The chief editors of the world’s two most influential medical journals have publicly admitted that most of the research their journals publish is fake. Such statements backed up by other influential analysts we’ll quote below demonstrate the scary consequences of allowing vested interests to fund research.
The New England Journal of Medicine is the world’s most widely read and influential general medical journal, which has the world’s highest impact factor. Dr. Marcia Angell, the former Editor-in-Chief of this esteemed journal, could put up with only so much, it seems, before deciding to expose the malpractice surrounding her. Dr. Angell admits:
It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of the New England Journal of Medicine.
Richard Horton, the editor in chief of the prestigious UK medical journal The Lancet, agrees. The Lancet is the world’s second most influential journal in general and internal medicine, according to the latest Journal Citation Reports of Thomson Reuters. In 2015, Horton published a much talked about editorial admitting how much fake research The Lancet publishes. In his editorial, Horton mentions attending a symposium about:
one of the most sensitive issues in science today: the idea that something has gone fundamentally wrong with one of our greatest human creations.
The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness. As one participant put it, “poor methods get results”. The Academy of Medical Sciences, Medical Research Council, and Biotechnology and Biological Sciences Research Council have now put their reputational weight behind an investigation into these questionable research practices. The apparent endemicity of bad research behaviour is alarming. In their quest for telling a compelling story, scientists too often sculpt data to fit their preferred theory of the world. Or they retrofit hypotheses to fit their data. Journal editors deserve their fair share of criticism too. We aid and abet the worst behaviours. Our acquiescence to the impact factor fuels an unhealthy competition to win a place in a select few journals. Our love of “significance” pollutes the literature with many a statistical fairy-tale.
The good news is that science is beginning to take some of its worst failings very seriously. The bad news is that nobody is ready to take the first step to clean up the system.
The medical community has in fact been well-aware of the situation described for more than a decade. In 2005, Greek researcher John P. A. Ioannidis first announced that “much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong.” About Dr. Ioannidis and his research, The Atlantic writes:
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. … 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. … Ioannidis may be one of the most influential scientists alive.
In one of his famous papers published in 2005 in Plos Medicine, Dr. Ioannidis has told The Atlantic why he’s reached his following conclusion:
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 Atlantic covers another famous 2005 paper by Dr. Ioannidis , explaining he analyzed 49 of the most highly regarded research findings in medicine over the previous 13 years, he found:
Of the 49 articles, 45 claimed to have uncovered effective interventions. Thirty-four of these claims had been retested, and 14 of these, or 41 percent, had been convincingly shown to be wrong or significantly exaggerated.
The Atlantic describes what causes the situation Dr. Ioannidis uncovered:
“The studies were biased,” he [Ioannidis] says. “Sometimes they were overtly biased. Sometimes it was difficult to see the bias, but it was there.” Researchers headed into their studies wanting certain results – and, lo and behold, they were getting them. … in fact it’s easy to manipulate results, even unintentionally or unconsciously. “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 world where most research funding is provided by the drug companies wanting to increase their profits, the same article in The Atlantic adds:
Most journal editors don’t even claim to protect against the problems that plague these studies. University and government research overseers rarely step in to directly enforce research quality, and when they do, the science community goes ballistic over the outside interference. The ultimate protection against research error and bias is supposed to come from the way scientists constantly retest each other’s results … except they don’t.
The above conclusion of Dr. Ioannidis confirms Horton’s admission when he wrote a decade later:
“Our acquiescence to the impact factor fuels an unhealthy competition to win a place in a select few journals. Our love of ‘significance’ pollutes the literature with many a statistical fairy-tale.”
Many doctors misinformed by self-serving researchers and journal editors continue to prescribe harmful drugs or make dangerous or ineffective recommendations to trusting patients. The fact that even Dr. Ioannidis’s great influence has failed to improve the research literature indicates the painful reality that the situation may never improve. Or maybe it can, if conscientious researchers and journalists focus on raising the awareness of the public to demand that something is done. For starters, I recommend reading Dr. Angell’s book The Truth About Drug Companies: How They Deceive Us and What To Do About It.