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LIES, DAMNED LIES, AND MEDICAL SCIENCE

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Posted by abeodbart October 31, 2010 at 9:00 am

“IN 2001, RUMORS were circulating in Greek hospitals that surgery residents, eager to rack up scalpel time, were falsely diagnosing hapless Albanian immigrants with appendicitis. At the University of Ioannina medical school’s teaching hospital, a newly minted doctor named Athina Tatsioni was discussing the rumors with colleagues when a professor who had overheard asked her if she’d like to try to prove whether they were true—he seemed to be almost daring her. She accepted the challenge and, with the professor’s and other colleagues’ help, eventually produced a formal study showing that, for whatever reason, the appendices removed from patients with Albanian names in six Greek hospitals were more than three times as likely to be perfectly healthy as those removed from patients with Greek names. “It was hard to find a journal willing to publish it, but we did,” recalls Tatsioni. “I also discovered that I really liked research.” Good thing, because the study had actually been a sort of audition. The professor, it turned out, had been putting together a team of exceptionally brash and curious young clinicians and Ph.D.s to join him in tackling an unusual and controversial agenda.

Last spring, I sat in on one of the team’s weekly meetings on the medical school’s campus, which is plunked crazily across a series of sharp hills. The building in which we met, like most at the school, had the look of a barracks and was festooned with political graffiti. But the group convened in a spacious conference room that would have been at home at a Silicon Valley start-up. Sprawled around a large table were Tatsioni and eight other youngish Greek researchers and physicians who, in contrast to the pasty younger staff frequently seen in U.S. hospitals, looked like the casually glamorous cast of a television medical drama. The professor, a dapper and soft-spoken man named John Ioannidis, loosely presided.

One of the researchers, a biostatistician named Georgia Salanti, fired up a laptop and projector and started to take the group through a study she and a few colleagues were completing that asked this question: were drug companies manipulating published research to make their drugs look good? Salanti ticked off data that seemed to indicate they were, but the other team members almost immediately started interrupting. One noted that Salanti’s study didn’t address the fact that drug-company research wasn’t measuring critically important “hard” outcomes for patients, such as survival versus death, and instead tended to measure “softer” outcomes, such as self-reported symptoms (“my chest doesn’t hurt as much today”). Another pointed out that Salanti’s study ignored the fact that when drug-company data seemed to show patients’ health improving, the data often failed to show that the drug was responsible, or that the improvement was more than marginal.”

Read more at The Atlantic (Thanks Elke)

COMMENTS
October 31, 2010 at 9:15 am

WARNING: THIS DOES NOT SUPPORT YOUR PET THEORY!

Ioannidis’s work shows that any particular novel result in only one paper tends to be wrong. His work is not really about well-established, well replicated results, such as that vaccines don’t cause autism. These results show that there are many problems with the way that science is conducted, but scientific consensus is still by and large your best guide to the truth, not because it’s perfect but because every other method has worse problems.

There are lots of good blog entries on scienceblogs.com that help to put this work in context. See in particular http://scienceblogs.com/insolence/2007/09/the_cranks_pile_on_john_ioannidis_work_o.php


October 31, 2010 at 9:49 am

For the best visualisation and interactive tool exploring how proven and poular different health giving (or nit as thevdase often is) substances are go to
http://www.informationisbeautiful.net/play/snake-oil-supplements/ and click on SnakeOil
Utter genius.
It now sites all the medical reports used to comp lie it too.
Graham Bishop


October 31, 2010 at 9:59 am
NTS says:

What drug companies are doing, which is often ignored, is spending billions of dollars surpressing ‘non-pharamaceutical’ evidence. Acupuncture for example could hapily replace a lot of first line analgesics and be as efficacious. The same is true for hypertension. I’m not an acupuncturtist but keep a keen analytical eye on the evidence. A simple search of sciencedirect will lead you in the right direction.


October 31, 2010 at 3:16 pm
roz says:

damn skippy. even a dozen studies cant prove everything. :(

so what’s the answer? keep studying, i guess…

and have a merrie samhain! :)


November 3, 2010 at 8:02 pm
WereTaco says:

I’m not sure why this is surprising information, just about any entity ( an organization, a complex collection of cells that is you, etc ) STRIVES for survival. Any information that will help is greatly reveled in, any information that will hinder is looked down upon. Bring your boss some information that will hinder the company you work for and see what happens.

This is why the larger an organization gets, the more important it becomes to be skeptical about the veracity of claims that it makes
:) :( :) :( :) :( :) :(


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