Could this be the most outrageous thing I've ever heard of?

Just about. I mean, it's not the holocaust but it's pretty damn evil. Graham Cole and Darrel Francis in BMJ tell the horrific tale.

It starts with one of my least favorite things, scientific fraud. A schtickdreck named Don Poldermans published a series of clinical trials testing whether giving beta blockers before surgery reduces the risk of mortality. The trial reports said it did, by a lot. Even though other studies didn't find this, the European Society of Cardiology relied on Poldermans's studies to recommend the treatment, which is not surprising since Polderman chaired the task force the developed the guidelines.

Only problem: Polderman made it all up. There were 5 trials in the series. He made up patients, made up data, even made up collaborators. Without his trials, meta-analysis shows that giving beta blockers increases the mortality rate. Cole and Francis calculate that something like 800,000 people have died because of the fraud. Polderman of course has been fired, but I haven't heard anything about a murder prosecution.

Anyhow, the first trial in the series, DECREASE 1, was more than ten years old at the time of the investigation so it was not reviewed. But as Cole and Francis show, it is obviously bogus as well. It contains impossible data and internal contradictions. However, the ESC continues to rely on it and has not reversed its recommendation! The guideline setting process is secret. The Society's journal, the European Heart Journal, has resisted accepting the new meta-analysis. There is more detail about the whole contretemps that I won't go into.

Arrogance, secrecy, vested interests, lies -- and people die. I don't know what the guidelines are for this practice in the U.S. or how the situation has played out here, but guidelines committees are certainly plagued by conflicts of interest and lack of transparency. This must change. It's your life that's at stake.