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KNEE PAIN ANTI -INLFAMMATORIES

 Poster: A snowHead
Poster: A snowHead
Jonpim, It is often difficult to eliminate bias when conducting clinical trials which is why they are often "double blind" - which means neither investigator nor patient know whether they are taking an active compound or placebo. That is not possible with meta-analysis. If I were being cynical, I would say that the final paragraph of the abstract to that BMJ paper reveals its bias:

Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.

Which to me, gives N.I.C.E and private health insurers an easy way to offload the cost of treatment on to the patient; and given that many arthritis suffers are of an age where they get free prescritions or have private health care, it begs the question.

Personally I have never used glucosamine, coming from a pharmaceutical manufacturers background I've always had my own bias toward 'natural' remedies, but I think that has sometimes blinded me to the fact that mother nature frequently provides useful remedies to common ailments Very Happy
Quote:
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Quote:

Personally I have never used glucosamine, coming from a pharmaceutical manufacturers background I've always had my own bias toward 'natural' remedies, but I think that has sometimes blinded me to the fact that mother nature frequently provides useful remedies to common ailments

I don't understand that sentence. Puzzled
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
mozwold,
I suspect Jonpim knows a fair bit about trials one can bias blinded trials in many ways such as by choosing not to publish them. Surely much of the point of Met a analysis though is to choose as a starting point the best trials and how this is done is laid down in the methodology so you can look for the authors bias there rather than in the conclusions.
In the BMJ meta analysis the authors appear to be Swiss so are disinterested as far as NHS funding is concerned.
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pam w, lol sorry yes, meant have been biased against of course Embarassed

T Bar, Of course, though you've hit the nail on the head wrt to meta-analysis as well: which papers are included and which not; though I have to say that I think their selection criteria for this study seems pretty good to me - though the statistical treatment to attempt like for like comparisons will always be open to criticism. As for their nationality, I'm not sure that's relevent to the paper per se. I'm not familiar with the Swiss Health Care system but presumably they have insurers who wish to manage their costs? And they may not have targeted the NHS, but the paper was published in the BMJ so would be read here.

I have no axe to grind here as I don't use glucosamine, but from my years of reading clinical papers I just get suspicious when someting like this is in the abstract.
Quote:

Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.


This is supposed to be a clinical paper so why not stop after the first line of their conclusion ie. a clinical conclusion, unless they had another agenda? Very Happy
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
mozwold,
Quote:

I'm not familiar with the Swiss Health Care system but presumably they have insurers who wish to manage their costs?

Well The study was funded by grants from the Swiss National Science Foundation’s National Research Program 53 on musculoskeletal health
Who would generally take a pretty unbiased view on drugs for patients benefit I would have thought. Nor are the medicines likely to be super expensive me too type drugs causing a significant dent in budgets as they are not subject to patent and if used widely would probably be very cheap to produce . If they were to deliver benefit they could lessen the costs to insurers overall if they reduce the need for surgery or other drugs such as anti-inflammatories particularly considering the cost to medical systems from the side effects of anti-inflammatories.
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T Bar, good point.
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