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Sometimes Cheaters Win
by Mary Barry, MD
But that ain’ t the way it ought to be.
For instance, people who tried to be healthier by using xylitol, an artificial sweetener, just got the news from the European Society of Cardiology that it has been linked to much higher rates of experiencing, or dying from, a heart attack or stroke. It is cheering to read that sometimes sugar can be your friend. But I imagine the study participants are gnashing their teeth.
An August 2000 study in Science magazine, reported by Eliot Marshall, revealed that up to 30 % of medical study participants tell whoppers about their use of or compliance with the study’ s rules, medications and guidelines.
Teams from both UCLA and Johns Hopkins reported that in a study of subjects with COPD, who were unaware that their inhalers had a built-in recorder, nearly a third of patients were dumping the med just before a scheduled clinic visit, instead of using their inhalers correctly per the study protocols. Not only that, but researcher Cynthia Rand, PhD, described them at the time as“ Our loveliest, most pleasant, eager-to-please patients.” There was no correlation to race, gender, education or lifelong smoking history. Yet those who lied about taking their medicine as directed were actually more likely to tell the truth about continuing to smoke during the study.
Dr. Rand reported that there was no good way to improve compliance by either exhorting or repeated teaching. She worried that many studies’ data might end up as skewed because of responses from cheaters who aimed to please rather than to record. She worried about dose-response calculations that will not reflect actual usage and will potentially be either excessive or ineffective.
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Meanwhile, at the National Cancer Institute, director Dr. Anthony Letai is worried that China is outpacing the U. S. in drug development, particularly for chemotherapies. He had a lab at Harvard and the Dana-Farber Cancer Institute that he left to take the directorate, when asked by President Trump a year ago.
Dr. Letai was glad to report that his entire extramural research budget, as reported by Jocelyn Kaiser this month on the Science magazine website, has been allocated and will have been spent by the end of this month,“ in a fairly typical year for funding external research,” he told reporter Ms. Kaiser for her Sep. 8 article.
“ The $ 7.35 billion institute will spend its entire extramural research grants budget by 30 September, the end of the fiscal year,” Dr. Letai told Science. Moreover, NCI grant success rates have not plummeted as observers widely feared. This year“ winds up to be a fairly typical year for the NCI in terms of funding external research,” Dr. Letai said last week.
Ms. Kaiser also reported that“ The NCI’ s lab in Frederick, MD is writing a paper on the results of tests run on ivermectin against an existing 60-cancer cell line assay, to look for tumor-killing activity.” In addition,“ Scientists are wrapping up animal experiments with ivermectin.”
Dr. Letai made the decision to study ivermectin in the spirit of scientific inquiry and fact-finding, with a total cost around $ 150,000. He denied any pressure from Secretary Kennedy to do so, though he noted that Secretary Kennedy supported his idea. Dr. Letai said,“ People in the U. S. want to know about it. We’ re the NCI: it’ s our job to give them the information.”
“ The decision to study this was mine,” he said.“ It’ s hard to think of a more controversial drug, it’ s been getting so much public attention,
OPINION