Tuesday, February 8, 2011

Grey's Anatomy tackles Clinical Trials?!

I came in here to vent. Hailey is watching last week's episode of Grey's Anatomy in the living room and I was having a hard time biting my tongue any more, so here I rant.

Normally Grey's is an OK show. Not what I'd choose to watch in my own time, but an acceptable "sure dear, we can watch that" sort of show. This season the Patrick Dempsey doctor guy is doing a Clinical Trial looking at an Alzheimer's medication. Great! Public exposure for clinical research is a great thing. We currently have several clinical trials for Alzheimer's meds, so I spend a good portion of every work week in this world. But boo to this episode.

So they have a guy on the table and it's time to "Randomize" the patient. This involves opening an envelope which says "He gets Placebo," pulling out a syringe labeled "Saline" and administering the treatment. Um, no? Why isn't this double blind? Why does the injecting and evaluating physician know what the treatment is? Oh, right, because later it's dramatic if a grieving wife can plead with the assistant to swap the medication if her husband is assigned to the placebo group. No. Just No. Randomization. Blinded trials. Important, no?

They spend a bit of time on the placebo effect, also good if not totally twisted. Dr. Dempsey (I don't know the character's name, whatever) even goes so far as to tell his helper dude that he should be encouraging! He should be more positive about the trial because that will lead to better outcomes if the caregiver thinks it will work! Helper dude is trying to give a realistic assessment of the potential benefit of this new med and he's shut down and told to be more positive! Um, ethics much? You don't enroll someone in a trial with unreasonable expectations.

A more minor quibble is that they don't talk at all about how the endpoints will be measured. Sure they're surgeons, but the amount of cognitive testing that goes into efficacy assessments in real life is totally ignored. I guess that's not good TV.