If the barrage of conflicting medical information has left you skeptical about clinical research, then you're on the right track. According to David H. Freedman, in his article for the November 2010 issue of Atlantic magazine "Lies, Damned Lies, and Medical Science", much of the research on the drugs we are prescribed, the supplements we are told to swallow, even the so-called healthy diets we are advised to follow are likely to be wrong.
Fortunately, a new brand of research is on the horizon and may help light the way out of the dark-ages of modern medical research. Meta-research scientists have been studying the studies that we have been sold as "truth".
Can Evidence-Based Medicine Change the Face of Clinical Research?
Meta-research emerged two decades ago when the Cochrane Collaboration was formed; a non-profit group of international scientists whose mission was to study the prevailing research. Challenging the medical status-quo at the time was a paradigm-busting undertaking. It still is. The British medical journal The Lancet, has hailed the Cochrane Collaboration as ". . . an enterprise that rivals the Human Genome Project in its potential implications for modern medicine".
Around the same time, according to Freedman, a young Harvard physician and researcher Dr. John Ioannidis, was also noticing that something was amiss. Physicians were prescribing treatments built on clinical trials that were flimsy at best. What he found would end up dictating a new direction for his career in what was then the new field of "evidence-based medicine".
Medical Research on Supplements, Antidepressants, Even Weight-Loss on the Chopping Block
Today, Ioannidis is a leader in the field of meta-analysis and his findings--along with those of the Cochrane Collaboration--are upending the world of clinical research. Ioannidis states flatly that up to 90 percent of all published medical research--everything from vitamin supplements to diets, to popular medical procedures--is flawed or just plain wrong. Here are just a few of the entrenched research studies he has challenged:
- Vitamin E for heart health and the prevention of heart disease.
- Anti-depressants as an effective treatment of depression.
- An Aspirin a day recommended for the prevention of strokes.
- Overweight linked to ill-health and early mortality.
The Cochrane Collaboration adds these to the list of failed studies:
- Breast self-exams as effective in the prevention of breast-cancer.
- Anti-oxidant supplements to prevent ill-health and extend life.
- Green tea for the prevention of cancer.
On the plus side the CC found that:
- The supplement 5-HTP has been shown to increase serotonin levels (a brain hormone important in alleviating depression).
- Probiotics have shown promise in the treatment of ulcerative colitis.
It is reassuring to know that some clinical research has yet to fail the test of rigorous review. However, the numbers of studies that fail under re-examination is alarming. The seeming glut of misinformation out there begs the question, what the heck is going on?
The Root of Faulty Clinical Research
Data is apparently much more malleable than it would seem. That a less-than-scrupulous corporate researcher might play slight-of-hand in order to game the system is not particularly surprising. More surprising is that honest, well intentioned researchers, end up fudging-the-facts as well. How does this happen?
For Ioannidis, the answer is found within the system itself and the symbiotic relationship between a success-hungry academia and a media addicted to breakthrough headlines. In the academic world where funding is everything and failure isn't funded (and may even herald the end of a hard-won or brilliant career) the pressure to fluff the evidence is huge. Failure, a once valuable component of the clinical process, has no place in medical research today. Publish or perish, succeed or succumb, these are the choices.
Taking Our Healthcare into Our Own Hands, Free Access to Health Information
What can be done? Is there any course of action available other than passively offering up our health (and perhaps our lives) to the latest fad in clinical research? Just ignoring the media stream of studies (as Ioannidis recommends in Freedman's article) may not be practical for those with chronic or life-threatening illnesses. How are we to make sense of the onslaught of conflicting information? Self-education offers some hope. The Cochrane Collaboration's online library offers the public a free resource and access to all of its latest studies. The findings are summarized for the public in "plain language" that won't make your head spin.
Sources
David H. Freeman, "Lies, Damned Lies, and Medical Science", Atlantic, November, 2010.
Maia Szalavitz, "A Researcher's Claim: 90% of Medical Research Is Wrong", Time, October 20,.2010
Catherine Guthrie, "Do Breast Self-Exams Do any Good? Time, July, 2008.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
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