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Wednesday, October 20, 2010

Peer review: How much more believable than fortune telling these days?

A number of red flags have shot up recently about comfy relationships between science, media, and corporate interests. Here's a small batch to contemplate:

- Elizabeth Landau asks at CNN, "Where's the line between research and marketing?" (October 13, 2010):
JAMA, one of the premier peer-reviewed health publications in the United States, published the Jenny Craig-funded study that had to do with -- surprise! -- women losing weight in the Jenny Craig weight-loss program. The study found that women in the Jenny Craig program lost between three and four times as much weight as those who dieted independently.

Fontanarosa says the study passed the journal's requirements for a privately funded study: the sponsor - Jenny Craig - tried to minimize its influence over the management analysis of data and reporting of the findings. An academic investigator had access to all data, and an academic biostatistician conducted the analysis.

But some experts say the public should have extra skepticism than when viewing the results of a study like this.
The experts' further advice, as properly recounted by Landau, is no substitute for plain old hardline skepticism. Here's some skeptical advice on weight loss programs in general.

- In "Lies, damn lies, and medical science"(The Atlantic, November 2010) David H. Freedman reports on the shifting sands of health dangers uncovered by peer-reviewed studies:
That question has been central to Ioannidis’s career. 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. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. 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. Given this exposure, and the fact that his work broadly targets everyone else’s work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.

[ ... ]

It didn’t turn out that way. In poring over medical journals, he was struck by how many findings of all types were refuted by later findings. Of course, medical-science “never minds” are hardly secret. And they sometimes make headlines, as when in recent years large studies or growing consensuses of researchers concluded that mammograms, colonoscopies, and PSA tests are far less useful cancer-detection tools than we had been told; or when widely prescribed antidepressants such as Prozac, Zoloft, and Paxil were revealed to be no more effective than a placebo for most cases of depression; or when we learned that staying out of the sun entirely can actually increase cancer risks; or when we were told that the advice to drink lots of water during intense exercise was potentially fatal; or when, last April, we were informed that taking fish oil, exercising, and doing puzzles doesn’t really help fend off Alzheimer’s disease, as long claimed. Peer-reviewed studies have come to opposite conclusions on whether using cell phones can cause brain cancer, whether sleeping more than eight hours a night is healthful or dangerous, whether taking aspirin every day is more likely to save your life or cut it short, and whether routine angioplasty works better than pills to unclog heart arteries.
Go here for more.

- And don't expect the legacy mainstream media to run to help. Too many of them are part of the pattern themselves, as Paul Raeburn at Knight Journalism Tracker points out:
Yesterday, I criticized the foundation for taking funding from Pfizer for its “all-expenses-paid” annual cancer conference for reporters.

This morning, I looked at the press foundation’s donors. In its 2009 annual report, the foundation said “nearly 300 journalists benefitted from our training in Washington, around the world, online and through webinars. And it boasted that “in one of the tumultuous years in the U.S. media business, we did all this without charging journalists a dime, with programs that received some of our highest evaluations ever.”

How did the National Press Foundation do it?
Raeburn figures they did it because pharmaceutical corporations contributed about one quarter of the money and the journalism organizations' contributions were "far smaller." He adds,
When the National Press Foundation says in its annual report that it is funded, in part, by “concerned corporations,” it’s right on the money. You can bet that Pfizer, Merck, and the others are concerned about what appears in the press!
No kidding. The corruption here isn't open, it's insidious. The questions one does not ask, the research one does not do, the people one knows better than to confront, the backing down and the sliding away ... Sound familiar, anyone?

Do I say peer review is bad? No, but it can be useless or misleading. The key problem is that it is treated as a seal of approval. Yet it can often be the means by which third rate stuff gets attention and serious stuff is suppressed. The system is now corrupt enough that one can no longer take seriously claims like "Orthodox science doesn't accept this." My immediate response is, "Is THAT all you got by way of objection?"

I have written about the peer review scandal elsewhere:

"Peer review, mere review, and smear review"

"Peer review: Life, death, and the British Medical Journal"

Science: A year-end wad of fraud, falsified data, and other award-winning tenure strategies ...

Peer review: What if your peers would have to be otherconspiracy theorists? (No, really!)

Peer review: Gold standard or gold in "them thar hills"

* In fairness, journalism has been hit hard in recent years by layoffs, etc. But that's when we should just hold cheaper conferences and lump it until good stories start making money again.

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