Trojan Horse Journals, Medical Education and Scientific Policy: The Nearly Imperceptible Intermixing of High-Quality Science with Propaganda, Lies, and Unethical Inertia
Dr Alex Vasquez, article-in-progress last updated 12 July 2017
12 July 2017 from New England Journal of Medicine's Journal Watch:
"Two large studies find an inverse association between coffee consumption and mortality, but recommending more of the stuff "would be premature," according to an editorial in the Annals of Internal Medicine: "Two large studies find an inverse association between coffee consumption and mortality, but recommending more of the stuff "would be premature," according to an editorial in the Annals of Internal Medicine. The EPIC study followed over a half-million subjects in 10 European countries for an average of 16 years. It found that those in the highest quartile of consumption had significantly lower all-cause mortality than nonconsumers after adjustment for smoking and other covariates. The Multiethnic Cohort study followed some 200,000 Hawaiians and Californians, also for an average of 16 years. As with EPIC, higher consumption was associated with lower all-cause mortality after adjustment. The effect was seen across all ethnic groups, Native Hawaiians excepted."
Commentary by Dr Vasquez: Two massive studies with more than 700,000 participants (enormous study group considering that many clinical trials have as few as 40 and often a few hundred or a couple of thousand subjects at best) followed for 16 years (very long follow-up; most trials only have 3-6 months of follow-up) report benefit of coffee-drinking on all-cause mortality, and yet the mainstream medical authorities New England Journal of Medicine and Annals of Internal Medicine decree that "recommending more of the stuff would be premature." So we as doctors are told to not recommend coffee because "more research is needed", but at the same time we're forced to deliver and receive vaccines that have not been proven safe nor effective any clinical trial. I'm quite interested in the curious paradox of the medical profession's caution on certain things such as diet and nutrition contrasted with its drunken embrace of every new drug and vaccine that comes on the market. Look at Vioxx – the published data no later than 2001 published in JAMA (2001 Aug, 954-9) was very clear that the drug increased mortality yet we as a medical profession still used millions of dollars worth of this drug and caused some tens of thousands of early deaths until the drug was finally pulled in 2004 (N Engl J Med 2004 October, 1707-1709; DOI:10.1056/NEJMp048286), with blame shifted to the drug company and the FDA; same with Bextra. But we have to be careful in recommending an extra cup of coffee because more research is needed.
Data from 700,000 participants over 16 years would be the envy of any researcher in the world, given that most studies have a few dozen, a few hundred, or at most a couple thousand patients, who are typically followed for 6 months for most studies, a few years at best for a small group of studies. And yet the authoritative "take home message" is to not have an extra cup of coffee because doing so "would be premature." How about the opposite perspective: that delaying implementation of a low-cost convenient and pleasant treatment would be unethical.
This situation simultaneously puzzled me and began to become more clear when I saw a series of articles and editorials published by JAMA and Medscape, which are two of the most popular medical news sources in the United States and -- to a lesser but still important degree -- in other parts of the world. Both of these sources (same with others, such as Mayo Clinic Proceedings and the American College of Rheumatology) publish good science intermixed with overtly corrupt stupidity and pro-pharma propaganda. These sources generally promote drug sales, the "idiopathic paradigm" (which I decoded more than 10 years ago), and they rabidly attack clinical nutrition in general and vitamin D in particular, despite the overwhelming science and clinical outcomes favoring these interventions for prevention and treatment of many diseases.
I have decoded this, in the context of what I am calling Trojan horse science/medicine/journals. They talk about "scientific method" and "critical thinking" maybe 80-90% of the time, and in this way they gain esteem and the confidence of the people (intellectual and emotional "entry"); then, the other 10-20% of the time, it is a freak-show of snake oil sales and fake science pushing vaccines, statins, opioids, antidepressants, and high-carb diets while blocking progress and anything related to autonomy such as nutrition or worse -- because it would give power to other professionals -- nutritional supplementation. Try looking at it from this perspective: these medical "authorities" appear so cool calm and collected and cautious...on nutrition and diet; but they will sell their souls to push whatever new drug comes along, regardless of the costs and risks and bogus science, as long as it was authoritatively endorsed (such as lies from the CDC endorsing vaccines), taught in medical school, or published in a top-tier pay-to-play medical journal that is biased toward publishing favorable drug studies because the Editors know that the pharmaceutical companies will pay millions of dollars to the journal in the form of "reprints and permissions."
Much of what we learn and do not learn in medical school is unscientific, especially the mythology of vaccines. We should seek to be clear and organized thinkers, not simply Medication Dispensers at the beck-and-call of the pharmaceutical industry.
Dr Alex Vasquez
Alex Vasquez DO ND DC FACN
Where can doctors learn about the clinical management of acute and chronic pain via evidence-based nutritional and functional interventions?
Large textbook: Inflammation Mastery
Clinical protocol book: Volume 2: Clinical Protocols
Color-printed book and ebook: Pain Revolution
Grayscale book and (color) ebook: Brain Inflammation
Small ebook excerpt on migraine: Migraine and Headache Revolution
Small ebook excerpt on fibromyalgia: Fibromyalgia Solution
What is Dr Vasquez's authority on this information?
Doctor-approved: Dr Vasquez has published/presented this information to doctors in post-graduate education conferences and peer-reviewed publications.
International authority and experience: Dr Vasquez has lectured to doctors and medical students nationally and internationally for 20 years; DrV has more than 120 professional publications.
20 years of clinical practice in various settings: Teaching clinics, private practice, outpatient community clinics (family medicine), hospital-based urgent care and inpatient medicine
Context: Dr Vasquez has published more than 120 books, articles, and essays, most of which are directly related to metabolism, nutrition, and clinical medicine.
FOR CLARITY: Chapter 5.1b from Inflammation Mastery 4th Edition was published separately as
Pain Revolution in color and later as
Brain Inflammation in discounted grayscale; the digital versions are identical.