Saturday, 20 February 2010

Thromboembolism propaganda from HMG

The government is trying to convince us of the massive threat of venous thrombembolism (VTE), for some reason the threat of deep vein thromboses and pulmonary emboli has been hyped up beyond all proportion in recent years. Sometimes myths get propagated from nowhere as no one has bothered to check the actual facts from scratch, in my opinion this is the case with venous thromboembolism. This is a direct quote from the Department of Health's document on the subject:

"In 2005 the Health Select Committee estimated that there were around 25,000 deaths each year from VTE in hospitals in England and that the cost of treating the long-term disability caused by VTE was around £640 million a year. In 2007 there were 16,670 recorded deaths in England and Wales where pulmonary embolism and deep vein thrombosis (VTE) were mentioned on the death certificate (Office of National Statistics)."

This is disingenuous to say the least. Clots in the leg veins (DVTs) are common, pulmonary emboli (PEs) are much rarer and deaths from PEs are even rarer again. The government is spinning the evidence and facts. There were only 16670 deaths in one year with DVT or PE on the death certificate, so a DVT or PE was only the leading cause or a contributory cause in this number. They then go on to say that there are many more that are not put on the death certificate, in actual fact this is their faulty assumption. In reality DVTs are common and are by far the most common reason that VTE will end up on a death certificate, however equating a death certificate with a DVT as a contributory factor as being a preventable death directly due to VTE is simply preposterous, it is the logic of spin doctors, not scientists, no wonder this 25,00o fugure came from the Health Select Committe and not a proper medical journal.
To then jump to the conclusion that there are 25,000 'preventable deaths' a year from VTE is utterly ludicrous, there are probably way under this figure in terms of deaths, so to assume that 100% of these deaths are preventable is utterly ludicrous, utterly utterly ludicrous.

Medicine and life is a game of risks and balances. The government and NICE have come up with VTE prevention guidelines which mean that virtually everyone in hospital needs to be treated with blood thinners. Basically by making the above faulty assumptions they are forcing blood thinning drugs on a hell of a lot of patients and probably doing a lot more harm than good. For one there is no good evidence that any prophylactic agents can reduce the risk of fatal VTE, also the blood thinning drugs have some very well documented side effects, some of which are rather rare but extremely serious and life threatening.

To illustrate just how ludicrous the government's figure of 25,000 preventable deaths is, I have done a little mathematical calculation. Interestingly this figure of 25,000 was not produced by scientists or in a reputable medical journal, it was made up by the politicians of the Health Select Committee. Anyway if one assumed that every single person in the country had a hip replacement in one year, one would then expect there to be about 40,000 deaths from VTE that year, of note hip replacements are a very high risk procedure for death from VTE. So even if the whole country had a hip replacements then it could still be argued that we would not even get to 25,000 'preventable' deaths.

This whole sorry saga is rather reminiscent of the whole swine flu hype. The weak and corrupt state wants to make itself appear powerful and clever by creating a massive threat and then trying to stamp it out, hence creating the massively exaggerated threat of death from VTE and then try to combat it. As part of the same process a lot of drug companies and their friends on government panels like NICE are making a lot of money from selling a lot of over hyped drugs that thin the blood. At the same time patients are probably worse off as a result of the various side effects of these drugs, while the rate of death from VTE will not really be affected at all. Same old politics, a new topic for abuse and propaganda.


Anonymous said...

Oh having undiagnosed Von Willebrands and being given Heparin..interestingly more likely to happen to women!

Anonymous said...

By establishing a guideline for a common emergency, it offers the opportunity to "convict" many doctors of doing the wrong thing - becuase the outcome was wrong, your conduct was wrong.

Off to the GMC with you - you will not survive the civil standard and the test of insight.

It is the state applying control - but not in the interests of patients - largely as a means of killing doctors.

Sir Liam Donaldchild HonFFPH, HonFRCP, HonFRCPath, HonFRCOG, available for after dinner speeches from May *** NOTE my retirement party has been cancelled because I have no friends*** said...

Hyping up health problems-that I then tackle-has been my Modus operandi for years. That, and cynically pretending to be “passionate” about tackling health inequalities not only earnt me an honorary chair it got me the oxygen of self-publicity. By toadying up to New Labour, when they were in the ascendancy, I also got myself an A distinction award.

I also weaselled my way into the CMO job. I’ve used this as a springboard to shamelessly promote myself. I think I’ve done rather well for myself. I’ll shortly retire before the tories can touch my pension. Loadsamoney, loadsamoney.

Who cares about the truth? Pretending that VTE leads to thousands of preventable deaths annually gives me a chance to basque in the reflected glory of saving all those lives, through leading a hard-hitting campaign. Our PR consultants advise that hyping these stupid guidelines could con voters that Labour has improved the NHS. Do I look as if I care about a few hundred people developing brain bleeds, intraocular haemorrhage, cardiac tamponade or post-op haemorrhage? Sod them. I reckon this will get me a few nice lucrative directorships for my retirement. I’m alright Jack. Loadsamoney, loadsamoney.