Hitting a Nerve

Spin doctors


The 1992 presidential election fell during my last year of medical school. I remember watching the three-way debates over at a friend’s apartment.

Dr. Allan M. Block, a neurologist is Scottsdale, Ariz.

Dr. Allan M. Block

After each one they’d cut to representatives of each candidate, and for the first time I heard the phrase “spin” or “spin doctors” referring to those who put a very selective angle on their candidates performance, no matter how bad it may have been, to make it sound like something amazingly awesome. This trend, driven now by the Internet and the 24/7 news cycle, has only accelerated over time.

Recently, I’ve been reading slides, press releases, and preliminary reports for the many agents that are seeking to cure Alzheimer’s disease. A desperately needed effort if ever there was one.

Yet, I get the same feeling I did in 1992. It seems like a lot of the statements are more selective than real: a carefully worded attempt to emphasize the good points and minimize the bad. Granted that’s the nature of many things, but here, in a world of a few percentage points, it seems more conspicuous than usual.

After all, even a non–statistically significant improvement of 1%-2% can look really good if you use the right graph style or comparison scale.

When I read such articles now, I find myself wondering if the drug really works or if the spin doctors have gotten so good at making even the most minuscule numbers look impressive that I can’t tell the difference. In theory many of these drugs should work, but, in Alzheimer’s disease “should” and “does” haven’t matched up particularly well to date.

To be clear, I’m not cheering for these drugs to fail. On the contrary, if one showed overwhelming evidence of benefit (as opposed to having to be spun to look good), I’d be thrilled. Along with the patients and their support circles, it’s their doctors who watch the sad downhill slide of dementia, with the patients dying long before their bodies do. I would be thrilled to be able to offer them something that had clearly meaningful benefit with a decent safety profile.

But, barring more solid data, I’m worried that many treatments in development for Alzheimer’s disease are more spin than substance.

I hope I’m wrong.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

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