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Meta-Research Debunks Medical Study Findings
jenningsthecat writes "From The Atlantic comes the story of John Ioannidis and his team of meta-researchers, who have studied the overall state of medical research and found it dangerously and widely lacking in trustworthiness. Even after filtering out the journalistic frippery and hyperbole, the story is pretty disturbing. Some points made in the article: even the most respected, widely accepted, peer-reviewed medical studies are all-too-often deeply flawed or outright wrong; when an error is brought to light and the conclusions publicly refuted, the erroneous conclusions often persist and are cited as valid for years, or even decades; scientists and researchers themselves regard peer review as providing 'only a minimal assurance of quality'; and these shortcomings apply to medical research across the board, not just to blatantly self-serving pharmaceutical industry studies. The article concludes by saying, 'Science is a noble endeavor, but it's also a low-yield endeavor ... 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.' I've always been somewhat suspicious of research findings, but before this article I had no idea just how prevalent untrustworthy results were."
That fat in your diet is bad for you.
If medical research were really as close-to-useless as The Fine Summary claims, we'd be hardly better off with modern Western medicine than with homeopathy and prayer. Clearly, we are, refuting the idea that medical research doesn't do a huge amount of good. I'm not saying it isn't flawed, but give it some credit.
Le français vous intéresse?
The problem I think is the people doing the research and not the research itself. People can lie about the results, which happen far to often.
So this is a research paper that tries to convince the reader that research papers can't be trusted. Really now.
I click on that link, and .... I got just an article!!! I was sure my browser was broken when 30 ads and noise from all directions didn't load. Oh the beautiful text! Ok one banner ad but nice...
But the results are copyrighted and can't be used without a licensing fee.
Prof. Farnsworth - "Oh a lesson in not changing history from Mr I'm-My-Own-Grandpa!"
... that most people will believe anything, as long as it starts with 'study shows'.
... it's the most useless way to progress, except for all others.
Be a skeptic, but don't confuse skepticism with truthiness. Unfortunately, I expect a rise in the use of truthiness over science when people will investigate reality.
Those who can, do. Those who can't, sue.
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.
Okay - so I only bothered getting this far into TFA.
Now - I'm no medical junkie, I didnt' even take Bio in high school, but I have occaisonally watched Scrubs and House and ER and a bunch of other medical dramas from time to time.
One thing that always seems to surface in these TV shows is the patients history, like their religion, nationality, where they work, etc. This leads me to believe that maybe - JUST MAYBE - there is actually some correlation between something in the Albanian culture and society that has an increased chance of appendicitis, and that its entirely possible that this pushes doctors towards diagnosing that when some of the symptoms appear. (Not that this is particularily the best course of action, but what else would you do? Run every test?)
But at the same time I know how incredibly innaccurate a lot of television can be about portraying a subject. However, the IT Crowd has basically mimicked my life, but thats another story for another time. Anyways, so if I'm absolutely and completely wrong, feel free to mod me down - but I just thought I'd interject.
We've known this for a while. Here's *how* they do it: http://www.guardian.co.uk/society/2003/dec/07/health.businessofresearch
Need Mercedes parts ?
The problem I know because I am (retired) RN. I went to my MD for a severe sinus infection and chest infection some years ago. During the visit I asked for Abuterol Inhailer to assist with clearing my chest. This is standard Respiratory Therapy stuff. They gave me a puffer which I took home, used 10 or 15 puffs out of and threw it in the drawer. Ever after that BCBC has me as Diagonsis Asthma. I am not asthmatic. This will screw up my healthcare for the rest of my life! Makeing all of these errored stupid databases cross link will do far worse than this. My daughter (age 23) was emergency taken to the local hospital with what appeared to be an Epileptic Seizure. Consequences included she couldn't drive for 6 months! I will skip the details, her seizure was a cardiac seizure. It took her actually taking her case to the local Fire Department to get a heart monitor strip to make this undeniable. She is now treated well but forever she will be DX Epileptic even though it is completely wrong. Does any sane person want this sort of a system where you cannot go to another doctor and have him/her look at you rather than some record first? Who wants in that trap? If you are an MD in that trap even if you see that the record is wrong, you can go to jail, lose your job etc all if you go against this insane record that is completely in error. Please wake up people this is a prison without walls! You cannot escape! You will have to leave the country to get away from a bad diagnosis or a stupid keystroke error. Remember the computers have a forever memory and no intelligence.
I'd replace item C with regular fucking. Don't see the quacks, just fuck someone. Chiropractors are worthless and evil. Fucking is fucking AWESOME!
Fascism trolls keeping me up every night. When I starts a preachin', he HITS ME WITH HIS REICH!
"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."
I'm not surprised that this is true even of well-conducted research and well-written papers. How many baby steps had to be taken between the discovery of a disease and development of a way to cure it or control it? Every one of those baby steps would be a paper that had no real effect on clinical outcomes.
As far as I can see, the most important thing is to get the disproved and superceded papers out of circulation. The internet and a good database would probably be useful, but many medical doctors tend to be reluctant to embrace technology outside their expertise.
I've calculated my velocity with such exquisite precision that I have no idea where I am.
Considering that when I was treated for cancer I was put on experimental therapy, I'm lucky to have my arm and be alive (been in remission for 15+ years). Praise God. (:
"There is a way that seems right to a man, but its end is the way of death." Proverbs 16:25 (NKJV)
So are meta-studies implicated?
What about the meta-study published in the JAMA which determined that allopathic medicine (MDs, hospitals, pharmacies) is the second leading cause of death in this country? You know, deadly infections in hospitals, wrong drug dosages, drug interactions, drug side affects, botched surgery, failure to detect disease, misdiagnosis. And the occasional murder.
The first report was that medicine is the third leading cause of death, and then a follow-up study raised it to the second leading cause.
So do I believe that study, which jibes with the fine article, or is this meta-study suspect?
Medical people tend to understand statistics, to reuse an old saw, the way a drunk understands a lightpole--using it more for support than illumination.
/.ers know, for a statistical inference to be valid, the underlying dataset must be completely random. Not just sort of random, not just I'm pretty sure it's random, not just that's the best I could do random, not just they-said-it-was random. It must be completely random. Most of the time included random variables must also be completely independent (unless you're doing covariance studies, but let's not go there).
As most/all
Thing is, complete randomness and independence of variables within a human dataset is probably impossible, even in the big ones sponsored by NIH, the Census Bureau and so on. If that is so, then doing "statistical studies" on human datasets--which AFAIK is what the majority of medical studies attempt to do--is about as scientific as creationism.
My meta-meta research (the one I just did) found that the article has 6,000+ words in it. About 1,000 unique. The word FESTOONED is present which immediately debunks the entire premise asserted.
John Ioannidis and his team of meta-researchers (just one meta) have obviously been padding their numbers....
But then I saw a paper showing how unreliable meta-studies are.
bad-um-tsching!
"Lost time is not found again."
I don't want to discount the value of the study itself. Clearly it's important to quantify how bad the problem is and try to develop solutions. But at the same time, the article and summary might give one the impression that the errors and biases involved were newly discovered by the researchers. A few examples:
The secondary marker problem (e.g. tracking cholesterol levels instead of real outcomes like deaths)
Comparing new drugs only to placebo or only to drugs that aren't best-in-class or using an intentionally weak dose of the comparison drug
Using meta-analysis of other studies instead of doing new research (and often doing it badly)
Doing retrospective analyses like chart reviews instead of prospective studies (and often doing those badly)
To expand upon that last example: common problems with the methodology of chart review studies were investigated thoroughly by Gilbert and Lowenstein in 1996. Despite their findings and recommendations for how to do a chart review properly, things haven't improved much since.
Many doctors and researchers have been critiquing studies and warning about these problems for years. In the emergency medicine context, for example, Jerome Hoffman, a UCLA medical professor and emergency department physician, is well known as a critic of poorly designed studies in the emergency medicine literature. He has critically reviewed studies since 1977 as part of a continuing medical education program called Emergency Medical Abstracts.
So the problems are well known. The bigger issue is how to fix them.
Studies say that Jenny McCarthy says that the MMR will give you the dreaded Autism. Andrew Wakefield told me so, and his patent for a competing vaccine has nothing to do with it
So which shot is "the autism shot" you could probably ask 10 moms and 5 would tell you "MMR", even though the whole thing is obvious fraud horseshit.
I have no idea why "information" is perpetuated so quickly but "rebuttal" is so slow.
Science is a noble endeavor, but it's also a low-yield endeavor
This may be true, but it is the ONLY reliable yielding endeavor. Everything else that works, can't prove it works. If you could prove it, it would be science.
Science is like democracy. It's the worse system there is, except for all the other systems.
a meta study? right there is suspect.
Now there are things you need to understand when reading a study.
A)Sometimes the conclusions do not match the data. This rarely happens in proper qualified journals, but it does happen.
B) Understand what p value means and when it's significant.
C) Understand blinding.
D) Understand sample size.
E) people make mistakes, but that doesn't necessarily mean a study is wrong. In fact, very few times is any one flag mean the study is bad.
F) many things called studies, aren't really studies. Of course, he lumps anything the uses the word 'studies' into the same category. Effectively saying TV is just a valid of a place to get studies as is NEMJ.
t seems to me, that this guy like to take certain situation and that extrapolate them to ridiculous levels. I wouldn't trust him to give me directions. He cherry picks data and then applies the sharp shooter fallacy.
He also doesn't seem to know there is a difference between blinded, double blinded and triple blinded.
The Kruger Dunning explains most post on
What the fuck are you talking about?
Why should I trust the researchers in TFA? Oh ... I see ... they have the truth.
All a person needs for good health is:
A) Proper diet.
B) Exercise.
C) Regular Chiropractic Adjustments to keep your nerve function at peak performance.
Which one of those prevents Tetanus? Just curious.
I'm a firm believer in Homoeopathy. I don't believe in all of it though, just a homoeopathic proportion of its principles.
If I have seen further it is by stealing the Intellectual Property of giants.
Nice interview with a charismatic guy. His opinion, not data. It may even be true. This link was not a study though!
... is it took a meta review to bring this forward. What do you think will happen when University research funding sources are corporations with very specific short term interests?
The social phenomena described is quite common. People in general trust the messages coming from some sources more than others. Being high on the trust ladder is what Marketing people are hoping to achieve with their efforts. My favorite example in the "trust the messenger" department is Microsoft. How many times over how many years does it take before people will disregard their "yeah, we've got that feature" a year or more out from a product release? Lots. Doesn't matter though. The same people that trust Microsoft after being routinely mislead then defend Microsoft. They trust Microsoft. Pharma does the same thing.
http://www.maxineudall.com/2010/02/should-economists-be-sued-for-malpractice.html
If medical research were really as close-to-useless as The Fine Summary claims, we'd be hardly better off with modern Western medicine than with homeopathy and prayer.
In fact, we aren't: medical research has added fairly little to our life expectancy. Most increase in life expectancy is due to improved public health, hygiene, quarantine, isolation, city planning, etc. Of course, there are some success stories: some vaccinations, antibiotics, some surgeries, but they represent a tiny fraction of all medical research. Another dirty little secret is that for many drugs, while the drug treatment is statistically better than a placebo, the placebo effect is often bigger than the little bit of extra effect you get from the drug.
Having been sick recently, I also found that doctors really have very little idea of what's going on. Their hands-on experience is valuable, but they don't really think about it much (or just get it wrong); they are really more like medicine men with knives and drugs, and they rely less on medical research and more on their own experience.
Let's see - the list of orgs who betray our trust:
1) government ... .. the research establishment !!!
2) banks and financial institutions
3) education
4) media
and now
Oh no.
Who is next?
Religion?
Personally, I would have modded this "Funny."
Support SETI@home
OK, so the article was saying that other articles are misleading or untrustworthy, etc. But why take this article at face value? Just because it's negative towards other articles? It seems to be human nature to believe the *second* thing you hear is correct, because it implies that the truth has finally come out. There is no real basis for that to be true though.
oops - forgot ..
every single business and corporation in existence.
This will screw up my healthcare for the rest of my life! Makeing all of these errored stupid databases cross link will do far worse than this.
She is now treated well but forever she will be DX Epileptic even though it is completely wrong
Have you checked the MIB to see if both of you have those entries? If they are there, dispute them.
For those those don't know, the MIB is yet another company that collects data on us to report to subscribers who want to know about your health care history.
You gave them permission to use that information when you signed the patient information form at the doctors office in order to get treatment.
RIP America
July 4, 1776 - September 11, 2001
I know doctors and you, sir, are no doctor.
So it's reasonable to criticize medical studies AND they realize that peer-review is, well, not so good AND they point out that erroneous conclusions persist....
Good thing AGW has avoided all that.
No brain, no pain.
Why I don't doubt that some good critical thinking, and legitimate questioning come from these meta-research studies, I fear that the process is ripe for abuse, as basically being so awash in data (information overload) that given enough data you can pick and choose to fit your a priori or posteriori hypothesis.
I applaud the increased scrutiny of statistical analysis, which is truly difficult to administer on even the best designed and controlled biological and medical studies, where you have very little "total control" of the experimental subjects - damn ethics committees on testing human subjects, and using double blind testing is the best you can do to eliminate bias, yet may mask discovery of experimental flaws during the testing phase. Things go "wonky" in strange ways, for example testing a heart medication, and a freak snowstorm skews all the results because of the rise of heart attacks from the increase in shovelling. We can't legally put 1000s of humans in vats for 10-20 years to test everything, and computational models are primitive and only address what the model is designed to look for, while most medical testing focuses on the unexpected results and effects that may only appear in a small fraction of society, yet if the consequences are dire, it can kill an entire potentially life-saving product.
I fear that the "undergrad social science" approach of meta-study research will make the approach stained with a reputation of people who want to "do science", but without the messy get-your-hands-dirty that costs money (an increasingly mythical subatomic particle in most fields of science and labs around the world) and just do a PR-style re-spin (think: re-branding) of the results of multiple similar but different experiments to reach a conclusion that was not considered by the original experimenters, so whom may not include appropriate experimental controls to minimize draw incorrect conclusions from this re-interpretation of the experimental data. Of if they are really lazy (like social science elective takers), draw conclusions from a compilation of results, and not even bother looking at the original (raw or filtered) data at all. I guess I'm trying to say that there is limited latitude for re-interpreting data for anything beyond what the experiment was designed to test. It can be very useful for detecting and thwarting bad or biased experiments, but as far as I know, it cannot produce trustworthy results from bad experiments.
you could fuck a chiropractor tho, just to be safe
And exactly how are we to determine wether homeopathy or prayer doesn't work as well as the results found in medical journals / studies, if they are all flawed and biased in different sorts of ways.
I am glad I am not the only one who sighs every morning when reading a newspaper about some study claiming all sorts of stupid "facts" we:
A) already know about, ie. common sense. Example: Your hygiene may affect how many mating partners you may get, or some other ridiculously subjective and unnecessary study. Just an example pulled up from the air, but in today's media, not entirely unlikely.
B) can find no direct proof of causation, ie. correlation != causation. Example: Teenage pregnancy and video games. Study shows correlation, but if you give these "researchers" the task to find correlation between weather climate in Dakhar and teenage pregnancies in USA, their statistical short-curcuiting will "prove" correlations there also, and present it like it is a significant causation. Especially if you don't reveal where their datasets really come from... (just a hint)
C) find littered with known prejudices, political biases and limited understanding, ie. bias. Example: Global cooling, global warming. One decade the first is the Truth And Only Truth, then another decade the latter one is the Truth And Only Truth.
Now I'm NOT saying all these studies are garbage, or that we can't derive anything meaningful from them. However, they are misrepresented in media, and when funding them, blown out of proportion and usually fails the "common sense check", ie. your reality check.
So when the quality of science today is so low, how can we REALLY know that prayer doesn't work (btw, lots of studies show that prayer DO work in many cases, ie. as a placebo effect or something similar), or homeopathy? If you're gonna present something "better" than existing cures, then you gotsa make sure the science is there, or your just falling into the same trap as we've fallen in for the last thousands of years of authorities making bad decision based on flawed data.
My personal opinion is that whatever works the best for you, will work. Western medicine is mostly based on herbalism, and works for fixing immediate damages to the body. While, sports, yoga, meditation, prayer, healing, good friends, smiles, laughter, will do wonders to prevent later ailments and make life more enjoyable.
What I find despicable, is people offering healing for dying patients, when there is no proof to support the cure, especially when offering money, which is illegal. However, other than that I think people should take responsibility for their own actions, and have freedom to choose what works the best for them.
Why not combine the best methods, or let people decide for themselves, and stop playing games once and for all?
http://www.debunkingskeptics.com/
Alright, I'm going to stop trusting scientific studies - starting with this one.
or else!
anyone with a pre-school education could do it. just look around you, like they do.
the corepirate nazi holycost (life, liberty etc...) is increasing by the minute. you call this 'weather'?
continue to add immeasurable amounts of MISinformation, rhetoric & fluff, & there you have IT? that's US? thou shalt not... oh forget it. fake weather (censored?), fake money, fake god(s), what's next? fake ?aliens? ahhaha. seeing as we (have been told that) came from monkeys, the only possible clue we would have to anything being out of order, we would get from the weather. that, & all the other monkeys tipping over/exploding around US.
the search continues; on any search engine
weather+manipulation
bush+cheney+wolfowitz+rumsfeld+wmd+oil+freemason+blair+obama+weather+authors
meanwhile (as it may take a while longer to finish wrecking this place); the corepirate nazi illuminati (remember, (we have been told) we came from monkeys, & 'they' believe they DIDN'T), continues to demand that we learn to live on less/nothing while they continue to consume/waste/destroy immeasurable amounts of stuff/life, & feast on nubile virgins while worshipping themselves (& evile in general (baal to be exact)). they're always hunting that patch of red on almost everyones' neck. if they cannot find yours (greed, fear ego etc...) then you can go starve. that's their (slippery/slimy) 'platform' now. see also: http://en.wikipedia.org/wiki/Antisocial_personality_disorder
never a better time to consult with/trust in our creators. the lights are coming up rapidly all over now. see you there?
greed, fear & ego (in any order) are unprecedented evile's primary weapons. those, along with deception & coercion, helps most of us remain (unwittingly?) dependent on its' life0cidal hired goons' agenda. most of our dwindling resources are being squandered on the 'wars', & continuation of the billionerrors stock markup FraUD/pyramid schemes. nobody ever mentions the real long term costs of those debacles in both life & any notion of prosperity for us, or our children. not to mention the abuse of the consciences of those of us who still have one, & the terminal damage to our atmosphere/planet (see also: manufactured 'weather', hot etc...). see you on the other side of it? the lights are coming up all over now. the fairytail is winding down now. let your conscience be your guide. you can be more helpful than you might have imagined. we now have some choices. meanwhile; don't forget to get a little more oxygen on your brain, & look up in the sky from time to time, starting early in the day. there's lots going on up there.
"The current rate of extinction is around 10 to 100 times the usual background level, and has been elevated above the background level since the Pleistocene. The current extinction rate is more rapid than in any other extinction event in earth history, and 50% of species could be extinct by the end of this century. While the role of humans is unclear in the longer-term extinction pattern, it is clear that factors such as deforestation, habitat destruction, hunting, the introduction of non-native species, pollution and climate change have reduced biodiversity profoundly.' (wiki)
"I think the bottom line is, what kind of a world do you want to leave for your children," Andrew Smith, a professor in the Arizona State University School of Life Sciences, said in a telephone interview. "How impoverished we would be if we lost 25 percent of the world's mammals," said Smith, one of more than 100 co-authors of the report. "Within our lifetime hundreds of species could be lost as a result of our own actions, a frightening sign of what is happening to the ecosystems where they live," added Julia Marton-Lefevre, IUCN director general. "We must now set clear targets for the future to reverse this trend to ensure that our enduring legacy is not to wipe out many of our closest relatives."--
"The wealth of the universe is for me. Every thing is explicable and
This is a bit like finding out politicians lie during campaigns.
I will often ask new grad students in my lab to try and find a new journal article that will never be superceded by future research. This is, of course, a nearly impossible task. Scientific publications are all a work in progress and represent one group's current understanding of some experiment. In physics (my field), this is all a nice scholarly activity and something that everyone knows and understands at some level. Einstein corrected Newton and one day someone will correct Einstein. The point of all this is to get them to think for themselves; there's almost nothing more frustrating than being in a scientific argument with someone who treats published papers like a fundamentalist Christian treats Bible verses. It's a bit scary to realize the same thing happens in medicine, but not surprising. The fundamental structure of how scientific careers are advanced will need to change if we want to change this behavior.
Homoeopathy. Heh. That's when you're just a little gay.
Actually, that should logically be when have the same problem as another person, but that's less funny.
If corporations are people, aren't stockholders guilty of slavery?
Ask any Chiropractor, Naturopath or Homoeopath and they will all tell you the same thing: MODERN MEDICINE IS POISON
That's when you turn to another chiropractor, naturopath or homeopath, and discover *oh shocks*, that they have a different opinion! Hell, some of them even works WITH a doctor, a hospital or physician!
The flaw is in our mind: Our prejudices and secret biases. We think we don't reveal them, but they are revealed in everything we speak and do, and it limits our understanding of reality as it really is, not like how we'd like it to be..
http://www.debunkingskeptics.com/
Gasp! Maybe the guys touting globalwarmingclimatechangeglobalclimatedisruption might want to step back from the terms "conclusive", "overwhelming", and "consensus".
Seriously though... Why is it that the /. crowd embraces the idea that the field of medical research can be corrupted by money and the peer review system rendered worthless by internal politics, and yet be unable to see the rampant fraud in the global climate science?
So when the quality of science today is so low, how can we REALLY know that prayer doesn't work (btw, lots of studies show that prayer DO work in many cases, ie. as a placebo effect or something similar), or homeopathy?
We can't prove a negative. Lots of studies funded by religious groups show that prayer does work in many cases. Lots of independent studies show that prayer has no effect whatsoever. Homeopathy studies have almost always shown no effect... one years old did show an effect, but you're going to get some that show effects by random chance occasionally. The placebo effect does not affect someone's illness, it affects how they feel about their illness. There is a big difference.
My personal opinion is that whatever works the best for you, will work. Western medicine is mostly based on herbalism, and works for fixing immediate damages to the body. While, sports, yoga, meditation, prayer, healing, good friends, smiles, laughter, will do wonders to prevent later ailments and make life more enjoyable.
All of those may make life more enjoyable... they do nothing to the actual disease in most cases though. Much as medical professionals would love to claim that a positive outlook helps, it doesn't. It's a myth to help the doctors and nurses with their jobs.
The problem isn't with medical research, it's with the popular media misinterpreting what medical studies say.
You can't do a meta-analysis without sufficient strength, yet you persist in taking our studies involving rare diseases, based upon diagnoses which are our BEST GUESS and applying them to everything.
A case study with 15 subjects and 15 age-matched controls can't be used as more than an INDICATOR of what MAY be happening.
A study describing one pathway can't be used to say that stopping this will cause things to change - most biological systems in humans have THREE biochemical pathways in use - a primary one that we probably found, a secondary one that is not very well documented in the literature, and a tertiary backup pathway evolutionarily inherited which is only brought back into use when you shut down the first two.
We say one thing. You interpret what we say incorrectly.
Now, get mild to moderate exercise, drink moderate amounts of red wine with your meals, eat a varied diet, and stop stressing out over things you have little or no control over.
You'll probably get killed crossing the street or taking a shower, anyway.
-- Tigger warning: This post may contain tiggers! --
It is rare for any medical journal to publish negative results, and yet that is precisely what we need to advance science.
Both positive results - and the failures that prove they were flawed. But journals only publish the former, not the latter.
-- Tigger warning: This post may contain tiggers! --
Religion has been betraying our trust for thousands of years. For recent examples, look at all the catholic priests fucking little boys, faith healers 'curing' diseases and televangelists taking people's money (well a lot more of it that churches normally do in any event).
geekoid is correct.
A)Sometimes the conclusions do not match the data. This rarely happens in proper qualified journals, but it does happen.
in addition, you need to read all the details that describe the data. They may apply only to specific conditions, not the general population. What works for someone with TB may be a bad idea for someone with Malaria, for example.
B) Understand what p value means and when it's significant.
Also, how randomized were the cases.
C) Understand blinding.
D) Understand sample size.
If the study doesn't have 250 or more with age-matched controls, it's not as useful. But studies like that are expensive.
E) people make mistakes, but that doesn't necessarily mean a study is wrong. In fact, very few times is any one flag mean the study is bad.
other than those cloning ones.
F) many things called studies, aren't really studies. Of course, he lumps anything the uses the word 'studies' into the same category. Effectively saying TV is just a valid of a place to get studies as is NEMJ.
There are a lot of published works based on people doing DRN for example, but the rigor for these is less than that of a doctoral thesis level study.
-- Tigger warning: This post may contain tiggers! --
We can't prove a negative. Lots of studies funded by religious groups show that prayer does work in many cases. Lots of independent studies show that prayer has no effect whatsoever
Are you sure, or do you just relabel those positive findings to be "religious" and negative findings to be "independent". Honestly, I can see anyting sponsored by a following will of course have a bias in their results, however, maybe the "independent" studies are flawed in some ways also, and therefore unable to repeat the experiments?
My point is, if quality is really as lackluster as many of us have suspected, we can't really conclude anything right now.
Homeopathy studies have almost always shown no effect... one years old did show an effect, but you're going to get some that show effects by random chance occasionally.
Right, I'll buy that. Have never tried homeopathy, but its a relative newcomer, and a bit suspect. It may not be anything beyond the "placebo effect".
The placebo effect does not affect someone's illness, it affects how they feel about their illness. There is a big difference.
Are you sure? Often, when one life-partner / spouse dies, the other is sure to follow, days or a few months afterward. Are you sure outlook on life is to be disregarded entirely? What is the basis of your findings, and do you find it practical in your own life?
I personally believe the "placebo effect" is heavily underrated in today's medical climate. When we "have nothing to live for", that itself can be a catalyst for further serious decline of health, in one form or many forms.
All of those may make life more enjoyable... they do nothing to the actual disease in most cases though. Much as medical professionals would love to claim that a positive outlook helps, it doesn't. It's a myth to help the doctors and nurses with their jobs.
But the doctors don't care about this. They only treat the symptoms, not the patient, or their lives. We don't really want them encroaching on our lives either. Then we go to a healer, a therapist, a priest, a friend, a mate, family, or someone else.
From where do you draw the conclusion that common sense is garbage and to be disregarded?
If someone is aggressive their whole life, will not their bloodpressure rise to abnormal levels? Don't we suffer, even serious illnesses, due to stress?
Why not see the patient as an entire human being with a life, thought-processes and environment, rather than just a check-list of symptoms?
http://www.debunkingskeptics.com/
Another problem with any medical study is that people rarely take the actual dosage of medication they report.
In fact, for many studies, we literally give you the dosage and watch you take it, for precisely that reason.
People frequently underreport other medications they are on, ignore herbal medications (which can interact), and are not very accurate in their estimations of actual behavior.
-- Tigger warning: This post may contain tiggers! --
Ask any Chiropractor, Naturopath or Homoeopath and they will all tell you the same thing: MODERN MEDICINE IS POISON
Ask any pharmacist and they will say the same. It's the whole point of modern medicine: You introduce a poison into the human body that is more effective at killing off certain germs than it is at causing damage to the human body. Or, in other cases, you introduce a poison in such low dosages that it counters something unwanted (such as high blood pressure) without causing more harm than good.
If you want to argue that introducing any poison in any dosage is bad I'll remind you that even tap water is lethal if ingested in sufficient quantities. Paracelsus had a point.
USE HOT GRITS WITH STATUE OF NATALIE PORTMAN (NAKED AND PETRIFIED)
Exactly.
When we look at what works, we find the most effective drugs are the cheapest and oldest ones.
Aspirin for example. Still a wonder drug. Still reduces inflammation, which is a major risk factor for just about everything.
But it's cheap as heck.
So nobody makes money on that.
-- Tigger warning: This post may contain tiggers! --
A) Proper diet.
B) Exercise.
C) Regular Chiropractic Adjustments to keep your nerve function at peak performance.
a) No good doctor would ever recommend proper diet.
b) No good doctor would ever suggest exercise.
c) Unfortunately, the research data in chiropractics, homeopathy, naturopathy is far worse than medicine in every measurable and unmeasurable manner.
Yes, I agree with 2/3.
I've heard a lot of disgusted (perhaps accurate, perhaps not) complaints about how politicians (usually this complaint is aimed at Republicans, as in the book title "The Republican War on Science") have "cut money for basic, fundamental research -- the kind that benefits all of us." It's a slight paraphrase, and you might consider it a straw man, but I don't think these gripes are hard to find.
Meta studies like this are worth thinking about when someone says we need more "basic research" in any given area: it might be sincere, well-intentioned (or who knows, even perfectly accurate, in some platonic universe where "needs" could be accurately, objectively assessed and compared), but it might also mean that well-intentioned money would be spent on stuff that is very sciency, but not very helpful.
timothy
jrnl: http://tinyurl.com/c2l8yr / foes: http://tinyurl.com/ckjno5
If medical research were really as close-to-useless as The Fine Summary claims, we'd be hardly better off with modern Western medicine than with homeopathy and prayer.
Not so, since prayer is actually harmful!
Space game using normal deck of cards: http://BattleCards.org
we'd have cured cancer and aging, and we'd be able to engineer bacteria to cook dinner and take out the trash. The only problem is that we would be ruled by cyborg genius rats.
Doctors are notoriously bad at doing scientific investigations, and since peer review journals are reviewed by peers, they don't know bad science when they see it.
I've been arguing with my father about this for... what, fifteen years?!? He subscribes to the New England Journal of Medicine and is forever telling me about the latest study telling you to that standing on one leg reduces breast cancer in nuns. These studies are, without fail, trivial to eviscerate as their control groups are either non-existent or very poorly picked.
Doctors just don't know much about science. That shouldn't be surprising. They have terrible educations. After all, they studied premed in college and then went to a vocational school. MD/PhDs really ought to do better, but I suspect they do their doctoral work with faculty who come from the same under-educated group.
The problem is one of prestige. You cannot walk into a group of doctors and tell them why they're dumbasses and what to change. They know, and society confirms for them, that they are the best educated people on the planet and smarter than anyone else. "Heck, just look at our paychecks," they might respond. "That proves it right there, doesn't it? Figure it out from that data point only -- you don't need a control group."
The bigger issue is how to fix them.
The people are the problem.
One thing particularly bad about medical research is that everyone's a doctor. And they believe it. Any "doctor" can do research or just sign onto a ghost written study.
In academia, doctor generally means a PhD with a modicum of research training and in-depth knowledge of an area of research.
Medical Physicians are more artisans/mechanics than researcher, even down to the apprenticeship/internship. They are not trained to be researchers in medical school.
With everyone who has an MD believing they can do research, high quality research is drowned out by the tons of mediocre, bad, or downright misleading research.
What got me started thinking about this is a movement I heard about a few years ago:
Evidence-Based Medicine.
What? Doctors have to be convinced to follow evidence-based medicine? What were they practicing before? And why are they against it?
The idea that doctors are ALLOWED to prescribe drugs for off-label use horrifies me (it's off-label because there's no proof it works for the off-label condition).
So yeah, it's the people.
passetspike!
It's actually been known for an awfully long time that a rumor, once started, is impossible to call back.
This is something children used to learn in Sunday School.
I guess we need to be careful when we throw out all the false religion, not to through out the good stuff, too.
Computer memory is just fancy paper, CPUs just fancy pens with fancy erasers; the 'net is just a fancy backyard fence.
Bing drinking is bad for you.
erm, binge.
Anyway, I don't think binge drinking is in the same class of activities as consuming fats, unless you are trying to drag the topic from reasonable fat consumption to binge eating.
One of the problems with boh studies and meta-studies is the definition of reasonable. It seems to vary from person to person, whether you are talking about subjectively reasonable or objectively reasonable.
Computer memory is just fancy paper, CPUs just fancy pens with fancy erasers; the 'net is just a fancy backyard fence.
scientists and researchers themselves regard peer review as providing 'only a minimal assurance of quality'
The idea that "peer reviewed" means "correct", or that it even should mean that, is a misunderstanding of what peer review is about. When I review a paper, I don't check every last statement to make sure it's correct, work through their derivations in detail searching for errors, look up all their references to be sure they say exactly what the article says they do, etc. That's just not what peer review is about. Recommending an article for publication basically means the following:
1. The work described in it is likely to be interesting to other researchers.
2. The work seems to have been carried out reasonably competently.
3. The article describes it clearly enough so that readers can understand what was done.
Once it's published, lots of other people will analyze it much more carefully and try to reproduce the work. If they find errors or can't reproduce it, they in turn will publish that. Science is a conversation. Recommending an article for publication just means it deserves to be a part of that conversation.
"I'm too busy to research this and form an educated opinion, but I do have time to tell everyone my uninformed opinion."
Don't do either without doing your own research.
I recently read a book called "How Doctors Think" by a Hematologist associated with Harvard. He went around interviewing the top doctors in the country about their cognitive fuck-ups and triumphs.
Serendipitously, along the way, some doctors were more than honest with him about medical dogma, being lazy in keeping up with research and how drug company money/gifts influence medical opinions.
Spinal fusions have no proven clinical benefit for reducing pain. At all. It has been known for a long time, but financial interests keep that procedure being done.
Hormone replacement therapy has been proven to be potentially dangerous ( cancer ,etc ) but with negligible benefit. Aside from middle aged women & estrogen, I'm sure you noticed the new commercials trying to convince aging men to supplement with testosterone.
It is natural for testosterone levels to gradually decrease as men age. Testosterone levels fluctuate often and hard. If a doctor tells you that you have below normal testosterone asked to be tested again. Get off of the things that lower testosterone ( ie alcohol ) and do the natural things that boost like hard exercise ( lift weights ) for a few weeks. Then get tested again.
Of course the peer-review studies done for Global Warming are Perfect and never, ever wrong.
Hi this is my first time posting and I just can't be bothered to create an account. The statements that "all medical research is false" is a pretty hardcore assumption - but here's some research based on the original 2005 paper "Why Most Published Research Findings Are False" (Which is located at http://dx.doi.org/10.1371/journal.pmed.0020124 in case you readers, like me, have grown accustomed in having to find the sources on their own instead of the journalists supplying it in their articles) which shows that the mathematical model that Ioannidis has postulated and proven is simply wrong: http://www.bepress.com/jhubiostat/paper135/ , also published at http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0040168
tl;dr: Ionnaidis published a paper in 2005 and a journalist found it in 2010, yet is has been disproven in 2007
My comment on another article: http://slashdot.org/comments.pl?sid=1692444&cid=32644166
Basically, many researchers keep looking for a magic bullet they can patent, but overlook the basics they can't patent (like vegetables&fruits&legumes, exercise, sleep, meditation, humor, friendships, dogs, a clean environment, good work, peace of mind, etc.)
Examples:
http://www.vitamindcouncil.org/treatment.shtml
http://www.lewrockwell.com/sardi/sardi111.html
http://www.alternativeratreatments.com/eat-to-live.html
http://www.bluezones.com/makeover-about
http://books.google.com/books?id=bCuC2H-6k_8C
http://books.google.com/books?id=RKZreNYKNHQC
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.
In so many areas of scientific research, who is funding the study says more about the outcome and conclusions than almost anything else. So whether you're talking about climate change and greenhouse gases, whether it's safe to add more ethanol to our gasoline, whether certain products or procedures have medical benefit that outweighs the risks, or just about anything else, keep your eyes open, keep your mind open, and follow the money trail.
But timeless. This will still be relevant years from now because the goal of science is discover the unknown, based on known ideas and methods.
Anyways, here's the paper mentioned in the TFA (I was too impatient to read TFA, a journalist's take on a paper which suffers from the same problems it tries to expose):
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/
Ioannidis has a long history of publishing articles describing basic mistakes researchers make in understanding and reporting research. Although this titles of his articles have a sort of "the sky is falling" kind of quality, the contents of the articles are very level-headed. He certainly does not argue that science or scientific findings are in general worthless, only that there are things we should correct in scientific practice that would improve the situation markedly. In broad outline, no practicing scientist could possibly disagree, although of course the particulars are always up for debate. Although he covers some ground that others have as well, he seems to have made it a focus of his career, and writes more level-headedly than most.
Many of his articles are easily readable by non-specialists, and at least a few are available for free (see pubmed).
Slashdot can be hazardous to your health.
The day Microsoft creates a product that doesn't suck, it will be known as the Microsoft Vaccuum Cleaner!
If someone could genuinely tell me how I lost 40 lbs (190~200 down to 155~160) in Japan, then please do.
In Japan, diets consist almost exclusively on noodles, rice, various breaded and fried things, bread (so much bread), and vegetables. Meat is almost never a main course, it is nearly always a smaller thing, meant to bring about flavor, not to actually be the food itself.
In Japan, I could literally eat until I was burstingly full, but I would still lose weight. Virtually everyone that has ever gone to Japan from the US has similar stories.
So, my question to anyone who can answer (I genuinely want to know) is how did I lose all of that weight (I have kept off 30 of those 40 lbs for two years, now, in the US) while eating an almost excessively carb-diet. My only observations are: I rode a bike every day (not exercising, but for transportation); portion sizes were smaller; there is very little sugar, so much so that I, for the first time in my life, no longer got cravings for sugar if I hadn't had it in a long time (wonderful feeling, btw); Japanese are very serious about what is and as not in season -- fruits and vegetables are sold only when they're their freshest and in season; the amount of preservatives was exceedingly low compared to the US.
Obviously, riding a bike helps. I wasn't riding a marathon -- just to and from school -- but at least it's something. Smaller portion sizes go some of the way. But the amount of carbs that I ate is staggering by Western standards. Is the small amounts of exercise and reduced portion sizes more influential than the carbs? How did I (and everyone I know) lose so much weight?