2 posts tagged “media”

I don’t talk about politics here very much.  Which isn’t to say that I don’t find politics interesting.  We talk about it at home all the time, which often makes for spirited happy-hour discussions.

Hillary Clinton

One thing we agree on is that the Democratic Party has got to be losing its collective mind if it thinks that front runner and presumptive nominee Hillary Clinton has a good shot of winning the Presidency a year from now.  They have apparently ignored a poll taken in the spring in which 50% of adults (including 45% of women) said that they would not vote for her.  Period.  (Or maybe they think her charming personality will win people over in time.)  Now you can win the presidency with a minority of the popular vote – George W. Bush did that in 2000, as Bill Clinton did in 1992 -- but I wouldn't think that's your first-choice strategy.

The Dems must feel that the polls are somehow wrong or that they will change.

And they’re right.  They probably are wrong.

I was in graduate school at the University of North Carolina in 1990 during a US Senate election between incumbent Jesse Helms and Charlotte Mayor Harvey Gantt.  Helms had been around for 20 years and was the dominant political voice in the state.  He was incredibly polarizing.  People either loved him or hated him.  Unapologetically, he’d just tell you what he liked and didn’t, what he’d vote for and what he wouldn’t.  Helms was never much of a friend to blacks or gays and to me he was the archetypal conservative Southern politician of that era.

Jesse Helms

Gantt was African-American and attacked Helms for his record on race and gender equality.  It seemed that after the Reagan-Bush 80s, there was beginning to be some interest in having the pendulum swing back to the left.  Polls throughout the summer and fall showed Gantt with lead – anywhere from 5 to 9 points.  It looked liked the end for Helms.

On Election Day, Helms won 53% to 47%.

How could this happen?  Where did Gantt’s lead go?  How could all these polls be so wrong?

The truth is that people lied to the pollsters.  When it came down to it, they told pollsters that they would vote one way (i.e. vote for Gantt), but when the ballot got marked as many as 10% of people voted the other way.

I’m sure people have written books and op-ed pieces and given speeches on what this sort of behavior says about society and how we deal with media-expectations and why we choose to vote the way we do.

But the kernel of truth is this: Hillary Clinton is polarizing (though not for the same reasons that Helms was – I’ve yet to get a sense of what she really thinks because it changes so often).  A huge chunk of the electorate has already said they simply will not vote for her.

The question is: how many of those that said they might, when it really comes down to it – won’t?

Well, I guess the FDA advisory panel does.  Well, not exactly.  They just don’t dislike it enough to pull it off the market.

Avandia

In a remarkable 22-1 decision, the advisory panel voted to allow Avandia (the multi-billion dollar drug from Glaxo for Type-II diabetes).  I find this remarkable because I wasn’t sure the Agency had the cajones to stem a rapidly swelling tide against the drug. 

Much hay was made in May when a NEJM article described a meta-analysis of thousands of patients and found an increase in myocardial ischemia (a loss of bloodflow usually caused by a blockage) which can offer be a pre-cursor to a heart-attack. 

A meta-analysis is performed by combining results from several studies to form a database with a large number of patients.   And that's the problem -- because the combined trials were all run differently, its really hard to extract statistically meaningful data – and so such analyses are used to guide specifically designed clinical trials that WILL yield statistically significant data – if there’s anything to find.

And here’s the kicker – Glaxo’s been DOING THAT TRIAL.  They know they need this answer.  The damn thing is Avandia has always had a “heart disease” issue, and is contra-indicated in people likely to have congestive heart failure. They think their compound is safe (enough) and that the trial will show it.  But suddenly, there were ascending cries to remove the compound from the marketplace right now.

And I’m glad it wasn’t.  The FDA can not let media feeding frenzies dictate the nation’s health policy. 

That said – if I was diagnosed as a Type II diabetic, would I want to take Avandia?  No.  Not because of the heart risk (if its there), but because Avandia is hell on your liver, causes edema AND there are new medicines that take advantage of a different mechanism that has a good chance of being way better than Avandia.  I would choose to take Amylin’s Byetta or Merck’s Januvia.

But that’s just me – if you’ve got questions, go talk to your doctor – better yet get your PCP to recommend an endocrinologist and get the real deal from someone that knows.

(end of rant -- back to travel and music and books and movies...)