Tuesday, June 19, 2007

My Opinion Matters More Than Yours

Over at Furious Seasons, Philip Dawdy has a long and highly recommended post on the latest in the child bipolar wars. It is regarding the recent Boston Globe interview with Dr. Joe Biederman, who clearly believes that child bipolar is relatively common and undertreated. Background on child bipolar here and here. I'm in firm disagreement with Biederman, but am more than willing to change my position should the science start to improve.

What really concerned me was how Biederman discussed his critics in the Globe article:
Biederman dismisses most critics, saying that they cannot match his scientific credentials as co author of 30 scientific papers a year and director of a major research program at the psychiatry department that is top-ranked in the "US News & World Report" ratings.

"The critics 'are not on the same level. We are not debating as to whether [a critic] likes brownies and I like hot dogs. In medicine and science, not all opinions are created equal,' said Biederman, a native of Czechoslovakia who came to Mass. General in 1979 after medical training in Argentina and Israel. He now lives in Brookline.

I really hope he was taken out of context and that he didn't get all braggy about his 30 papers per year and about the US News rating of his department. Just because you've published 30 papers per year does not mean you're right about child bipolar. Indeed, despite publishing a mountain of research, some questions still loom large...

1. Does child bipolar really exist in substantial quantity?
2. Does treatment help kids with this "disorder"?
3. Why would a leading "expert" in child "bipolar disorder" say that up to 75% of children who are "bipolar" become suicidal without citing any supporting evidence?

True, all opinions are not created equal in science -- but the idea that child bipolar is a hugely underdiagnosed and undermedicated condition is not backed by consistent data. It would seem that Biederman is confusing quantity (e.g., publishes a boatload of papers) with quality of evidence. Again, please see my above questions. If they can be answered sufficiently, then I'll be glad to jump on the child bipolar bandwagon.

Now, does this mean I'm "not on his level" because I have the audacity to ask questions and point out gaping holes in the so-called evidence base regarding this purported disorder? I suppose his opinion is more valid because he has published more articles than his critics? I'm really hoping that Biederman was quoted out of context, but if he was not, he looks pretty arrogant.


Stephany said...

Biederman's massive influence in the psychiatric community, therefore mainstream psychiatrists used his published hotdog vs. brownie theories as a diagnostic criteria for kids, based on his so-called experience, peer reviewed yada yada.

THIS is why Biederman deserves the scrutiny he is getting and he is responsible indirectly, yet profoundly--in the death of Rebecca Riley and the mis diagnosis of children such as my daughter.
Broad brush? no.

Why? because he dominated the field with that arrogant attitude, self-appointed authority burned in wood with his published worked funded by Pharma.

Why wouldnt we question this?

I am sorry but anyone with any public background doesnt say hotdogs and brownies when talking about Seroquel, Depakote and 2-4 year olds.

That is reckless endangerment of lives and he is holding the arrogant bag of bullshit that attained status on the back of innocent kids.

Just my opinion, and Ive got reason to have one.

Influence of doctors by peer reviewed publications and Pharma reps is what most psychs use for protocol for treatment. That is wrong. Biederman knows it. He ran with the ball. Ethically the guy is off base. Arrogance usually ends up frying a soul in the end.

Anonymous said...

Of course Philip Dawdy thinks his opinion is better than everyone else's as well.

Radagast said...


We've just been working on a piece, over at Seroxat Sufferers, concerning the Protocol 329 debacle http://fiddaman.blogspot.com/2007/06/life-and-times-of-martin-b-keller-md_23.html. One thing I discovered as I trawled through the story (which I accept is an old one, but absorbing, for all that), is that the number of papers one has to one's name has very little to do with one's intellectual output.

I'm not sure how widespread ghostwriting is in the area of medical research, but if Biederman researches, collates and writes up an article every one and half weeks, then I take my hat off to him, although I have a sense that he must be a machine, rather than a man.

Anyway, I know nothing of Biederman's theories for treatment of BPD in minors. I imagine they're advanced.


Uneasy Rider said...

And now.... the REST of the story....