BMJ ya sake yi. An buga wani yanki mai ruɗi sosai game da babban sa hannun lafiyar jama'a: "alurar rigakafi ta HPV lafiya kuma tana rage haɗarin kansar mahaifa, nazarin bayanan karya ya gano."1
Babu wani abu kamar "bita-da-kullun bayanan sirri." Abin da muke da shi shine tsari da rashin tsari, wanda ake kira labari, sake dubawa. Kuma babu wani abu kamar lafiyayyen magani. Duk magunguna, gami da alluran rigakafi, suna haifar da lahani ga wasu mutane.
Amma yanzu muna da wani abu da za mu iya kiransa labarin rashin fahimta, wanda aka fi sani da labaran karya, kuma abin da labarin BMJ yake. Tuni jumla ta farko ba daidai ba ce: "Alurar rigakafin cutar papillomavirus (HPV) na rage yawan cutar kansar mahaifa da kashi 80 cikin 100 a cikin mutanen da aka yi wa alurar riga kafi a ko kafin shekaru 16, bisa ga sake dubawa biyu na Cochrane."2,3
Bita na Cochrane na Gwaje-gwajen Randomized
An buga sake dubawa biyu na Cochrane a ranar 24 ga Nuwamba. Ɗaya daga cikinsu shi ne nazarin meta-bincike na hanyar sadarwa na gwaje-gwajen da bazuwar allurar HPV.2 The Abstract lura da cewa: "Nazarin ba su da isasshen lokacin da ciwon daji ya ci gaba ... Ba a gano cutar kansa ba ... Babu bayanai da aka samo don ciwon mahaifa ko wasu sakamakon ciwon daji, kuma babu wani bayani game da sakamakon ciwon daji da aka samu don maganin rigakafi a karkashin shekaru 15." Don haka, ta yaya zai nuna raguwar kashi 80 cikin 100 na ciwon sankarar mahaifa?
Marubutan Cochrane sun lura cewa sun haɗa da ƙarin Rahoton Nazarin Nazari (CSRs) fiye da yadda ƙungiyar bincike ta yi don nazarin tsarin mu daga 2020.4 Mun dauki shekaru uku kafin mu sami 24 daga cikin 50 da suka cancanta CSRs daga Hukumar Kula da Magunguna ta Turai (EMA) kuma mun kafa bitar mu akan wadancan, kamar yadda ɗayanmu ya buƙaci yin bitar karatun digirinsa. Marubutan Cochrane sun haɗa da gwaji na 60 kuma suna da CSRs don 33 daga cikinsu, amma babu inda a cikin bita na 344-shafukan da suka ce yawancin marasa lafiya da waɗannan gwaje-gwajen 33 suka haɗa. A cikin meta-bincike, sun kuma haɗa da rahotannin gwaji da aka buga. Suna da kusan ninki biyu na marasa lafiya da ke da mummunan al'amuran da suka faru fiye da yadda muke da su amma sun lura cewa "Ba za a iya kusantar da ƙayyadaddun bayanai game da rikice-rikicen tsarin juyayi mai tsanani ba a cikin nazarinmu."
An dade ana zargin allurar rigakafin cutar ta HPV da haifar da lahani ga jijiya. A cikin 2008, GlaxoSmithKline ya sanar da iyaye cewa sun nemi su shigar da 'ya'yansu mata a gwajin Cervarix cewa allurar "ya shafi tsarin juyayi."5
Ya bambanta da Cochrane, mun gano, a kan duk rashin daidaito, kamar yadda ƙungiyoyi masu sarrafawa, ban da ƙananan nazarin guda biyu, suna da masu kwatanta aiki, cewa maganin rigakafi na HPV ya karu da rashin lafiya mai tsanani: 72 vs 46 marasa lafiya, hadarin haɗari 1.49 (P = 0.04).4 Mun kira shi binciken bincike, amma shine mafi mahimmanci saboda abubuwan da ake zargi da cutar da tsarin juyayi mai cin gashin kansa shine abin da ya sa EMA ta tantance amincin maganin rigakafi a cikin 2015.5
Postural Orthostatic Tachycardia Syndrome (POTS) da Complex Regional Pain Syndrome (CRPS) su ne cututtukan da ba su da wuyar ganewa, kuma mun san cewa kamfanoni sun ɓoye abin da suka samu a cikin gwajin su da gangan.5 Don tantance idan akwai alamu da alamun da suka yi daidai da POTS ko CRPS a cikin bayanan, mun sake yin wani bincike na bincike inda muka tambayi likitan makafi tare da ƙwarewar asibiti a cikin waɗannan cututtukan don tantance sharuɗɗan da aka fi so na MedDRA (waɗanda sune sharuddan lambar da kamfanoni ke amfani da su don rarrabawa da bayar da rahoton abubuwan da suka faru). Alurar rigakafin HPV sun ƙara haɓaka mummunan lahani tabbas da ke da alaƙa da POTS (P = 0.006) ko CRPS (P = 0.01). Sabbin cututtukan farko da ke da alaƙa da POTS kuma an ƙara su (P = 0.03).4
A matsayina na ƙwararriyar sheda a ƙara da Merck, na karanta shafuka 112,452 na rahotannin bincike na sirri kuma na rubuta cewa Merck ya yi amfani da dabaru da yawa don gujewa ba da rahoton munanan cutar cututtukan ƙwayar cuta na Gardasil, wanda, a ganina, a wasu lokuta ya zama zamba.5 Na yi bincike-bincike da yawa kuma na kammala da cewa ko shakka babu cutarwar rigakafin cutar ta HPV ta zama ruwan dare sosai kuma wani lokaci mai tsanani ko kuma mai tsanani, kuma cewa Merck's aluminum adjuvant yana da illa. Wasu ƙwararrun shaidu sun rubuta irin wannan, ta amfani da wasu bayanai.6
Binciken Cochrane na Nazarin Lura
Sauran nazarin Cochrane3 ba zai iya cewa komai a dogara ba game da rigakafin cutar kansa. Wani bita ne na karatun lura, wanda muka san suna da son zuciya saboda tasirin sa kai mai lafiya: Wadanda suka yanke shawarar yin allurar gabaɗaya sun fi sauran lafiya kuma suna iya yin gwajin cutar ta HPV.
Binciken Cochrane ya rubuta wannan. A cikin binciken ƙungiyar, ƙima na yin gwajin ya ninka ninki biyu ga waɗanda aka yi wa rigakafin kamar na mutanen da ba a yi musu allurar ba.3 Tunda ciwon daji na mahaifa yana girma a hankali don haka gwajin yau da kullun yana kusa da 100% tasiri don rigakafinta,5 wannan son zuciya ta soke nazarin Cochrane gaba daya. Amma marubutan ba su ambaci wannan batu ba a cikin tattaunawarsu ko kuma a zayyana, wanda ke da matukar ruɗi. Ba su ma haɗa da tasirin sa kai mai lafiya ba a cikin jerin masu rikice-rikice shida duk da cewa shine mafi mahimmanci.
Marubutan Cochrane sun nakalto bincike da yawa na lura don rashin lahani na jijiya. A lokacin da aka gabatar da ni, lauyan Merck ya ƙidaya wasu binciken guda ɗaya, amma na nuna cewa suna da kuskure sosai.5
Marubutan sun nakalto ɗaya daga cikin waɗannan binciken don samun “ƙananan ƙasa” haɗarin mutuwa tare da alurar riga kafi, yawan adadin abubuwan da ke haifar da mace-mace 0.52 (95% tazarar amincewa 0.27 zuwa 0.97).3 Wannan yana nuna son zuciyar marubuta. Tazarar amincewa tare da iyaka na sama kusa da 1 ba haɗarin “ƙasasshe sosai” ba. Bugu da ƙari, yana da wuyar gaske cewa rigakafin HPV ya rage yawan mace-mace; a gaskiya, yawancin bincike sun gano cewa alluran rigakafin da ba su da rai suna da yawa ƙara jimlar mace-mace.6
Yana da gaske cewa marubutan sun fara ne ta hanyar yin la'akari da duk nazarin su "shaida mai mahimmanci" (sai dai idan an sami takamaiman batutuwa tare da su), wanda ke nufin sun kasance da tabbaci cewa tasirin gaskiya yana kusa da kimanta tasirin. Ba shi yiwuwa masanin kimiyya na gaske ya sami irin wannan kyakkyawan fata don nazarin lura da rigakafin cutar kansa.
Wani batun da ya soke bita na Cochrane shine rashin ingancin karatun da aka haɗa. Yana da ban mamaki karatu:3
Daga cikin nazarin 20 da ke ba da rahoto game da ciwon daji na mahaifa, 9 sun kasance cikin haɗari mai mahimmanci na rashin tausayi gaba ɗaya saboda sun kasa sarrafa duk wani abin da zai iya rikicewa, 7 sun kasance cikin haɗari mai tsanani, kuma 4 sun kasance cikin haɗari na matsakaici.
Wannan ya bar karatu ɗaya kawai! Ga CIN3 +, mai saurin kamuwa da cutar kansa, ba binciken guda ɗaya ba tare da nuna bambanci mai mahimmanci ba: 22 na 23 nazarin sun kasance cikin haɗari ko haɗari mai haɗari kuma binciken ɗaya yana cikin matsakaicin haɗarin rashin son zuciya.
Ya sabawa dalilin yadda marubutan Cochrane akan wannan bangon zasu iya kiransa "matsakaici-tabbacin shaida" cewa, ga waɗanda aka yi wa alurar riga kafi a ko kafin shekaru 16, "akwai 80% rage haɗarin ciwon daji na mahaifa (RR 0.20, 95% CI 0.09 zuwa 0.44; I).2 = 69%)” ba tare da ambaton cewa munanan son zuciya suna bata da'awarsu ba.
Cutarwa ta Dogon Rigakafin
Jumla ta biyu a cikin labaran BMJ kuma tana da matuƙar ɓata:1 "Sakamakon sake dubawa na tsari kuma sun gano cewa allurar rigakafin ba ta da alaƙa da haɗarin haɗari na dogon lokaci ko rashin haihuwa."
A ƙarƙashin taken Cochrane na wajibi, "Yarjejeniya da rashin jituwa tare da wasu karatu ko Bita," bita na Cochrane na nazarin lura kawai ya ambaci bitar mu ta wannan hanyar:3 "Kimanin takamaiman abubuwan da suka faru da suka faru a kafofin watsa labarun sun fi iyakancewa fiye da sakamakon tasirin maganin alurar riga kafi. Waɗannan abubuwan da suka faru ba su da yawa kuma galibi ba a tantance su ba a cikin gwaji na asibiti (Jørgensen 2020)."
Jumla ta uku a cikin labaran BMJ ita ce:1 "Masu bincike sun ce suna son raba bayanai masu inganci don magance munanan bayanan da ake yadawa a shafukan sada zumunta, wanda ya yi tasiri mai yawa kan adadin allurar."
Don kiran bayanan lura da ɓarna "high quality" yana da muni kamar yadda ake samu. Wanke bayanan datti, Cochrane ya kasance wawaye masu amfani da masana'antar rigakafin, kuma BMJ da farin ciki sun shiga jam'iyyar.
Gangamin Tsoro na Cochrane da BMJ
Dabarun kasuwancin masana'antar shine don tsoratar da jama'a da adadi mai yawa don yaduwar cututtuka da adadin wadanda suka mutu, da kuma ba da mafita, tare da lambobi masu ban sha'awa don tasirin yayin yin watsi da illolin da barin duk wani ambaton farashin kuɗi.
Cochrane yana amfani da littafin wasa iri ɗaya. Tara daga cikin marubutan akan bita biyun sun kasance iri ɗaya kuma yawancin rubutu a cikin sashin Baya sun kasance iri ɗaya: "Canwon daji na mahaifa shine na huɗu mafi yawan cutar kansa kuma shine babban dalilin mutuwa daga cutar kansa a tsakanin mata a duk duniya, tare da kiyasin sabbin maganganu 570,000 da mutuwar 311,000 a cikin 2018 (Bray 2018 shine mata masu ciwon daji, mata masu fama da ciwon sankara na gama gari). musamman a cikin masu shekaru 25 zuwa 45 (Bray 2018)… ko da a cikin Burtaniya, tare da shirin kan gaba a duniya, cutar kansar mahaifa a cikin mata masu shekaru 25 zuwa 49 shine na huɗu mafi yawan sanadin mutuwar cutar kansa.”
Cochrane yana da nauseatingly siyasa daidai. Me yasa magana game da "matasa matasa" da "mutanen da ke da mahaifar mahaifa"? Shin 'yan mata ba su da mahaifa, kuma masu ciwon cervix ba mata ba ne? Lokacin da Lancet a cikin 2021 yana da saƙon shafi na gaba game da "jiki mai ɗauke da al'aura," mata da yawa sun fusata kuma ɗayan ya lura cewa, a cikin wani tweet da aka buga akan cutar sankara ta prostate kwanaki 4 kacal da suka gabata, Lancet bai kira maza a matsayin "jiki masu al'aura ba."7
Maimakon tsoratar da mata masu yawan gaske, Cochrane zai iya tabbatar musu da cewa haɗarin mutuwa daga cutar sankarar mahaifa ba ta da yawa. Dangane da kididdigar hukuma ta Burtaniya, mutuwar cutar kansar mahaifa ta ƙunshi kashi 0.5% na duk mutuwar kansa kuma kashi 0.1% na duk mace-mace.8
Bugu da ƙari, yana da ɓatarwa don mai da hankali kan ƙungiyar masu shekaru 25 zuwa 45. Zai yi mamakin yawancin mutane su san cewa kusan rabin waɗanda ke mutuwa daga cutar sankarar mahaifa sun haura shekaru 70.5 kuma adadin mace-macen a Burtaniya ya fi yawa a cikin mata masu shekaru 85 zuwa 89.8 Don haka abin ya yi kamari lokacin da Jo Morrision, babban marubucin sharhin Cochrane guda biyu, ya ce kansar mahaifa “har yanzu cuta ce ta matasa mata, yana barin su ko dai sun kasa samun iyalai ko kuma su bar iyalai matasa ba tare da uwayensu ba.”1
BMJ ta lura cewa ɗaukar rigakafin HPV ya ragu da kashi 20% a tsakanin ɗalibai mata da kashi 16% a tsakanin ɗalibai maza, kuma Jo Morrison, ya ce: "Al'amarin rashin fahimta ya kasance a duk duniya, kuma barazanar rigakafin a wasu ƙasashe ya yi tasiri mai yawa kan yawan allurar rigakafi a Burtaniya."
Ta yaya za ta san hakan? Wataƙila mutane sun fi saninsu a yau fiye da yadda suke da shekaru goma da suka wuce don haka sun fi son yin allurar?
Jo Morrison shine edita9 wanda ya amince da bitar maganin rigakafin HPV na Cochrane na farko, wanda aka buga a cikin 2018,10 wanda kungiyar bincike ta suka yi kakkausar suka.11 Binciken Cochrane ya kasance abin kunya. Ya rasa kusan rabin gwajin da aka cancanta da mata aƙalla 25,000 kuma an yi tasiri ta hanyar ba da rahoton son zuciya da ƙirar gwaji. Bugu da ƙari, mawallafa sun yi kuskuren amfani da kalmar placebo don bayyana ma'auni na tushen aluminium, ko da yake GlaxoSmithKline ya bayyana cewa adjuvant yana haifar da lahani, wanda ni da wasu na rubuta.5
A wancan lokacin, Jo Morrison ya yi ƙoƙari ya kore ni saboda sukar da na yi game da bitar maganin rigakafin HPV na Cochrane na farko.9 Ta rubuta koke ga shugabancin Cochrane, wanda ya zargi tawaga tawa da haifar da lahani ga kungiyar, da rura wutar hana vaxxers da jefa “rayuwar miliyoyin mata a duk duniya ta hanyar cutar da adadin alluran rigakafin,” kamar yadda Morrison ya yi ikirarin.12
Tom Jefferson mai binciken alurar riga kafi daga ƙungiyarmu ya ce: "Idan nazarin ku ya ƙunshi karatun da ba su da son rai kuma a wasu lokuta an rubuta fatalwa ko kuma karatun da aka zaɓa kuma ba ku la'akari da hakan a cikin bitar ku ba, to yana da datti a ciki da datti… tare da ƙaramin tambarin Cochrane mai kyau a kai."12
Ƙarin Cochrane da BMJ Nonsense
BMJ ta lura cewa nazarin Cochrane na gwaje-gwajen da bazuwar ya sami "shaida mai girma" cewa babu wani ƙarin haɗari na mummunar mummunan al'amura tare da dukkanin allurar rigakafin HPV guda hudu.1
Wannan abin dariya ne. Lokacin da kamfanonin ƙwayoyi suka aikata zamba ta hanyar barin mummunan lahani na samfuransu a cikin littattafansu, bai kamata a ba su lada don rashin da'a ta hanyar kiransa "babban tabbaci."
A saman wannan, nazarin Cochrane2 yana da bincike wanda ke nuna mahimman abubuwan da ba su da kyau tare da Gardasil 9 fiye da Gardasil a cikin babban gwaji kwatanta biyun (P = 0.01, lissafin na). Wannan bindigar shan taba ce saboda Gardasil 9 ya ƙunshi ƙarin antigens na HPV guda biyar da fiye da ninki biyu na adadin aluminium adjuvant kamar Gardasil.5
Ba abin mamaki ba, nazarin Cochrane na nazarin lura3 "An kuma gano ba shi da alaƙa da kewayon takamaiman abubuwan da masu binciken suka gani suna da alaƙa da jab a kan kafofin watsa labarun."1 Tabbas ba haka bane. Wadannan binciken sun yi amfani da fa'idodin rigakafin, ba illarsa ba.
Maganar karshe ta BMJ na ɗaya daga cikin daidaiton siyasa: "Bincike da aka buga kwanan nan a cikin BMJ ya nuna cewa shirin rigakafin HPV yana da alaƙa da raguwa mai yawa a cikin kamuwa da cutar kansar mahaifa a duk ƙungiyoyin tattalin arzikin zamantakewa kuma yana iya taimakawa rage rashin daidaiton lafiya."1
Abin da BMJ da Cochrane marubuta ba su faɗi ba shi ne cewa mutane ba sa buƙatar maganin idan ana duba su akai-akai.
BMJ da Cochrane suma sun yi kasa a gwiwa sosai dangane da tantancewar mammography
Watanni biyu kacal kafin waɗannan bala'o'i, BMJ ita ma ta gaza ga lafiyar jama'a sosai, wannan karon dangane da tantancewar mammography. Ya buga wani binciken ƙungiya na nunawa13 da edita,14 wanda na yi sharhi a washegari, kuma a cikin BMJ.15
Editan ya yi da'awar ƙarya cewa "Mammograms na iya gano kansar nono da wuri, sau da yawa kafin a ji dunƙulewa, wanda ke inganta damar samun nasarar magani da rayuwa."14
Na farko, duban mammografi baya gano ciwon daji da wuri amma da wuri. Matsakaicin girman ƙwayar ƙwayar cuta a cikin gwaje-gwajen da bazuwar shine 16 mm a cikin ƙungiyoyin da aka bincika da 21 mm a cikin ƙungiyoyin sarrafawa.16 Yana ɗaukar ƙarin rabon tantanin halitta guda ɗaya don ƙari mai girman mm 16 don zama ɗayan mm 21. Idan muka ɗauka cewa lokutan sau biyu da aka lura suna aiki daga farawa har sai an gano ƙwayar cutar, matsakaiciyar mace ta ɗauki cutar kansa tsawon shekaru 21 kafin ta sami girman 10 mm.
Na biyu, a cikin farfagandar nunawa, "maganin nasara" yawanci yana nufin ƙananan maganin cutarwa,17 wanda kuma karya ne. Saboda ƙwaƙƙwaran ƙwanƙwasawa, da kuma saboda canjin tantanin halitta na farko, carcinoma a wurin, galibi ana yaɗuwa a cikin ƙirjin ɗaya ko duka biyun, dubawa yana ƙara mastectomies.18,19
Na uku, dubawa baya inganta rayuwa. Editan ya yi iƙirarin cewa tantancewar yana rage mace-macen cutar kansar nono da kashi 15% sannan ya yi kuskuren daidaita wannan tare da raguwar mace-mace. Mutuwar cutar kansar nono wani sakamako ne mara kyau wanda ya fi son tantancewa, musamman saboda rarrabuwar kawuna na sanadin mutuwa, amma kuma saboda kula da mata da aka yi wa gwajin cutar kanjamau yana kara mace-mace,17,18 kuma tantancewar baya rage yawan mace-macen cutar kansa (ciki har da kansar nono), ko yawan mace-mace.18 Sabbin bayanai sun nuna cewa don gwaje-gwajen tare da isasshen bazuwar, haɗarin haɗarin ya kasance 1.00 (95% tazarar amincewa 0.96 zuwa 1.04), don yawan mace-macen cutar kansa, da 1.01 (0.99 zuwa 1.04), don duk-sakamakon mace-mace.20
Editorial yayi magana game da "yiwuwar cutar kanjamau." Ba shi yiwuwa; sakamakon dubawa ne wanda ba zai yuwu ba.16-19
Bugu da ƙari, edita ya yi iƙirarin cewa binciken lura13 yana ba da "tabbatacciyar shaida cewa gwajin farko yana rage mace-mace," wanda karya ne. Binciken kawai ya yi iƙirarin cewa tantancewar yana rage mace-macen cutar kansar nono. Babban kuskure ne cewa mawallafin wannan binciken, wanda aka yi a Sweden, ba su gaya wa masu karatun su game da mutuwar ciwon daji da kuma yawan mace-mace ba, wanda zai kasance da sauƙin rubutawa.
Nunawa baya rage mace-mace kuma binciken lura ba zai taba nuna dogaro da cewa tantancewa yana rage mace-macen cutar kansar nono ba. Dukkansu suna nuna son kai ta hanyar lafiyayyen aikin dubawa, wanda babu adadin daidaitawar ƙididdiga da zai iya daidaitawa. Ya kamata mu yi watsi da nazarin binciken da ke da'awar cewa gwajin mammography yana aiki. Kuma ya kamata mu yi watsi da duban mammogram, saboda yana da illa.17
Editan ya bi littafin wasa mai ban haushi kamar na allurar HPV, tare da adadi mai yawa da zato:14 Kimanin sabbin mutane miliyan 2.3 da mutuwar mutane 670,000 a shekarar 2022. An yi hasashen cewa za a iya samun karuwar da kashi 38% zuwa miliyan 3.2, yayin da mace-mace za ta karu da kashi 68% zuwa miliyan 1.1 nan da shekarar 2050, idan yanayin da ake ciki ya ci gaba.
Game da binciken ƙungiyar,13 Editorialer ya ce matan da ba su halarci aikin tantancewar na farko ba, ba za su iya shiga cikin tantancewar da za su yi a nan gaba ba kuma za su iya fuskantar ci gaban cutar kansar nono da kuma yawan mace-macen cutar kansar nono, don haka “saƙon a bayyane yake: shiga cikin gwajin mammography na farko na iya samun fa’ida mai ɗorewa.”14
Wannan sakon bashi da inganci. Mun san shekaru da yawa cewa matan da ba su halarci gwajin ba za a iya kwatanta su da waɗanda suka halarta. Ba abin mamaki ba ne a gare ni cewa binciken da editan ya ambata an buga su ne daga wasu masu bincike marasa gaskiya a wannan yanki, misali Stephen Duffy, Lázló Tabár, Peter Dean, Robert A. Smith, Sven Törnberg, da Daniel Kopans.
Na rubuta cewa wasu ma sun yi karya game da binciken nasu lokacin da na kama su suna yin kuskuren kimiyya.21 Tabár, Duffy da Smith sun ba da rahoton raguwar mutuwar cutar kansar nono da kashi 63 cikin 100 a cikin waɗanda suka halarci tantancewar kuma har ma sun yi iƙirarin raguwar 13% a cikin mace-mace duka, wanda ba zai yuwu ba a ilimin lissafi, kamar yadda cutar kansar nono ta ƙunshi kashi 2% na duk abin da ke haifar da mace-mace.8
A watan Nuwamba, BMJ a ƙarshe ya farka kuma ya buga abin da ake kira nuna damuwa game da edita da kuma binciken da aka ambata, ta yin amfani da maganganun Birtaniya:22
"An faɗakar da BMJ game da damuwa cewa saƙon a cikin mahimman wuraren ba zai iya samun isassun goyan bayan bayanan da aka gabatar a cikin aikin ba… Kiran bai cika tushe ba a cikin ƙarshen bayanan da aka bincika a cikin wannan takarda… BMJ yana tattaunawa tare da marubuta game da menene canjin buguwa ga ayyukansu da ake buƙata don tabbatar da cewa yana nuna daidai sakamakon da sauran shaidun da suka dace, kuma a bayyane yake game da rashin tabbas. ”
BMJ da Cochrane suna cikin jirgi iri ɗaya da ke nutsewa.9,12 Lokacin da na fara buga bita na Cochrane na gwajin mammography a cikin 2001, Cochrane ya ƙi yarda in haɗa da manyan illolin da ke tattare da tantancewa, fiye da kima da ƙari.21,23 Ya ɗauki shekaru biyar na gwagwarmaya mai tsanani kafin in sami waɗannan bayanai a cikin nazarin Cochrane, wanda na sabunta sau da yawa daga baya. Lokacin da muka sabunta shi kwanan nan tare da ƙarin bayanan mace-mace, Cochrane ya ƙi buga sabuntawar, ba tare da wata hujja mai ma'ana ba. Wannan wani babban abin kunya ne ga Cochrane, wanda ya sa na buga labarin, "Cochrane akan aikin kashe kansa."23
Shin BMJ yana kan aikin kashe kansa kuma? Wasu daga cikinmu suna tunanin haka kuma daya daga cikin abokan aikina da ake mutuntawa da shaida a Burtaniya ya ce jaridar ta riga ta mutu. Sauran manyan mujallolin kimiyya suma suna maida kansu baya.24 Abin da muke gani a cikin shekarun nan bala'i ne kan bala'i a cikin wallafe-wallafen kimiyya inda gaskiyar kimiyya ba ta da mahimmanci fiye da amfanin siyasa, son kai, da muradun guild da kuɗi. Lokacin da na yi nazarin labaran BMJ guda 33 game da gyare-gyaren rigakafin da Kennedy ke buƙata, na gano cewa sun yi kama da kisan kai; ya kasance game da bangaskiya, ba game da kimiyya ba, ko game da cancantar gyare-gyarensa.25
References
1 Mai hikima J. Alurar rigakafin HPV mai lafiya kuma yana rage haɗarin kansar mahaifa, an gano bitar rashin fahimta. BMJ 2025 Nov 24;391:r2479.
2 Bergman H, Henschke N, Arevalo-Rodriguez I, et al. Alurar rigakafi na papillomavirus (HPV) don rigakafin cutar kansar mahaifa da sauran cututtukan da ke da alaƙa da HPV: meta-bincike na cibiyar sadarwa. Cochrane Database Syst Rev 2025;11: CD015364.
3 Henschke N, Bergman H, Buckley BS, et al. Tasirin shirye-shiryen rigakafin cutar papillomavirus (HPV) akan ƙimar al'umma na cututtukan da ke da alaƙa da HPV da cutarwa daga allurar.. Cochrane Database Syst Rev 2025;11: CD015363.
4 Jørgensen L, Gøtzsche PC, Jefferson T. Amfani da cutarwa na rigakafin cutar papillomavirus (HPV): nazari na yau da kullun tare da nazarin bayanan gwaji daga rahotannin binciken asibiti.. Ru'ya ta Yohanna 2020; 9:43.
5 Gøtzsche PC. Yadda Merck da masu kula da magunguna suka ɓoye munanan lahani na rigakafin HPV. New York: Skyhorse 2025.
6 Benn CS, Fisker AB, Aaby P (eds.). Aikin Lafiya na Bandim 1978 - 2018: shekaru arba'in na cin karo da hikima ta al'ada. 2018.
7 Gøtzsche PC. Goge mata ta hanyar tashin hankali “daidaitawar siyasa.” Cibiyar 'Yancin Kimiyya 2023;
8 Kididdigar mutuwar cutar daji. Cancer Research UK da Kididdigar Rijistar Ciwon daji, Ingila, 2021 - Cikakken saki.
9 Gøtzsche PC. Rushewa da faduwar daular Cochrane. Copenhagen: Cibiyar 'Yancin Kimiyya; 2022 (akwai kyauta).
10 Arbyn M , Xu L , Simoens C , et al. Prophylactic alurar riga kafi da ɗan adam papillomaviruses don hana ciwon sankarar mahaifa da precursors.. Cochrane Database Syst Rev 2018;5: CD009069.
11 Jørgensen L, Gøtzsche PC, Jefferson T. Binciken maganin rigakafin Cochrane HPV bai cika ba kuma ya yi watsi da muhimmiyar shaida na son zuciya. BMJ Magani-Tsarin Shaidar 2018; Yuli 27.
12 Demasi M. Cochrane - Jirgin ruwa mai nutsewa? BMJ blog 2018; Satumba 16.
13 Ma Z, He W, Zhang Y, et al. Binciken mammography na farko da kamuwa da cutar kansar nono da mace-mace a cikin shekaru 25 masu zuwa: binciken ƙungiyar jama'a. BMJ 2025;390:e085029.
14 Ma ZQ. Kasancewa a farkon gwajin mammography. BMJ 2025;390:r1893.
15 Gøtzsche PC. Binciken mammografi baya ceton rayuka ko ƙirjin. BMJ 2025; Satumba 26.
16 Gøtzsche PC, Jørgensen KJ, Zahl PH da Mæhlen J. Me yasa gwajin mammography bai yi daidai da tsammanin gwajin da aka yi ba. Ciwon daji yana haifar da Sarrafa 2012;23:15-21.
17 Gøtzsche PC. Binciken mammografi yana da illa kuma yakamata a yi watsi da shi. JR Soc Med 2015; 108: 341-5.
18 Gøtzsche PC da Jørgensen KJ. Binciken ciwon nono tare da mammography. Cochrane Database Syst Rev 2013;6: CD001877.
19 Jørgensen KJ, Keen JD, Gøtzsche PC. Shin gwajin mammography yana da hujja idan aka yi la'akari da yawan adadin bincikensa da ƙaramin tasirinsa akan mace-mace? Radiology 2011; 260: 621-7.
20 Gøtzsche PC. Binciken ciwon nono tare da mammography. Copenhagen: Cibiyar 'Yancin Kimiyyar Kimiyya 2023; Mayu 3.
21 Gøtzsche PC. Binciken mammography: gaskiya, karya da jayayya. London: Radcliffe Publishing; 2012 da Gøtzsche PC. Nunin mammography: babban hoax. Copenhagen: Cibiyar 'Yancin Kimiyya; 2024 (akwai kyauta).
22 BAYANIN DAMUWA: Haɗin kai na mammography na farko da kamuwa da cutar kansar nono da mace-mace a cikin shekaru 25 masu zuwa: binciken ƙungiyar jama'a. BMJ 2025;391:r2394.
23 Gøtzsche PC. Cochrane a kan aikin kashe kansa. Jaridar Brownstone 2025; Yuni 20.
24 Gøtzsche PC. Me ya sa wasunmu ba sa son bugawa a cikin manyan mujallun likitanci. Cibiyar 'Yanci na Kimiyya 2023; Nuwamba 14.
25 Gøtzsche PC. Rubutun BMJ na Gyaran Rigakafin Rigakafin Kennedy Yakai Kisan Hali. J Acad Publ Lafiya 2025; Nuwamba 10.
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Dokta Peter Gøtzsche shi ne ya kafa Cochrane Haɗin kai, wanda da zarar an yi la'akari da babbar ƙungiyar bincike ta likita mai zaman kanta ta duniya. A cikin 2010 Gøtzsche an nada shi Farfesa na Tsarin Bincike na Clinical da Bincike a Jami'ar Copenhagen. Gøtzsche ya buga fiye da 100 takardu a cikin "manyan biyar" mujallolin likita (JAMA, Lancet, New England Journal of Medicine, British Medical Journal, da Annals of Internal Medicine). Gøtzsche ya kuma rubuta litattafai kan al'amuran kiwon lafiya da suka hada da Magungunan Mutuwa da Laifukan Tsara.
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