Methodology in medical research, learn how to better evaluate results

[Merc.]

I recently posted this on another board also .. So you might have seen it already...

I wanted to post this here as it has a lot of great info .. So if you are a fellow researcher/scientist ( or you just like science) this is a great read from Dr Ollie ( a very respected member in our scientific community).. check it out..


hi,

This thread is intented to help science savvy members to upgrade their ability to make proper judgements on the research findings they encounter. The ability to assess study quality and make inferences beyond author's conclusions is the skill that separates great scientists from the rest. In the internet, such level of ability is a rare phenomenon indeed. Plus, I'll guarentee you, this is the skill that provides the most amount of benefit in shortest amount of time.

I'd be delighted especially if some of the ImmInst hard-core scientist would pop in to provide insights or perhaps point us to source of information they themseves have found valuable, remembering of course level of knowledge of the audience they are addressing.

I'll begin by providing few links that not only give great insights to the nature of evidence, also might give direct relevant information on the phenomena themselves. Take your time with these and enjoy:

Some basics (you may want to follow the links on the wikis by yourself, I just collected some of the most important ones)

http://en.wikipedia.org/wiki/Evidence-based_medicine
http://en.wikipedia.org/wiki/Study_design
http://www.cebm.net/study_designs.asp
http://en.wikipedia.org/wiki/Clinical_trial
http://en.wikipedia.org/wiki/Randomi...ntrolled_trial
http://en.wikipedia.org/wiki/Case-control
http://en.wikipedia.org/wiki/Cohort_study
http://clio.stanford.edu:7080/cocoon...ort/index.html
http://clio.stanford.edu:7080/cocoon...ort/index.html

http://en.wikipedia.org/wiki/Meta-analysis
http://en.wikipedia.org/wiki/Systematic_review
http://en.wikipedia.org/wiki/Study_heterogeneity

http://en.wikipedia.org/wiki/Longitudinal_study
http://en.wikipedia.org/wiki/Cross-sectional_study
http://en.wikipedia.org/wiki/Experimental_control
http://en.wikipedia.org/wiki/Confounding

http://www.montrealinternational.com...rinciples.html
http://www.montrealinternational.com...ug/stages.html
http://www.montrealinternational.com...target-id.html
http://www.montrealinternational.com...y-lead-id.html
http://www.montrealinternational.com...imization.html
http://www.montrealinternational.com...al-trials.html
http://www.montrealinternational.com...v-phase-1.html
http://www.montrealinternational.com...v-phase-2.html
http://www.montrealinternational.com...v-phase-3.html
http://www.montrealinternational.com...v-phase-4.html

http://en.wikipedia.org/wiki/Categor...imental_design
http://en.wikipedia.org/wiki/Category:Epidemiology
http://en.wikipedia.org/wiki/Category:Clinical_trials
http://en.wikipedia.org/wiki/Clinica...ising_outcomes
http://en.wikipedia.org/wiki/Guideline_%28medical%29
http://en.wikipedia.org/wiki/Consensus_%28medical%29

More specific subjects (a good way to learn more is to check the list of references):

This articles discusses the relationship between diet and cancer while given insights to the research methodology, not very hard-core stuff yet:
http://www.nypcancerprevention.com/i.../iss_ins.shtml

This is rather rigorous paper on relialibity and nature of research findings
http://medicine.plosjournals.org/per...pmed%2E0020124

And here is our own John Schloendorn's commentary on statistical significance, with references of course (page 3, don't know why the links never work):
http://www.imminst.org/forum/index.p...3&#entry106530

[Merc.]

I also thought this has some good info on Impact Factor ... In the case of no peer reviewed journals, I was taught that the best way to determine research quality is generally considered to assess impact factor ... and check the credibility of the institution that published the data... check this info out .

http://www.hsl.virginia.edu/services/howdoi/hdi-jcr.cfm

[Merc.]

I posted this in a diffrent thread also .. But it is a intrestering read so I wanted to post it here in case anyone missed the other post about it ..


Why Most Published Research Findings Are False

Abstract

Summary
There is increasing concern that most current published research findings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance. Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias. In this essay, I discuss the implications of these problems for the conduct and interpretation of research.

Citation: Ioannidis JPA (2005) Why Most Published Research Findings Are False. PLoS Med 2(8): e124. doi:10.1371/journal.pmed.0020124


http://www.plosmedicine.org/article/...l.pmed.0020124


Merc.

[MuscleScience]

I posted this in a diffrent thread also .. But it is a intrestering read so I wanted to post it here in case anyone missed the other post about it ..


Why Most Published Research Findings Are False

Abstract

Summary
There is increasing concern that most current published research findings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance. Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias. In this essay, I discuss the implications of these problems for the conduct and interpretation of research.

Citation: Ioannidis JPA (2005) Why Most Published Research Findings Are False. PLoS Med 2(8): e124. doi:10.1371/journal.pmed.0020124


http://www.plosmedicine.org/article/...l.pmed.0020124


Merc.

That all really depends on the field of science and the journal that each study is published in. Finding a good journal with a good R value is always the number one goal of a researcher. If the study does not hold up to a particular journals standards it is reject, either conditionally or completely based on methodology. The next step for the researcher is to find another journal with lesser standards and so on. Fields in the primary sciences are usually pretty stringent.

[Merc.]

That all really depends on the field of science and the journal that each study is published in. Finding a good journal with a good R value is always the number one goal of a researcher. If the study does not hold up to a particular journals standards it is reject, either conditionally or completely based on methodology. The next step for the researcher is to find another journal with lesser standards and so on. Fields in the primary sciences are usually pretty stringent.

Yep you are correct my friend ( thats exactly how it goes down)...

Heres a blog post ( from awhile ago ) It is from Dr Steven Novella ( He is a MD - surgeon- and a respected scientist ...) He also co- founded The New England Skeptical Society .. and is the Founder and Executive Editor of Science-Based Medicine ( blog) .. He just goes into more detail about what you were stating ..




Peer-Review

Published by Steven Novella under General Science

I have been asked multiple times to discuss the whole issue of peer-review, so here it is. Peer-review is a critical part of the functioning of the scientific community, of quality control, and the self corrective nature of science. But it is no panacea. It is helpful to understand what it is, and what it isn’t, its uses and abuses.

Overview

When the statement is made that research is “peer-reviewed” this is usually meant to refer to the fact that it has been published in a peer-reviewed journal. Different scientific disciplines have different mechanisms for determining which journals are legitimately peer-reviewed. In medicine the National Library of Medicine (NLM) has rules for peer-review and they decide on a case by case basis which journals get their stamp of approval. Such journals are then listed as peer-reviewed.


The basic criterion is that there is a formalized process of peer-review prior to publication – so this presents a barrier to publication that acts as a quality control filter. Typically, the journal editor will give a submitted paper to a small number of qualified peers – recognized experts in the relevant field. The reviewers will then submit details criticism of the paper along with a recommendation to reject, accept with major revisions, accept with minor revisions, or accept as is. It is rare to get an acceptance as is on the first round.

The editor also reviews the paper, and may break a tie among the reviewers or add their own comments. The process, although at times painful, is quite useful in not only checking the quality of submitted work, but improving the quality. A reviewer, for example, may point out prior research the authors did not comment on, or may point our errors in the paper which can be fixed.

It is typical for authors to submit a paper to a prestigious journal first, and then if they get rejected to work their way down the food chain until they find a journal that will accept it. This does not always mean that the paper was of poorer quality – the most prestigious journals have tons of submissions and can pick and choose the most relevant or important studies. But sometimes it does mean the paper is mediocre or even poor.

The limitations of Peer-Review

It is important to realize that not all peer-reviewed journals are created equal. Small or obscure journals may follow the rules and gain recognized peer-reviewed status, but be desperate for submissions and have a low bar for acceptance. They also have a harder time getting world-class experts to review their submissions, and have to find reviewers that are also farther down the food chain. The bottom line is that when a study is touted as “peer-reviewed” you have to consider where it was reviewed and published.

Even at the best journals, the process is only as good as the editors and reviewers, who are people who make mistakes. A busy reviewer may give a cursory read through a paper that superficially looks good, but miss subtle mistakes. Or they may not take the time to chase down every reference, or check all the statistics. The process generally works, and is certainly better than having no quality control filter, but it is also no guarantee of correctness, or even the avoidance of mistakes.

Peer-reviewers also have biases. They may be prejudiced against studies that contradict their own research or their preferred beliefs. They may therefore bias the published studies in their favored direction, and may be loath to give a pass to a submission that would directly contradict something they have published. For this reasons editors often allow authors to request or recommend reviewers, or to request that certain people not be asked to be reviewers. Each journal has their own policy. Sometimes an editor will specifically use a reviewer that the authors request not be used, thinking they may be trying to avoid legitimate criticism.

The process can be quite messy, and full of politics. But in the end it more or less works. If an author thinks they were treated unfairly by one journal, they can always go to another or they can talk directly to the editor to appeal a decision and try to make their case.

Perhaps the biggest weakness of peer-review, however, is when an entire discipline of peers is lacking in some fundamental way. For example, there are now many journals dedicated to alternative medicine. The editors have a pro-CAM bias, and they find reviewers with a pro-CAM bias. So pretty much any pro-CAM article can get published. They also have enough ideological friends at the NLM that they can get approved as peer-reviewed, despite glaring biases in their editorial policy.

Post Publication Peer Review

The term peer-review is sometimes used to refer to the fact that papers are read and reviewed by the broader scientific community once they are published. However, this post-production review should not be confused with “peer-reviewed” and that term should not be used to refer to post-publication review, to avoid confusion.

The process, however, is even more critical to quality control in science. Now, instead of one editor and 2-3 reviewers looking at a study, dozens or hundreds (maybe even thousands) of scientists can pick over a study, dissect the statistics and the claims, bring to bear knowledge from related areas or other research, and provide detailed criticism. This is the real “meat grinder” of science. Hundreds of reviewers are more likely to find problems than the few pre-publication reviewers. Arguments can be tested in the unforgiving arena of the scientific community, weeding out bad arguments, honing others, so that only the best survive.

Bottom line – peer-review is a necessary component of quality control in science, but is no guarantee of quality, and you have to know the details of the journal that is providing the peer-review.

[MuscleScience]

Yep you are correct my friend ( thats exactly how it goes down)...

Heres a blog post ( from awhile ago ) It is from Dr Steven Novella ( He is a MD - surgeon- and a respected scientist ...) He also co- founded The New England Skeptical Society .. and is the Founder and Executive Editor of Science-Based Medicine ( blog) .. He just goes into more detail about what you were stating ..




Peer-Review

Published by Steven Novella under General Science

I have been asked multiple times to discuss the whole issue of peer-review, so here it is. Peer-review is a critical part of the functioning of the scientific community, of quality control, and the self corrective nature of science. But it is no panacea. It is helpful to understand what it is, and what it isn’t, its uses and abuses.

Overview

When the statement is made that research is “peer-reviewed” this is usually meant to refer to the fact that it has been published in a peer-reviewed journal. Different scientific disciplines have different mechanisms for determining which journals are legitimately peer-reviewed. In medicine the National Library of Medicine (NLM) has rules for peer-review and they decide on a case by case basis which journals get their stamp of approval. Such journals are then listed as peer-reviewed.


The basic criterion is that there is a formalized process of peer-review prior to publication – so this presents a barrier to publication that acts as a quality control filter. Typically, the journal editor will give a submitted paper to a small number of qualified peers – recognized experts in the relevant field. The reviewers will then submit details criticism of the paper along with a recommendation to reject, accept with major revisions, accept with minor revisions, or accept as is. It is rare to get an acceptance as is on the first round.

The editor also reviews the paper, and may break a tie among the reviewers or add their own comments. The process, although at times painful, is quite useful in not only checking the quality of submitted work, but improving the quality. A reviewer, for example, may point out prior research the authors did not comment on, or may point our errors in the paper which can be fixed.

It is typical for authors to submit a paper to a prestigious journal first, and then if they get rejected to work their way down the food chain until they find a journal that will accept it. This does not always mean that the paper was of poorer quality – the most prestigious journals have tons of submissions and can pick and choose the most relevant or important studies. But sometimes it does mean the paper is mediocre or even poor.

The limitations of Peer-Review

It is important to realize that not all peer-reviewed journals are created equal. Small or obscure journals may follow the rules and gain recognized peer-reviewed status, but be desperate for submissions and have a low bar for acceptance. They also have a harder time getting world-class experts to review their submissions, and have to find reviewers that are also farther down the food chain. The bottom line is that when a study is touted as “peer-reviewed” you have to consider where it was reviewed and published.

Even at the best journals, the process is only as good as the editors and reviewers, who are people who make mistakes. A busy reviewer may give a cursory read through a paper that superficially looks good, but miss subtle mistakes. Or they may not take the time to chase down every reference, or check all the statistics. The process generally works, and is certainly better than having no quality control filter, but it is also no guarantee of correctness, or even the avoidance of mistakes.

Peer-reviewers also have biases. They may be prejudiced against studies that contradict their own research or their preferred beliefs. They may therefore bias the published studies in their favored direction, and may be loath to give a pass to a submission that would directly contradict something they have published. For this reasons editors often allow authors to request or recommend reviewers, or to request that certain people not be asked to be reviewers. Each journal has their own policy. Sometimes an editor will specifically use a reviewer that the authors request not be used, thinking they may be trying to avoid legitimate criticism.

The process can be quite messy, and full of politics. But in the end it more or less works. If an author thinks they were treated unfairly by one journal, they can always go to another or they can talk directly to the editor to appeal a decision and try to make their case.

Perhaps the biggest weakness of peer-review, however, is when an entire discipline of peers is lacking in some fundamental way. For example, there are now many journals dedicated to alternative medicine. The editors have a pro-CAM bias, and they find reviewers with a pro-CAM bias. So pretty much any pro-CAM article can get published. They also have enough ideological friends at the NLM that they can get approved as peer-reviewed, despite glaring biases in their editorial policy.

Post Publication Peer Review

The term peer-review is sometimes used to refer to the fact that papers are read and reviewed by the broader scientific community once they are published. However, this post-production review should not be confused with “peer-reviewed” and that term should not be used to refer to post-publication review, to avoid confusion.

The process, however, is even more critical to quality control in science. Now, instead of one editor and 2-3 reviewers looking at a study, dozens or hundreds (maybe even thousands) of scientists can pick over a study, dissect the statistics and the claims, bring to bear knowledge from related areas or other research, and provide detailed criticism. This is the real “meat grinder” of science. Hundreds of reviewers are more likely to find problems than the few pre-publication reviewers. Arguments can be tested in the unforgiving arena of the scientific community, weeding out bad arguments, honing others, so that only the best survive.

Bottom line – peer-review is a necessary component of quality control in science, but is no guarantee of quality, and you have to know the details of the journal that is providing the peer-review.

To bad the author was an MD, he points out to editorial and ideological bias in CAM journals which shows his apparent AMA indoctrination of anti-CAM medicine. Simple stated the same can be said as far as ideological and bias for any specific area of medicine. For example it is well known that the field of cardiology has a huge bias. A large portion of cardiologist look down on all other types of MD's and PhD's. Unless you have a Cardiologist as a co-author on a paper it is virtually impossible to get a paper in Circulation, or Heart. Bias really should be weeded out in the peer review process. Most scientist and MD's have a lot of respect for the integrity of the science that goes into journals.

[Merc.]

To bad the author was an MD, he points out to editorial and ideological bias in CAM journals which shows his apparent AMA indoctrination of anti-CAM medicine. Simple stated the same can be said as far as ideological and bias for any specific area of medicine. For example it is well known that the field of cardiology has a huge bias. A large portion of cardiologist look down on all other types of MD's and PhD's. Unless you have a Cardiologist as a co-author on a paper it is virtually impossible to get a paper in Circulation, or Heart. Bias really should be weeded out in the peer review process. Most scientist and MD's have a lot of respect for the integrity of the science that goes into journals.

Yea also the field of psychiatry ( has huge bias ) and IMO has the least scientific backing in the entire medical field .. They give meds that just poison peeps ( Geodon for example kills 1 in 120 peeps ) ..

I know exactly what you are saying about cardiologist ( most I know think they are GOD and know everything)..


Merc.

[Flagg]

Some pretty good stuff there and a lot of stuff that I do now, Cohort Study is just one thing I can see that I have to know. All those links are wikipedia though. That's not to say that's bad, as wikipedia is suprisingly reliant, however most Lecturers really take a dim view to that site. Still, I like to think of it as a good place to start researching something new. A lot of wikipedia info is usually copied and pasted from an online journal or pdf paper, with additional links and references provided at the bottom. Hahaha, ive been using wikipedia today to look up some basic stuff on parasites and sanitation.

[Monster87]

Someone should sticky this...

[Vitruvian-Man]

Yea also the field of psychiatry ( has huge bias ) and IMO has the least scientific backing in the entire medical field .. They give meds that just poison peeps ( Geodon for example kills 1 in 120 peeps ) ..

I know exactly what you are saying about cardiologist ( most I know think they are GOD and know everything)..


Merc.

Yes; however, psychiatry is also one of the most intricate jobs on Earth. These are M.D's, who've specialized in the treatment of mental disorders (often disorders that we know little to no reliable info on.)

"Least scientific backing". Well that's because they are forced to diagnose and treat extremely severe mental illnesses (all of which are individual to the patient). Neuro-science is a new field my friend. These are doctors who have spent 14+ years of their post-secondary career dedicated to the studies of medicine, psychology, and pharmacology... I think you need to give them a little more credit then "they just give meds that poison ppl"...

I mean honestly... Have you invented any new anti-depressants that can antagonize serotonin receptors, while causing no liver/kidney damage, and while not sensitizing the mesolimbic pathway??... because if so, you would be given a Noble Prize. LOL.

^^ I don't mean to sound like an asshole. I just think it's unbelievable how people blame specific faculties of medicine for over-diagnosing, when they have one of the most difficult jobs on Earth. (IE) Trying to convince someone with Schizophrenia, and who is Bipolar to take their anti-psychotics is NOT an easily done.

Little off topic... but..

hehe, sorry boys

[Bojangles69]

We are studying the methodology in psychological research, and so far its been by far the MOST boring, yet most interesting class I've ever had lol
Its hard to get through but the information is invaluable.

The most valuable thing I've learned is how much information we're exposed today that literally means nothing. Its amazing when you deduce the results of a study for what they actually mean rather then what people will interpret them for.
Not sure if this is what your post touches on, but if it has anything to do with proper research I'm a strong advocate.

[MuscleScience]

Yea also the field of psychiatry ( has huge bias ) and IMO has the least scientific backing in the entire medical field .. They give meds that just poison peeps ( Geodon for example kills 1 in 120 peeps ) ..

I know exactly what you are saying about cardiologist ( most I know think they are GOD and know everything)..


Merc.

Yes; however, psychiatry is also one of the most intricate jobs on Earth. These are M.D's, who've specialized in the treatment of mental disorders (often disorders that we know little to no reliable info on.)

"Least scientific backing". Well that's because they are forced to diagnose and treat extremely severe mental illnesses (all of which are individual to the patient). Neuro-science is a new field my friend. These are doctors who have spent 14+ years of their post-secondary career dedicated to the studies of medicine, psychology, and pharmacology... I think you need to give them a little more credit then "they just give meds that poison ppl"...

I mean honestly... Have you invented any new anti-depressants that can antagonize serotonin receptors, while causing no liver/kidney damage, and while not sensitizing the mesolimbic pathway??... because if so, you would be given a Noble Prize. LOL.

^^ I don't mean to sound like an asshole. I just think it's unbelievable how people blame specific faculties of medicine for over-diagnosing, when they have one of the most difficult jobs on Earth. (IE) Trying to convince someone with Schizophrenia, and who is Bipolar to take their anti-psychotics is NOT an easily done.

Little off topic... but..

hehe, sorry boys

LOL, I was going to use psychology, sociology and Public health as an example but I didnt want to offend anybody...

[Merc.]

Yes; however, psychiatry is also one of the most intricate jobs on Earth. These are M.D's, who've specialized in the treatment of mental disorders (often disorders that we know little to no reliable info on.)

"Least scientific backing". Well that's because they are forced to diagnose and treat extremely severe mental illnesses (all of which are individual to the patient). Neuro-science is a new field my friend. These are doctors who have spent 14+ years of their post-secondary career dedicated to the studies of medicine, psychology, and pharmacology... I think you need to give them a little more credit then "they just give meds that poison ppl"...

I mean honestly... Have you invented any new anti-depressants that can antagonize serotonin receptors, while causing no liver/kidney damage, and while not sensitizing the mesolimbic pathway??... because if so, you would be given a Noble Prize. LOL.

^^ I don't mean to sound like an asshole. I just think it's unbelievable how people blame specific faculties of medicine for over-diagnosing, when they have one of the most difficult jobs on Earth. (IE) Trying to convince someone with Schizophrenia, and who is Bipolar to take their anti-psychotics is NOT an easily done.

Little off topic... but..

hehe, sorry boys

Dam I didnt know you were a psychiatrist.. I didnt mean to offend anyone ..

Dr Marty Hinz MD has proven the 40 year old mono amine theory is wrong ....

You cant just manipulate serotonin or it will deplete dopamine( and vise versa) .. He has peer reviewed papers from the university of minnesota and works with Ingrid kolstad ( from Johns Hopkins .. ).. Hers one of his many valid research papers .. http://www.neuroassist.com/Serotonin...20Nov%2030.pdf

He has the largest data base in the world on this subject ( which goes back 10 years ).. He has a 100 % sucess in treating depression ( since 2005) YES 100 % .. He uses amino acids to take the patient past threshold levels to achieve relief of disease ( symptoms).. Same rate for parkinson's disease ( 100 % relief of symptoms using Dr Marty Hinz protocol.. Keep in mind the depression success rate when using a anti depressant drug is really bad ( like 77% of peeps using a anti depressant are getting ZERO Relief ) ..




He treats over 80 types of neurotransmitter dysfunction ... using Amino Acids ( he uses 5 -HTP , L-Tyrosine , Mucuna and L cysteine )

Dr Hinz also teaches a 16 Hours AMA Category I course to train Dr how to use his protocols ... http://neurosupport.com/Course%20Info.htm

Here is a excerpt from his course info ( from above link )..

Marty Hinz, MD Family Practitioner Morgan Park Clinic Duluth, MN NeuroResearch Clinics Web Site

President Clinical Research, NeuroResearch Clinics, Inc. Duluth, MN NRD
Medical Director Morgan Park Clinic Duluth, MN

Alvin Stein, MD Orthopedic Surgeon Stein Clinic Plantation, FL Stein Clinic Web Site

Medical Director Stein Clinic Plantation, FL
Board Certified Chronic Pain Management
15 years experience in management of toxins

Tom Uncini, MD Pathologist Hibbing Hospital Hibbing, MN DBS Labs, Inc. Web Site


Dual board certified in Laboratory Medicine and Forensic Pathology
Medical Director DBS Labs, Duluth, MN
Medical Director Hibbing Hospital Lab, Hibbing, MN
Medical Director Cook Hospital Lab, Cook, MN



Faculty Experience

These are the physicians who are rewriting the medical text books with their cutting edge research. These are the physicians that formulated the "Bundle Damage Theory Model" in treatment and the "Dual Impedance Lumen Theory" in management or serotonin and catecholamine related illness.

They are the inventors of "non-invasive in-clinic laboratory assay of the functional status of the serotonin and dopamine transport by the basolateral monoamine transporter of the kidneys". This assay optimizes of treatment outcomes and optimizesf regulatory functions relating to serotonin and catecholamines. This approach was developed while caring for their patients on the front line of their clinical practice. The faculty of these educational events will discuss in clinic patient treatment results, relief of disease symptoms and manipulation of serotonin and dopamine regulatory function not previously known to medicine. This approach that has been described at national medical conferences where this research has been presentedas a "paradigm shift in medicine" .

Bundle Damage Theory

The bundle damage theory extends the known damage to the neuron bundles beyond the traditional to other diseases of the serotonin and catecholamine systems.
Neurotoxic damage with resulting symptoms is not only found in Parkinsonism under the MPTP model. This research has demonstrated that toxic damage occurs in virtually every disease process involving neurons, serotonin, and the catecholamines.
The core of the Bundle Damage Theory is currently being studied by the University of Minnesota Medical School and in writings in publication by Ingrid Kohlstadt, MD editor of Johns Hopkins University. Identification and management of these disease processes is discussed in the conference.


And here is a link to his website ( it is huge has tons of his published research you have to look around ..because there is so much info).. http://www.neuroassist.com/




Merc.

[Merc.]

Also heres a thread I started awhile back about Neuro Research and Dr Hinz..

Neuro Research , Neuro Replete


Merc.

[Merc.]

Here is a article that I agree alot with .. This part for starters .. quoted from article.. (I agree that psychiatry has a lot of very dirty bathwater, but there is also a very healthy baby in there that should be kept, cherished, nourished, and helped to grow – scientifically)


Psychiatry-Bashing


Published by Harriet Hall under Neuroscience/Mental Health, Science and Medicine, Science and the Media

Psychiatry is arguably the least science-based of the medical specialties. Because of that, it comes in for a lot of criticism. Much of the criticism is justified, but some critics make the mistake of dismissing even the possibility that psychiatry could be scientific. They throw the baby out with the bathwater. I agree that psychiatry has a lot of very dirty bathwater, but there is also a very healthy baby in there that should be kept, cherished, nourished, and helped to grow – scientifically.

Common criticisms in the media

We are over-medicating our children, producing a generation of drugged zombies.
We are using medication indiscriminately for people who don’t fit the diagnosis (i.e. antidepressants for people who only have normal mood fluctuations and life problems).
Antidepressants lead to violence and suicide.
Psychotropic medications all have terrible side effects.
Antidepressants are no better than placebo.
Psychotherapies are no better than talking to a friend.
Electroconvulsive therapy (ECT) is a barbaric, damaging assault with no redeeming value.
And we all remember how Tom Cruise attacked Brooke Shields on the issue of postpartum depression.
Thomas Szasz: Mental Illness is a Myth

Thomas Szasz goes even further: he rejects the whole concept of mental illness and considers it a plot to interfere with people’s human rights. He says:

Psychiatric diagnoses are not valid because they are based on symptoms rather than on objective tests. (Steve Novella has pointed out that there are other well-established diagnoses like migraine that cannot be verified by any objective tests.)
Mental illness is a myth: unusual behavior does not constitute a disease.
Psychiatric diagnoses are an arbitrary construct of society to facilitate control of individuals whose behavior does not conform.
Involuntary commitment is never justified even for the protection of the patient: patients always have the right to refuse treatment even if that means they will die.The CCHR

Szasz and Scientology (a marriage made in heaven?) joined forces to create the Citizens Commission on Human Rights. They have a slick website with a home page that proclaims its bias with a picture of a door labeled “Psychiatry: An Industry of Death.” They claim to be supporting human rights, but they appear to be engaged in a vendetta against psychiatry and psychotropic medicines. They do have some good points, but they go way overboard. And they systematically ignore any evidence showing that psychiatric care benefits patients.

A Recent Study

A recent study published in the New England Journal of Medicine helps bring several controversial psychiatric issues into focus. It was a randomized trial of 488 children age 7-17 with “substantial impairment” from anxiety disorders. It compared an SSRI drug (sertraline), a psychotherapy (cognitive behavioral therapy), a placebo medication, and a combination of sertraline and CBT. 23.7% of subjects improved with placebo, 59.7% improved with cognitive behavior therapy alone, 54.9% improved with sertraline alone, and 80.7% improved with combination therapy. Adverse events, including suicidal and homicidal ideation, were no more frequent in the sertraline group than in the placebo group; no child in the study attempted suicide. As would be expected, there were fewer side effects (insomnia, fatigue, sedation and restlessness) in the CBT group than in the sertraline group. An accompanying editorial suggested that many children are not being identified and treated appropriately, and that early treatment could reduce subsequent problems. Instead of “we are overmedicating our children” it suggests that “we are failing to treat all those who would benefit from treatment.”

This study is not perfect and can’t stand by itself, but it confirms previous studies showing that psychotherapy and SSRIs are both effective and the combination is even more effective.

SSRIs and Suicide

In 2004 warnings inundated the media: studies had indicated an increase in suicidal ideation (from 2% to 4%) in children taking SSRIs for depression. The studies were flawed, and there was no increase in actual suicide rates, only in reported ideation. There were other clear data showing that SSRIs reduced suicide rates in depressed children. Nevertheless, the scare caused prescription rates to fall by 18-20%. And suicide rates promptly increased by 18%. The misguided attempt to prevent suicide instead led to an increase in suicides.

DSM

The Diagnostic and Statistical Manual of Mental Disorders or DSM is problematic. Diagnoses like homosexuality come and go depending on societal pressures. It is not very scientific. Neither was Freud, whose ideas have been largely discounted and whose diagnosis of “neurosis” is no longer used. DSM is seriously flawed, but it’s better than any previous diagnostic system. It’s a noble effort, and the best we have at the moment. The real problem is when people misuse it and over-diagnose. Instead of discarding it, we can work to make it more reliable.

Mental Illness Does Exist

It’s rejecting reality to think that mental illness doesn’t exist. Something is clearly wrong with an individual who is too depressed to get out of bed or eat, who is afraid to leave the house, or who believes he is Jesus Christ. These symptoms interfere with life and are usually distressing to the patient. One of my uncles developed paranoid schizophrenia: he lost contact with reality and was a danger to himself. In a previous century he might have spent the rest of his life warehoused in a locked ward. Medications allowed him to function: he married, had children and grandchildren, was loved, and led a relatively normal life in society. He had some side effects from the medications, but he and his loved ones felt that was a small price to pay.

Patients who clearly have mental illness can be appropriately diagnosed and treated. Admittedly, a lot of not-so-clear cases end up with diagnoses and treatments they should not have. But that’s not a problem with psychiatry per se, but with the misapplication of psychiatry. We need to do better and we can do better. With science.

Science-Based Psychiatry

The mental health professions have made some stunning errors in recent decades, including the recovered memory craze, Satanic abuse confabulations, facilitated communication, multiple personality disorder with up to a hundred or more alters including animals, and Harvard psychiatrist John Mack’s gullible speculations about alien abductions. The good news is that science and reason have worked to identify these as errors and they have been largely avoided in mainstream practice.

Science is harder to apply to psychiatry than to other medical disciplines. Mental illness can’t be studied like pneumonia. We have no good animal models for most mental illnesses because animals don’t mentate the way humans do. We can’t do a blood test for depression like we do for diabetes. But we certainly can identify patients who are impaired by a recognizable constellation of symptoms, and we can test various treatments to see what relieves those constellations of symptoms. We can also look for underlying causes and ways to prevent illness.

Modern psychiatry, with its psychotropic medications and psychotherapies, is not as scientific or as effective as we would like, but it has undeniably saved lives and improved the quality of life of countless sufferers. Instead of bashing psychiatry for its faults, we should build on psychiatry’s successes and make it ever more science-based. Let’s put an end to psychiatry-bashing and stick to bashing specific practices that are not science-based and to bashing psychiatric malpractice like over-diagnosis and inappropriate prescribing. There is an excellent journal that tries to do exactly that: The Scientific Review of Mental Health Practice It is far more credible than anything Szasz and Scientology have written.


Merc.

[Merc.]

Here is a link to the paper that Dr Hinz and Ingrid Kohlstadt ( Johns Hopkins ) wrote ..

Really interesting ..


http://www.neuroassist.com/Hinz-depr...0208IK-web.pdf


Merc.

[Merc.]

Some pretty good stuff there and a lot of stuff that I do now, Cohort Study is just one thing I can see that I have to know. All those links are wikipedia though. That's not to say that's bad, as wikipedia is suprisingly reliant, however most Lecturers really take a dim view to that site. Still, I like to think of it as a good place to start researching something new. A lot of wikipedia info is usually copied and pasted from an online journal or pdf paper, with additional links and references provided at the bottom. Hahaha, ive been using wikipedia today to look up some basic stuff on parasites and sanitation.

Yea when I first saw that post Dr Ollie did I thought the same thing ( about the Wikipedia ) , But I read them all and like you said .. They were surprisingly correct..... Good point ...


Merc.

[BJJ]

Some pretty good stuff there and a lot of stuff that I do now, Cohort Study is just one thing I can see that I have to know. All those links are wikipedia though. That's not to say that's bad, as wikipedia is suprisingly reliant, however most Lecturers really take a dim view to that site. Still, I like to think of it as a good place to start researching something new. A lot of wikipedia info is usually copied and pasted from an online journal or pdf paper, with additional links and references provided at the bottom. Hahaha, ive been using wikipedia today to look up some basic stuff on parasites and sanitation.

Agreed.
It is good for a first glimpse on a topic but then it is lacking on deepness.

[BJJ]

Hey Merc., when you have time pls have a look at this thread:

http://forums.steroid.com/showthread.php?t=398351

I would like to have your opinion on what I have written on post n.6; based on my studies in biology and 20 years of practical experience.

Thank you

[Merc.]

Hey Merc., when you have time pls have a look at this thread:

http://forums.steroid.com/showthread.php?t=398351

I would like to have your opinion on what I have written on post n.6; based on my studies in biology and 20 years of practical experience.

Thank you

Great write up BJJ .. You are a really good writer ...




Merc.

[BJJ]

bump