This blog is going to blow your mind. I love random nights that you get drunk and talk about all kinds of fucked up shit. Out of the blue, up until three thirty in the morning just genuine conversation. This is what people need to really get to know each other...just get all liquored up and have conversation. Talk.
Henceforth, i've decided to blog about things that blow my mind. It's basically a free lance blog about all of the random things i can't understand. Hopefully you play along and pick up on my usual underlying hidden message. Getting to the bottom of this one is trickier than you think, though.
Every great discussion is started with an old cliche argument. Being both pharmacists in training, last night's escapade started with a discussion about clinical trials. How sad is our existence?
Ramipril is a drug that is used to treat hypertension. So this drug is used frequently, lots getting prescribed to use it every day all over the world. Why you ask?
Evidence.
In some laboratory a greedy "me first" scientist proved ramipril lowers your blood pressure (hypertension means high blood pressure...it is critical to get it down so you don't die a miserable death).
Stop and think about that. Anyone can do research. Don't believe me? My article on peroxide based explosive detection is floating out there somewhere on the interweb. Now, do you think I love everything about lateral field excited sensing devices? Fuck no. I loved reading about sensors about as much as I like waking up the next morning after debating into wee hours of the morning after drinking twelve beers and like a thousand shots.
Anways, my point is that people aren't doing research to because they enjoy it. I'll let the cat out of the bag and inform you that people are trying to get paidddd. People put their entire life in one basket and try to cure diseases that'll make them rich by inventing a magical pill that will net a fortune.
Hands down that is what is going on here. I mean there is probably one honorable, naive, old bag out there that has wasted most of his life righteously on a noble cause. Just plugging away, hoping and waiting for that one big break to cure cancer for his dying daughter. For the most part, its people trying to get rich though...
I digress.
Dr. so and so discovered that ramipril lowers blood pressure. (Honorable dad scientist will drown his sorrows with liquor and late night conversations to re-digress...we'll count that as one word, i think that it's hyphenated).
De-digressing for a second time (also hyphenated, and thus one word again for those of you taking the time to play along with me).
Every study performed after the discovery that ramipril lowers blood pressure MUST use ramipril! I cannot stress this enough. It would be unethical for us to then not give ramipril to patients that may come in with high blood pressure. You can't study the sole effectiveness of a new agent because a few ramipril down the hatch and you're blood pressure will be lowered!
Now that means even if there was a better drug and it would lower blood pressure better than ramipril you might never know it!! It could cover up this effect! I know what you're thinking,
"Maybe you would know because it would lower blood pressure even more so!"
Essentially to know for sure the full effect of the new drug though, you would have to give it alone! What if you're taking ramipril with this new drug and somehow it is dampening the new drugs effect! It is almost sad thinking that we might not ever see the full benefits of the newer and better drug because of the discovery of ramipril by greedy Dr. so and so!! Current guidelines impede the future benefits!
So this doesn't make sense to me.
Stop and think about this.
All that we think we know actually may not be right. Everything and anything as we know it in treating patients could be wrong.
Gaining our second wind, discussion picked up.
Even deeper if you think about it, statistics from trials in of themselves are ridiculous. Lord forbid we discuss results and findings in lay terms. No sir, let's make up a bunch of t-scores and p-values and "power" requirements. What it all boils down to is that people use statistics to confuse the fuck out of each other. It just goes on and on.... if you take the odds ratio of group one with treatment and divide it by the odds ratio of your control group you get an absolute reduction value that will determine the benefit of using the drug . So this side of the room will try to tell me what the fuck that means. Ummm..
Everyone knows that you just now made that shit up, guy. This means that we need to treat thirty people with this new drug for the benefits of the drug to be seen.
Very intriguing. So you mean to say that you must give these drugs to the calculated "number needed to treat" for at least two years or they don't see the effect and don't actually see any benefit whatsoever??
Everyone knows that you just now made that shit up, guy. "Statistics" don't actually work. There is always an exception to the rule. Something could happen a thousand times out of a thousand and they (referring to stupid retard statisticians) would declare with 95% confidence that this event will happen again.
Right... but you just said yourself that you're only 95% sure? So there is a 5% chance you're completely fucking wrong every time. Make up some more shit, guy. I don't like those odds bro, especially if its my life we're talking about.
You follow me?
20 years from now, if i have my way, statistics will be a thing of the past.
Worse comes to worse I'll probably be dead in 20 years from heart failure because of failed treatment of hypertension....But you said you were 95% sure, guy.
Obviously its time for me to bring things back full circle like I always do. Life is complex. You can't assume that the simplest or first "answer" is always right. You don't know. Maybe if we toss all medicine books from the past 100 years and design studies with all drugs...maybe I'll then consider trusting my heart to Lipitor or ramipril. Fucking maybe..
Right now though, because of ethics, i don't see that happening. Apparently its not "ethical" to use new drugs on prisoners in order to help humanity. It's all your "they have rights too bullshit" you can't get around. Its those people that don't understand my message. Let's all face the facts here:
Doctor Ramipril doesn't give a fuck about you...get the message?
Somehow I've fucking done it again.
BRYtunes Genius Recommendation: Drug Ballad- Eminem (44)
Repeat Offender: In Your Eyes (acoustic) (51)
The first letter of each paragraph tells you that there is a hidden message every 20 words. Every 20 words gives you the first verse and refrain of the song "The Drugs Don't Work" by Ben Harper. Get it. The blog was about drugs not working. And the hidden message too. And yes this took a long time.
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