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Medical Lies Dammed Lies and ..its all Greek to me


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Rather an intriguing start to an article from The Atlantic

In 2001, rumors were circulating in Greek hospitals that surgery residents, eager to rack up scalpel time, were falsely diagnosing hapless Albanian immigrants with appendicitis. At the University of Ioannina medical school’s teaching hospital, a newly minted doctor named Athina Tatsioni was discussing the rumors with colleagues when a professor who had overheard asked her if she’d like to try to prove whether they were true—he seemed to be almost daring her.

She accepted the challenge and, with the professor’s and other colleagues’ help, eventually produced a formal study showing that, for whatever reason, the appendices removed from patients with Albanian names in six Greek hospitals were more than three times as likely to be perfectly healthy as those removed from patients with Greek names. “It was hard to find a journal willing to publish it, but we did,” recalls Tatsioni. “I also discovered that I really liked research.”

Good thing, because the study had actually been a sort of audition. The professor, it turned out, had been putting together a team of exceptionally brash and curious young clinicians and Ph.D.s to join him in tackling an unusual and controversial agenda.

http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269

Apparently a lot of testing is dubious.:

He chose to publish one paper, fittingly, in the online journal PLoS Medicine, which is committed to running any methodologically sound article without regard to how “interesting” the results may be. In the paper, Ioannidis laid out a detailed mathematical proof that, assuming modest levels of researcher bias, typically imperfect research techniques, and the well-known tendency to focus on exciting rather than highly plausible theories, researchers will come up with wrong findings most of the time.

Simply put, if you’re attracted to ideas that have a good chance of being wrong, and if you’re motivated to prove them right, and if you have a little wiggle room in how you assemble the evidence, you’ll probably succeed in proving wrong theories right.

His model predicted, in different fields of medical research, rates of wrongness roughly corresponding to the observed rates at which findings were later convincingly refuted: 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 article spelled out his belief that researchers were frequently manipulating data analyses, chasing career-advancing findings rather than good science, and even using the peer-review process—in which journals ask researchers to help decide which studies to publish—to suppress opposing views. “You can question some of the details of John’s calculations, but it’s hard to argue that the essential ideas aren’t absolutely correct,” says Doug Altman, an Oxford University researcher who directs the Centre for Statistics in Medicine.

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In general I have a mistrust of the medical profession..I know that I should not, and it is not a personal issue like "I hate doctors" just is more of a situation where, it is one of the few times a person is really entirely at the mercy of someone else's professional integrity and abilities, and that does tend to make me nervous.

That said, even with it taken into account, if this is true it is one of the worst examples. Amazing that some of them were able to keep their license to practice medicine in Greece, or the EU.

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In general I have a mistrust of the medical profession..I know that I should not, and it is not a personal issue like "I hate doctors" just is more of a situation where, it is one of the few times a person is really entirely at the mercy of someone else's professional integrity and abilities, and that does tend to make me nervous.

That said, even with it taken into account, if this is true it is one of the worst examples. Amazing that some of them were able to keep their license to practice medicine in Greece, or the EU.

Of course you kind of also put you life on the line every time you get in a car. Especially a taxi. Mrs Affentitten was alarmed the other morning on a 5 am trip to the airport to find that the taxi driver had nodded off and she had to punch him awake just as they strated to drift towards the barrier.

Regarding the Greek thing, I think you have to take into account just how the Greeks tend to think of Albanians. Somewhere between donkeys and cockroaches would be about right. Useful for heavy work, but maybe still better off being eradicated.

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I suppose given the taxi driver knows your address the desire to remedy the sleeping taxi driver problem is tempered with self-preservstion! I must admit I might not have tipped afterwards : )

I suppose an enquiry to the Sidnet taxi licensing board on whether they routinely test drivers - or only after a fatal crash might be interesting. Is their a limit/mechanism for how many hours they can drive?

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Anyway back to the thread:

Ioannidis anticipated that the community might shrug off his findings: sure, a lot of dubious research makes it into journals, but we researchers and physicians know to ignore it and focus on the good stuff, so what’s the big deal? The other paper headed off that claim.

He zoomed in on 49 of the most highly regarded research findings in medicine over the previous 13 years, as judged by the science community’s two standard measures: the papers had appeared in the journals most widely cited in research articles, and the 49 articles themselves were the most widely cited articles in these journals. These were articles that helped lead to the widespread popularity of treatments such as the use of hormone-replacement therapy for menopausal women, vitamin E to reduce the risk of heart disease, coronary stents to ward off heart attacks, and daily low-dose aspirin to control blood pressure and prevent heart attacks and strokes. Ioannidis was putting his contentions to the test not against run-of-the-mill research, or even merely well-accepted research, but against the absolute tip of the research pyramid.

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. If between a third and a half of the most acclaimed research in medicine was proving untrustworthy, the scope and impact of the problem were undeniable.

That article was published in the Journal of the American Medical Association.

It really is quite scary when you think of all the hype that has surrounded some of these theories. Rather like the mortgage bubble there is more to "made" by talking these things up rather than burying them or defusing them. Here again surely making the discoveres liable in some tangible sense will make them more rigorous in experimenting and cross-checking.

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As a doctor, I'm delighted that someone's looking at this in a scientific way. I suspect (though can't prove) that "the integrity factor" in medicine is well above average when compared to some other professions. What does this say for our financial, legal and political systems....

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"Simply put, if you’re attracted to ideas that have a good chance of being wrong, and if you’re motivated to prove them right, and if you have a little wiggle room in how you assemble the evidence, you’ll probably succeed in proving wrong theories right."

Kettlerian methodology.

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"Simply put, if you’re attracted to ideas that have a good chance of being wrong, and if you’re motivated to prove them right, and if you have a little wiggle room in how you assemble the evidence, you’ll probably succeed in proving wrong theories right."

Kettlerian methodology.

I just knew somebody was going to make that connection.

Michael

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"Simply put, if you’re attracted to ideas that have a good chance of being wrong, and if you’re motivated to prove them right, and if you have a little wiggle room in how you assemble the evidence, you’ll probably succeed in proving wrong theories right."

Kettlerian methodology.

I think that it is actually incredibly rude, not to mention dishonorable, to attack someone in a post where that person has not even posted anything...not really sure what the mods think, but that seems the dictionary definition of "cheap shot" or at least close to "axe-grinder" as listed.

However, if I misunderstood what you wrote (I understood it as an insult to a poster not who has not even written in this topic) then I apologize.

Ron

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Ah yes repeating a calumny for extra mileage - a well-known gutter press activity!!!

Only kidding Ron : )

I don't think that as abuse goes this is actually much. I speak as a habitual defender of JK's right to post. Also in a way it is a back-handed corroboration of unpopular views are not necessarily wrong and mainstream theories are not always supported by true science.

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http://www.urbandictionary.com/define.php?term=Kettlerian

adj.

Kettlerian

Relating to or evocative of, the random conspiracy theories of John Kettler, a contributor to various UFO and Atlantis fan magazines. In every mundane military story, there is a alien tesla particle weapon, and in every political expose, there is a reptiloid alien shape shifter infiltration, in every WWII epic, there lurk Nazi UFOs.

If Wilhammer had used the adjective 'Kafkaesque would anyone assume it was a slur aimed at Franz Kafka...

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