Often I have seen David Sackett introduce himself at medical meetings. He generally uses the pseudonym – Kilgore Trout. Of all my heroes (and yes he is clearly one of my heroes) he has the best sense of humor. This piece from the BMJ uses humor in hopes of making us think about the insidious relationship of academic researchers and the pharmaceutical industry. HARLOT plc: an amalgamation of the world’s two oldest professions

Hopefully a couple of excerpts will whet your appetite to read the entire piece.

It has finally dawned on us that being good and being poor are causally related: being good doesn’t pay. Accordingly, we have decided that it’s time for us to find out whether being bad pays better. We’re combining the world’s oldest and second oldest professions, cashing in on our reputations, and distributing this confidential prospectus for our new company, HARLOT plc.

HARLOT services

HARLOT plc will provide a comprehensive package of services to discriminating trial sponsors who don’t want to risk the acceptance and application of their products and policies amid the uncertainties of dispassionate science. Through a series of blind, wholly owned subsidiaries, we can guarantee positive results for the manufacturers of dodgy drugs and devices who are seeking to increase their market shares, for health professional guilds who want to increase the demand for their unnecessary diagnostic and therapeutic services, and for local and national health departments who are seeking to implement irrational and self serving health policies. The tables summarise our services: table 1 shows the ways we can cook the data in an individual randomised controlled trial; table 2 displays an array of aftercare services for keeping the truth from interfering with sales and implementation; and table 3 lists the services that we offer to our non-elite (that is, shallow pockets) customers. Limited space permits the individual description of only a few of our services. References for all of them can be obtained by subpoena from our legal department.

And

Our FPSU (Find the Pony Statistical Unit) services include back-stepwise sample size calculation software (just tell us how many patients you can get, and we’ll instantly tell you the relative risk reduction claims you’ll need to fabricate to justify your trial). We can provide unblinded analyses after every event, so that you will learn of impressive but irrelevant trends in the data long before your Data Safety and Monitoring Board does.

Our speciality is data dependent subgroup analysis through the use of the “Munchausen statistical grid.” This strategy exploits the happy fact that the number of potential ponies in a muck of trial data is 2n where n = the number of dichotomised subgroups. Even if your intervention is totally worthless, we’ll keep doubling the number of subgroups until we can emerge from the muck with at least one pony subgroup in which it seems to work. What is more, we’ll then turn that phoney result over to our BS (Biology and Sociology) brain trust, which will supply a minimum of three highly plausible theories to support our otherwise patently unbelievable subgroup result. We reconcile statistical significance in the face of multiple analyses by simply ignoring this meddlesome issue.

The entire piece represents much too much effort for these intellects. However, I suspect that this farce is and was a labor of love. So enough of my ranting, read the article and enjoy a good laugh. Then remember the serious issues that stimulated this piece. Then laugh again.

Related posts:

1. Physicians and the pharmaceutical industry
2. Another take on the pharmaceutical industry
3. The pharmaceutical industry – the good, the bad, and the ugly
4. Another strike against the pharmaceutical industry
5. Why must maintain an arm length relationship with the pharmaceutical industry

Related posts brought to you by Yet Another Related Posts Plugin.