About

Dear reader,

My name is Jorge Ramírez,  I work as a professor of pharmacology at Universidad del Valle (Cali, Colombia). Despite 10 years of experience in university teaching and research, I have to  confess that I know very little about the safety and effectiveness of drugs in humans.

I am trying to understand several common practices in the mainstream medicine (pharmacological and non-pharmacological) widely prescribed by doctors in many countries around the world, despite that the effectiveness and safety of these popular interventions have not been adequately supported by high-quality evidence. My current emphasis involves the analysis of different research designs used to test the safety & effectiveness of drugs in humans, I am specifically interested in the hierarchical levels of different study designs (meta-analysis, clinical trials, observational studies, and case-reports) and the foundations of evidence based medicine. My analysis include the use of linear and nonlinear models (i.e., chaos theory) to understand data collected from clinical trial registries (e.g., ClinicalTrials.gov, EudraCT, ChiCTR, and CTIR), platforms (i.e., WHO ICTRP) and other publicly available databases (e.g., PubMed, Embase, Propublica, ISI Web of Knowledge, Altmetric, Embase, EBSCO, among others). My research data is open at my figshare profile.


BlogWithIntegrity.com

Información en Español* 

Hola, me llamo Jorge Ramírez y trabajo como profesor de farmacología en la Universidad del Valle (Cali, Colombia). A pesar de llevar una experiencia de diez años en la docencia e investigación universitaria, debo confesar que conozco muy poco acerca de la seguridad y efectividad de los fármacos en humanos.

En este blog, usted conocerá de la frustración de un profesor de farmacología que está involucrado en actividades docentes con otros profesionales que se dedican a prevenir, dar tratamiento y rehabilitación en enfermedades diversas (medicina, odontología y enfermería), los cuales desconocen en buena parte los factores de seguridad y efectividad de los fármacos que estudian para luego utilizarlos en humanos.

Mi esfuerzo está en entender los fármacos que muchos prescriben a sus pacientes basados en creencias y/o costumbres, en lugar de conocimientos derivados de hechos investigativos. Pretendo enfatizar en el análisis de diferentes diseños de investigación que se usan para evaluar la seguridad y eficacia de los fármacos en humanos, me interesa específicamente en los niveles jeráquicos de algunos diseños de estudio (metanálisis, ensayos clínicos, estudios observacionales y reportes de caso), además de los fundamentos de la medicina basada en evidencias. Mi análisis incluye el uso de modelos lineales y no lineales (ej. Teoría del caos) para entender los datos recogidos en los registros de ensayos clínicos (ej. ClinicalTrials.gov, EudraCT, ChiCTR, and CTIR), plataformas de datos (ej. WHO ICTRP) y otras bases de datos de dominio público (ej. PubMed, Embase, Propublica, ISI Web of Knowledge, Altmetric, Embase, EBSCO, entre otras). Todos mis archivos de datos investigativos están abiertos y pueden ser consultados haciendo click en las imágenes de mis perfiles públicos  (arriba).

* Traducción gracias a mi amigo y colega José M. Salmeron, Esp. Psiquiatría, Managua, Nicaragua.


  • Disclaimer & Conflict of Interests: 

http://chaoticpharmacology.com/disclaimer-coi/

  • My research is open (level: raw data)

http://figshare.com/authors/Jorge_H_Ramirez/587826

http://impactstory.org/Jorge

  • My other public profiles

https://publons.com/author/201293/ramirez-jh

http://co.linkedin.com/in/jorgehramirez/

http://scholar.google.com.co/citations?user=W33HNg0AAAAJ&hl=en

https://orcid.org/0000-0001-6176-2816

https://twitter.com/Jor_H_R

https://www.researchgate.net/profile/Jorge_Ramirez35


Research production: Oct 2013 to Feb 2015

  1. Letters to The BMJ editor (n = 21) – Impact Factor > 17

“Rapid responses are electronic letters to the editor. Our weekly letters are edited selections of posted rapid responses and are indexed in PubMed. Rapid responses are not indexed in PubMed but they have their own URL and are retrievable in an advanced search of thebmj.com in perpetuity. Thus a rapid response is published with its first appearance online.”

  • Poor quality of scientific journalism about the human papillomavirus vaccine: open letter to Colombian news media
  • Re: Concerns over data in key dabigatran trial
  • Re: US incentive scheme for neglected diseases: a good idea gone wrong?
  • The meta-analysis of published and unpublished studies of agomelatine is misleading
  • Zombie statistics strikes again
  • Any reason not to retract?
  • Hypothesis: hierarchical levels of evidence based medicine are wrong
  • Response to J. Castellani (PhRMA): An ounce of data (i.e., 64740 data values)
  • “Novo Nordisk replies to BMJ investigation on incretins and pancreatic damage” – Re: let’s start this discussion again
  • Dabigatran ClinicalTrials.gov unpublished studies (completed before Jan 2012) = 12/22 (54.5%)
  • Re: Global rules for global health: why we need an independent, impartial WHO
  • Re: Tamsulosin treatment for benign prostatic hyperplasia and risk of severe hypotension in men aged 40-85 years in the United States: risk window analyses using between and within patient methodology
  • Expression of concern about tamsulosin: at least 78.4% of the studies are unpublished.
  • Correction: “Expression of concern about tamsulosin: at least 78.4% of the studies are unpublished.”
  • Re: Evidence based medicine is broken
  • Re: The US requirement to deposit trial data within a year is unworkable
  • PubMed publication trends (1992 to 2014): evidence based medicine and clinical practice guidelines
  • Re: Putting GlaxoSmithKline to the test over paroxetine
  • Evidence based medicine (EBM) not evidence-based: medicine is broken.
  • Drug policy: we probably need an “irrational authority”
  • A message to people responsible for abandoned or misreported trials: you will be published or retracted.
  1. Articles published in peer-reviewed biomedical journals (Nov 2013 to present; n = 4)
  • Ramirez JH. Severe hypotension associated with α blocker tamsulosin. BMJ 2013; 347:f6492
  • Ramírez JH, Parra B, Gutierrez S, et al. Biomarkers of cardiovascular disease are increased in untreated chronic periodontitis: a case control study. Aust Dent J 2014;59:29–36.
  • Ramírez JH. Lack of transparency in clinical trials: a call for action. Colomb Med 2013;44:243–6.
  • Cruz-Olivo A, Ramirez JH, Contreras A. La moxifloxacina como coadyuvante en el tratamiento de las periodontitis. Rev Clin Periodoncia Implantol Rehabil Oral. 2014;07:194-9.
  1. Negative studies, articles in progress & research raw data

More research production (over 100 products with doi) at my figshare & impactstory public profiles

  1. Pubmed Commons
  • “Tamsulosin treatment for benign prostatic hyperplasia and risk of severe hypotension in men aged 40-85 years in the United States: risk window analyses using between and within patient methodology.” | BMJ
  • “Efficacy and safety of solifenacin plus tamsulosin OCAS in men with voiding and storage lower urinary tract symptoms: results from a phase 2, dose-finding study (SATURN).” | Eur Urol
  • “Combination therapy with solifenacin and tamsulosin oral controlled absorption system in a single tablet for lower urinary tract symptoms in men: efficacy and safety results from the randomised controlled NEPTUNE trial.” | Eur Urol
  • “Severe hypotension associated with α blocker tamsulosin.” | BMJ
  • “A piece of my mind. Beyond conflicts of interest: disclosing medical biases.” | JAMA
  • “Dabigatran versus warfarin in patients with atrial fibrillation.” | NEJM
  1. Academic congresses

5.1. XVI Simposio de Investigaciones en Salud

5.2. Evidence Live 2015: Oxford University and The BMJ


 

 

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Foto: Yo (→) acompañado de Antonio Villafaina (←) – polimedicado.org – después de almorzar en la galeria del Alameda de Cali (Sep 2014) – el día que nos conocimos en su paso por Sur América.

Leer más:

– http://chaoticpharmacology.com/desvirtualizados/










 

  8 comments for “About

  1. March 31, 2015 at 3:56 am

    Could prejudiced based pharmacology act in the same way suggestion works? Quite difficult to document, I imagine. :-) Especially with uncooperative subjects.

    Perhaps you could glean more about case histories if you used different words? The word PREJUDICE tends to predisposed everyone to defensive stubbornness. The word TRADITIONAL tends to free up information for incident and effectiveness studies. Ritual really does enhance the curative properties of traditional medicines. Used correctly ritual can help modern medicine, also. Just some thoughts, I had, when I skimmed over your “about”. I have not yet read anything in depth, so maybe I am missing the point entirely.

    If you want prescribers to used medicines with proven effectiveness rather than whatever they a just used to using, again you might have to avoid words like prejudice that tend to stop up ears and turn brains off … even intelligent (ha!) people have trouble if the light switch gets moved.

    As to what to teach students :-) Perhaps you can help research students learn to ask the right questions? Questions that lead to better and better questions. Isn’t science the art of asking good questions?

    Me: mostly now I am just a Crazy Old Swamp Hermit Lady Bear that sometimes talks too much.

    Helping the People to be healthier and more comfortable in their bodies is a difficult and noble calling. Thank you for all that you have done.

    • April 4, 2015 at 3:28 am

      Thank you for your feedback, you are right about avoiding the use of words like prejudice, I just edited these contents, please take a look and tell me what you think now (the error is because I was confused about the meaning of that word – English is not my first language -). By the way, I was thinking about updating this section, a lot of things have ocurred since I started this blog, I am also updating the section of my conflict of interests (non-financial).
      Kind regards,
      Jorge.

      • April 4, 2015 at 3:39 am

        Thank you so very much for taking the time to write this. It is much appreciated. ;-)

    • April 26, 2015 at 5:35 am

      “As to what to teach students :-) Perhaps you can help research students learn to ask the right questions? Questions that lead to better and better questions. Isn’t science the art of asking good questions?”
      Very good questions indeed! cheers :-)

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