What follows is not a scientific problem: If I said that two pills plus two pills does not equal five pills, I am not talking about pharmacology or medicine. Likewise, my analysis does not lean on the study of science or disease. It leans on math and deduction. As an introduction, here are some analogies of what will follow.
Zebras: If zebras were suddenly called “horses,” would we have more of either or both in the world?These industry-funded efforts are more aptly called linguistic strategies than prevalence studies. A higher than expected prevalence is necessary to sound the alarm of “underdiagnosis.” It is the point of leverage in the publication strategy. And it is a false claim. Separate diseases have been conflated … a simple linguistic manipulation. In fact, after careful inspection, prevalence for FH-as-LDLR in these reports is actually lower than the established numbers. It’s as if professor A did a prevalence study of domesticated horses, and professor B did the same, but included zebras as if “horses.” If professor B does not explain the conflation of “zebras” with “horses” and claims a higher prevalence of “horses,” he uses culturally inherited assumptions to deceive his readers. See slide here; full analysis click here.
Geno-mandering: In the USA, Regeneron continues the geography-management shown in the Danish studies, cherry-picking areas with inordinately high prevalence. Just as politicians can misrepresent the public’s choice through gerrymandering, so can Pharma misrepresent FH prevalence by selecting precisely those regions with higher than average disease prevalence. SeeSlide here; full analysis click here.
A Tomato is not an Apple: Stepping backwards to view a tomato from 20 yards does not make it a red apple. Likewise, lowering standards for diagnosis does not increase a patient population. It inflates the count with false positives.Slide here; full analysis click here.
The whole Pie: If someone hands me ¼ of an apple pie, I can subtract ¼ from 1 and calculate the existence of the remaining 3 slices, being ¾ of the pie. If after explaining the procedure, someone hands me a whole strawberry pie, and using the whole strawberry pie as if a fraction of that Apple pie, can I really come up with a “remainder” equal to 3 whole strawberry pies? See slide here; full analysis click here.
Galapagos: It’s as if a Galapagos scientist made a special drug and then went out to convince everyone that there is a disease specific to sea-swimming turtles, while showing everyone how easy it is to find and inoculate the land-based tortoises. See slide here; full analysis click here.