Why Much of Medical Literature is Wrong

hi doxie - I think the link is asking for a password. You might check it. The article sounds interesting though.

Yes, this is valuable information for the public. It is very important for the general public to learn critical thinking. (Not that I do critical thinking well.)



However, I think the title misrepresents a big section of the problem.
'Why Much of the Medical Literature Is Wrong' I do not think that 'much
of the medical literature is wrong'.



Yes, I think that specific authors, papers, and methods can be flawed. I
am NOT NOT NOT trying to excuse bad science. I think that eventually,
over time, science gets things right, or at least better. It may take
centuries to get things right. Eventually it is self correcting.

But, did you realize the current state of independent biomedical grants? In this paper (Mar 2014)



"Today, the resources

available to the NIH are estimated to be at

least 25% less in constant dollars than they

were in 2003.)



"Now that the percentage of NIH grant

applications that can be funded has fallen

from around 30% into the low teens, bio-

medical scientists are spending far too much

of their time writing and revising grant applications and far too little thinking about

science and conducting experiments.



"the average age

at which PhD recipients assume their first

tenure-track job is 37 y, and they are ap-

proaching 42 y when they are awarded their

first NIH grant.



" As competition for jobs and promo-

tions increases, the inflated value given to

publishing in a small number of so-called

“high impact”journals has put pressure on

authors to rush into print, cut corners, ex-

aggerate their findings, and overstate the

significance of their work. Such publication

practices, abetted by the hypercompetitive

grant system and job market, are changing

the atmosphere in many laboratories in dis-

turbing ways. The recent worrisome reports

of substantial numbers of research pub-

lications whose results cannot be replicated

are likely symptoms of today’s highly pres-

sured environment for research (4–6). If

through sloppiness, error, or exaggeration,

the scientific community loses the public’s

trust in the integrity of its work, it cannot

expect to maintain public support for science



http://www.pnas.org/content/111/16/5773.full.pdf+html



When you are an academic biomedical scientist, and you don't get a
grant, essentially, you don't get a paycheck, unless you can get funded under someone else's funding.   If <20% of biomedical grants are funded,
that means that about 80% of the scientists who apply for an NIH grant
do not get a grant. This means, at least for the vast majority of them,
they get to find another career.   Article reviewers say they get to decide whose career they get to end.

How would you like to face this kind of competition every year to few years for this kind of job security?  Is this the way to attract the best and brightest?



I am NOT NOT NOT excusing bad science.



Critical thinking, such as outlined in the medscape paper, are essential
to learning more. I am NOT trying to excuse the mistakes that papers
make. I had no idea about the current biomedical research situation
until I started listening to podcasts such as This Week in Virology,
which also mentioned this PNAS paper.



This year, I tried to donate a chunk of my yearly charitable contribution to basic biomedical research.

My son is in biomedical engineering...he tells me that the brightest ones get sick of the crap and move into development, which is where the industry is heading...like the watch that monitors your bio-activity, or shirts that tell you your heartrate and will eventually be worn to diagnose and communicate info realtime to your doctor.

And one  of my dearest friends oversees clinical trial development for a Big Pharma - A former Harvard professor of Biostatistics. They moved their operation overseas for lots of the same reasons. Anytime I freak out over a current trial result online, he researches the study then shows me why the study is probably flawed, and most seem to be. If you look really hard into who designed the trial, often they have interests involved somehow. Thought usually not disclosed properly. Just because something is a published result doesn't mean a whole lot to me anymore. Keeping my grains of salt handy.

From the article by Kwame Boadi (which kayb was kind enough to post a link to): I would subtitle "Even Science Writers Can Be Wrong"!  

 ...And 21 years elapsed between the key enabling discovery for the ovarian cancer drug Nolvadex and its introduction to the market.... [emphasis added - indication was always for BC]

He's referring to tamoxifen and the fact that it was initially synthesized in an effort to produce an anti-estrogen birth control pill in England. It was through the personal conviction of Craig Jordan who came to the University of Wisconsin and was able to prove efficacy as a receptor blocker that this miracle medication was made available. There's your history lesson of the week.

The rest of the analysis is pretty good. I know a person who just got hired to help oversee the distribution of research dollars. Otherwise, there can be multiple teams trying to do the same thing,