Has SCI publishing really benefitted the masses from medical research? The cat is out of the back recently according to a report presented by Dr. John Ioannidis on how medical ethics are grossly compromised in the last century. Medical research results are manipulated to favor the sponsoring pharmaceutical companies, which raises the most important question: do lives of the common man don’t matter at all to the government and state agencies?
Clinical Trials sponsored by pharma companies cause conflict of interest
In the clinical trials sponsored by drug companies, the clinical outcome is NOT measured in terms of “survival v/s death” but it only lays emphasis on symptoms reported by subjects, such as “chest pain,” “fever,” “vomiting,” etc. While reporting improvements in the conditions of patients, research studies do not exactly explain whether the administered drug had an effect on the condition of the patient. In other words, statistical analyses are not conducted to reflect whether the novel drug discovery indeed produces prognostic effect that is more than marginal.
All these findings were reported by Georgia Salanti, a biostatistician assisting Prof. John Ioannidis who practices and teaches at the medical school affiliated with the University of Ioannidis. How did drug companies so successfully manage to introduce their novel drugs with successful clinical trial results? What was the secret code of their magic formula?
Manipulations begin NOT just at statistical analyses but AT experimental study design
Even before data crunching and statistical analyses are implemented, drug companies carefully choose their hypothesis. For example, the experimental study design is such that their novel drug is pitted against drugs that have been proven to be less effective in previous studies. Yet again, questions in the analyses directly introduce the biases, not answers, said Prof. Ioannidis. The moot point now is—can medical research studies really be trusted?
How has Prof. Ioannidis grappled with this topic throughout his career in medical research? Well, he is the one who specializes in conducting meta-analysis of research studies. His expertise in these kinds of work has made him a global name in medical research.
Physicians providing misleading advice to patients thanks to these studies
Much of the results reported by biomedical scientists in their published work are falsely fabricated to suit the needs of the sponsoring agencies. All these studies provide misleading information to the physician, and most physicians are really aware of the drug lobby, most possibly hand-in-glove with these commercial agencies.
So, there may be cases where the patient had simply a normal chest pain but had to undergo angioplasty as the physician diagnosed it as myocardial infarction (heart attack). There may also be instances where a simple medication could have cured your annual flu attack, but the physician prescribed expensive antibiotics to handle the case. According to the noted meta-researcher Prof. Ioannidis, almost 90% of the results published in medical journals is either misleading or simply amplified to suit the drug lobby.
Prof. Ioannidis, a noted medical researcher with expertise in meta-analyses
What are the real credentials of Prof. Ioannidis in the medical research community? His findings have mostly been published and highly cited in the most noted medical journals. In fact, he is a leading speaker at various medical conferences all over the world. Nevertheless, medical ethics have so rampantly been tampered in these studies that the results are mere embellishments and not innovations: the “conflict of interest” term is simply coined to enter medical journals, with the fact being that most studies do have conflict of interest as they were sponsored by pharma companies: commercial establishments.
Prof. Ioannidis first came across rampant malpractices in research studies as early as 1990s while working as a young medical researcher at the prestigious Harvard Medical School, USA. In that era, studies focusing on rare diseases had limited data from previous studies. Most medical researchers preferred the rule of thumb rather than performing statistical analyses. However, most medical researchers investigating common diseases, such as cancer, diabetes, heart illness, etc. also followed the same principle. The “hard data” illustrating the probability of “survival v/s death” should be actually used to govern their medical diagnosis of patients. However, this data was actually NOT reported in most studies.
A novel arena of “evidence based research” was looking promising to young researchers in the 1900s. Prof. Ioannidis also joined the fray of young researchers. Thus, he worked at the following prestigious medical institutions: Tufts University, John Hopkins University, and the National Institute of Health. Although he was a math-genius in school in Greece, Prof. Ioannidis decided to emulate his illustrious parents, who themselves were renowned medical researchers. The “contradictory results” in medical research studies is not an uncommon phenomenon. For example, recent studies have proved that mammographs, colonoscopies, and PSA tests are not really useful in detecting cancer, unlike studies in previous era that reported otherwise. Furthermore, the efficacy of anti-depressant drugs like Prozac was questioned in recent research studies as their efficacy was not more than that of a placebo. In the previous era, most doctors recommended constantly replenishing your body with fluids during intense workouts: the current lot of medical researchers is questioning the health-outcomes of this advice.
Prof. Ioannidis is today spell-bound at how peer reviewed studies employing “randomized clinical trials” are producing absolutely antagonistic results: a case in point is whether the extensive use of cell phones causes brain cancer. Thus, “randomized clinical trial,” previously considered as a gold-standard of medical research, is today being questioned for its accuracy in producing reproducible results in independent research studies.
Plausible causes for studies with antagonistic results on the same topic
So, how are so many studies on the same topic or condition coming up with conflicting results? The answer lied in the errors introduced by researchers at various levels: i) the questions that were evaluated by researchers examining the subjects; ii) the study design used to handle an objective; iii) the inclusive criteria laid down for the subjects; iv) the various medical parameters that were examined during the study; v) the statistical tests used for data analyses; vi) the reported results in these studies, and finally vii) the publication of these studies in medical journals of various impact factors.
The extreme pressure of noted medical journals: only “novel results” are published
What makes medical researchers compromise on their ethics? It is the extreme pressure to receive funding for their work, so the data is easily manipulated to suit the vested interests of the funding agencies. Manipulation of results may either be done voluntarily or it may have occurred unforeseen. Why is the pressure so extreme to manipulate results? This is because it is NOT enough to publish medical research in journals: the impact factor of the journal decides the prospects of the researcher. Most noted medical journals have a rejection rate of more than 90%. Thus, only “novel studies with innovative results” make the cut in these journals.
Though Prof. Ioannidis had to carry out his research work in the form of meta-analyses for many years, he continued with his effort finally bearing fruit: the Open Access Journal PLOS Medicine. The journal publishes all fittingly correct medical papers, regardless of whether the results are “innovative.”
Final remark: SCI Journals have failed medical research completely in their quest of publishing “innovative result,” rather than “true results.”
According to the model put forth by Prof. Ioannidis, medical research studies are flawed grossly because the rates of wrongness were almost equal to the rates at which the so-called “novel findings” were substantially proved to be wrong. Check out his astounding statistical report: the most common type of study design is non-randomized clinical trial and 80% of these clinical trials are ultimately proved to be wrong in terms of results. Furthermore, the so-called randomized trials that serve as gold standards also prove to be wrong is as much as 25 % instances. Strange but true, the most high-quality platinum standard studies involving “large randomized trials” also have 10% chances of being wrong.