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Executive summary
* This week’s note looks at a classic statin/heart-disease study from 1994 – the Scandinavian Simvastatin Survival Study (abbreviated to 4S).
* Simvastatin was made by Merck & Co. Merck funded, monitored, presided over and analysed all the data for the 4S study.
* The 4S study recruited 4,444 patients with heart disease. It intended to follow people until total mortality reached 440 deaths.
* The 4S study was the first to claim that statins reduced overall mortality. It was a gamechanger for statin manufacturers.
* This note presents and explains five main criticisms:
1) Conflicts of interest.
2) The study end.
3) The regional allocation.
4) The miracle finding.
5) The small peer group.
* Any one of the criticisms should have undermined the study. The five together should have condemned it and yet it is still being used today, more than 30 years on, to persuade people to take statins.
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Zoe
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