Homo_ludens

Please, don't feel obliged to be a scientist to participate in this discussion. I would love to hear from non-scientists whether they were aware of these issues and how reading this effects them. This touches us all.

Though I do admit that when you make a claim, I believe it is important to provide evidence or resources. Otherwise, it wouldn't be a discussion.

Homo_ludens

In 2010 Discover magazine published 'The Problem With Medicine: We Don't Know If Most of It Works'. To my best knowledge (by all means contradict me), the problems are still rampant.

From the article:

A panel of experts convened in 2007 by the prestigious Institute of Medicine estimated that “well below half” of the procedures doctors perform and the decisions they make about surgeries, drugs, and tests have been adequately investigated and shown to be effective. The rest are based on a combination of guesswork, theory, and tradition, with a strong dose of marketing by drug and device companies.

The holes in medical knowledge can have life-threatening implications, according to an Agency for Healthcare Research and Quality report published in 2001: More than 770,000 Americans are injured or die each year from drug complications, including unexpected side effects, some of which might have been avoided if somebody had conducted the proper research. Meaningless or inaccurate tests can lead to medical interventions that are unnecessary or harmful. And risky surgical techniques can be performed for years before studies are launched to test whether the surgery is actually effective.

A 2002 study in the Journal of the American Medical Association (JAMA) found that 87 percent of guideline authors received industry funding and 59 percent were paid by the manufacturer of a drug affected by the guidelines they wrote.

Nowhere in medicine is this more of a problem than in surgery. Even essential surgery may pose risk of infection, medical error, or a bad reaction to anesthesia. But risks are compounded because many common surgical techniques are not as effective as physicians believe or are simply performed on the wrong patients, says Guy Clifton, a neurosurgeon at the University of Texas Medical School at Houston and author of Flatlined: Resuscitating American Medicine.

All drugs must undergo a slew of tests before they are approved, but many studies the FDA oversees are poorly designed or too small to answer important questions, such as how often rare but potentially harmful or lethal side effects occur, and which patients are unlikely to be helped. And many drugs are not adequately monitored for safety problems after they reach the market.

USC’s Hoffman says the scenario repeats itself time and again. “Some expensive new drug becomes a blockbuster best seller following extensive marketing, even though the best one might be able to say about it is that it seems statistically ‘non-inferior’ to an older, cheaper drug. At the same time, we don’t have any idea about its long-term side effects.”

in many cases, physicians perform surgeries, prescribe drugs, and give patients tests that are not backed by sound evidence because most doctors are not trained to analyze scientific data, says Michael Wilkes, vice dean of education at U.C. Davis.

Newman started his talk by explaining two concepts: the “number needed to treat,” or NNT, and the “number needed to harm,” or NNH. Both concepts are simple, but often doctors are taught only a third number: the relative decrease in symptoms that a given treatment can achieve.

An essential part of the solution is better medical evidence based on independent research, and lots of it. Yet the NIH allocates less than 1 percent of its $30 billion annual budget to “comparative effectiveness research,” the kind needed to sort out the surgeries, drugs, and devices that work from those that do not. The rest goes toward more basic science aimed at finding new cures.

The article: http://discovermagazine.com/2010/nov/11-the-problem-with-medicine-dont-know-if-most-works

Homo_ludens

Just watched the documentary 'Silence of the labs'. 45 min portrayal of how politics and industry gutted science and silenced scientists by cutting funding and dismissing scientists in Canada. A chilling documentary showing one of the major problems science is facing today.

Do you know other sources showing this? And what other problems do you think is eating away at science?

The documentary: https://m.youtube.com/watch?v=Ms45N_mc50Y

Charlie_Prime

Scientists can't be trusted because they destroyed their credibility.

Homo_ludens

Right. Generalisation, because that is such a constructive argument. Or do you have actual evidence supporting your claim that all scientists destroyed all their own credibility? Because this scientist sure would love to see that.

Homo_ludens

I'm assuming you are not aware that the layman article you linked to is based on the article I posted in my OP. I'm also assuming you didn't read either my OP or your own link as they both mention Richard Horton and The Lancet.

Now, how does your link provide any evidence for your claim that all scientists can't be trusted because they all destroyed their credibility?

I appreciate comments, but this is not a productive argument nor does it lead to a flourishing discussion. This is too bad...

Charlie_Prime

'...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'

Good reputations are very difficult to build, yet very easy to lose. Scientists should have done a better job of policing themselves. Doctors do it better. Accountants do it better. Plumbers do it better.

Homo_ludens

Since you don't feel inclined to provide claims that are actually substantiated, I don't feel inclined to continue this discussion with you.