Stats
Dishonesty in medical research (September 15, 2005).
Category: Fraud in research
Roy Poses, a regular contributor to the email discussion group Evidence Based Health wrote
a provocative email pointing out the manipulation of research, ghost-writing, and suppression
of research that is being done to support the marketing of unsafe and/or ineffective drugs.
Some of the web links that Dr. Poses included are quite interesting.
He then goes on to wonder if this dishonesty invalidates the evidence based medicine
process.
Physicians may no longer trust the EBM process to find an approximation of the
truth in the face of purposeful manipulation of the evidence by vested interests
There's no easy answer to this. One positive thing is that one of the most powerful tools
in the arsenal of EBM, the systematic review, is the tool that has been used to uncover much
of the dishonesty in research. So you could argue that we would be a lot worse off if we
didn't have EBM, because we wouldn't even know we were being deceived.
Another thing to remember is that a lot of research being done has no vested commercial
interests. The big drug trials get all the attention, but there is a lot more to the practice
of medicine than just prescribing drugs. I'm not a doctor, but I suspect that most of the
things that you do to help your patients get better don't involve a pill. Do we disregard all
of the non-pharmaceutical research just because the research on drugs is possibly tainted?
And you also might want to read a counterpoint to all the criticisms about pharmaceutical
statistics that was written by Stephen Senn.
We have to be careful not to throw out the baby with the bathwater. A lot of good work is
done by people with a commercial interest in the outcome. You just have to make sure that the
appropriate safeguards are in place. Research done by people with a commercial interest in
the outcome is like observational research. Some of it is done badly and some of it is done
quite well. The trick is to recognize which is which.
In spite of all this, I do share some of the pessimism of Dr. Poses. There's a lot of
funny stuff going on behind the scenes and it is almost impossible for us outsiders to
uncover the truth.
07/08/2008.
