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Old 08-10-2018, 11:10 PM
 
Location: Georgia, USA
21,504 posts, read 26,116,900 times
Reputation: 26477

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Quote:
Originally Posted by Good4Nothin View Post

You don't know what you're talking about. ]
It is simple elementary school math. You keep saying "percent reduction" when what you mean is a "percentage point reduction".

A reduction from 5% to 4% is a reduction of 1 percentage point: 5%-4%=1%.

That 1% is 1% divided by 5% = a 20 percent reduction of the original 5%.

Quote:
I know what a meta-analysis is. The point is that no one can see the raw data for studies that are NOT meta-analyse, if they are done by drug companies.
There is no law saying they cannot.

Quote:
You KNOW that I was talking about primary prevention.
So was I.

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0071769/

"A recent Cochrane systematic review identified 18 RCTs on statin therapy versus placebo or control in primary prevention."

Quote:
YOU would not have designed it that way! I can't even ... never mind.
Nope. I would not have put bladder and bowel where they can be injured in childbirth and I would not have put the egress for urine and feces close together. Urinary infections, you know, are much more common in women than in men.

Quote:
Most of it is not understood, not even by YOU.
I am quite sure there are experts that know more than either of us. That is why I listen to them, not you.

Quote:
Instead of responding to anything I actually say, you write these long meaningless comments. You hope to confuse everyone.
No one but you seems to be confused.

 
Old 08-11-2018, 03:00 AM
 
3,356 posts, read 928,435 times
Reputation: 2571
I have very carefully explained the difference between relative and absolute risk reduction. SuzyQ has ignored it. Anyone can look this up, or take links I provided.

A drug company will claim, for example, that statins reduce the risk of heart disease by 50%. But that is a relative reduction. In reality, the absolute risk may be reduced from 2% to 1%, which is a 1% absolute risk reduction. When you look at the NNT (number needed to treat), you might find that 100 people have to take the drug for 5 years to prevent one case of heart disease. But the NNT is not shown in most drug company reports.

You don't have to believe me, this information is now well known by people who bother to think and question the drug companies.

Risk is very small for people who do not have genetically high cholesterol or existing heart disease. So if you reduce that very small risk by half, you get a 50% risk reduction, in relative terms. But in absolute terms it is more like 1%.

SuzyQ refuses to admit this! This is the very center of the drug companies' deception on statins! They are promoted for primary prevention, but they have only a miniscule effect for people with low risk. And MOST of the people taking statins are taking them for primary prevention!

SuzyQ wastes everyone's time by writing comments that try to distract from what is important.

And her arrogance in thinking she can design a better human body is beyond words. Ok, prove it, go ahead and build your perfect human and see how well that works out for you.
 
Old 08-11-2018, 03:03 AM
 
3,356 posts, read 928,435 times
Reputation: 2571
So every time you see a statin drug promotion saying it reduced risk by 40%, or whatever, try to figure out what they really mean. You probably won't see the absolute risk or the NNT mentioned.

Different studies got different NNTs, but for primary prevention it has always been very high, way over 100, or over 200.

And, very often, all-cause mortality was not reduced, or is not mentioned.
 
Old 08-11-2018, 03:11 AM
 
Location: Florida
18,290 posts, read 18,545,587 times
Reputation: 20975
Quote:
Originally Posted by suzy_q2010 View Post


Evolution did do a poor design job in some ways. Why don't humans have wings?

I would not have designed the way the human female urinary, reproductive, and GI systems terminate, for example. They are too close together.

.
You're so right about that one!
Maybe it worked out better when we were crawling around on all fours but it's a PITA now.(No pun intended)
 
Old 08-11-2018, 04:48 AM
 
Location: Georgia, USA
21,504 posts, read 26,116,900 times
Reputation: 26477
Quote:
Originally Posted by Good4Nothin View Post
I have very carefully explained the difference between relative and absolute risk reduction. SuzyQ has ignored it. Anyone can look this up, or take links I provided.

A drug company will claim, for example, that statins reduce the risk of heart disease by 50%. But that is a relative reduction. In reality, the absolute risk may be reduced from 2% to 1%, which is a 1% absolute risk reduction. When you look at the NNT (number needed to treat), you might find that 100 people have to take the drug for 5 years to prevent one case of heart disease. But the NNT is not shown in most drug company reports.
I did not ignore it. I just gave you NNTs that are much lower than the one you want to use and refuse to source. The NNT to prevent any CVD event (fatal and nonfatal) was 49. If you count only fatalities you are ignoring the morbidity of the nonfatal events, which can create severe disability. A nonfatal stroke, for example, can be a ticket to the nursing home.

By the way, an NNT of 49 translate to an absolute risk reduction of 2 percentage points. If you are given the numbers used to calculate the relative risk, the NNT can also be calculated.


https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0071769/

"A recent Cochrane systematic review identified 18 RCTs on statin therapy versus placebo or control in primary prevention. The number of participants was 56,934 (60.3% men, 39.7% women), and the studies were conducted between 1994 and 2008. The median level of CVD risk in the control group was 15% over 10 years. Table 59* details the NNTs for all-cause mortality, CVD outcomes and diabetes over 5 years. The review reported that rates of overall adverse events (17%) and stopping treatment (12%) were similar in the 2 groups. The incidence of myalgia, rhabdomyolysis, liver, enzyme elevation and renal dysfunction did not differ between the groups. The authors concluded that the benefits of statins in primary prevention outweigh the risks of serious life threatening illness."

Table 59*:

NNT

All-cause mortality: 138
Total CVD events: 49
Total CHD events: 88
Total stroke: 155

Quote:
You don't have to believe me, this information is now well known by people who bother to think and question the drug companies.
If you are going to "question the drug companies" you need to cite a specific study and tell us what is wrong with it.

Quote:
Risk is very small for people who do not have genetically high cholesterol or existing heart disease. So if you reduce that very small risk by half, you get a 50% risk reduction, in relative terms. But in absolute terms it is more like 1%.
Source for the opinion in bold?

In this study, 3.7% of patients with known cardiovascular disease had familial hypercholesterolemia. That means that over 96% of such patients do not have it. Most atherosclerotic heart disease happens in people who do not have the severe genetic problem.

https://www.ncbi.nlm.nih.gov/pubmed/29249427

An absolute risk reduction of 1 percentage point translates to an NNT of 100, not 250. Where did that NNT of 250 come from, by the way?

Quote:
SuzyQ refuses to admit this! This is the very center of the drug companies' deception on statins! They are promoted for primary prevention, but they have only a miniscule effect for people with low risk. And MOST of the people taking statins are taking them for primary prevention!
Statins are prescribed for people depending on their personal level of risk and how much risk they are willing to accept. That is where the risk calculator comes into play.

Quote:
SuzyQ wastes everyone's time by writing comments that try to distract from what is important.
LOL! You say that while the focus of this post is me rather than showing why my sources are wrong. This comment contributes exactly what to the discussion?

Quote:
And her arrogance in thinking she can design a better human body is beyond words. Ok, prove it, go ahead and build your perfect human and see how well that works out for you.
I merely pointed out some of the deficiencies of female human anatomy, and I did not even mention the inconveniences of monthly bleeding and not being able to stand up to pee.

Yep, some poor engineering by evolution there.

Quote:
Originally Posted by Good4Nothin View Post
So every time you see a statin drug promotion saying it reduced risk by 40%, or whatever, try to figure out what they really mean. You probably won't see the absolute risk or the NNT mentioned.

Different studies got different NNTs, but for primary prevention it has always been very high, way over 100, or over 200.

And, very often, all-cause mortality was not reduced, or is not mentioned.
I gave you a meta-analysis where the NNT was below 100, so it is incorrect to say "for primary prevention it has always been very high, way over 100, or over 200."

The NNT in your own example is 100, not 250. If an author does not calculate it, it is possible to do it yourself.

The NNT also depends to the baseline risk in the population. The risk calculator helps to determine that.

The source I gave listed the NNT for all cause mortality: 138.
 
Old 08-11-2018, 05:09 AM
 
Location: SW Florida
9,156 posts, read 6,339,451 times
Reputation: 12722
Quote:
Originally Posted by Good4Nothin View Post
I have very carefully explained the difference between relative and absolute risk reduction. SuzyQ has ignored it. Anyone can look this up, or take links I provided.

A drug company will claim, for example, that statins reduce the risk of heart disease by 50%. But that is a relative reduction. In reality, the absolute risk may be reduced from 2% to 1%, which is a 1% absolute risk reduction. When you look at the NNT (number needed to treat), you might find that 100 people have to take the drug for 5 years to prevent one case of heart disease. But the NNT is not shown in most drug company reports.

You don't have to believe me, this information is now well known by people who bother to think and question the drug companies.

Risk is very small for people who do not have genetically high cholesterol or existing heart disease. So if you reduce that very small risk by half, you get a 50% risk reduction, in relative terms. But in absolute terms it is more like 1%.

SuzyQ refuses to admit this! This is the very center of the drug companies' deception on statins! They are promoted for primary prevention, but they have only a miniscule effect for people with low risk. And MOST of the people taking statins are taking them for primary prevention!

SuzyQ wastes everyone's time by writing comments that try to distract from what is important.

And her arrogance in thinking she can design a better human body is beyond words. Ok, prove it, go ahead and build your perfect human and see how well that works out for you.
SusyQ does an excellent job of countering the fallacies and assumptions inherent in your claims, and in the documentation to support what she says.

Your bashing and personal attacks on this poster do nothing to convince the masses of your suppositions and theories here.
They only serve to indicate you have no valid argument to counter what she has said, and your frustration with this predicament.

Your anti-medical establishment and anti-"Big Pharma" bias are obvious, of course you are entitled to believe as you choose, and act on those beliefs for your own health and welfare. But pages and pages and pages of your arguments ( and back to the statin argument, LOL) have likely become tiresome even to those following this thread with baited breath.

Which is why, I'd imagine, the last few comments have waxed in a more tongue-in-cheek or facetious manner. It's human nature.
 
Old 08-11-2018, 05:59 AM
 
3,356 posts, read 928,435 times
Reputation: 2571
Quote:
Originally Posted by Travelassie View Post
SusyQ does an excellent job of countering the fallacies and assumptions inherent in your claims, and in the documentation to support what she says.

Your bashing and personal attacks on this poster do nothing to convince the masses of your suppositions and theories here.
They only serve to indicate you have no valid argument to counter what she has said, and your frustration with this predicament.

Your anti-medical establishment and anti-"Big Pharma" bias are obvious, of course you are entitled to believe as you choose, and act on those beliefs for your own health and welfare. But pages and pages and pages of your arguments ( and back to the statin argument, LOL) have likely become tiresome even to those following this thread with baited breath.

Which is why, I'd imagine, the last few comments have waxed in a more tongue-in-cheek or facetious manner. It's human nature.
Maybe some people are resisting getting the message, because it threatens their faith in their medical doctors.

Did SuzyQ, or you and the other pro-drug commenters, ever get the main point expressed here? I have no reason at all to think so.
 
Old 08-11-2018, 08:37 AM
 
Location: Early America
1,474 posts, read 692,964 times
Reputation: 3131
Quote:
Originally Posted by Good4Nothin View Post
Maybe some people are resisting getting the message, because it threatens their faith in their medical doctors.
Some people have unquestioning faith in a pharma drug to keep them healthy while some have unquestioning faith in a dietary supplement to keep them healthy. They are opposite sides of the same coin but I don't think they realize they are alike. Evidence or logic that challenges their unquestioning faith will be rejected, ignored or perceived as an attack.
 
Old 08-11-2018, 11:25 AM
 
3,356 posts, read 928,435 times
Reputation: 2571
Quote:
Originally Posted by SimplySagacious View Post
Some people have unquestioning faith in a pharma drug to keep them healthy while some have unquestioning faith in a dietary supplement to keep them healthy. They are opposite sides of the same coin but I don't think they realize they are alike. Evidence or logic that challenges their unquestioning faith will be rejected, ignored or perceived as an attack.
I have been trying to reason with people who have absolute faith in modern mainstream medicine, and the drug industry. It doesn't matter what you say, all they hear is a threat to their faith, and all they do is react.

Having a rational discussion with them is not possible.

Statin drugs are overused, and I found plenty of respectable sources who say that.

Most of the experts who promote statins as primary prevention are connected with drug companies. Most of the statin research is done by drug companies.

Why is there such a need to have blind unquestioning faith?
 
Old 08-11-2018, 11:34 AM
 
3,356 posts, read 928,435 times
Reputation: 2571
Quote:
Originally Posted by suzy_q2010 View Post

The source I gave listed the NNT for all cause mortality: 138.
Different research has found different NNTs for different outcomes.

But 138 is not good. That means the absolute risk reduction was less than one percent. Yet is probably reported as relative risk reduction, as 30% or whatever.

You can't see any deception in that? And you can't see any problem with 138 people taking a drug every day for 5 years to prevent one death?

I am sure you will say that every life is important, we must prevent death. But of course you will miss the point as always. Taking excessive precautions is not sensible, especially when those precautions can be harmful.

And hardly anyone would be taking statins if they knew the actual NNTs, instead of the relative risk reductions their doctor tells them, or they see on TV.
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