A Riccardo Maceratini, pioniere della telemedicina che per ... - E-LIS

and the practitioner. I will give you another example in a minute. But what I want to tell
you also is that in part this is to do with who funds our studies. This is a review of
medical literature. These authors reviewed 370 trials from 25 Cochrane reviews and
they found that there was a 5-fold increase in the odds of concluding that an
experimental investigational therapy is beneficial and should be the treatment of choice
if there was “for profit” funding involved. I will give you one more example of what
authors can actually do with identical studies and identical evidence.
Two more systematic reviews:
The effect of inhaled corticosteroids on lung
function in patients with COPD
↓ 7.7 ml/year
(95% CI 1.3 to 14.2), p = 0.025
“The results (...) suggest that
ICS significantly slow the
rate of deterioration in FEV 1 “
↓ 5.0 ml/year
(95% CI -1.2 to 11.2, p = 0.11)
“… did not find any
association between ICS use
and rate of decline of FEV 1 ”
Thorax 2003;58:937–941
941
Ann Intern Med 2003;138:969-973
973
These are 2 systematic reviews on the benefits of steroid therapy in patients with
chronic obstructive lung disease. Two teams of investigators investigated all the
available rcts in their field, and they found a benefit – and this is of little relevance – of
7.7 ml decrease in the loss of lung function, which is the most important predictor of
survival of patients with obstructive lung disease. These results were statistically
significant and they concluded that the results suggest that inhaled corticosteroids
significantly slow the rate of deterioration in FEV1. A different team of investigators
used slightly different methods. They found that the decrease was only about 5ml per
year. These results were not statistically significant and they concluded that they did not
find any association between ICS use and the rate of decline of FEV1. One of the
authors on this study was employed by the pharmacological industry.
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