Joining a clinical trial

I have read countless reports of clinical trials but I had never been in one. Until I got an invitation to join one. Last month, I got a letter from the hospital I attend (not the one I work at) along with an appointment letter. I thought it would be interesting to have an inside view of a trial and I contacted the lead researcher. After a phone call assessing eligibility, an appointment was made for me to visit the main hospital for an interview, blood test and covid booster. This took about an hour. What is this trial? It is the BOOST-IC trial. It aims to determine whether an extra covid booster vaccination gives extra protection to people with solid organ transplants (that’s me), blood cancers (like leukaemia), or AIDS. Even though my kidney is now failing (last bloods indicated 12% function), I was still eligible.

After the initial clinic visit, I had to fill out an online form about vaccine side effects, which included taking my temperature every day for 7 days. Then nothing doing until the following month when I will go to one of the hospital pathology clinics to have a blood test. Then some more weeks will go by and I will have another blood test.

At the first appointment, I was asked if I would like a copy of the results when they become available. I demurred, saying that I will look it up and read the RCT. I asked which journal they were considering and they hadn’t decided on one yet. They have a wide choice due to the population they are studying. I also mentioned JANE (Journal Author Name Estimator) and that they could present at numerous conferences (AIDS, various cancer conferences, vaccinations/immunology and renal).

It will be years until I get to read it though!

If you are invited to join a trial or come across one that is recruiting that you are eligible for, I encourage you to join. It’s an interesting project to be involved in.

Are beauty products placebos?

The first episode (season 3) of ABC’s The Checkout did a fun investigation into the claims of the beauty industry. Reduces the appearance of fine lines by 90%! 95% smoother skin! Oh really? How often have we heard these sort of claims?  Well, surprise surprise, the ‘clincial trials’ this industry carries out are not based in science. The Checkout team approached some beauty industry companies and asked for the results to the trials. All but one said it was a commercial secret (so of course, you wouldn’t expect to find them publishing in dermatology

journals). One company did reveal some information.  The company in question (and most of the beauty industry)  hire companies such as Cutest Systems to run ‘trials’ and tailor the results to the beauty company’s market goals. I don’t believe in any of the claims and laugh at the funny ‘scientific’ diagrams and product names. And yet, I use beauty products. Why? I think it is all down to the placebo effect. The placebo effect is a very powerful psychological impulse/reaction and can make people feel better when all that has been taken is a fake treatment or inert substance masquarding as an active one. Marketing has a lot to do with how beauty products are perceived and there is also social pressures around ideals too. So, if I use a cream that I know is no better than sorbelene  but makes me feel good and the gives me the belief that I am looking after myself, do you think – (to paraphrase ) it’s worth it?

Homeopathy is bunkum

Homeopathy is bunkum. That’s the conclusion that the final NHMRC report into the evidence base of homeopathy has reached. They didn’t quite say bunkum though. What they did say was: “Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC concludes that there are no health conditions for which there is reliable evidence that homeopathy is effective”. You can read the full statement by clicking here. Nicely worded, to the point and very polite.

SBS featured a news segment about the  findings on Wednesday evening and the first person to be interviewed about it was a homeopath. The homeopath disagreed of course, and the Australian Homoeopathic Association is going to publish an official response soon. If they are serious about criticising the report, what they should do is include a critical appraisal of the report. It is no good to just say ‘oh, they didn’t look at all the evidence’ (btw, the AHA submitted papers to the NHMRC as part of the public submission process and these papers were critically appraised using SIGN methodology). You have to do more work than that. Your response is also more likely to be respected if you do. There was a piece in the  Guardian mid-week about the report ( Homeopathy not effective for treating any condition, Australian report finds) and the comments from readers are interesting (and funny) to read.  Some of the comments are revealing. Some object to the reductionist approach taken by the evidence appraisal method and some highly regard first hand and anecdotal evidence, rejecting the paternalistic tone that the NHMRC has. There are quite a few people skeptical about how independent the NHMRC is (btw, the evidence review was undertaken by a third party).

The NHMRC is not in the business of telling consumers what health products they should or should not purchase. What they are doing is in the interest of the consumer – do these health products act in the way they are advertised? The final report indicates that they don’t. It is fine to use homeopathic remedies as a placebo – if it makes you feel good, then do so. Just tell your medical practitioner everything you are taking or doing.