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posted by martyb on Sunday June 04 2017, @03:49PM   Printer-friendly
from the content-and-context dept.

Researchers have found that a one paragraph letter to the New England Journal of Medicine in 1980 was "uncritically cited as evidence that addiction was rare with long-term opioid therapy" [emphasis in original retained]:

Canadian researchers have traced the origins of the opioid crisis to one letter published almost 40 years ago.

The letter, which said opioids were not addictive, was published in the New England Journal of Medicine (NEJM) in 1980.

Dr David Juurlink says the journal's prestige helped fuel the misguided belief that opioids were safe.

His research found that the letter was cited more than 600 times, usually to argue that opioids were not addictive.

On Wednesday, the NEJM published Dr Juurlink's rebuttal to the 1980 letter, along with his team's analysis of the number of times the letter was cited by other researchers.

The two names to blame? Dr. Hershel Jick and his assistant Jane Porter. Dr. Jick did not anticipate the misuse of his short letter:

Jick still works at Boston University School of Medicine. He told the Associated Press this week that he is "essentially mortified that that letter to the editor was used as an excuse to do what these drug companies did."

"They used this letter to spread the word that these drugs were not very addictive," he said. Jick noted that he testified as a government witness in a lawsuit some years ago concerning the marketing of pain drugs.

A 1980 Letter on the Risk of Opioid Addiction (DOI: 10.1056/NEJMc1700150) (DX)

Addiction Rare in Patients Treated with Narcotics (DOI: 10.1056/NEJM198001103020221) (DX)


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  • (Score: 2, Interesting) by Anonymous Coward on Sunday June 04 2017, @03:59PM (3 children)

    by Anonymous Coward on Sunday June 04 2017, @03:59PM (#520245)

    In conclusion, we found that a five-sentence letter published in the Journal in 1980 was heavily and uncritically cited as evidence that addiction was rare with long-term opioid therapy.

    When I did medical research I would find stuff like this all the time. Sometimes a paper would cite an earlier one that just speculated something in the intro/discussion, then another paper would cite that one until the speculation became something "everyone knows". Other times they would cite a paper claiming it included an experiment when it simply didn't. Other times the original paper would claim to have checked something (eg no correlation between x and y) but if you extract the data from the charts and analyze yourself you see a very huge one. AFAIK that drug is still in clinical trials. Watch out.

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  • (Score: 3, Informative) by Anonymous Coward on Sunday June 04 2017, @05:34PM (1 child)

    by Anonymous Coward on Sunday June 04 2017, @05:34PM (#520285)

    When I did medical research I would find stuff like this all the time.

    Its not just medical research. Everyone here ought to be familiar with the waterfall model of software engineering.
    Well its origin was a 1970 paper [obsglobal.com] that used it as a simplistic process for the purposes of demonstrating the flaws of simplistic engineering processes. But people didn't pay attention to the thesis of the paper, they just uncritically cited it to legitimize a very flawed but very simple engineering process. That snowballed and pretty soon it became accepted as an industry standard.

    We all stand on the shoulders of those who came before us. It is impossible for anyone to know more than a tiny fraction of the knowledge out there. But it is also important not to be intellectually lazy. Finding a balance is hard, go too far in one direction and you become a lemming jumping off a cliff, go to far in the other direction and you sit there constantly re-inventing the wheel but never using it to go forward.

    • (Score: 2) by goodie on Monday June 05 2017, @03:14PM

      by goodie (1877) on Monday June 05 2017, @03:14PM (#520778) Journal

      Interesting comparison with the waterfall model. What I love about this one is that Royce never advocated for the kind of rigid, linear process that "agile" claims it is. And his paper has a section called "involve the customer". Anyway, it's become a stereotype for better or worse.

  • (Score: 2) by FatPhil on Monday June 05 2017, @10:19PM

    by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday June 05 2017, @10:19PM (#521011) Homepage
    What I don't understand is that when an old family friend was on his last legs, back in the late 70s, I remember hearing my parents discussing the problems with the opioids that were being prescribed. In particular, I remember the discussions touching upon the adddictive nature of the drugs. (And the follow-up of "well, it's not going to fuck him up for long".) Why was medicine in the UK so different from medicine in the US?
    --
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