Response to: "DePalma is lying to hype Mesoblast"

[visp]

It is evident that I need to correct the participants on the thread: “DePalma is lying to hype Mesoblast.”

Here are the facts as I presented them at SIS in July 2016:

1. At 24 months, 50% of the 6M cell group and 13% of the saline group had > 50% reduction in index LBP. If cases lost to follow are categorized as failures, these %’s become 43% and 10% respectively. In both instances, the 95% confidence intervals do not overlap and therefore the 2 groups are different

2. At 24 months, 46% and 54% of the 6M and 18M cell group respectively and 13% of the saline group experienced > 15 point reduction in ODI scores. When lost to follow up cases are treated as failures, these %’s become 40%, 47%, and 10%, respectively. Again the 95% CI’s do not overlap.

3. At 24 months, 39% and 13% of the 6M cell group and saline group had > 50% reduction in index LBP, AND > 15 point reduction in ODI, AND no treatment at the index level. The 95% CI’s do overlap and as I stated at SIS, the 2 groups were not different using this combined outcomes metric.


The below link is to a press release by the study sponsor in which I am quoted referencing the above findings. Any quotes not preceded by my name are not my comments:


https://ryortho.com/breaking/low-back-pain-mesoblast-receives-best-basic-science-award/


My comments in this linked article are supported by the above findings as I presented them at SIS in July, 2016.


It appears “ampaphb” and “lobelsteve” either misinterpreted my presentation or have elected to misrepresent my presentation. And to what avail? There’s no reason to post your thread “ampaphb” on my fellowship position advertisement. You’re deliberately initiating and perpetuating misinformation. There are more professional means by which to raise your query and it starts first by removing your mask to have an adult discussion.

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Members don't see this ad.

 

[lobelsteve]

I will break out my SIS evidence based medicine course materials and see how your data holds up..

From your presentation:

1. SAEs occurred in: 5.0%, 5.0%, 10.0% & 6.7% of the Saline, HA, 6M & 18M groups, respectively
2. None of the SAEs determined by the investigator related to MPCs
3. Saline group- 1 incidence of fatigue
4. HA group- 1 incidence of LBP
5. 6M group- 1 incidence of: dermoid cyst; procedure related discitis
6. 18M group- 2 incidences of LBP

#2- You, as the CAB, determine that discitis was from your sloppy technique and not the injection? So how do you make this determination? Discitis after discogram is not a common thing, what is the number of discogram or disc procedures needed to see one infection?

 

[DrCommonSense]

It is evident that I need to correct the participants on the thread: “DePalma is lying to hype Mesoblast.”

Here are the facts as I presented them at SIS in July 2016:

1. At 24 months, 50% of the 6M cell group and 13% of the saline group had > 50% reduction in index LBP. If cases lost to follow are categorized as failures, these %’s become 43% and 10% respectively. In both instances, the 95% confidence intervals do not overlap and therefore the 2 groups are different

2. At 24 months, 46% and 54% of the 6M and 18M cell group respectively and 13% of the saline group experienced > 15 point reduction in ODI scores. When lost to follow up cases are treated as failures, these %’s become 40%, 47%, and 10%, respectively. Again the 95% CI’s do not overlap.

3. At 24 months, 39% and 13% of the 6M cell group and saline group had > 50% reduction in index LBP, AND > 15 point reduction in ODI, AND no treatment at the index level. The 95% CI’s do overlap and as I stated at SIS, the 2 groups were not different using this combined outcomes metric.


The below link is to a press release by the study sponsor in which I am quoted referencing the above findings. Any quotes not preceded by my name are not my comments:


https://ryortho.com/breaking/low-back-pain-mesoblast-receives-best-basic-science-award/


My comments in this linked article are supported by the above findings as I presented them at SIS in July, 2016.


It appears “ampaphb” and “lobelsteve” either misinterpreted my presentation or have elected to misrepresent my presentation. And to what avail? There’s no reason to post your thread “ampaphb” on my fellowship position advertisement. You’re deliberately initiating and perpetuating misinformation. There are more professional means by which to raise your query and it starts first by removing your mask to have an adult discussion.

It looks interesting but there is another Regenexx stem cell owner that claims you are overhyping your results due to lack of morphological changes on the MRI post injections.

His full critique is here:

http://www.regenexx.com/did-the-mesoblast-stem-cell-disc-trial-succeed-or-fail/

From a pain/function standpoint, the above information appears promising. Surely more promising for DDD of the lumbar spine than current very expensive modalities such as spinal fusion.

 

[Doctodd]

It looks interesting but there is another Regenexx stem cell owner that claims you are overhyping your results due to lack of morphological changes on the MRI post injections.

His full critique is here:

http://www.regenexx.com/did-the-mesoblast-stem-cell-disc-trial-succeed-or-fail/

From a pain/function standpoint, the above information appears promising. Surely more promising for DDD of the lumbar spine than current very expensive modalities such as spinal fusion.

That is from Centeno.....not just any regenexx owner.

 

[DrCommonSense]

That is from Centeno.....not just any regenexx owner.

Yeah but he's not exactly impartial either.

The only stronger argument he made was about the morphology changes in my opinion. If there was a clear cut morphological benefit for the DDD, that would be literally checkmate in favor of stem cells (mesoblast in particular).

I still would hold mesoblast to the same standards compared to all other procedures/medications on a cost/benefit ratio in terms of pain/functional benefit.

Mesoblast shouldn't be held to higher standards than fusions. Lyrica, etc when it comes to pain/functional endpoints.

Considering Lyrica is about 650/month (over 7K/year on average for each year), the cost of mesoblast stem cells is actually cheaper overall. Fusion surgery will run in the 50-100K range when hospital costs/rehab/meds are taken into account.

If mesoblast gets better results for this problem than the above modalities under the pain/functional scales, why shouldn't this be the go do modality for DDD rather than the others?

 

[drusso]

I wonder if autologous BMAC would be non-inferior to Mesoblast's product in a head-to-head trial? Boy, wouldn't that be something? All that $$ invested in cell culture and expansion facilities, etc just to make a product non-inferior to autologous BMAC. I wonder how Mesoblast's investors and stock option holders would feel about that result...

 

[DrCommonSense]

I wonder if autologous BMAC would be non-inferior to Mesoblast's product in a head-to-head trial? Boy, wouldn't that be something? All that $$ invested in cell culture and expansion facilities, etc just to make a product non-inferior to autologous BMAC. I wonder how Mesoblast's investors and stock option holders would feel about that result...

Would kind've suck for them lol

Although eventually, you would expect the stem cell technology to advance sufficiently to show morphological changes for the DDD. Obviously the "holy grail" of pain medicine would be stem cells that cause morphological changes to actually regenerate the disc. I suspect the technology is still too primitive for too extensive of a morphological change (although in animal studies they did appear to have some very impressive results so far)

Unfortunately, mesoblast/other stem cell companies have been quite unsuccessful in terms of CHF treatment and regeneration of the heart tissue.

 

[ampaphb]

It is evident that I need to correct the participants on the thread: “DePalma is lying to hype Mesoblast.”

Dear Dr. VISP:

Thank you so much for deigning to take time from your busy day to "correct" we mere mortal hoi polloi, who are obviously not as well versed regarding your study, and subsequent comments, as you are.

My comments in this linked article are supported by the above findings as I presented them at SIS in July, 2016.

Actually, your comments are inconsistent with, and not supported by, your data.

The slide you presented at SIS in New Orleans in July of 2016 entitled "% Meeting Overall Treatment Success Endpoint" (slide #22/24) reports this was achieved by 34.8% of patients who received 18 million MPCs, and 38.5% of patients who received 6 million MPCs. The 6M MPC group did not achieve statistical significance (P=0.09). As we know, most studies quote a placebo responder rate of between 30-35%. As a result, your numbers are marginally better than what we would anticipate a typical placebo or sham would yield. Why your saline group under performed the typical responder rate would be an interesting point to discuss.

However, comments such as

"... providing substantial improvement in pain and function over 24 months compared with control therapies" is an exageration.

1) Saline is neither a therapy nor a control. If you were comparing MPCs to conventional therapies, those would include PT, medication, interventions, and surgery. If you were comparing Mesoblast to controls, comparison to sham would have been more appropriate.
2) HA is neither a control nor a conventional therapy.
3) Substantial is defined as "of considerable size". If only 34.8% and 38.5% of patients achieved your self-described Overall Treatment Success Endpoint, that is clearly not "substantial". The 6M MPC group did not achieve statistical significance (P=0.09), and certainly not a minimal clinically important difference. While no P value is reported for HA, given that it outperformed saline, I am left to assume neither the HA or saline "controls" performed statistically significantly better than the treatment arm.​

"... that an appreciable proportion of patients experienced clinically meaningful improvement" is simply false.

1) If you performed Minimal Clinically Important Improvement/Difference (MCII/MCID) anaylsis, you did not make mention of it at SIS in New Orleans July of 2016. Thus the use of a term of art like "clinically meaningful improvement" is unreasonable.
2) Appreciable is defined as "large or important enough to be noticed". While 34.8% and 38.5% is noticably different from the 12.5% and 17.7% who received saline or HA, it is neither large nor clinically meaningful when compared with expected placebo responder rates.​

and "... if MPCs demonstrate similar results in the Phase 3 study, many of the patients with chronic low back pain ... may benefit" is just not true.

Many is defined as "a large number of". If only 34.8% and 38.5% of patients achieve your self-described Overall Treatment Success Endpoint in the Phase 3 study, that is clearly not "many" patients.
​

Most telling, however, is that you chose to not use these characterizations in the slide you entitled Conclusions (23/24) that you presented at SIS in July of 2016. There you wisely chose to not over-hype your results, and only claimed "Different MPC doses showed improvement relative to controls for pain and functional improvement." While even that is not entirely accurate (the 6M MPC group did not achieve statistical significance (P=0.09) when compared with saline), it was not the outright lie presented in the Orthopedics Today article.

 

[drusso]

It looks interesting but there is another Regenexx stem cell owner that claims you are overhyping your results due to lack of morphological changes on the MRI post injections.

His full critique is here:

http://www.regenexx.com/did-the-mesoblast-stem-cell-disc-trial-succeed-or-fail/

From a pain/function standpoint, the above information appears promising. Surely more promising for DDD of the lumbar spine than current very expensive modalities such as spinal fusion.

I read Centeno's blog differently: Maybe I'm just reading between the lines, but I think that he's trying to say that if one holds himself out as a huckster and ***** for Big Pharma, Big Biologic or even Big Data, then don't be surprised if the Boss wants to ride you roughshod once in a while. After all, you're not really being paid to tell THEM what you know--it's quite the opposite. So, expect that the Boss wants to paint up the data and stick their fist in your mouth from time to time. It goes with the territory...and they've already cut the check for your soul. Your job is to Kneel & Deliver.

 

[DrCommonSense]

I read Centeno's blog differently: Maybe I'm just reading between the lines, but I think that he's trying to say that if one holds himself out as a huckster and ***** for Big Pharma, Big Biologic or even Big Data, then don't be surprised if the Boss wants to ride you roughshod once in a while. After all, you're not really being paid to tell THEM what you know--it's quite the opposite. So, expect that the Boss wants to paint up the data and stick their fist in your mouth from time to time. It goes with the territory...and they've already cut the check for your soul. Your job is to Kneel & Deliver.

LOL that is true but Centeno is just as biased as everyone else considering he has financial interests in regenexx.

Look at the "clinical effect size" of Lyrica for Fibromyalgia or Neuropathic Diabetic Pain and you will find very unimpressive numbers compared to Placebo, yet Lyrica remains Pfizer's number 1 drug in terms of revenue generation.

 

[NYCpainMD]

Not sure where the hostility against DePalma is stemming from but he's far from a fraud. Mesoblast is publicly traded company - funny that a few people here seem to have a problem with his presentation of the data and somehow know the seedy underpinnings of his motives, yet investors who are trained to look for flaws seem perfectly comfortable investing millions upon millions of dollars without hesitation. Yes these are expanded stem cell lines - this is legal under the auspices of a clinical trial. So anyone reading this knows, this is not the only study ongoing in the US right now using expanded cell lines. There is a study from Korea on using expanded autologous adipose for knee pain just to name one.

Now the most ridiculous statement of all is using a quote from Chris Centeno (a very very well respected physician who is beyond credible for his work) saying Mesoblast isn't as good a Regenexx and using that to "prove" Mesoblast is fraudulent- WHAT DO YOU EXPECT HIM TO SAY? HE'S THE FOUNDER AND PRINCIPLE OWNER! That's like using a quote from the CEO of Pepsi saying Coke isn't as good as Pepsi to "prove" that Coke is garbage. He's looking out for his investment, as well he should.

DePalma is a consummate professional and a gentleman...I challenge anyone to find one shred of evidence that he's actually risking his reputation to hype a lie. We don't know which is better, which is why we do clinical trials.

 

[ampaphb]

Not sure where the hostility against DePalma is stemming from but he's far from a fraud. Mesoblast is publicly traded company - funny that a few people here seem to have a problem with his presentation of the data and somehow know the seedy underpinnings of his motives, yet investors who are trained to look for flaws seem perfectly comfortable investing millions upon millions of dollars without hesitation. Yes these are expanded stem cell lines - this is legal under the auspices of a clinical trial. So anyone reading this knows, this is not the only study ongoing in the US right now using expanded cell lines. There is a study from Korea on using expanded autologous adipose for knee pain just to name one.

Now the most ridiculous statement of all is using a quote from Chris Centeno (a very very well respected physician who is beyond credible for his work) saying Mesoblast isn't as good a Regenexx and using that to "prove" Mesoblast is fraudulent- WHAT DO YOU EXPECT HIM TO SAY? HE'S THE FOUNDER AND PRINCIPLE OWNER! That's like using a quote from the CEO of Pepsi saying Coke isn't as good as Pepsi to "prove" that Coke is garbage. He's looking out for his investment, as well he should.

DePalma is a consummate professional and a gentleman...I challenge anyone to find one shred of evidence that he's actually risking his reputation to hype a lie. We don't know which is better, which is why we do clinical trials.

Dear Dr. VISP:

Thank you so much for taking time from your busy day to "correct" those of us who are obviously not as well versed regarding your study, and subsequent comments.

Actually, your comments are inconsistent with, and not supported by your data.

The slide you presented at SIS in New Orleans in July of 2016 entitled "% Meeting Overall Treatment Success Endpoint" (slide #22/24) reports this was achieved by 34.8% of patients who received 18 million MPCs, and 38.5% of patients who received 6 million MPCs. The 6M MPC group did not achieve statistical significance (P=0.09). As we know, most studies quote a placebo responder rate of between 30-35%. As a result, your numbers are marginally better than what we would anticipate a typical placebo or sham would yield. Why your saline group under performed the typical responder rate would be an interesting point to discuss.

However, comments such as

"... providing substantial improvement in pain and function over 24 months compared with control THERAPIES" is an exageration.

1) Saline is not a therapy. If you were comparing to conventional therapies, those would include PT, medication, interventions, and surgery.
2) HA is not a control. If you were comparing Mesoblast to controls, you would have been comparing MPCs to sham.
3) Substantial is defined as "of considerable size". If only 34.8% and 38.5% of patients achieved your self-described Overall Treatment Success Endpoint of , that is clearly not "substantial". The 6M MPC group did not achieve statistical significance (P=0.09), and certainly not a minimal clinically important difference. While no P value is reported for HA, given that it outperformed saline, I am left to assume neither the HA or saline "controls" performed statistically significantly better than the treatment arm.​

"... that an appreciable proportion of patients experienced clinically meaningful improvement" is simply false.

1) If you performed Minimal Clinically Important Improvement/Difference (MCII/MCID) anaylsis, you did not make mention of it at SIS in New Orleans July of 2016. Thus the use of a term of art like "clinically meaningful improvement" is unreasonable.
2) Appreciable is defined as "large or important enough to be noticed". While 34.8% and 38.5% is noticably different from the 12.5% and 17.7% who received saline or HA, it is neither large nor clinically meaningful when compared with expected placebo responder rates.​

and "... if MPCs demonstrate similar results in the Phase 3 study, many of the patients with chronic low back pain ... may benefit" is just not true.

Many is defined as "a large number of". If only 34.8% and 38.5% of patients achieve your self-described Overall Treatment Success Endpoint in the Phase 3 study, that is clearly not "many" patients.
​

Most telling, however, is that you chose to not use these characterizations in the slide you entitled Conclusions (23/24) that you presented at SIS in July of 2016. There you wisely chose to not over-hype your results, and only claimed "Different MPC doses showed improvement relative to controls for pain and functional improvement. While even that is not entirely accurate (the 6M MPC group did not achieve statistical significance (P=0.09) when compared with saline), it was not the outright lie presented in the Orthopaedics Today article.

 

[Ducttape]

"investors who are trained to look for flaws seem perfectly comfortable investing millions upon millions of dollars without hesitation"

pure financial motivation. not sure how that factors into science.


on the other hand, since medicine (unfortunately) is all about $$$....

 

[ampaphb]

Non-medically sophisticated investors rely on experts like Dr. DePalma. When he exaggerates his findings, as he did in the Orthopedics Today article, he is misleading potential investors

 

[VA Hopeful Dr]

"investors who are trained to look for flaws seem perfectly comfortable investing millions upon millions of dollars without hesitation"

pure financial motivation. not sure how that factors into science.


on the other hand, since medicine (unfortunately) is all about $$$....

Yeah we need only look at Theranos to see that investors don't know much about medicine

 

[NJPAIN]

My hat is off to the mortal hoi pollois Lobel and ampaphb for defending their positions and not backing down. I sincerely admire your dedication to and passion for the science in our specialty.

 

[Ohioispine]

My hat is off to the mortal hoi pollois Lobel and ampaphb for defending their positions and not backing down. I sincerely admire your dedication to and passion for the science in our specialty.

ampaphb went about this the wrong way. You could have been more professional. You could have emailed Dr. DePalma directly with any questions in regards to the mesoblast study. You could have asked questions after the presentation of the best papers in New Orleans. to post your thoughts on his fellowship page what purpose did that serve. You want future PM&R interventional spine fellows not to train under Dr. DePalma. It definitely seems like it. I am not exactly sure what your current or past contributions in the field spine related medicine. Dr. DePalma is someone who has clearly contributed to our field.

 

[ampaphb]

You seem not to understand my issue. I had no problem with VISP's presentation at SIS. In fact, I thought highly of him that he was willing to present numbers that demonstrated Mesoblast DIDN'T work. I have a huge problem with his misrepresentation of the data he presented to SIS when speaking with the media.

I didn't post anything on VISP's fellowship page. He advertised on SDN for fellows. I absolutely think his potential fellows should know the character of the fellowship director they are considering committing a year of their life to.

My contribution is to each of my patients every day. My contribution is teaching residents and fellows. My contribution is doing the best I can to improve my patients' quality of life, not to improve a corporation's bottom line. I am really not concerned what you think of me. I have the choice or eating well or sleeping well. I opt for sleep. I prefer to do what's right, what's ethical, and what allows me to have a clear conscience, rather than what's best for my bank account.

 

[iSpinedoc]

It's unfortunate to see this site utilized as a vehicle to advance one's personal agenda. An intelligent, respectful discussion of the presented data between peers is sufficient; hurling insults is inflammatory and unfounded. Our fraternity is readily aware of Dr. DePalma's considerable contributions and efforts to advance our field. Attempts to tarnish his reputation and instill hesitation in potential fellowship candidates is counterproductive. Comments with regards to patient volume are comical. The serious interventional spine fellow should thrive on volume; if you wanna be an olympic swimmer, you've gotta spend a lotta time in the pool. I'd implore candidates pursuing training in our field to do their own research rather than listen to a few disgruntled docs.

 

[VA Hopeful Dr]

Man, there are an awful lot of brand new posters who appear to have signed up purely to comment in this thread... how interesting

 

[NJPAIN]

Man, there are an awful lot of brand new posters who appear to have signed up purely to comment in this thread... how interesting

Crips vs. Bloods

 

[SSdoc33]

It's unfortunate to see this site utilized as a vehicle to advance one's personal agenda.

Is that not exactly what DiPalma is doing in his "response" to the original thread?

The cross post on his fellowship offer, however, was unnecessary.

One last thing: DiPalma, if you are listening: It's not gonna work. I applaud your effort (even if it is semi-tainted by the almighty dollar)...... But its not gonna work.

 

[drusso]

The important lesson for posters here is that at the end of the day all you have is your reputation: Once you barter that away you're just another Kardashian....And, really, the checks don't come for free. Your employer will expect you to say and do things that you might not agree with. Biotech companies are bought, sold, and flipped like cheap real estate. Investors want their money "in and out" fast. No one will remember the VP of blinkecty-blank 2 years from now, but as a physician, your name and reputation will be tied to your scientific conduct for the rest of your life.

 

[ampaphb]

The cross post on his fellowship offer, however, was unnecessary.

While I don't entirely disagree, you will note that that is what caught his eye, and appears to have caused him (and his minions) to respond.

 

[Doctodd]

Man, there are an awful lot of brand new posters who appear to have signed up purely to comment in this thread... how interesting

kinda like Hillary supporters.

Autologous vs Mesoblast is loaded in Mesoblast's favor. Not everyone's MSC's will grow. I expect Mesoblast has removed that variable in their favor.

 

[Ligament]

kinda like Hillary supporters.

Autologous vs Mesoblast is loaded in Mesoblast's favor. Not everyone's MSC's will grow. I expect Mesoblast has removed that variable in their favor.

Are the CTR nerdvirgins on SDN now?

 

[DrCommonSense]

The important lesson for posters here is that at the end of the day all you have is your reputation: Once you barter that away you're just another Kardashian....And, really, the checks don't come for free. Your employer will expect you to say and do things that you might not agree with. Biotech companies are bought, sold, and flipped like cheap real estate. Investors want their money "in and out" fast. No one will remember the VP of blinkecty-blank 2 years from now, but as a physician, your name and reputation will be tied to your scientific conduct for the rest of your life.

This is amusing. The vast majority of "academic research physicians" are literally ****** working for big pharma and device companies whereby the "massage" the data to get the results the company is looking for.

The celebrex/vioxx fiasco is just the tip of the iceberg. Despite being "peer reviewed", this guy was literally able to become the forefront expert for YEARS with data that was TOTALLY made up. The only thing that stopped him was not getting IRB approval for 2 of his studies blatantly. If he didn't do that, he would still be the "expert" in the field.

For every Reuben that has been discovered, there are a 100 other "expert" researchers who are massaging the data AT BEST who have never been caught.

https://www.scientificamerican.com/article/a-medical-madoff-anesthestesiologist-faked-data/

Or look at this beauty from the "heart stem cells studies" where there discrepancies were routine.

http://www.forbes.com/sites/larryhu...-a-house-of-cards-about-to-fall/#747fac757341

Come on man, don't be naive.

 

[drusso]

The vast majority of "academic research physicians" are literally ****** working for big pharma and device companies whereby the "massage" the data to get the results the company is looking for.

Agree. Still, the meta-analyticians are the worst. They don't even create primary scholarship. GIGO.

 

[lobelsteve]

This is amusing. The vast majority of "academic research physicians" are literally ****** working for big pharma and device companies whereby the "massage" the data to get the results the company is looking for.

The celebrex/vioxx fiasco is just the tip of the iceberg. Despite being "peer reviewed", this guy was literally able to become the forefront expert for YEARS with data that was TOTALLY made up. The only thing that stopped him was not getting IRB approval for 2 of his studies blatantly. If he did that, he would still be the "expert" in the field.

For every Reuben that has been discovered, there are a 100 other "expert" researchers who are massaging the data AT BEST who have never been caught.

https://www.scientificamerican.com/article/a-medical-madoff-anesthestesiologist-faked-data/

Or look at this beauty from the "heart stem cells studies" where there discrepancies were routine.

http://www.forbes.com/sites/larryhu...-a-house-of-cards-about-to-fall/#747fac757341

Come on man, don't be naive.

I had big bucks invested in Provasic and was going ro make bank. until Dr. Kimble ruined everything.

 

[DrCommonSense]

Agree. Still, the meta-analyticians are the worst. They don't even create primary scholarship. GIGO.

Very true. Notice how they were all published in prestigious "peer reviewed" journals.

The reality is that no one actually looks at the primary data accumulation in the first place. The "meta analysis" that is done is usually performed by "studies" conducted by a handful of big pharma/device company physicians who are paid millions.

These physicians have their "data" sent to a statistician that will do tons of "post hoc" analyses to find the statistical test that gives the biggest efficacy benefit. The companies then hype of these findings big time while downplaying the side effects.

Examples include:

1) Lyrica
2) Statins
3) Celebrex/Vioxx
4) All antidepressants
5) The VAST majority of highly costly CA drugs in the last 20 years.

Basically, almost all of the drugs on Pfizer's formulary have very little if any proven benefit yet gross the companies 10s of billions in revenue a year.

Device companies do this for all types of procedures including:

1) Medtronic and JNJ for fusion studies
2) All the major stent players
3) Arthroscopic device companies

 

[Ducttape]

I had big bucks invested in Provasic and was going ro make bank. until Dr. Kimble ruined everything.

next time, dont hire one armed men... get those with 2 arms.

and Drlackingcommonsense, i have worked with many academic physicians and at one point was part of an academic tract (Clinician/Teacher/Researcher). the vast majority, just like the vast majority of pain physicians, are admirable, decent, hard working scientists/physicians who want to progress medical knowledge.

you clearly have no idea how academic institutions work, how hard it is to get published, and how much or how many attempts at finding something important fail and are never revealed or discussed.


try doing academic research before you spout untruths and lies.

 

[DrCommonSense]

next time, dont hire one armed men... get those with 2 arms.

and Drlackingcommonsense, i have worked with many academic physicians and at one point was part of an academic tract (Clinician/Teacher/Researcher). the vast majority, just like the vast majority of pain physicians, are admirable, decent, hard working scientists/physicians who want to progress medical knowledge.

you clearly have no idea how academic institutions work, how hard it is to get published, and how much or how many attempts at finding something important fail and are never revealed or discussed.


try doing academic research before you spout untruths and lies.

Cool story bro.

People don't bite the hand that feeds them. If they are getting dollars from Pfizer or Medtronic, don't you think there is a pressure placed on them?

Also, do those scientists do their own "data analysis" or do they send it off to a statistician that the pharma/device company hires? Yeah thought so.

If its so "hard" to get published, how do so many frauds get into the "peer reviewed" literature?

 

[drusso]

But the worst are the population-health/ideologically socialist academics sucking off the government teat publishing GIGO science and "health service research."

http://healthydebate.ca/opinions/he...are-we-blind-to-our-own-conflicts-of-interest

"Most of us who have functioned as advisors to government have signed confidentiality agreements, which are similar to those signed by consultants to industry. Many health service researchers who are not directly employed by government still receive some or all of their salaries from government, and they often work in research institutes substantially funded by government. It seems to me that this can put us in a similar potential conflict of interest as industry funding places those who consult for industry. However, many of my colleagues do not appear to agree with me."

The point is that we don't know what kind of confidentially agreements promoters of any kind of intervention may have signed with Big Pharma, Big Bio, Big Data, or Big Government. These entities "consult" with physicians because they want something. Let the light shine in!

 

[Disciple]

FDA Guidelines are still not finalized.

Anyone expect biotech to grease the FDA?

 

[drusso]

FDA Guidelines are still not finalized.

Anyone expect biotech to grease the FDA?

You bet'cha! Best Democracy money can buy!

http://rickjaffeesq.com/2016/10/06/game-changing-stem-cell-debate/

 

[Ducttape]

Cool story bro.

People don't bite the hand that feeds them. If they are getting dollars from Pfizer or Medtronic, don't you think there is a pressure placed on them?

Also, do those scientists do their own "data analysis" or do they send it off to a statistician that the pharma/device company hires? Yeah thought so.

If its so "hard" to get published, how do so many frauds get into the "peer reviewed" literature?

Wrong again.

These scientists are distinctly encouraged not to get any money from financial institutions.

I think you are confusing drug company bought researchers with legitimate doctors working at a university setting, whose goal is to get an R01 from NIH, get full professorship, tenure.

Your bias prevents you from realizing that the vast majority of research is not fraud, but it is usually stuff that you don't hear about. Important because each tiny piece of knowledge adds to the pool and influences our understanding of how things work...

As a side note, most academic departments hire their own statistician, to assist and for confirmation of the results by the primary researcher.


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[DrCommonSense]

Wrong again.

These scientists are distinctly encouraged not to get any money from financial institutions.

I think you are confusing drug company bought researchers with legitimate doctors working at a university setting, whose goal is to get an R01 from NIH, get full professorship, tenure.

Your bias prevents you from realizing that the vast majority of research is not fraud, but it is usually stuff that you don't hear about. Important because each tiny piece of knowledge adds to the pool and influences our understanding of how things work...

As a side note, most academic departments hire their own statistician, to assist and for confirmation of the results by the primary researcher.


Sent from my iPhone using SDN mobile

Cool story bro

http://www.collective-evolution.com...orld-most-cancer-research-is-largely-a-fraud/

The worst of "basic science" has been all the fraud in Cancer research with Stem Cells being a close second.

Also, I was speaking about "clinical" research studies has been a clearly a quid pro quo with drug/device companies.

But "basic" science hasn't been much better in recent years to be honest.

 

[Ducttape]

you believe what you want to believe.

by your comments, however, i would have anticipated that you would have a very healthy disdain for mesoblast...

 

[PainDrain]

Is there any in vivo data to show that either of these two dubious technologies produce a cell line that survives and regenerates? Have they tried tagging these cells and then looking for viability? I can think of about three methods of doing this and it honestly wouldn't be that hard. I just find it hard to believe that a viable cell line is established and resurrects a dead disc. It sounds like snake oil.

 

[Disciple]

You bet'cha! Best Democracy money can buy!

http://rickjaffeesq.com/2016/10/06/game-changing-stem-cell-debate/

Heard there's going to be another round of hearings next April.

Sounds like they're at least deliberating on this.