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Archive for the ‘bariatric surgery’ Category

Therapeutic knee arthroscopy and vertebroplasty; surgical scams for which we all pay

Posted by Colin Rose on December 18, 2010

These are just more examples of surgical impunity. There are many others such as “bariatric” surgery and coronary angioplasty for chronic coronary disease.

If one wishes to market a drug the FDA and Health Canada demand proof of effectiveness and safety requiring many years and many millions of dollars worth of research and clinical trials. But any surgeon can concoct some superficially attractive operation and he and his colleagues can make millions of dollars selling it before anyone gets around to doing a controlled trial of the procedure out of curiosity, not because surgeons are required to do so. Why do surgeons enjoy impunity from scientific proof demanded of drug makers?

Even if there is hard scientific proof that a procedure is totally useless, surgeons are still free to perform them and get paid for doing them by insurance companies and medicare. There are good trials of therapeutic knee arthroscopy for osteoarthritis and vertebroplasty with sham operated controls showing the total absence of benefit of these procedures and yet they are still done. See below for excerpts from these reports. These trials also show the necessity for SHAM OPERATED CONTROLS in testing any surgical procedure for chronic diseases. Sham operation are perfectly ethical when a procedure is not proven to have benefit and has risks associated with it.

Dr. Yee says, “… there’s a bit of a lag in catching up with the evidence. That’s normal.” What’s “normal” about the lag? Surgeons are illiterate? Surgeons are destitute? If a procedure is shown to be useless, just stop doing it. Why aren’t these procedures delisted immediately? Some surgeons might miss the payments on their Jags? They might decide to go to the US?  If they are doing useless operations who needs them anyway? If a drug, approved on the basis of small clinic trials, is found to have unexpected serious side effects when sold to the general population, it is delicensed and instantly removed from the pharmacist shelves. Why is should surgical procedures not be instantly halted if proven to be useless?

With this rampant dereliction of professionalism by some surgeons one can hardly blame patients with MS for also demanding that medicare support a more recent unproven, scientifically absurd surgical scam, Zamboni’s “liberation” treatment for “CCSVI”, his fantasy for the cause of MS.

A toilet money award goes to all surgeons performing therapeutic knee arthroscopy for osteoarthritis and vertebroplasty

 

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Common back and knee surgeries fail to ease pain: study

ANDRÉ PICARD,

PUBLIC HEALTH REPORTER— From Friday’s Globe and Mail
Published Thursday, Dec. 16, 2010 6:48PM EST
Last updated Friday, Dec. 17, 2010 7:12AM EST

There are thousands of unnecessary surgeries being done on the knees and backs of Canadians, particularly patients with osteoarthritis, a new report concludes.

There were 3,600 therapeutic knee arthroscopies and 1,050 vertebroplastiescarried out in Canadian hospitals in the fiscal year 2008-09, according to new data from the Canadian Institute for Health Information.

In both cases, there is mounting evidence that the procedures are largely ineffective to combat certain ailments, and those are but two examples cited in the report that more needs to be done to align care with evidence that it actually helps patients, said John Wright, the president and CEO of CIHI. “Evidence and appropriateness of care are a significant issue in Canada’s health-care debate,” he said.

Mr. Wright said improving efficiency is one of the keys to getting health spending under control.

Knee arthroscopy, a minimally invasive surgery, was once used to diagnosis and treat a host of minor knee problems. But it has fallen out of favour as studies showed it did little to reduce pain and that a large number of patients went on to have knee replacements within one year.

Vertebroplasty is a spinal surgery in which bone cement is infused into fractured vertebrae through a small incision. Recent research has shown that people with compression fractures (a common problem in those with osteoporosis) are not any better that those who undergo a placebo (or fake) procedure. Yet the number of vertebroplasties done in Canada has doubled over the past three years.

Albert Yee, an orthopedic surgeon at Sunnybrook Health Sciences Centre in Toronto, said that the new data are useful but they should not be interpreted as meaning that surgeons are ignoring evidence. With most innovative technologies and surgical techniques, he said, “over time, there are scientific studies that refine the appropriate indications and there’s a bit of a lag in catching up with the evidence. That’s normal.”

Dr. Yee said he hopes policy-makers will not use this data as an excuse to delist procedures like arthroplasty and vertebroplasty (meaning they would no longer be paid by medicare): “I think we need to be careful. These procedures work for some patients; we just need to use them for the proper indications.”

The CIHI report also underscored, once again, the large variations in the number of cesarean sections and hysterectomies performed in various parts of Canada. For example, 23 per cent of birthing women in Newfoundland and Labrador had a c-section, compared to just 14 per cent in Manitoba.

With hysterectomies – the surgical removal of the uterus and sometimes the fallopian tubes and ovaries as well – rates range from a low of 311 per 100,000 population in B.C. to a high of 512 per 100,000 population in PEI.

“When we see these kinds of variations, it is a cue to start asking questions about whether the care being provided is appropriate,” said Jeremy Veillard, vice-president of research and analysis at CIHI. “Reducing unnecessary surgical procedures is beneficial to the patient but there are cost implications for the system as well.”

Mr. Veillard noted that cesarean deliveries cost about twice as much as vaginal births – an average $4,930 versus $2,265. Nationally, hospital costs related to cesareans total about $292-million a year. If nationwide c-section rates were lowered to Manitoba’s level of 14 per cent, there would be 16,200 fewer surgeries annually and an estimated $36-million in savings. Flattening out the regional variations in hysterectomies would deliver similar savings.

According to CIHI, hospitalizations for hysterectomies cost $192-million a year. If the national rate was reduced to B.C.’s current level, 3,700 fewer women a year would undergo the procedure and that would generate savings of $19-million.

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Posted in angioplasty, bariatric surgery, ccsvi, multiple sclerosis, professionalism, randomized trial, sham operation, surgery, therapeutic knee arthroscopy, vertebroplasty, Zamboni | Tagged: | 4 Comments »

MY FAITH IN SWEET SCIENCE IS DOUBLE-BLIND

Posted by Colin Rose on August 16, 2009

Those chiropractors certainly look like willfully ignorant charlatans but some medical doctors are also guilty of the same unwillingness to perform or abide by the results of randomized trials. For example angioplasty of coronary arteries for “treating” stable angina (chest pain caused by inadequate blood flow to the heart during exercise) has been shown in multiple randomized trials to cause more heart attacks than treating with drugs only. But these procedures are still done at great expense to our medical system. As an example of unwillingness to perform randomized trials, consider “bariatric” surgery. Even our Minister of Health and Social Services, Yves Bolduc, a neurosurgeon, believes various forms of gastric surgery is a cure for obesity but there has never been a single randomized, sham-operated controlled study showing surgery is any better than treatment for junk-food addiction alone without the operation. Bariatric surgeons refuse to do a randomized trial and are not compelled to. And yet $billions are being spent on these operations. Like the chiropractors, if you ask these doctors why they are ignoring or not doing randomized trials they will answer that they know what is right for the patient, no need to do trials.


MY FAITH IN SWEET SCIENCE IS DOUBLE-BLIND
SCHWARCZ
The Gazette
16 Aug 2009

“Awhite crystalline substance is known to be either glucose or fructose. How would you identify it?” That’s been a standard question asked on organic chemistry exams for over a hundred years. Glucose and fructose are both simple sugars with exactly…read more…


Posted in bariatric surgery, coronary artery disease, ethics, obesity, professionalism, randomized trial, surgery | Tagged: , | Leave a Comment »

Flash! Morbid Obesity Cured Without Gastric Bypass

Posted by Colin Rose on July 21, 2009

Those, like “bariatric” surgeons, flogging gastric bypass  as the only cure for morbid obesity, take note. Dupont was able to control his addiction to junk food, the only way to cure obesity.


He’s really a winner. Dan Dupont has lost more weight than anyone profiled so far in the Shaping Up column: an incredible 260 pounds
J UNE THOMPSON
The Gazette
21 Jul 2009

Well, it’s official. I finally met the biggest loser – and I certainly don’t mean that in the negative sense. He is, in fact, the biggest weight-loss winner I’ve ever met, and he’s also one of the most gentle, calm and kind souls I’ve ever met. Meet…read more…

Posted in bariatric surgery, diet, obesity, surgery | Leave a Comment »

Obese dying awaiting operations

Posted by Colin Rose on June 3, 2009

Dr Nicholas Christou, a bariatric surgeon, claims that obese people are dying for lack of bariatric surgery. Do you ask a barber if you need a haircut? There is not a single randomized, sham-operated, controlled trial proving that gastric bypass or banding has saved even one life. Morbidly obese people are not dying from lack of bariatric surgery but from junk food addiction . Before the discovery of drugs for reducing stomach acid, many thousands of gastric bypasses were done to treat peptic ulcer disease but they were never associated with major weight loss. But now stomach surgery is touted to be the cure for obesity. If “diet and exercise” don’t work then why do patients after bariatric surgery still have to “stay on their diets”? Quite likely, bariatric surgery “works” only because patients are convinced that they must control their addiction or suffer abdominal pain. Eventually they discover they can eat as before and, if they haven’t mastered their addiction, regain the weight. Before we spend many billions of dollars on this unproven “treatment” a controlled trial is essential.


Obese dying awaiting operations
SHARON KIRKEY CANWEST NEWS SERVICE
The Gazette
03 Jun 2009

Patients in Canada are dying while waiting their turn for obesity surgery, according to new research that says wait times for bariatric surgery are the longest of any surgically treated condition in the country. In 2007, 6,783 patients were waiting…read more…

Posted in addiction, bariatric surgery, diabetes, Type 2, diet, obesity | Leave a Comment »

Weight-loss programs scamming Canadians: Journal

Posted by Colin Rose on February 17, 2009

There is no mention of the biggest weight loss scam, bariatric surgery. Unlike diet scams, surgery can kill. There has never, ever been a sham-operated controlled trial of bariatric surgery. Until there is, all bariatric surgery should be prohibited.


Weight-loss programs scamming Canadians: Journal
SHARON KIRKEY CANWEST NEWS SERVICE
The Gazette
17 Feb 2009

Scams and programs that promise fast and easy fat loss are swindling Canadians desperate to lose weight, Canada’s top medical journal says. The Canadian Medical Association Jour nal, in an editorial published this week, says most commercial…read more…

Posted in bariatric surgery, diet, obesity, surgery | Leave a Comment »