Keep Saying NO on OTC cholesterol drugs

While the FDA consideres lining the Merck bank account with a new line item of profit it blocks the sale of statin containing red rice yeast in OTC settings.

There isn't much difference but you can see the line clearly between the FDA attitude toward non-drug products.

When I questioned this the FDA told me their reason was that the consumer had no access to a doctor to be properly informed. I replied to the FDA with a number of statistics indicating that doctors are handing out statins like candy with no information about the risks, as is required by law.

One person I spoke with recently had no idea that the statin drug she had been prescribed promoted liver and kidney failure as well as cancer. She also did not know that the drug delpeted Co enzyme Q 10 and that this could lead to sudden death.

We need an FDA that is more interested in protecting consumer right-of-choice and access in health, not an agency flagrantly ignoring its own (so-called) standards.

FDA weighs over-counter cholesterol drug By LAURAN NEERGAARD, AP Medical Writer

The government is questioning if too many of the wrong people will take cholesterol-lowering Mevacor if it's sold without a prescription, days before Merck & Co. makes its third try to move the drug over the counter.

Merck says selling a low dose of this long-used medication on drugstore shelves, next to the aspirin, could get millions of people at moderate risk of heart disease important treatment that they otherwise may miss.

A preliminary Food and Drug Administration review released Tuesday agreed that nonprescription Mevacor would be "a reasonably safe and effective" option — if consumers used it as directed.

But when Merck tested if consumers could judge who was a proper Mevacor candidate, only 20 percent answered all the questions completely correctly — 50 percent if researchers counted people who said they'd check some things with their doctor before purchasing, concluded FDA's lead medical reviewer.

Moreover, about 30 percent of people who already were diagnosed with heart disease, diabetes or had had a stroke wanted to purchase over-the-counter Mevacor, people who need a doctor's care, the FDA documents say.

The studies "have not convinced this reviewer that there is adequate consumer comprehension of the proposed product label to ensure safe and effective use of this product," the preliminary assessment concluded.

Merck argues that most people made the right decision on whether they should buy OTC Mevacor even if they missed some answers.

On Thursday, Merck will present its case to the FDA's independent scientific advisers, hoping they will recommend that Mevacor become the first in the family of cholesterol-lowering "statin" drugs to be sold in this country without a prescription. Twice before, FDA has said no.

Copyright © 2007 The Associated Press.

Why Acid?

The FDA released a report on drugs commonly used for what you are lead to believe is a need to have less acid in your stomach. What they don't tell you, because of the narrow limitations of their "study" is that there are risks.

Acid in your stomach is absolutely necessary to help digest protein. Since the 'gut' is the seat of a major player in your body's immune system health you might want to read more.

Warning! Heartburn drugs do cause risks that may not outweigh alleged benfit.

FDA reviews two major heartburn drugs

Patients who suffer from heartburn are not at increased risk for heart problems as a result of taking Prilosec or Nexium, according to a review released Monday by the Food and Drug Administration.

The FDA and its Canadian counterpart began reviewing the drugs, used by tens of millions of people, back in May. The drug's manufacturer, AstraZeneca PLC, provided them with an early analysis of two small studies that suggested the possibility of a risk. The agency said its review of that study as well as 14 others indicated no increased risk for patients.

"FDA recommends that health care providers continue to prescribe, and patients continue to use these products as prescribed," the agency said.

Nexium is the world's No. 2 selling drug, with 2006 sales of $6.7 billion, according to health care research firm IMS Health.

Its the Cyanide Silly, just one more time

Yes, it is the tiny seeds in these fruits that attack cancer cells. Just to remind you, the cyanide compounds are present in seeded fruit as a survival mechanism. These compounds protect the perpetuation of the species so to speak, and protect the seeds from viruses and bacteria, allowing them to sprout into new plants.

This is interesting because so many years ago these compounds began being attacked - in the form of almond pits known to many as Laetrile.

The government banned Laetrile because they told you that there was cyanide in the almond pits and this was dangerous for your health. More likely than not the idea that natural food could cure disease was so foreign to the FDA, steeped in payola from Big Pharma. The goal was to protect the soaring profits of the drug companies rather than support the right of the people supposed to be protected from catastrophic disease.

Cabbage and broccoli are in the Brassica family along with cauliflower and brussel sprouts and contain many cancer fighting substances. These foods are in the mustard family so perhaps you recall that mustard gas was used in war to kill many people and then became a cancer treatment. I suppose its in the dose...

The Brassicas do contain thyroid suppressing compounds. It is best to reduce this through light steaming or use the sprouts. Lowered thyroid function is directly connected to problems with cancer; you can find this out by reading the proper research.

The real message here is to eat your vegetables and fruit, in that order. And perhaps consider getting a Jack LaLanne juicer as a holiday gift, and start sprouting.

From Reuters Fri Dec 7, 2:36 PM ETStudies show how fruits and veggies reduce cancer

Just three servings a month of raw broccoli or cabbage can reduce the risk of bladder cancer by as much as 40 percent, researchers reported this week.

Other studies show that dark-colored berries can reduce the risk of cancer too -- adding more evidence to a growing body of research that shows fruits and vegetables, especially richly colored varieties, can reduce the risk of cancer.

Researchers at the Roswell Park Cancer Institute in Buffalo, New York, surveyed 275 people who had bladder cancer and 825 people without cancer. They asked especially about cruciferous vegetables such as broccoli and cabbage.

These foods are rich in compounds called isothiocyanates, which are known to lower cancer risk.

The effects were most striking in nonsmokers, the researchers told a meeting being held this week of the American Association of Cancer Research in Philadelphia.

Compared to smokers who ate fewer than three servings of raw cruciferous vegetables, nonsmokers who ate at least three servings a month were almost 73 percent less likely to be in the bladder cancer group, they found.

Among both smokers and nonsmokers, those who ate this minimal amount of raw veggies had a 40 percent lower risk. But the team did not find the same effect for cooked vegetables.

"Cooking can reduce 60 to 90 percent of ITCs, (isothiocyanates)," Dr. Li Tang, who led the study, said in a statement.

A second team of researchers from Roswell Park tested broccoli sprouts in rats.

They used rats engineered to develop bladder cancer and fed some of them a freeze-dried extract of broccoli sprouts. The more they ate, the less likely they were to develop bladder cancer, said Dr. Yuesheng Zhang, who led the research.

They found the compounds were processed and excreted within 12 hours of feeding. That suggests the idea that compounds are protecting the bladder from the inside, said Zhang.

"The bladder is like a storage bag, and cancers in the bladder occur almost entirely along the inner surface, the epithelium, that faces the urine, presumably because this tissue is assaulted all the time by noxious materials in the urine," Zhang said.

In a third study, a team at The Ohio State University fed black raspberries to patients with Barrett's esophagus, a condition that can lead to esophageal cancer.

Black raspberries, sometimes called blackberries or blackcaps, are also rich in cancer-fighting compounds.

Ohio State's Laura Kresty and colleagues fed 1.1 ounces (32 grams) of freeze-dried black raspberries to women with Barrett's esophagus and 1.6 ounces (45 grams) to men every day for six months.

They measured urine levels of levels of two compounds -- 8-isoprostane and GSTpi -- that indicate whether cancer-causing processes are going on in the body.

Kresty said 58 percent of patients had marked declines of 8-isoprostane levels, suggesting less damage, and 37 percent had higher levels of GSTpi, which can help interfere with cancer causing damage and which is usually low in patients with Barrett's.

(Reporting by Maggie Fox, editing by Julie Steenhuysen and Vicki Allen)

It's more of that anti-cancer Cyanide

All seeded berries contain seeds with a proven anti-cancer compound called proanthocyanidins. You might do as well with the whole foods and skip this pricey drink.

The blueberry drink that can shrink tumoursBy FIONA MACRAE - 7th December 2007

A mixed fruit punch could provide a devastating blow against prostate cancer.

The blueberry, grape, raspberry and elderberry cordial rapidly slashes the size of prostate tumours, research shows.

In tests, Blueberry Punch cut the size of tumours by a quarter in two weeks.

Trials are now planned to see whether a daily glass or two of the drink could treat the disease and even prevent it developing in the first place.

Blueberries: Cancer fighting qualities

Prostate cancer is the most common cancer in British men, with nearly 35,000 new cases a year and more than 10,000 deaths.

Blueberry Punch is an Australian product but is available for sale on the internet at £16 a bottle.

It also includes a host of other natural ingredients thought to boost health, including green tea, olive leaves, the herb tarragon and the spices turmeric and ginger.

It is thought the ingredients act together to cut inflammation and block a cancer gene.

Dr Jas Singh, who conducted the research on mice at Sydney University, said: "We have undertaken efficacy studies on individual components of Blueberry Punch in the same laboratory setting and found these effective in suppressing cell growth in culture.

"We reasoned that synergistic or additive effects are likely to be achieved when they are combined."

The researchers looked at the effect of Blueberry Punch on both cancer cell cultures in the laboratory and genetically engineered mice with human prostate tumours. After only two weeks of having the syrupy solution added to their drinking water, their tumours had shrunk by 25 per cent, an American Association for Cancer Research conference heard.

Greg Jardine, the drink's inventor, said the results were comparable to drugs used to treat prostate cancer.

Successful human trials would give the punch 'more credibility within the medical and scientific communities', he said, adding: "We would like it to be considered in the same league as a drug."

In Britain, the Prostate Cancer Charity, said the drink had shown 'promising results' but cautioned that the research was still at an early stage.

Debbie Clayton, the charity's information manager, said: "The researchers are planning a small study of 150 men with prostate cancer who will drink three glasses of the juice every day.

"This is a large quantity for men to consume on a regular basis and further studies will be needed to establish the most effective. These studies will need to involve much larger numbers of men and it may be several years before we are able to offer men clear guidance on how the drink may help them.

"In the meantime, we would recommend that men include a variety of fresh fruit and vegetables in their diet, ensuring they get a "rainbow" of colours."

The research was part-funded by Blueberry Punch's Australian manufacturer, Dr Red Nutraceuticals. However, the scientists said they designed and conducted the experiments independently.

Safe Stevia

For many years the FDA has been making a concerted effort to block the general use of stevia as a safe sweetener while it allows carcinogenic aspartame and the highly toxic chlorinated hyrocarbon insecticide substance known as sucralose (Splenda) to be sold in thousands of products and packages.

I suppose you have to wonder whose zooming whom in this scenario.

Aspartame, as we know from the science, can cause reproductive and fetal problems, cardiovascular issues, tumours and more. It does - when exposed to heat (about 85 degrees) disintegrate into formaldehyde-methyl alcohol-and a tumour forming chemical. And you thought this was safe. NOT!

Stevia extract has been used for thousands of years as a sweetener. It's known to be safe (that is, outside the walls of the Rockville Ranch) and it won't give you diabetes {some new studies show that stevia (see related articles in this BLOG)seems to help prevent you from developing diabetes} and protects you from cavities.

Maybe questioning the government's motive is the clue...

FDA warns about herbal tea sweetener risk
Additive used in some Celestial Seasonings drinks raises 'safety concerns'

WASHINGTON - U.S. health regulators warned Hain Celestial Group Inc about a potentially unsafe herb in some of its herbal teas, saying it might be dangerous to blood sugar, reproductive, cardiovascular and renal systems.

The U.S. Food and Drug Administration sent a letter to Hain dated August 17 calling the herb, a natural sweetener made from a South American herb called stevia, “an unsafe food additive.” The agency released the letter on its Web site on Tuesday.

Stevia is being eyed by big beverage makers looking for new low-calorie sweeteners. In May, Coca-Cola Co and Cargill Inc said they would work together to market the new sweetener, despite lack of FDA approval. Stevia has been approved in a dozen other countries including Japan, China and Brazil.

The FDA letter said that although it has received requests to use stevia in food, “data and information necessary to support the safe use have been lacking.”

It also said “literature reports have raised safety concerns,” including those “about control of blood sugar, and the effects on the reproductive, cardiovascular and renal systems.”

A spokeswoman for Boulder, Colorado-based Hain had no immediate comment.

The Lost Art in Medicine

Maybe this is a sign of these times?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

By John Gever, Contributing Writer, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.

BOSTON, Dec. 4 -- Although physicians pronounce that the integrity of medicine requires observance of the highest standards of professionalism, many concede that their own behavior falls short of this goal.

In short, found Eric G. Campbell, Ph.D., of Massachusetts General Hospital, and colleagues, in a survey of 1,662 physicians and surgeons, doctors don't always practice what they preach when it comes to professional conduct.

For example, 96% agreed that a physician who was impaired or incompetent should be reported to authorities but 45% said they had failed to do so, found the survey, reported in the Dec. 4 issue of Annals of Internal Medicine. Action Points
--------------------------------------------------------------------------------

Explain that the study found that while most physicians embrace strong standards of professional conduct, they do not always follow them in their own practices.

Point out that physicians often must follow policies set by others and may not have complete freedom in their medical decisions.
"Physicians report behaviors that are consistent with the tenets of being honest with patients and protecting patient confidentiality," the authors wrote. "However, for other norms, there were gaps between physician beliefs and what they reported doing."

The investigators sent a two-part professionalism questionnaire to 3,504 physicians in family practice, internal medicine, cardiology, pediatrics, surgery, and anesthesiology, with a 58% response rate.

The first part addressed nine categories of professional standards, asking for agreement or disagreement with the need to encourage participation of patients in clinical trials (83% agreed) and the desirability of periodic recertification (77% agreed).

The second part dealt with specific behaviors corresponding to the general standards. For example, doctors were asked whether they had actually encouraged a patient to participate in a clinical trial in the past three years (41% said they had), and whether they had undergone a competency assessment by a provider organization or health plan (33% said yes).

Another disparity between agreement and adherence was in the category of fair distribution of finite resources, a concept that 98% agreed was a valid standard. But asked whether they would order a clinically unnecessary MRI scan for a patient who insisted on one, 36% said they would.

Also, 93% of respondents agreed with the general principle that physicians should provide necessary care without regard for payment, Yet 69% said they were accepting patients who are unable to pay, and 74% said they had provided care to poor and underserved patients in the past three years without expectation of payment.

Responses varied according to certain physician characteristics, such as their specialty, practice setting and payment system.

For example, 44% of cardiologists and 43.2% of FPs said they always reported personal knowledge of impaired or incompetent colleagues. But 57.4% of pediatricians said they did so.

Physicians in staff-model HMOs were less likely to have provided care without expectation of payment (28.3%), while those in solo practice less frequently participated in a formal medical error reduction program (43.5%) than those in group practices (56.3%).

Similarly, salaried physicians were less likely than those in capitation payment plans to have undergone a competency assessment.

Dr. Campbell and colleagues suggested that some deviation from professional standards could be attributed to employment arrangements. "It is not a physician's sole responsibility if a policy of the organization in which he or she works limits his or her participation in certain professional behaviors, such as caring for the poor or undergoing competency assessments," they said.

"Our findings give reason for both optimism and concern," they concluded. On the plus side, "the near-universal acceptance of key professional norms" is reassuring.

"At the same time, however, our findings suggest opportunities for increasing levels of professional conformance to these norms, at least in the selected areas we probed."

The group said their survey could not capture all behaviors that reflect on professional standards. Also, relying on physician self-reports "probably resulted in over-reporting of socially desirable activities," they acknowledged.

"We do not regard our data on self-reported behaviors as sufficient to judge the overall professionalism of respondents or to conclusively assess their adherence to particular norms," the group said.

Harold C. Sox, M.D., the journal's editor, agreed in a commentary with the survey's overall mixed review of the medical profession.

"We can -- indeed we must -- improve our performance in many of these areas," Dr. Sox said.

The Institute on Medicine as a Profession funded the survey. The survey researchers and Dr. Sox had no relevant financial disclosures.

Primary source: Annals of Internal Medicine
Source reference:Campbell E, et al "Professionalism in medicine: results of a national survey of physicians"Annals of Internal Medicine 2007; 147: 795-802.

Professionalism in Medicine: Results of a National Survey of Physicians
right arrow Eric G. Campbell, PhD; Susan Regan, PhD; Russell L. Gruen, MD, PhD; Timothy G. Ferris, MD, MPH; Sowmya R. Rao, PhD; Paul D. Cleary, PhD; and David Blumenthal, MD, MPP

4 December 2007 | Volume 147 Issue 11 | Pages 795-802

Background: The prospect of improving care through increasing professionalism has been gaining momentum among physician organizations. Although there have been efforts to define and promote professionalism, few data are available on physician attitudes toward and conformance with professional norms.

Objective: To ascertain the extent to which practicing physicians agree with and act consistently with norms of professionalism.

Design: National survey using a stratified random sample.

Setting: Medical care in the United States.

Participants: 3504 practicing physicians in internal medicine, family practice, pediatrics, surgery, anesthesiology, and cardiology.

Measurements: Attitudes and behaviors were assessed by using indicators for each domain of professionalism developed by the American College of Physicians and the American Board of Internal Medicine. Of the eligible sampled physicians, 1662 responded, yielding a 58% weighted response rate (adjusting for noneligible physicians).

Results: Ninety percent or more of the respondents agreed with specific statements about principles of fair distribution of finite resources, improving access to and quality of care, managing conflicts of interest, and professional self-regulation. Twenty-four percent disagreed that periodic recertification was desirable. Physician behavior did not always reflect the standards they endorsed. For example, although 96% of respondents agreed that physicians should report impaired or incompetent colleagues to relevant authorities, 45% of respondents who encountered such colleagues had not reported them.

Limitations: Our measures of behavior did not capture all activities that may reflect on the norms in question. Furthermore, behaviors were self-reported, and the results may not be generalizable to physicians in specialties not included in the study.

Conclusion: Physicians agreed with standards of professional behavior promulgated by professional societies. Reported behavior, however, did not always conform to those norms.

Context

* Whether practicing physicians conform to norms of professionalism is unknown.

Contribution

* This survey of 3504 practicing physicians in the United States found that most physicians agreed with principles regarding fair distribution of resources, access to and quality of care, conflicts of interest, and self-regulation that were proposed by professional societies in 2002. Self-reported behaviors, however, showed that about one half did not follow self-regulation principles and that about one third would order unneeded magnetic resonance imaging for back pain in response to a patient's request.

Implication
* Although physicians generally agree with proposed professional norms, they do not always follow all of them.

—The Editors

Author and Article Information
From Massachusetts General Hospital, Institute for Health Policy, Boston, Massachusetts; School of Public Health, Yale University, New Haven, Connecticut; and University of Melbourne, Center for Medical Research, Royal Melbourne Hospital, Parkville, Victoria, Australia.

Acknowledgment: The authors acknowledge the contributions of Drs. Janice Ballou and Frank Potter for Mathematica Policy Research.

Grant Support: By a grant from the Institute on Medicine as a Profession.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Eric G. Campbell, PhD, Institute for Health Policy, 50 Staniford Street, 9th Floor, Boston, MA 02114; e-mail, ecampbell@partners.org.

Current Author Addresses: Drs. Campbell, Regan, Ferris, Rao, and Blumenthal: Massachusetts General Hospital, Institute for Health Policy, 50 Stanford Street, 9th Floor, Boston, MA 02114.

Dr. Gruen: University of Melbourne, 6th Floor, Center for Medical Research, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia.

Dr. Cleary: Yale University, School of Public Health, 60 College Street, New Haven, CT 06513.

The Real Benefit of the Correct Supplements for Health

With the concerted effort on the part of Big Pharma to control the supplement industry, you often see or hear many false articles in the media.

One of my favorite myths is that beat carotene is not helpful for health. In these studies you see that NO vitamin A is offered with the beta carotene. Since many people cannot convert beta carotene to vitamin A, of course you'll get skewed results, no matter what the form of the study happens to be.

Enough vitamin A is great to help with all respiratory health concerns, especially pneumonia. But the dose is similar to the famous 3H enema; lots of it and for short duration.

Vitamin E studies also raise the hair on the back of my neck only because the failure, as I see it, is the researchers total failure to do a thorough search of the
literature at the front end of the study. There are other reason as well such as using too small an amount to serve as a therapeutic level, using synthetic vitamins, or - perhaps the real failings - no knowledge of nutrition and no knowledge of the facts and benefits of the supplements. The studies are also too short and have too few participants on the average.

Much of my logic can be extrapolated if you read my comments on the - now highly advertised - Centrum Cardio - in this BLOG.

So if it was me, I'd be using natural vitamin E and lots of it. When taken for two days prior to a chemo treatment, 2000IU will help protect you from hair loss. When taken daily, 2400 IU will protect your from peripheral neuropathy if you have diabetes. Vitamin E also keeps your blood "thin" so you won't suffer from silent bleeding with coumadin or aspirin, and it is very helpful for hot flashes and other menopausal complaints. Vitamin E is the premiere cardiovascular vitamin, proven effective in the 1950s by the Canadian physicians, the doctors Schute.

Any one for a trip to the stacks?

I'd say your health is worth the effort!

IOANNINA, Greece, Dec. 5 -- Although randomized clinical trials have discredited any purported cardiovascular benefits of vitamin E, peer-reviewed medical journals keep citing old disproved epidemiologic findings, found researchers here.Action Points
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Explain to interested patients that this study found that articles in the literature continue to cite the protective benefits of vitamin E, beta-carotene, and estrogen for cardiovascular disease, cancer, and Alzheimer's disease, respectively, even though strong evidence from clinical trials has found otherwise.

That emerged from an analysis of citation patterns in journal articles published before, soon after, and several years after the vitamin E claims were contradicted, John P.A. Ioannidis, M.D., of the University of Ioannina School of Medicine, and colleagues, reported in the Dec. 5 issue of the Journal of the American Medical Association.

They said the same pattern -- citing observational findings from epidemiologic studies that have been solidly countered by randomized trials -- also continued for studies of beta-carotene and estrogen.

This trend wastes time, effort, and money and can "also perpetuate a literature of false impressions that can affect future scientific efforts by providing a misleading starting base," said Dr. Ioannidis and colleagues. They did not cite the offending journals by name.

Two articles touting the benefits of vitamin E were published in 1993, but the HOPE trial, which was published in 2000, found that vitamin E did not reduce the risk of cardiovascular events.

A favorable finding for vitamin E was less likely in papers published in 2005 than in 2001 or 1997 (P0.001), yet half of the 46 vitamin E studies published in 2005 cited the two 1993 papers as evidence of the benefit of vitamin E, Dr. Ioannidis and colleagues said.

Moreover, when researchers analyzed 29 articles published in 2005 that cited the HOPE trial, 20.7% of those were still favorable to vitamin E's role in cardiovascular protection, 37.9% were equivocal, and 41.4% were unfavorable.

The researchers found an even higher rate of erroneous claims for articles on beta-carotene and estrogen.

Clinical trials published in 1994 and 1996 found no evidence that beta-carotene supplements prevent cancer, but 10 of 16 articles published in 2006 cited a 1981 review of epidemiology research, which suggested the antioxidant may help reduce the risk of developing the disease. The remaining six articles were evenly divided between equivocal and unfavorable.

For estrogen, 61.7% of 47 articles published in 2006 indicated the hormone may protect against Alzheimer's disease on the basis of a 1996 observational study, even though a clinical trial in 2004 found a trend for increased risk of dementia in postmenopausal women taking estrogen. Of the remaining articles, 29.8% were equivocal, and 8.5% were unfavorable.

Articles that espoused beta-carotene's cancer preventive effect did not consider contradicting evidence, but many of the studies touting the positive benefits of vitamin E or estrogen included counterarguments for why the clinical trial findings did not hold, including information biases or differences in study participants, interventions, co-interventions, and outcomes measured.

The possibility that some of these counterarguments are valid cannot be fully excluded and poses one limitation for the study, Dr. Ioannidis said. However, he added, the more likely scenario is that these researchers have a "wish bias" and are unwilling to let go of their hypotheses, even when the contradicting evidence is overwhelming.

One way of improving this situation is for researchers who specialize in very narrow fields, such as specific vitamins or hormones, to communicate more with those in clinical science and evidence-based medicine, Ioannidis said. "This communication may improve the rational design of translational research efforts to find effective treatments," he said.

Christian Gluud, M.D., of Copenhagen University Hospital in Denmark, said he thinks this pattern of not accepting the findings of randomized clinical trials when they refute epidemiological studies happens in other areas beyond vitamins and hormones.

"I don't think they've identified a rare behavior," Dr. Gluud said in an interview. "I think what they've identified is the norm." Dr. Gluud was not involved in the study.

In addition to spurring research that is based on false premises, the practice could also harm the public, Dr. Gluud said. If the general population picks up on the erroneous results, people could jump the gun and start taking vitamin supplements for diseases for which they have not been shown to be effective or safe, he said.

Primary source: Journal of the American Medical Association
Source reference:
Tatsioni A, et al "Persistence of contradicted claims in the literature"JAMA 2007; 298: 2517-2526.