The Futile Cycle

I think that half the problems of the US tort system come from the fact that the US didn’t grow up learning from Oscar Wilde that the appropriate response to a slap in the face is a devestatingly witty comeback, and lacking that, one would just walk away with pride tucked between the legs. For our ignorance, we get nuisance lawsuits for slander and libel. My sympathies to PZ Myers.

I’m not sure when exactly they did so, but Nature has changed its website to a much more web 2.0-y look. They’ve started to really highlight a lot of their new internet initiatives, including Connotea, Precedings, and their Networks and Blogs. I’m a big fan of science journals actually embracing this whole internet thing that’s been here for around 15 years, rather than simply using it as a way to get subscriptions to PDFs. Nature’s been doing this a lot.

But I don’t like their redesign that much. It’s kinda cluttered — much less so than before, I’ll give them that — but still quite so, which is the opposite of what a journal should be.

In the latest entry into the whole Avandia (a.k.a. rosiglitazone) deal, yet another meta-analysis published in the Annals of Internal Medicine shows no statistically significant increase in cardiovascular risk from Avandia, further giving weight to the quote from Ernest Rutherford, “if your experiment needs statistics, you ought to have done a better experiment.” Or weight to any number of other quotes, including Mark Twain’s, “there are three kinds of lies: lies, damned lies, and statistics.”

So, in conclusion, drugs have side effects, sometimes which are risky. (oooh.) Maybe Avandia has some, too, but no one knows. All Steve Nissen’s study shows is that we should conduct a clinical trial specifically to address this issue before making any more definitive conclusions.

Hopefully, I will never have to touch Microsoft Word ever again, thanks to Apple. The new version of their word-processing and page layout program, “Pages”, finally has a “change tracking” feature, which is apparently compatable with Microsoft Word’s Track Changes. This was really the last reason for me to use Word, which I’ve avoided as much as I can with LaTeX. Word was slow, buggy, and not native to Intel Macs (making them even slower). It was also kind of a pain to use. Now that I can do the editing in Pages, I don’t have any need for Word, other than to open the occasional file sent to me. But that’s what PDFs are for, right?

I’m a big fan of Martin Nowak, so it’s great to see his great stuff being proselytized to the masses by the New York Times (found via The Loom). Everyone even remotely interested in evolutionary biology absolutely needs to read Evolutionary Dynamics. Be patient with the math (some calculus, a little linear algebra), because really, it’s absolutely necessary to truly understand the insight he has on the topics. Just read it. It’s got great side chapters on the evolution of linguistic universal grammar, virology, and wonderful stuff on game theory in evolution.

On the BBC, Israeli scientists try to circumvent chemotherapeutic sterility for girls with cancer. Essentially, the problem is that little girls with cancer can generally be cured with chemotherapy, but the aggressive regimes can sometimes leave the girls sterile. Thus, what the scientists did was isolate (surgically) unmatured oocytes and chemically induce them to mature, turning into eggs, which can be frozen to be used for in vitro fertilization (IVF) later in the girl’s life. An interesting idea, essentially “time-shifting” the eggs.

Anyway, they have a strange quote from an activist, Josephine Quintavalle, who demonstrates that she doesn’t know biology very well:

Josephine Quintavalle, of Comment on Reproductive Ethics expressed concern that if the eggs were donated to a woman of childbearing age, a resulting child could have a biological mother who was only a few years older. She said: “Are we going to end up with a child who has a mother who is just six years older? What happens if the child dies? Could the eggs be donated to someone else?

In case Ms. Quintavalle doesn’t realize, the current model of egg maturation in humans is that eggs essentially remain dormant, and usually only one matures at a time during each menstrual cycle (if more than one matures, it can lead to fraternal twins, triplets, etc.). Which means that a woman’s eggs in her ovaries haven’t aged very much compared to the woman herself, anyway.

To put it another way, let’s say someone donates eggs, and they sit for 100 years until someone else uses them for IVF. Assuming the science can actually do that, is it wrong that the “biological mother” (i.e. the egg donor) might be some 120 years older than the child? It’s not really any different (from an ethical point of view) from having the egg donor be a 5-year-old. Eggs are eggs, as long as they’ve matured properly. Now, there are plenty of objections one can make on the biological viability of the eggs, or the ethics of creating life by a procedure that may or may not lead to unexpected health consequences. This objection seems pretty groundless.

Strange that an activist on “reproductive ethics” would demonstrate so little knowledge of human biology. Really, what Ms. Quintavalle is exhibiting is nothing more than being squeemish:

I feel uncomfortable about this development.

That’s really the only thing she’s correct about.

I was in the middle of an interesting article on two documentary film-makers doing an exposé of Michael Moore, when I saw this sentence:

They were kicked out of Moore’s Traverse City (Mich.) Film Festival after questioning his nonprofit’s investments in defense contractor Halliburton and drug maker Eli Lilly.

Now, I understand that the main point is about Michael Moore’s hypocrisy, but I didn’t think I’d see the day where “Eli Lilly” and “Halliburton” were uttered in the same breath. I mean, as bad as drug companies can be, can one really compare them to a defense contractor?

Physicists, computer scientists, and mathematicians have long had arXiv, which is an online pre-print archive for prepublication of manuscripts, and for discussions, editorials, and commentaries that wouldn’t be published elsewhere. I don’t know anywhere else where a Cosma Shalizi and William Tozier’s cheeky A Simple Model of the Evolution of Simple Models of Evolution essay would be published.

Now, biologists have sort of the same outlet. Nature Precedings (no, that is not a typo) has gone online, and it looks like there’s some interesting stuff already. Its interface is a little cluttered, but so far the site looks very promising. It’s almost like an amalgamation of arXiv, PLoS ONE, and Digg, in terms of the way things are presented and what can be done with them. I’ll be watching to see what happens.

(EDIT: added accidentally omitted co-author)

Genentech’s CEO, Dr. Arthur Levinson, gives an interview in the Wall Street Journal on drug pricing and development. It’s a great article, and it can answer a lot of questions that people might have for the seemingly outrageous prices of biological drugs such as Avastin, Herceptin, and Lucentis, all of which are made by Genentech. There’s nothing here that people in the biotech industry wouldn’t already know, but it’s a wonderful look inside for the general public. Levinson also has a great point about generic biologics:

Makers of pharmaceutical pills can show chemical equivalence easily. But if you are producing a biological, it is not made by chemical synthesis. It is made by a Chinese hamster’s ovary cell or an E. coli bacterium — a very complex route. We do not yet have analytical techniques to tell you that a copy is clinically identical to the innovator’s drug. Our recommendation to the FDA would be to simply require a clinical trial to make sure that the drug is behaving in the clinic as expected.

There are a lot of prominent trials (or trials to be) involving Pharmaceutical companies right now, so here are two that have caught my eye over the past week (well, one of them was just pounded into my head over and over by the media).

From the TortsPorf Blog, Wyeth lost in a lawsuit against them in the Vermont Supreme Court in which a woman got gangrene from an accidental injection of a drug (”Phenergan”, a.k.a. promethazine) into her artery. Thing is, the drug’s label (approved by the FDA) “repeatedly and prominently warned” that gangrene is a risk if the drug is accidentally injected into an artery as opposed to a vein (alternatively, a doctor could choose to administer the drug, say, orally, which apparently works slower). A woman lost her arm because of a mistake, and so Wyeth lost the lawsuit. As Ben says, “If that’s the case, why don’t we sue gun manufacturers for every accidental death that guns cause?” I’d like to add, why don’t we sue car manufacturers for every injury sustained from not using seat belts?

Steve Nissen’s Meta-analysis of Avandia (a.k.a. rosiglitazone) is all over the news. Unfortunately, it’s being blown up to be a much bigger deal than it should be. In the Pipeline has a good overview about the caveats on the paper, from Steve Nissen himself as well as a good description about what meta-analyses are, and their inherent problems. Meanwhile, (from Pharmalot), lawyers are already holding conferences on how to sue GlaxoSmithKline. Pharmalot has a good post on the reactions to the NEJM article and the editorial that came with it, including a response editorial from the Lancet (PDF), and the various company affiliations that commenters have (e.g. Steve Haffner, who has been critical of the media frenzy, has gotten speaking fees from pharma companies in the past, and the NEJM editorialists have been paid as expert witnesses by plaintiffs’ lawyers in pharmaceutical trials). Orac has a set of links to good blog post articles on the article. The Examining Room of Dr. Charles has a good post on some unanswered questions about the methodology of the study.