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Objective
To explore the relation between study
concordance, take home message, funding, and
dissemination of comparative studies assessing the
effects of influenza vaccines.

Design
Systematic review without meta-analysis.
Data extraction Search of the Cochrane Library, PubMed,
Embase, and the web, without language restriction, for
any studies comparing the effects of influenza vaccines
against placebo or no intervention. Abstraction and
assessment of quality of methods were carried out.

Data synthesis
We identified 259 primary studies (274
datasets). Higher quality studies were significantly more
likely to show concordance between data presented and
conclusions (odds ratio 16.35, 95% confidence interval
4.24 to 63.04) and less likely to favour effectiveness of
vaccines (0.04, 0.02 to 0.09). Government funded studies
were less likely to have conclusions favouring the vaccines
(0.45, 0.26 to 0.90). A higher mean journal impact factor
was associated with complete or partial industry funding
compared with government or private funding and no
funding (differences between means 5.04). Study size was
not associated with concordance, content of take home
message,funding, and study quality. Higher citation index
factor was associated with partial or complete industry
funding. This was sensitive to the exclusion from the
analysis of studies with undeclared funding.

Conclusion
Publication in prestigious journals is
associated with partial or total industry funding, and this
association is not explained by study quality or size.

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Characteristics of primary studies
The figure shows the flow of the included studies.
We included 274 comparative studies/datasets (from
259 papers) in our population. These were mostly
randomised or semi-randomised (that is, the methods of
allocation were alternation or birth date) studies (138/
274, 50%) or prospective cohort studies (69/274, 25%).
Most studies were carried out on healthy or general
populations (203/274, 74%) and were government
financed (48%). Seventy per cent of studies reported
conclusions favourable to the vaccines but only 18%
showed complete concordance between data reported
and study conclusions. Over half (56%) of studies were at
high risk of bias, with only 4% being at low risk.

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Our analysis shows the presence of a strong positive
association between methodological quality and concordance between results presented and study conclusions (when we aggregated studies with moderate and
high risk of bias: odds ratio 16.35, 95% confidence
interval 4.24 to 63.04). In other words, the higher the
study quality (and the lower the risk of bias), the higher
the probability of concordance. In addition, the higher
the probability of concordance, the lower the probability that a study’s conclusions were in favour of
vaccines’ effectiveness (0.04, 0.02 to 0.09);

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There was no evidence
of association between either journal impact factor or
citation index factor and study design, methodological
quality, and concordance.

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WHAT IS ALREADY KNOWN ON THIS TOPIC
-Study sponsorship is associated with optimistic results
-Influenza vaccination continues to be recommended globally, despite growing doubts about
the validity of the scientific evidence underpinning policy recommendations
WHAT THIS STUDY ADDS
-Evidence is of poor quality, and studies with conclusions in favour of vaccines are of
significantly lower methodological quality
-Influenza vaccines studies sponsored by industry are published in journals with higher impact
factors and are cited more but are of similar size and quality to the others

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We cannot say for certain why industry sponsored
studies are more attractive to more prestigious journals,
but such journals are preferentially targeted by all
studies because of their prominence and prestige, so
industry sponsored studies might have a higher
probability of acceptance. The two mechanisms
might be linked, but further research, especially in
other specialties, is required.

Quote (Perd_Hapley @ Mar 24 2019 06:03am)

The authors seem to be taking painstaking steps to avoid stating the obvious: that pharmaceutical companies have bought their way into health policy and prestigious journals, and that publication in these journals is no longer indicative of quality research

Quote (Bogs @ Mar 28 2019 05:19pm)

This is the problem with the Jews and the fact that they run every facet of the world.

Quote (WitchfinderGeneral @ Mar 28 2019 04:47pm)

I wish more people were aware of this.

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At the 2004 "National Influenza Vaccine Summit," co-sponsored by CDC and the American Medical Association, Glen Nowak, associate director for communications at the NIP, spoke on using the media to boost demand for the vaccine. One step of a "Seven-Step `Recipe' for Generating Interest in, and Demand for, Flu (or any other) Vaccination" occurs when "medical experts and public health authorities publicly...state concern and alarm (and predict dire outcomes)—and urge influenza vaccination" (www.ama-assn.org/ama1/pub/upload/mm/36/2004_flu_nowak.pdf). Another step entails "continued reports...that influenza is causing severe illness and/or affecting lots of people, helping foster the perception that many people are susceptible to a bad case of influenza." Preceding the summit, demand had been low early into the 2003 flu season. "At that point, the manufacturers were telling us that they weren't receiving a lot of orders for vaccine for use in November or even December," recalled Dr Nowak on National Public Radio. "It really did look like we needed to do something to encourage people to get a flu shot." If flu is in fact not a major cause of death, this public relations approach is surely exaggerated. Moreover, by arbitrarily linking flu with pneumonia, current data are statistically biased. Until corrected and until unbiased statistics are developed, the chances for sound discussion and public health policy are limited.

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I was perturbed and slighty astonished last week to see last winter's excess mortality being largely attributed to the bad flu season, though it is well-established that this was not the case - the main culprit being on this occasion apparently the Office for National Statistics [ONS].

The BBC reported [1]:

"There were around 50,100 excess winter deaths in England and Wales in 2017-18 - the highest since the winter of 1975-76, figures from the Office for National Statistics show.

"The increase is thought to be down to the flu, the ineffectiveness of the flu vaccine in older people and spells of very cold weather last winter."

The Daily Mail reported [2]:

"More than 50,000 excess deaths were recorded across England and Wales last winter, official figures show.

"Excess deaths refer to the amount of patients that died unexpectedly, calculated by comparing the mortality rate from winter months to the rest of the year.

"The shocking figures have been partially blamed on the deadly strains of flu that swept the nations over the colder months of December to March. "

So the government are now apparent not only blaming fluctuations in winter mortality on flu but all excess winter mortality on flu, to the the tune of more than 50,000 deaths. The reality is that Public Health England had already published the flu mortality figures for the season in May [4]:

"Through the USISS mandatory scheme, a total of 3,454 ICU/HDU admissions of
confirmed influenza were reported across the UK from week 40 2017 to week 15 2018,
including 372 deaths, based on combined data from England, Scotland and Northern
Ireland. In England, the total number of influenza confirmed admissions to ICU/HDU
was 3,175 (rate of 0.22 per 100, 000 population) and 320 deaths during the same
period...

"The cumulative number of cases and deaths were higher compared to the 2016 to 2017
season (992 cases (rate of 0.06) and 112 deaths) and to the 2015 to 2016 season
(2,173 cases (rate of 0.14 per 100, 000) and 166 deaths) in England. This season
represents the highest number and rate observed since the beginning of the scheme
..."

On this basis, the number of deaths in England and Wales in an admittedly exceptionally bad year would have been only in the region of 335-340 deaths, and the ONS seem to have exaggerated the risk to the public by in the region of 150 times.

The House of Commons Science and Technology Committee have been complaining about low flu vaccine uptake again [5] but we do not even have any information about the vaccination status of the people who died. There are serious ethical issues both for medicine and government here which have yet to be addressed.

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Numbers justify fear. 50,000 abducted children, for example, or 50,000 predators prowling for children online. That last figure appeared in a recent introduction for NBC’s “Dateline.” And last week, Attorney General Alberto Gonzales cited Dateline’s number. But where did it come from? So far as statistics go, it turns out that 50,000 is something of a Goldilocks number in the media – not too big and not too small, but for scaring the public - just right.

Quote (Thor123422 @ Mar 25 2019 09:03am)

Some vaccines are undeniably effective, such as MMR, smallpox, and polio vaccines. We virtually eliminated these diseases in the United States (smallpox was globally eliminated due to mass distribution of the vaccine).

Some are questionable, such as yearly influenza (its hard to oredict future prominent strains) and H1N1 (fear leading to expedited research methods).

Quote (poopnose24 @ Mar 30 2019 09:18am)

Pretty pathetic multi