There is occult medicine amongst us. I’m not talking about witchdoctors, faith healers, crystals or miracle cures. I’m talking about Big Pharma.
The definition of occult from the OED is occultare ‘secrete’, frequentative of occulere ‘conceal’, based on celare ‘to hide’; the adjective and noun from occult- ‘covered over’, from the verb occulere. Occult is also used in medicine to describe conditions not readily diagnosed by manifest symptoms meaning that other options will have to be used e.g. blood tests.
Big Pharma regularly occults data, refusing to let the biomedical community access its full store of information. Select information is released, mostly putting positive spins on trials. Negative results are occulted. It is hard to determine how much information revealed to Big Pharma is occult. Is it a bigger percentage than the percentage Big Pharma have published? Who can say. What is known though that governments down to individuals have practiced unknown or secret medicine.
The AllTrials campaign is trying to turn the situation around by forcing Big Pharma to register and report the results of all trials, past, present and future. The Declaration of Helsinki recognised the ethical importance of releasing all clinical trial data but Big Pharma (and other research groups) still resist or ignore it. Efforts such as that of Peter Doshi and Tom Jefferson in wresting information about Tamiflu demonstrate the extent to which Big Pharma resist releasing information.
All results from any sort of clinical trial must be released, be it negative, indifferent or positive. Otherwise, clinicians practice occult medicine and lose the scientific and moral upper-hand when it comes to fighting quack medicine.