We all like good news. It is human nature. But not all news is good. This fact does not mean we can simply ignore it, tempting as that may be. In fact, it is often the case that we learn more when things go wrong.
So, you might think that in medical science findings which do not support your hypothesis are as important as those that do not. The whole idea of scientific inquiry is to test ideas and see whether they are correct. There is supposed to be a neutrality about the scientific process.
It has emerged that as much as 50% of medical research may go unpublished. As authors Paul Glasziou and Iain Chalmers point out on the BMJ if half of posted mail did not arrive there would be outrage, but this loss of 50% of research barely raises an eyebrow. Quite aside from the fact that results which are not what was expected, or wanted, being of equal significance to positive findings, the cost of these missing studies was estimated at $180 billion per year.
We are constantly hearing that medical research is underfunded. When this much money can be wasted, there is hardly a lack of dollars. I should point out that roughly a decade ago it became a requirement for publication in many medical journals that a trial be registered at the start. Previously there was no way of tracking if a study had actually been done. However, this seems to have done little to get papers published if the results are “inconvenient”.
It gets worse. Even studies which are published may not be verifiable. According to the Incidental economist “A few years back, scientists at the biotechnology company Amgen set out to replicate 53 landmark studies that argued for new approaches to treat cancers using both existing and new molecules. They were able to replicate the findings of the original research only 11 percent of the time.
Science has a reproducibility problem. And the ramifications are widespread.
These 53 papers were published in high-profile journals, and the 21 that were published in the highest-impact journals were cited an average of 231 times in subsequent work”.
Papers which have a positive result are then used in other studies as supporting evidence and can influence medical practice and health policy. That the results are subsequently not verified can also be completely overlooked.
Another aspect to this is when flawed studies which produce the “right” result get promoted and publicised. The Washington Post noted that media organisations were often uncritical of dodgy research. The authors said “…we’re concerned that breathless reporting on bad science can result in costly, ineffective and even harmful national policies”.
There are many examples of this but the best one is my favourite chestnut about low fat diets. The original work of Ancel Keyes was flawed due to massaging data to suit his hypothesis on cholesterol and heart disease. This was compounded by work in the 1970’s where studies showed a decrease in cholesterol with a low at diet, but overlooked that deaths increased. Publicity ensued, government got involved, low fat diets were recommended as healthy and the rest is history.
Fast forward and just last week it was confirmed that since 1980 (roughly the time that low fat diets started) obesity has significantly increased. Whilst correlation may not equal causation we know that insulin promotes fat storage and inhibits fat burning. It is released in response to carbohydrate and in turn the dietary guidelines have been for high carbohydrate and low-fat intake.
People can get it wrong. We once believed the earth was flat. But persisting when the evidence is clear is harder to understand. There is no evidence whatsoever to show that saturated fats in the diet are a problem. Yet the American Heart Association (and similar bodies worldwide) continues to promote a diet low in saturated fat.
The combination of missing data and dodgy research practices coupled with spin and governments blundering is a major problem. Once an idea in health becomes accepted it is difficult to change. Those who question orthodoxy risk being shut down and even persecuted. Yet it is easy to forget how what we believe today came to be accepted.
When the basis for our beliefs and policies are flawed we have a problem. Houston, can you hear us?
Dr Joe Kosterich MBBS is an author, speaker, media presenter and health industry consultant, who wants you to be healthy and get the most out of life. Dr Joe also gives practical, motivational health talks for the general public and organisations where he is known as “An independent doctor who talks about health”. His latest book “60 minutes to Better Health” is available on Amazon.