Comments Off on TED Talk Highlight: What Doctors Don’t Know
Dr. Ben Goldacre joins us from TED to give a sobering look at the state of medical research, specifically the publication bias that journals have to push positive results, rather than negative. He starts with a story about a precognition study that *was* published, and how immediately ten more studies showed it to be erroneous and irreplacable. We expect that to happen with silly stories about precognition, but the problem as Goldacre describes is that we have exactly the same issue inmedicine, and in that environment, it costs lives.
When clinicians tried to replicate 53 different basic cancer science studies looking at potential treatment targets in cancer, and out of those 53 studies, they were only able to successfully replicate six. Digging further, it turns out dozens of other studies on the same drugs that didn’t show results were buried and left unpublished, giving the same effect as flipping a coin 50 times and not telling the mark that you haven’t reported all the times it came up tails, and then selling them a two-headed coin.
More terrifying is the research in lorcainide, an antiarrythmic drug intended for use in post-heart attack patients. When their 1980 research showed it was not a useful treatment, they buried the drug and moved on. Only, research into antiarrythmics continued – with disastrous results. Future Antiarrythmatic drugs were responsible for some 100,000 additional deaths in heart attack patients over the next 15 years, deaths that could have been prevented if the original lorcainide researchers had published their negative research showing that it was a poor treatment. In 1993, the researchers who did that 1980 study,published a mea culpa to the scientific community, where they said, “When we carried out our study in 1980, we thought that the increased death rate that occurred in the lorcainide group was an effect of chance.” The development of lorcainide was abandoned for commercial reasons, and this study was never published; it’s now a good example of publication bias.
The dangers keep tumbling forth from the sham research done on drugs like Reboxitine, where Dr. Goldacre did research it himself before prescribing it, and found 4 studies, 1 positive and 3 neutral, and chose to prescribe based on those results. Imagine his horror when he discovered there were six more studies, all negative, giving a much-less rosy view of Reboxitine.
Ironically, even after both the medical journal community and then the FDA itself instituted mandatory reporting of all studies and results, good or bad, a new study found that only half of the studies were reported properly, and 1 in four wasn’t reported at all. This lack of “negative reporting” is a clear and present danger, and the risks are growing ever-greater as more and more drugs are tested, without the proper reporting protocols.