In 2005, Professor John Ioannidis published two papers that challenged the foundations of medical science, stating that many medical studies form unfounded conclusions or have exaggerated claims. He charges that 90% of published medical information is flawed. This is a cause for concern, because doctors are using these misleading studies as the basis for how they treat their patients. Overly positive results for the efficacy of drugs or surgical procedures can cause doctors to prescribe drugs or recommend treatments that not only not benefit, but also cause harm to the patient. Indeed, as researchers compete to secure research funding and get their results published in journals, some would skew their results in subtle ways to make their new techniques seem more promising than they actually are.
Interestingly, doctors are not surprised at his findings. We should be relieved at this observation, since we would expect that doctors who are skeptical of research findings in journals would be more prudent in recommending new treatment or prescribing new drugs. However, Ioannidis found that even findings that are highly-influential and well-regarded among the medical community are not usually reviewed, and the findings are occasionally overturned when other researchers attempt to verify the results. The influence of flawed medical research even extends to common wisdom regarding health. This means that even if doctors are skeptical, the public can still be harmed by the misleading results.
However, researchers who have done research similar to Ioannidis’ are concerned that telling the public about the findings of their research would draw the public away from conventional medicine. The conventional medicine community is already struggling to draw the public away from homeopathy, alternative therapy and internet self-diagnosis - treatments that are not based on reliable studies and are likely delay treatment. If such studies were to be released to the public, it might further draw them towards what is harmful to them. I find this line of reasoning to be troubling, because it indicates an unfounded bias towards conventional medicine. Science counts on the peer review system to separate the wheat from the chaff. But if the peer-review system is currently not working to make the findings from medical science reliable, why should people still believe that knowledge that comes from the medical research community is still somehow superior to alternative medicine? As Ioannidis himself states, “If we don’t tell the public about these problems, then we’re no better than nonscientists who falsely claim they can heal.”
It is a discomforting thought that despite all the support that has been given to the medical research community, most of what are published would not have much impact on public health, and some of them may even be harmful. Perhaps we should lower our expectations for medical science, and remain skeptical of their findings.
1 comment:
We live in an age of increasingly globalized communication, but with this immense privilege comes the responsibility to deal with the increase of disease permeating our now-connected societies. I agree with you that, obviously, we should push for a more reliable medical research system, but I do not agree with your allegation that a bias towards conventional medicine could be “unfounded”. Conventional medicine, even taking into account the problems in its peer-review system, is a fundamental cornerstone of an educated and responsible society. It is arguably the institution based on the scientific method most important to the survival of our species. Therefore, it is imperative that we do not even consider any resemblance between “medical” medicine and pseudoscience. In order to carry out our responsibility to the health of the global community, we must embrace this empirical system tightly, especially as we combat the extreme diseases of our day, such as cancer, AIDS, SARS, etc. By saying that it is illogical to have faith in conventional medicine, you are opening a can of worms that had best remain shut. In the end, this is the most logical and responsible way to find cures for the plagues of our time, and thus we must quickly condemn only pseudosciences lest we risk the condemnation of us all.
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