PLASTIC SURGICAL POSTERO-LATERAL REFIRECTION EXTENSION VULVO-VAGINOPLASTY

by J.C. BURT and A.R. SCHRAMM

FROM THE GYNECOLOGY SOUTH, DAYTON, OHIO, USA

Blue italics are the paper. Black text is the author of this site.

ABSTRACT

This paper offers a report of a vulvo-vaginoplasty. . .

Early in this paper is the following note.

MATERITALS AND METHODS

The patient material in this report is from the private gynecological practice of the surgical author (JCB).

Which is to say that the data is private. There is no way to check his facts.

Among other improvements for his patients, he reports that his surgery eliminates wife beating and suggests that child abuse also is cured by it.

Re wife beating: 26.8% reported such marital trauma occurring before surgery, 9.8% a slight amount, 9.8% a moderate amount and 7.3% much of the time. After surgery, 100.0% of these patients reported a decrease. Postoperative marital trauma was reported to be slight by 5.0%., moderate and much by 0.0%. Thus, wife beating was reported much or moderate by 17.1% preoperatively and 0.0% postoperatively. (physical child abuse inquiry was not made in this stud, but has correlated in frequency and severity with wife beating in clinical discussion.)

This is based on:

A quantitative, semantic differential questionnaire of 29 pages with 135 areas of inquiry was developed by the authors and mailed in late 1979 to 209 patients consecutively operated upon vaginally during the years from 1976 to 1979. . . The patients in the first two years of this study had had an earlier, less efficient surgical technique; those in the last few months of the study had not had time for completion of full adjustment to resumption of coitus at time of questionnaire mailing, but were mailed the questionnaires and their returns tabulated to maintain objectivity.

So any complaints or negative results were explained as resulting either from the patients having had an "earlier, less efficient surgical technique" or not having had time for "completion of full adjustment to resumption of coitus." And yet, in spite of that, it was 100% effective in curing wife beating.

Peer review does not cull these people from the profession

The problem is not merely whether healthcare professionals deceive patients (and even write about the virtues of doing so), and not merely whether they deceive each other, but also whether they deceive themselves. Mechanisms are not in place to protect patients when they do. The system protects the disintegrity of the healthcare professionals at the expense of patients. Complaints largely are unheeded. If patients speak publicly they are sued. If the patients sue and win, they are required to sign papers barring them from speaking about it. Negative information is not available for objective assessment and learning in the patient community or in healthcare (no one in healthcare bothered to assess Burt).

It's not as though he was doing this quietly and so no one noticed. An article in the Dayton Daily News on October 22, 1980 announces the beginning of a weekly radio talk show in which Dr. James Burt would take calls about sex. He also self-published a book called "Love Surgery." And with the number of surgeries he performed and the number of women who sought remedial medical care afterwards, it is not as though the medical community had no way to be aware of it. In the end, his mistake seems to have been one of volume. Had he ruined fewer lives, his career probably wouldn't have been curtailed after only 22 years of these operations.

Retrospective Study

The above paper is one that he left in his office for his patients to read. It is a "retrospective study," something done continually in medicine as though such studies were scientific proof of the benefits of whatever treatment the practitioner does. If such studies were that, they wouldn't universally agree with the biases of the practitioners doing them. The above case will be dismissed by healthcare professionals as being extreme, but it's extremity is what sheds light on what's wrong with retrospective studies no matter how moderate and reasonable the rest might seem to be.

Retrospective studies are done by looking back at what you already have done and pointing out that the results you got prove that what you do and the way you do it are right. This is one person looking at his/her own work and finding it good.

Even controlled studies in laboratories that then are published in peer reviewed journals don't have that good of a track record.

John, P. A. Ioannidis, in his paper "Why Most Published Research Findings Are False," studied the positive findings documented in peer-reviewed journals articles about medical hypotheses carried out in laboratory experiments and concluded most were likely to fail in the real world. Bayer Laboratories later confirmed this. They could not replicate two-thirds of the positive findings in medical journals when they attempted the experiments themselves.

Yet somehow the positive findings in the retrospective studies done by practitioners evaluating their own practices are accepted as though they must be right?

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