Lies, Damned Lies, and Medical Science

One of the twitter feeds I subscribe to tweeted this yesterday. Turned out to be a great read so I thought I'd share it.

Lies, Damned Lies, and Medical Science

Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors—to a striking extent—still drawing upon misinformation in their everyday practice? Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science.

These few sentences are quite damning. It's sad state of affairs, however true it may be. I interviewed Jonny Bowden C.N.S. last year and he touched on the subject from a nutritional standpoint.... (I can't upload audio to ATS media for some reason...here it is transcribed)

At best, an MD will maybe keep up with the New England Journal of Medicine and JAMA, they don't read the American Journal of Clinical Nutrition, let alone some the little bit less known journals. They're not searching pub med for information. Look, I go to nutritional medicine conferences all the time and and it's always the same 300 Doctors at all of them. And there's over 100,000 doctors in America. The same 300 doctors show up to learn about nutrition. So the vast majority of them are just completely not aware of any of this.

More from the article...

Ioannidis laid out a detailed mathematical proof that, assuming modest levels of researcher bias, typically imperfect research techniques, and the well-known tendency to focus on exciting rather than highly plausible theories, researchers will come up with wrong findings most of the time. Simply put, if you’re attracted to ideas that have a good chance of being wrong, and if you’re motivated to prove them right, and if you have a little wiggle room in how you assemble the evidence, you’ll probably succeed in proving wrong theories right.

Selection Bias? Confirmation Bias? Whatever you want to call it....if you're looking for a specific outcome, you'll find it.

“Even when the evidence shows that a particular research idea is wrong, if you have thousands of scientists who have invested their careers in it, they’ll continue to publish papers on it,” he says. “It’s like an epidemic, in the sense that they’re infected with these wrong ideas, and they’re spreading it to other researchers through journals.”

Claude Bernard said it best...

It is through the experimental method that science is carried forward--not through uncritically accepting the authority of academic or scholastic sources. In the experimental method, observable reality is our only authority. Bernard writes with scientific fervor:

”When we meet a fact which contradicts a prevailing theory, we must accept the fact and abandon the theory, even when the theory is supported by great names and generally accepted”[5]

Enjoy ....

This is good stuff!

I always compare confirmation bias with being in a crappy relationship. Think about it. You form your own facts when you are in an abusive relationship. You fool yourself into believing obvious lies:

"He wont hit me again"

"She wouldnt ever cheat on me again"

"He promised he would get a job".


9 times out of 10...if you have thought these things, you were wrong, were'nt you?

Same with a subject/experiment/research project you have a passionate feeling for. If you are burning with the desire to prove that sodium is good for human consumption in mass quantities (just an example) then you will do everything you can to prove your point...without being objective whatsoever.

The normal person seems to think that scientists, and doctors are somehow so much more advanced, that making mistakes is almost..."too human" of them. Therefore, most people believe whatever a person with higher learning believes.

BUt think about this....doctors once thought that there were healthy benefits from smoking cigarettes. They once thought that a woman with good intuition is a "witch"....

They are as fallible as we..

The sad thing is, researchers do this unwittingly. It's too easy to look at observational evidence and find the data that supports your hypothesis. It's similar to using google as a research tool.

I'm in agreement with you, that many physicians as well as researchers are playing a game of will it or won't it work with certain patients. The field of Oncology is one of those. Proven facts/theories always seem to follow by the wayside if that fact or theory could "cure" the patient. Better to keep them "sick" we'll make more money.

Not surprised to see that only 300 of the same doctors are interested in nutrition and show up at the conference year after year. Most doctors will refer you to a nutritionist rather than give you any info...not only because they don't know, but because their buddies in that field need the referrals and the money.

Notice the trend here, as if I need to say what it is?

Personal preference is homeopathic and natural remedies...but heaven forbid you suggest it to an aleopathic (sp) that you use a mixture of both kinds of medicine....and they become very irate. Been there.

Observation tells me that the money is what most physicians are in the business for, not the Hippocratic oath. Sadly those that are don't advertise it.

~holly

reply to post by Holly N.R.A.


That's pretty harsh to say all doctors are in it for the money. In fact, that's pretty ridiculous.

As a researcher, however, if you can't get funding...you don't have a job.

This Dr Oiannidis is pretty smart calm and collect, has a really good work ethic when it comes to being wrong and refocusing on facts and moving on. Just finished watching over 2 hours of interviews with him, here's one for anyone interested