On's enamik meditsiini-uuringuist väärad?

BioEdge, Michael Cook

With much of the debate over stem cells centring on the success of treatments, can peer-reviewed studies which report success be trusted?

A feature in the latest issue of Atlantic highlights the work of a Greek academic who is a world leader in the study of the credibility of medical research. Dr John Ioannidis, of the University of Ioannina, has found that between a third and a half of the most acclaimed research in medicine may be untrustworthy.

Dr Ioannidis was struck by how many studies have been disproved by subsequent studies - even randomised controlled trials, the gold standard of research.

"Baffled, he started looking for the specific ways in which studies were going wrong. And before long he discovered that the range of errors being committed was astonishing: from what questions researchers posed, to how they set up the studies, to which patients they recruited for the studies, to which measurements they took, to how they analyzed the data, to how they presented their results, to how particular studies came to be published in medical journals."

"At every step in the process, there is room to distort results, a way to make a stronger claim or to select what is going to be concluded," says Ioannidis. "There is an intellectual conflict of interest that pressures researchers to find whatever it is that is most likely to get them funded."

In a famous article in the open access journal PLoS Medicine he contended that scientists were frequently manipulating data analyses, advancing their careers rather than science, and even manipulating the peer-review process to suppress opposing views.

Ioannides is by no means anti-science, he tells Atlantic. "The scientific enterprise is probably the most fantastic achievement in human history, but that doesn't mean we have a right to overstate what we're accomplishing... Science is a noble endeavor, but it's also a low-yield endeavor. I'm not sure that more than a very small percentage of medical research is ever likely to lead to major improvements in clinical outcomes and quality of life. We should be very comfortable with that fact." ~ Atlantic, November