About studies and statistics and the crapshoot of life

From: cathy:- (anonymous@medispecialty.com)
Wed Jul 24 14:57:15 2002

I just wanted to expand on what Karla said about the (in)appropriateness of an ARD sufferer getting into one of these spray-gel studies.

One of the basic fundamental facts about ARD is that the human race seems to be divided up into 3 groups:

1) People who don't form adhesions.

2) People who form adhesions from abdominal surgery, but are never in any way bothered by them.

3) People who form adhesions and are to some extent suffering negative symptoms from them.

Groups 1 & 3 are pretty small (depending on how you count, maybe 5% of the population is in each goup) while group #2 is the vast majority of people (maybe 90% or so.)

Now if you have an adhesion barrier study and you only use type 1 people, well your study isn't going to tell you very much, because nobody is going to get adhesions whether or not you use a barrier. If you do a study on type 3 people (as in us!) then this has severe ethical problems because you shouldn't be doing surgery on type 3 people except for the gravest situations.

So, basically, we need to leave the studying to those type 2 people. In fact, the IDEAL candidate for one of these studies would be someone who has had at least 2 abdominal surgeries, adhesions were seen in later surgeries, and the person NEEDS surgery again. Because these are the people where it really doesn't matter whether they get adhesions or not, and they are going to have surgery anyway, and if they have surgery outside the study then they won't get the barrier anyway.

Then AFTER they do studies and show just how effective the spray-gel is, then the people suffering from ARD can make decisions about whether the expected benefits of an adhesiolysis with the spray-gel are worth the risks. But until they use the type 2 people for guinea pigs first, we don't know what the probabilities are for either the benefits or the risks.

cathy :-)

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