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  #46  
Old 08-13-17, 08:50 PM
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Re: Why Most Published Research Findings Are False

Most scholarly research is not necessarily always cogent because of the phenomenon of significant "demand characteristics"
That influences subjects in the research

https://www.verywell.com/what-is-a-d...ristic-2795098
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  #47  
Old 08-14-17, 02:43 PM
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Re: Why Most Published Research Findings Are False

The research constituting the science behind the disorder (of ADHD), which I've studied continuously over the last 30+

years, absolutely meets the aforementioned "Gold Standard."

As someone who was trained as a scientist/clinician, "demand characteristics" are a common confounding variable that

must be always considered and dealt with; primarily via the research design employed.

It's simply "too easy" of a criticism to employ regarding ALL scientific research. However, in this context, I am strictly

concerned about ADHD research and the implications set forth by the OP, whom I have great personal and professional

respect for.


tc

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  #48  
Old 08-15-17, 11:16 PM
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Re: Why Most Published Research Findings Are False

Hi Robert,
good to see you.
Broadly I agree with you- and one of the biggest problems that we here have all had to face is skepticism about the nature of ADHD.

However there are distortions in all fields- usually when there is plenty of money to be made.

We are getting quite a push in Australia to offer Vyvanse as a first line drug. Actually the old fashioned short acting methylphenidate and dexamphetamine do suit the majority of people perfectly well, and are much cheaper. However there is a spin on the science that is being presented to us by drug reps.

At a higher level the other challenge is that behaviours always have complex genesis in terms of neural pathways. ADHD is currently described as a behaviour cluster and will therefore always be heterogenous in terms of underlying neurology. A good deal of time has been wasted on the argument that because consistent neurological differences can't be found, therefore "ADHD does not exist". That has had serious consequences in scaring off people who may well have benefitted from treatment of their ADHD.

I think the field is looking very promising now as more professionals are contributing from their own angles. ie the neuropsychologist Leonard Koziol (author of "Subcortical Structures and Cognition"and "ADHD as a model of Brain Behaviour Relationships".
Koziol is especially impressive in that he is loose enough to say, as a clinician who works with ADHD:

www.leonardkoziol.com/publications/Attention_Evolution_Revolution_2015.pdf

Quote:
Just about every article concluded that traditional constructs of attention are outmoded, although we continue to assess attention from a clinical viewpoint that leads to limited practical applicability.
and

Quote:
First, ADHD is a behaviorally defined diagnosis as it is characterized in the DSM system. And in this regard, we completely agree with Carmichael and colleagues’ (this issue) bold statement that from a neuropsychological perspective, ADHD does not exist....
However, the fact of the matter is that from the behaviorally defined DSM system, ADHD does exist.
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  #49  
Old 08-15-17, 11:31 PM
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Re: Why Most Published Research Findings Are False

Now that analysis has probably turned up further reasons for failure of science-

too often we remain attached to old models that purport to explain the problem without understanding just how fragile the underlying concept is:
IE ADHD as being a "moral deficiency disorder"
or more recently ADHD as being a dopamine deficiency disorder (doesn't explain the therapeutic failure of stimulants in about 20% and doesn't account for the complex brain network models that are being discussed and replacing the neurotransmitter deficiency model- which is on its last legs).

So if you start with an inadequate model and base your research on that model-- it is never going to produce consistent and valuable results.

There are quite a number of reasons that research is often wrong-- but I agree with Ioannides that accepting a 0.05 confidence interval is leaving too much room for chance.

On top of that there are issues with drug companies meddling in results, and the serious problem that few studies are published with access to the database used. There have been many examples of this and they have been well documented leading to substantial payouts over the past few decades.
( I have just looked at one involving a vaccine in which serious results were buried deep in a 1271 page report that was meant to be confidential, but was released when the Italian Judge overseeing the matter deemed it in the public interest.

The truth is that science is not always funded by disinterested parties and we always need to be cautious about what we accept- especially when there is a big price tag attached to the products that come from it.
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Science advances --one funeral at a time.

I regard consciousness as fundamental. I regard matter as derivative from consciousness. We cannot get behind consciousness. Everything that we talk about, everything that we regard as existing, postulates consciousness.

both by:
Max Planck: Nobel Prize 1918 for inventing quantum physics.

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  #50  
Old 08-16-17, 09:47 PM
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Re: Why Most Published Research Findings Are False

Agreed. One only has to look at Eli Lilly getting warned by the FDA on Strattera.

tc

Robert
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  #51  
Old 08-16-17, 11:00 PM
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Re: Why Most Published Research Findings Are False

Quote:
Originally Posted by Kunga Dorji View Post
Now that analysis has probably turned up further reasons for failure of science-

too often we remain attached to old models that purport to explain the problem without understanding just how fragile the underlying concept is:
IE ADHD as being a "moral deficiency disorder"
or more recently ADHD as being a dopamine deficiency disorder (doesn't explain the therapeutic failure of stimulants in about 20% and doesn't account for the complex brain network models that are being discussed and replacing the neurotransmitter deficiency model- which is on its last legs).

So if you start with an inadequate model and base your research on that model-- it is never going to produce consistent and valuable results.

There are quite a number of reasons that research is often wrong-- but I agree with Ioannides that accepting a 0.05 confidence interval is leaving too much room for chance.

On top of that there are issues with drug companies meddling in results, and the serious problem that few studies are published with access to the database used. There have been many examples of this and they have been well documented leading to substantial payouts over the past few decades.
( I have just looked at one involving a vaccine in which serious results were buried deep in a 1271 page report that was meant to be confidential, but was released when the Italian Judge overseeing the matter deemed it in the public interest.

The truth is that science is not always funded by disinterested parties and we always need to be cautious about what we accept- especially when there is a big price tag attached to the products that come from it.
I think dopaminergic pathways are involved.

Other factors involved in the development of the dopaminergic pathways, could be the problem.


M
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  #52  
Old 08-17-17, 01:21 PM
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Re: Why Most Published Research Findings Are False

All one has to do is look at the (still) "landmark" NIMH brain scan study by Zametkin et. al., (1990), which

highlighted "diminished metabolic capacity" as a core feature of ADHD, followed by Zametkin et .al., (1993),

which successfully replicated those findings with a sample group of adolescent females, to see that there is

serious science behind the disorder.

As for "moral deficiency," I haven't heard that mentioned since reading about the early History of the disorder.

If one were to (literally) go back to the very beginning of the research on what we now call ADHD, you'd find

Alexander Crichton's "landmark" (1798) study which highlighted "mental restlessness" as a key feature.

Interestingly enough, today, both the adolescent & adult developmental manifestations of "hyperactivity",

are operationally defined by (subjective) "inner restlessness."

Those are (literally) the proverbial "drops in the bucket" when it comes to the multitude of serious research

on ADHD.

One of the best places to look would be to go to Russell Barkley's website and check out the research paper

entitled, International Consensus 2002. It's signed off on by over 80 of the world's leading researchers on

the subject, and goes on to stipulate the (evidence based) "proof" of ADHD being a "real disorder."

Hope that helps some.

tc

Robert
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  #53  
Old 08-26-17, 11:27 PM
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Re: Why Most Published Research Findings Are False

Quote:
Originally Posted by mctavish23 View Post
All one has to do is look at the (still) "landmark" NIMH brain scan study by Zametkin et. al., (1990), which

highlighted "diminished metabolic capacity" as a core feature of ADHD, followed by Zametkin et .al., (1993),

which successfully replicated those findings with a sample group of adolescent females, to see that there is

serious science behind the disorder.

As for "moral deficiency," I haven't heard that mentioned since reading about the early History of the disorder.

If one were to (literally) go back to the very beginning of the research on what we now call ADHD, you'd find

Alexander Crichton's "landmark" (1798) study which highlighted "mental restlessness" as a key feature.

Interestingly enough, today, both the adolescent & adult developmental manifestations of "hyperactivity",

are operationally defined by (subjective) "inner restlessness."

Those are (literally) the proverbial "drops in the bucket" when it comes to the multitude of serious research

on ADHD.

One of the best places to look would be to go to Russell Barkley's website and check out the research paper

entitled, International Consensus 2002. It's signed off on by over 80 of the world's leading researchers on

the subject, and goes on to stipulate the (evidence based) "proof" of ADHD being a "real disorder."

Hope that helps some.

tc

Robert

Crichton's account was a very good piece of observational medicine.

The main issue with the brain imaging studies is that the condition is very heterogenous (ie there are many causes of the clinical syndrome ADHD), and therefore they are not reliable as diagnostic features. That was actually the same issue that Koziol was getting at with his comments.
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Science advances --one funeral at a time.

I regard consciousness as fundamental. I regard matter as derivative from consciousness. We cannot get behind consciousness. Everything that we talk about, everything that we regard as existing, postulates consciousness.

both by:
Max Planck: Nobel Prize 1918 for inventing quantum physics.

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  #54  
Old 08-27-17, 02:25 PM
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Re: Why Most Published Research Findings Are False

Excellent points, which is why Daniel Amen has been so (correctly) criticized. Zametkin wasn't trying to diagnose tho, which

is why his work is still considered "landmark."

Thanks & hope all is well.

tc

Robert
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