Everything they tell you is wrong

[firecat]

http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269/

Ioannidis...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....Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.

The article is infuriating because it uses the same kinds of exaggeration that it's criticizing. ("one large randomized controlled trial even proved that secret prayer by unknown parties can save the lives of heart-surgery patients, while another proved that secret prayer can harm them." Um...I believe that individual scientific studies themselves don't pretend to "prove" anything?)

But I do agree with the point that, due to biases and pressures built into the system, the results of medical research are not reliable.

Comments

[lorres]

I think there's also probably a breakdown in medical practice as it relates to the research. If a doctor has read x study or x studies indicating that a certain treatment ends in positive results for certain symptoms, the doctor may be good or less good at judging whether the case in hand is a case that would probably be treatable in the same way the study(ies) indicate.

In my mind there's more work to be done in medical practice - how to use research knowledge that is come by in carefully controlled experiments in the treatment of real humans that are not statistically abstracted entities but individuals of complex mind/body being. And of course I believe that nasty side effects are way too often ignored by both researchers and practitioners.

[flarenut]

My favorite on the side effect thing was a study someone did (a drug company, but even so) on the relative experiences of doctors and patients regarding migraine treatment. Patients who thought their doctor wasn't listening to their descriptions of side effects or effectiveness would stop going to that doctor. Doctors whose patients stopped coming to them would figure that the patient's problem had gone away.