Monday, November 29, 2010

Lies, Damned Lies, Statistics, Studies & Science - making it hard to not call it all hokum.

I first remember reading something along these lines way back in Robert Anton Wilson's The New Inquisition - something to the effect that only about 40% [don't quote me, shooting from memory and impression here] of all recommended modes of therapy from MDs were actually supported by peer reviewed double blind placebo controlled studies.  The rest of the time they were just using medical "common sense."  Which struck me as no more commonsensical than normal "common sense" - which is rarely either.  When you read about Ioannidis' work debunking what passes as medical and scientific research, you run the risk of going too far around the bend.  It's certainly important to not make a god of science, or your opinion of what science is, but when you take it too far then you're potentially turning your back on centuries of progress.  Still, for the process of science to mean anything at all, it needs to be subject to every variety of examination and every attempt to poke holes in it.  That's the only thing that separates the concept of science from every other form of dogmatic belief.

Much more at the link, all interesting.

Lies, Damned Lies, and Medical Science - Magazine - The Atlantic:
"Ioannidis, who had mostly been listening, delivered what felt like a coup de grâce: wasn’t it possible, he asked, that drug companies were carefully selecting the topics of their studies—for example, comparing their new drugs against those already known to be inferior to others on the market—so that they were ahead of the game even before the data juggling began? “Maybe sometimes it’s the questions that are biased, not the answers,” he said, flashing a friendly smile. Everyone nodded. Though the results of drug studies often make newspaper headlines, you have to wonder whether they prove anything at all. Indeed, given the breadth of the potential problems raised at the meeting, can any medical-research studies be trusted?

That question has been central to Ioannidis’s career. He’s what’s known as a meta-researcher, and he’s become one of the world’s foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field’s top journals, where it is heavily cited; and he is a big draw at conferences...
...rates of wrongness roughly corresponding to the observed rates at which findings were later convincingly refuted: 80 percent of non-randomized studies (by far the most common type) turn out to be wrong, as do 25 percent of supposedly gold-standard randomized trials, and as much as 10 percent of the platinum-standard large randomized trials. The article spelled out his belief that researchers were frequently manipulating data analyses, chasing career-advancing findings rather than good science, and even using the peer-review process—in which journals ask researchers to help decide which studies to publish—to suppress opposing views."

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