Female Voter Suppression

I probably shouldn’t have been as surprised by this as I was, especially in a state that has been one of the most active in recent months in anti-choice politics.

Starting this November, Texans must show a photo ID with their up-to-date legal name instead of IDs like a birth certificate. That’s not a problem for single or married men — but it leaves a third of Texas women scrambling in a state with just 81 DMVs in its 254 counties. 

(occupydemocrats.com via watchdog.net)

Cochrane Collaboration joins AllTrials

That’s right, earlier today, the Cochrane Collaboration announced that it has “formalized its commitment to the AllTrials: All Trials Registered | All Results Reported initiative.”

This is great news, but I’m honestly a bit surprised that it took them so long. The Cochrane Collaboration is currently celebrating its 20th anniversary as a leader in the movement for evidence-based medicine. It was started as an answer to Archie Cochrane’s (a British epidemiologist) calls to maintain up-to-date, systematic reviews of randomized controlled trials (RCTs) of medical interventions. Cochrane Reviews, as they are called, are the gold standard in systematic reviews in the medical literature. This is because they use rigorous, standardized methods, published in the Cochrane Handbook, to ensure that the reviews are consistent, transparent, comprehensive, and as objective as possible. They are also accessible for free in over 100 low and middle-income countries (LMICs) (too bad they’re not open access).

When I first heard of Cochrane a few years ago, I couldn’t believe that something like them wasn’t already standard practice across the board. Come to think of it, I felt the same way when I first heard of “evidence-based medicine” for the first time. Wait, you mean huge portions of medical practice (even if you don’t count so-called “alternative” “medical” woo like homeopathy) are not based on evidence? Yes, it’s unfortunately true, or at least it was true before evidence-based medicine began to gather steam in the last two decades. Take, for example, the Cochrane logo:

cclogo300x350

The logo is what is called a forest plot[1] and this one is a tragic reminder of the danger of not using systematic reviews. Each horizontal line shows the results of one study. The vertical line is the point where the treatment does not help people, but it doesn’t hurt them either. The left side of the vertical line means that the treatment is good and the right side means that it’s bad. The length of the line shows how precise the results are (the shorter the line, the more precise it is). If a line touches the vertical line, that means the treatment didn’t make a clear difference. The diamond at the bottom is what you get when you combine all the studies. In this case, it’s for giving hormones called corticosteroids to pregnant women who are going to give birth too early in order to prevent their babies from dying. The study at the top was done in 1972.[2] Ten years later, it should have been clear that the corticosteroids worked (we now know they reduce the odds of babies dying by 30% to 50%). But, a systematic review was not published until 1989, so many doctors did not know how good corticosteroids were. Because of that, tens of thousands of babies probably died.

 It’s not an exact science, and it takes a lot of hard work to develop systematic reviews, but they really do save lives and prevent needless suffering. However, even though Cochrane has the world’s largest database of clinical trials, it is still vulnerable to the effects of not reporting the results of trials, or of not even registering them in the first place. I’m glad to see them join the campaign to get all trials registered and all results reported.

1. Though the plots themselves were being used by at least the 1970s, the term “forest plot” itself was not used in print until 1996 in Pittsburgh in a poster presented at a meeting of the Society for Clinical Trials in May 1996.

2. The 1972 study looks like it should have been clear that corticosteroids are awesome after just one study, but it’s risky to trust just one study. Science works because we’re always testing each other’s theories and questioning our results. If no one else can get the same results, then we throw them out and try something else.

AllTrials Update

Since I first posted about the AllTrials campaign to have All Trials Registered and All Results Reported, it has gathered considerable support. More than 40,000 people have signed it and hundreds of organizations have joined as well, including GSK (one of the biggest pharmaceutical companies in the world), AMSA (American Medical Student Association), the British Medical Association, many disease-specific research and advocacy organizations.

Their new goals are:

  • One million signatures on the petition
    • Every 10,000 new signatures, they’ll send the petition to health ministers in every country and to regulators.
    • Share this link to spread the word.
  • More international organisations signed up. (unfortunately very few U.S.-based orgs)
  • £40,000 so they can keep going. Donate here.

Here’s a video (~90 min) of Ben Goldacre, one of the leaders behind AllTrials, explaining the problems with clinical trial reporting that make AllTrials is necessary. He was promoting his new book, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients, but it’s still a good talk. The book’s been sitting on my bedside stand for 2 months now. Hopefully I’ll get around to reading it soon.

Alltrials.net campaign for registration and reporting of clinical trials and their results

All Trials Registered, All Results Reported is a campaign calling for “governments, regulators and research bodies to implement measures to achieve” registration of all trials past and present and complete reporting of the methods and the results.

It is an initiative of Bad Science, Sense About Science, BMJ, James Lind Initiative and Centre for Evidence-based Medicine.

According to Bad Science, one of the initiative’s organizers, the recently-launched alltrials.net campaign has already collected over 7,000 signatures and includes leading organizations in the movement for open science &/or evidence-based medicine such as:

  • The Medical Research Council
  • The Cochrane Collaboration
  • IQWiG (the German equivalent of NICE)
  • PLoS
  • BMJ Group
  • Drug and Therapeutics Bulletin
  • The Open Science Federation

Please join me in signing the petition.

A date which will live in infamy…

ACA rules going into effect today mean that women can now get access to birth control with no copay. Though it won’t do much to help women without health insurance and won’t affect existing plans until they are renewed, it will save money and lives in the long run. This is a major milestone on the road to true reproductive freedom. Unfortunately, some Republicans think that today is a milestone of a different sort. Rep. Mike Kelly (R-PA) had this to say about it:

“I want you to remember August 1, 2012 — the attack on our religious freedom. That is a date that will live in infamy, along with those other dates.”

Those dates he’s referring to are 12/7 (1941) and 9/11. The day after Pearl Harbor, we declared war on Japan. The “War on Terror” began shortly after 9/11. Yes, you read that right, he is literally equating free birth control to acts of violence that claimed thousands of lives. Should we expect the Republican party to declare war on women tomorrow? After all, they did strike first, just like the our enemies on 12/7 & 9/11, by demanding equal rights and reproductive freedom.

When politicians espouse insane ideas like this, why are they not met with pitchforks and torches to run them out of office? I’m not entirely sure, but politicians should never get away with pandering to their rabidly sexist base. The only way to stop this is to hold them accountable. Those who live in Rep. Kelly’s district should move to have him impeached. Americans in general need to take a stand against the current practice in our public sphere of accepting any and all viewpoints as legitimate, no matter how crazy or harmful to society, as long as they are couched in the language of religious freedom. Religious freedom means that you are free to do whatever you want in your house of worship. It does not mean that you have the freedom to force the federal government to impose your personal beliefs on the entire country.