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  #1  
Old 10-29-15, 05:01 AM
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Why Most Published Research Findings Are False

Read this, and weep:

http://journals.plos.org/plosmedicin...l.pmed.0020124

We imagine that "science" is a solid and objective lens, through which we can inspect reality in great detail.
Nothing could be further from the truth
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  #2  
Old 10-29-15, 10:06 AM
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Re: Why Most Published Research Findings Are False

I need to revise my stats but the arguments here look like they may actually have some validity
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Old 10-29-15, 10:18 AM
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Re: Why Most Published Research Findings Are False

I'm actually going to make a deeper study of this paper when I have the time, and post my conclusions. I like the author's methodology.
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Old 10-29-15, 05:06 PM
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Re: Why Most Published Research Findings Are False

Quote:
Originally Posted by Abi View Post
I need to revise my stats but the arguments here look like they may actually have some validity
haha, a lot of what is passed off as science these days is acutally statistics with [key] missing variables.
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Old 10-30-15, 06:43 AM
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Re: Why Most Published Research Findings Are False

More in the same vein:

http://www.doctoringdata.co.uk/

It gets much worse.
Virtually all preventive medicine (cholesterol, moderate hypertension, overweight [as opposed to obesity] Coronary Artery Bypass Grafts and Coronary stenting, to name the less controversial examples) is based on really incompetent (read "deliberately corrupted") interpretations of the scientific database.

Reading this book has confirmed my worst suspicions about the way my profession does business.
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Old 10-30-15, 07:17 AM
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Re: Why Most Published Research Findings Are False

Wow, this is interesting.

I wish Amtram were here, I'd like to hear what she would say.
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Old 10-31-15, 09:18 PM
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Re: Why Most Published Research Findings Are False

A quote that is now a couple of years old:
" It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgement 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. "
Dr Marcia Angell
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Old 10-31-15, 09:32 PM
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Re: Why Most Published Research Findings Are False

MkKendrick's blog is well worthwhile- and covers most of what is in the book.
Here is an example on cholesterol lowering via statins.

While this is not relevant directly to ADHD, it does give a very good idea of how statistics can be massaged by those who have an interest in doing so-- and gives a great idea of what we have to be thinking about when we are told certain "facts" about
the sffectiveness of medications or other interventions:
http://drmalcolmkendrick.org/2015/10...take-a-statin/

Quote:
What we have instead is the repeated use of relative risk. Which is often framed in the following type of way: ‘Atorvastatin/Lipitor will reduce the risk of dying of a heart attack by 36%’… and suchlike. Whilst that figure is true, or at least it was true in one study funded and run by Pfizer… who sell atorvastatin, I knew that a figure like that was horribly misleading. It gave the impression of a gigantic reduction in risk.
Reanalysis of the raw data from the 4S and the HPS trials (both key trials quoted b those in favour of using statins gave this result:
Quote:
Framing this slightly differently, what this meant was that taking a statin for one year, in the highest risk group possible, would increase your life expectancy by around three days.
He then analyses this data a little further:
Quote:
The main take away message I believe, is the following. Statins do not prevent fatal heart attacks and strokes. They can only delay them. They delay them by about one or two days per year of treatment. For those who have read my books you will know that I have regularly suggested we get rid of the concept of ‘preventative medicine’. We need to replace it with the concept of ‘delayative medicine’.


You cannot stop people dying. You can only make them live longer. How much longer is the key question. With statins this question has been answered. You can, to be generous, add a maximum of two days per year to life expectancy.


Which means that if you were to take a statin for thirty years you could expect to live about two months longer. (Possibly three, more likely one). Assuming, and this is a big assumption, that none of the trials done have been in any way biased towards statins. Even though every single one was funded by the pharmaceutical industry. Further assuming that any benefits seen in the trials will continue for the next twenty-five years.
So much for a drug that has now generated more than $125 billion in sales.

On second thoughts - this is relevant to ADHD- as memory loss and brain fog are reasonably common side effects of the drugs- and many ADHD individuals have addictive eating patterns that lead to them being put on statins in the first place.
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Old 10-31-15, 10:02 PM
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Re: Why Most Published Research Findings Are False

All this reminds me of a book i read decades ago:
To deliver good medical care is to do as much nothing as possible” ~
Samuel Shem, The House of God
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Science advances --one funeral at a time.

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Old 11-01-15, 08:25 AM
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Re: Why Most Published Research Findings Are False

Actually, this is nothing new. Note that Ioannides wrote this more than 10 years ago. Most published research is exploratory or preliminary, or an attempt to test a hypothesis. In addition to the research that comes to an incorrect conclusion because of sample size or methodology, there are thousands that reach negative results that are never published.

The scientific community is well aware of this, which is why such an overwhelming number of these studies are never cited nor attempted to be replicated. Scientists who have access to the full text and expertise in the subject area will see the flaws and dismiss the findings. There are also several platforms they use to discuss research among themselves and debate its merit or call for its retraction. There's a huge amount of science being done that the public never sees.

What the public does see is often chosen by non-scientists who look at press releases and publish stories about "ground-breaking" discoveries. There are almost no "ground-breaking" studies, because they all build upon accumulated knowledge, and change comes in much smaller increments because of the nature of scientific exploration.

Fortunately, since much of the problem, as Ioannides points out, is statistical manipulation, it's often not difficult for other scientists to detect the error. Even a layperson, with some knowledge of statistics and scientific methodology, can pick out some of the more egregious mistakes. This basic knowledge is a good thing to have if you find yourself exposed to lots of claims that seem too good to be true - say, a recent article made popular on facebook that says scientists have discovered a cure for Alzheimer's, for example. If you understand that 75% of a sample size of 50 is in no way conclusive, and that animal studies are used primarily to test potential, and that information is in the abstract, you know that you can dismiss this article as hyperbolic.
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Old 11-02-15, 02:56 AM
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Re: Why Most Published Research Findings Are False

Quote:
The main take away message I believe, is the following. Statins do not prevent fatal heart attacks and strokes. They can only delay them. They delay them by about one or two days per year of treatment. For those who have read my books you will know that I have regularly suggested we get rid of the concept of ‘preventative medicine’. We need to replace it with the concept of ‘delayative medicine’.


You cannot stop people dying. You can only make them live longer. How much longer is the key question. With statins this question has been answered. You can, to be generous, add a maximum of two days per year to life expectancy.


Which means that if you were to take a statin for thirty years you could expect to live about two months longer. (Possibly three, more likely one). Assuming, and this is a big assumption, that none of the trials done have been in any way biased towards statins. Even though every single one was funded by the pharmaceutical industry. Further assuming that any benefits seen in the trials will continue for the next twenty-five years.

I read the one on statins as well. I conclude they won't increase one's life expectancy if one is hit by a bus ...life expectancy is a tricky thing in that elevated cholesterol is not the only thing that can kill you ..... If statins make you feel like crap then living an extra day or two is probably not worth it but if they don't cause one any side effects than taking them is not necessarily a problem. Cholesterol is only on risk factor in a life time of possible causes of death.

I work daily with specialist and have never heard a single doctor prescribe drugs over life style changes. All of them encourage healthy life styles first and foremost. I see this pill popping mentality mostly in patients who would rather swallow a pill every day than give up their fatty foods or start an exercise program. Consumers who would rather take a pills don't care about the stats as most people do not understand stats and don't care that they don't. They go for what they think will be their easiest way out so I would not point the "figures" solely at drug companies for giving people what they want to hear

The annoyance is presenting this as a doctor/drug company driven problem when my experience it is a consumer/ patient driven problem. People would rather take statins than diet and exercise period .....
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Old 11-02-15, 08:27 PM
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Re: Why Most Published Research Findings Are False

Quote:
Originally Posted by meadd823 View Post
I read the one on statins as well. I conclude they won't increase one's life expectancy if one is hit by a bus ...life expectancy is a tricky thing in that elevated cholesterol is not the only thing that can kill you ..... If statins make you feel like crap then living an extra day or two is probably not worth it but if they don't cause one any side effects than taking them is not necessarily a problem. Cholesterol is only on risk factor in a life time of possible causes of death.

I work daily with specialist and have never heard a single doctor prescribe drugs over life style changes. All of them encourage healthy life styles first and foremost. I see this pill popping mentality mostly in patients who would rather swallow a pill every day than give up their fatty foods or start an exercise program. Consumers who would rather take a pills don't care about the stats as most people do not understand stats and don't care that they don't. They go for what they think will be their easiest way out so I would not point the "figures" solely at drug companies for giving people what they want to hear

The annoyance is presenting this as a doctor/drug company driven problem when my experience it is a consumer/ patient driven problem. People would rather take statins than diet and exercise period .....

It is a little more complex than that.

My experience in general practice was of these drugs being systematically misrepresented to us by the drug reps who spend so much time visiting doctor's offices, and then a series of effectively legally binding practice protocols coming out which were based on that misinformation.

In fact McKendrick is stating that there is NO evidence that cholesterol is, in the broader community, a significant cardiac risk. In fact he is arguing that given the limited improvements with medication, the cholesterol/ heart disease issue may well be a correlation rather than a causative relationship. A and B are both caused by X. A being heart disease, and B being cholesterol, x- being the unknown third factor-- which is probably chronic autonomic nervous system dysregulation.

Secondly he states rightly that the bulk of the side effects of statins are of insidious onset--so many of these side effects are only very gradually progressive. They are subtle and not easy to attribute to the medications.
We should also add cost of medication to the side effect list- as this can be considerable.


The other side of the problem is is that while doctors advise lifestyle change-- we are not very good at helping our patients achieve that.
The social pressures that lead to a poor diet and lack of exercise are complex and are not easily countered, and most of them are poorly understood by doctors who come from a highly specific part of society- high achieving, organised, high income, strong work ethic, with an interesting and ethically pleasing job to do ( and more often from not from families that have held these positions and work ethics for generations)-- that does not equip us to understand the pressures that drive poor diet and exercise choices.

So it is all very well telling a patient in an impossible position (60 hour work week low income, no time to spend on face to face child rearing, and kids going off the rails) to just change their diet, but without helping them to figure out how to do it we are not really helping all that much---

--but we can then "blame the victim" when they fail to follow doctors orders.
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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.

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Old 11-02-15, 08:56 PM
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Re: Why Most Published Research Findings Are False

Quote:
Originally Posted by Amtram View Post
Actually, this is nothing new. Note that Ioannides wrote this more than 10 years ago. Most published research is exploratory or preliminary, or an attempt to test a hypothesis. In addition to the research that comes to an incorrect conclusion because of sample size or methodology, there are thousands that reach negative results that are never published.

The scientific community is well aware of this, which is why such an overwhelming number of these studies are never cited nor attempted to be replicated. Scientists who have access to the full text and expertise in the subject area will see the flaws and dismiss the findings. There are also several platforms they use to discuss research among themselves and debate its merit or call for its retraction. There's a huge amount of science being done that the public never sees.
Quite correct- research into basic physics, or commercial applications is of little interest to most.

What the public does see is often chosen by non-scientists who look at press releases and publish stories about "ground-breaking" discoveries. There are almost no "ground-breaking" studies, because they all build upon accumulated knowledge, and change comes in much smaller increments because of the nature of scientific exploration.

Fortunately, since much of the problem, as Ioannides points out, is statistical manipulation, it's often not difficult for other scientists to detect the error. [/quote]

However, very often the target is not other scientists- it is health professionals, who simply do not have the time to go back to the core data, or the financial security to risk going up against skewed data that has become ossified into clinical practice protocols.

Given the nature of the medicolegal world, going against these is actually very dangerous professionally, and can easily find one answering a complaint to one's medical board (even though many of these practice protocols are later thrown out)

The worst cases of these are intra profession vendettas now being called "sham peer reviews" These commonly happen among closed professional trade groups and are usually directed against high profile and highly skilled professionals who will do surgery or procedures that the majority of doctors would not contemplate. We have had a couple of spectacular cases of this come to light in Australia in the past few months- they have forced several skilled and valuable practitioners out of work, and out of the country.

So lets look more closely at scientific research in the medical community.
I reference McKendrick again:

http://drmalcolmkendrick.org/2015/06...t-about-money/

Quote:
Here is what Richard Horton (Editor of the Lancet), has to say on the matter: ‘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.’



So that is the state f play vis a vis science within medicine.
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Old 05-22-16, 04:40 PM
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Re: Why Most Published Research Findings Are False

For any research that you find that suggests a certain theory to be true,
I can promise you that you can find research opposing that research..
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Old 05-23-16, 01:01 AM
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Re: Why Most Published Research Findings Are False

Witout thinking too deeply about it - science carries an obvious flaw in that it formulates models based on what is known.
If the problem domain is not sufficiently well understood then wholly false conclusions are arrived at - regardless of highly statistically significant findings being reported back.

High heritability index has been used to indicate high 'geneticness' of a condition.

All of this before epigenetics (the research is ongoing) jumped into the fray to shatter that over-simplistic view of common disease.

Quote:
The new Cambridge study initially discovered how the DNA methylation marks are erased in PGCs, a question that has been under intense investigation over the past ten years. The methylation marks are converted to hydroxymethylation which is then progressively diluted out as the cells divide. This process turns out to be remarkably efficient and seems to reset the genes for each new generation. Understanding the mechanism of epigenetic resetting could be exploited to deal with adult diseases linked with an accumulation of aberrant epigenetic marks, such as cancers, or in ‘rejuvenating’ aged cells.
However, the researchers, who were funded by the Wellcome Trust, also found that some rare methylation can ‘escape’ the reprogramming process and can thus be passed on to offspring – revealing how epigenetic inheritance could occur. This is important because aberrant methylation could accumulate at genes during a lifetime in response to environmental factors, such as chemical exposure or nutrition, and can cause abnormal use of genes, leading to disease. If these marks are then inherited by offspring, their genes could also be affected.
- See more at: http://www.cam.ac.uk/research/news/s....KJ2Pmh3O.dpuf
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