How prevalent are errors in medical research?

The latest issue of The Atlantic has profiles brave thinkers. One of these brave thinkers is Dr. John Ioannidis, who is profiled in “Lies, Damned Lies, and Medical Science.” Dr. Ioannidis challenges much of the medical establishment by charging that most medical studies are biased, misleading, or flat out incorrect. In the article, author David H. Freedman writes that “He [Dr. Ioannidis] charges that as much as 90 percent of teh published medical information that doctors rely on is flawed.”

Today, I review some excerpts from this very interesting article.

Bias in Physician Treatment

One study showed that “…the appendices removed from patients with Albanian names in Greek hospitals were more than three times as likely to be perfectly healthy as those removed from patients with Greek names.”

Bias in Research studies

In a discussion with colleagues, Ioannidis suggested that it could be possible “drug companies were carefully selecting the topics of their studies–for example, comparing their new drugs against those already known to be inferior to others on the market–so that they were ahead of the game even before the data juggling began?” In addition, “drug studies have the added corruptive force of financial conflict of interest.”

“An obsession with winning funding has gone a long way toward weakening the reliability of medical research…To get funding and tenured positions, and often merely to stay afloat, researchers have to get their work published in well-regarded journals, where rejection rates can climb above 90 percent. Not surprisingly, the studies that tend to make the grade are those with eye-catching findings.”

“Of the 49 [most highly regarded] articles, 45 claimed to have uncovered effective interventions. Thirty-four of these claims has been retested, and 14 of these, or 41 percent had been convincingly shown to be wrong or significantly exaggerated.”

“The peer review process often pressures researchers to shy awy from striking out in genuinely new directions, and instead to build on the findings of their colleagues (that is, their potential reviewers) in ways that only seem like breakthroughs…”

Nutritional Studies

Should you eat eggs or not? Is wine in moderation good for your health or not? Should we pay attention to these findings? “Ioannidis suggests a simple approach: ignore them all.”

Conclusion

“‘Science is a noble endeavor, but it’s also a low-yield endeavor,’ he says. ‘I’m not sure that more than a very small percentage of medical research is ever likely to lead to major improvements in clinical outcomes and quality of life. We should be very comfortable with that fact.'”