners,” not 10 years. In typical statin numerical manipulation, the pro-statin crowd immediately rounded 99 months (8.25 years) to 10 years, giving themselves an instant 21% false gain.

The Logic of Nutrition

According to the Whole Grains Council, “Every day, more and more studies show the benefits of whole grains.” This statement isn’t a surprise, coming from folks whose slogan is Whole Grains at Every Meal.

To assist us, they have compiled a list of studies showing just how healthful whole grains are.

Before I even examined this list, I predicted that these studies would use the same deeply flawed “grains are healthy” logic as displayed in the reports that whole grains reduce the incidence of Type 2 diabetes. Today’s misguided nutrition logic that says “if A can be shown to be better than our carefully controlled B, then an abundance of A is obviously beneficial to everyone.”

Let’s take a look at a couple of their cited studies in a little more detail.

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The One True Way to Get Enough Folic Acid

Most everyone knows that folic acid is important to good health, especially prenatal health. Folic acid deficiencies during pregnancy give rise to NTD’s (neural tube defects) such as spina bifida and anencephaly. According to the American College of Obstetrics and Gynecologists, women of childbearing age should consume at least 400 µg of folic acid every day. Folic acid isn’t just for women, however, as folic acid is used to make red blood cells and to produce and repair DNA.

So where might we obtain 400 µg of folic acid every day?

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Separating Science From Marketing

There seems to be an inverse relationship between our awareness that we’re an unhealthy nation and clarity on what we, as individuals, can do to be healthier. One of the biggest reasons that we’re simultaneously more aware and less informed is the incessant barrage of news headlines and magazine ads telling us what’s good for us and what’s not, without ever including enough detail for us to make a truly informed decision. We hear a sound bite, form an opinion, and move on.

This is not science. It’s marketing.

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