The Making of Killer EMarch 2005
By Terri Mitchell
Behind the Headlines, Controversy Rages
The ink was barely dry on the “killer E” meta-analysis before the criticism erupted. Experts of all kinds, including doctors, dieticians, and medical researchers, have questioned the validity of the analysis: “one might well expect that they should produce conclusions that are consistent with the authors’. This, unfortunately, is not the case . . .”; “You describe the pooled risk difference . . . But when I add the numbers . . . I get a risk difference of . . .”; “ . . . this Lancet study made an entirely different conclusion from your above study . . .”.28 The controversy will rage for months, if not years. Its effect will be positive, as more attention will be paid to the design of future antioxidant clinical trials, and the inadequacies of such studies in general will become more widely recognized.
But the question remains: why did the Annals of Internal Medicine publish such nonsense? The answer was clearly stated in that same publication. The point was to make public policy. The “killer E” meta-analysis was a call for an end to all “high-dose” supplements, a dare to American institutions to reverse their policies on vitamin E, and a challenge to “regulators and policymakers” to control which vitamins Americans take. Who are these people who want to control which vitamins we take?
The study authors are not unfamiliar with the glow of headlines. In the New England Journal of Medicine, they claimed that fish oil increases heart attack risk,29 a claim that was refuted in the same issue by a different research group.30 The editor who published the “killer E” meta-analysis in the Annals of Internal Medicine has a long history of trying to dictate public policy, and has announced that he is using that journal as the mouthpiece for a committee that he formerly chaired, known as the US Preventive Services Task Force.31 Among other things, he acknowledges only meta-analyses and mega-clinical trials as bona fide scientific evidence, and has led the “task force” in assigning “ratings” to the value of such things as prostate cancer screening (no approval), vitamin use (no approval), and cost-benefit analyses (strong approval).31-33
In upcoming issues, Life Extension will be telling members more about what this editor, his “task force,” and others have in store for you. Stay tuned for more sequels to the “killer E” meta-analysis, coming to a newspaper or website near you in the new age of “shared decision making” and sensational “science.”
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