1. Patients launch $1.27 million crowdfunding campaign for ME/CFS gut microbiome study.
    Check out the website, Facebook and Twitter. Join in donate and spread the word!
Dr. Kerr, I presume?
Clark Ellis brings us a rare interview with British researcher Dr. Jonathan Kerr who is now living in Colombia.
Discuss the article on the Forums.

Publication bias and how it misleads medicine

Discussion in 'Other Health News and Research' started by Dainty, Sep 30, 2012.

  1. Dainty

    Dainty Senior Member

    Messages:
    1,356
    Likes:
    530
    Washington State
    Ben Goldacre in this TED talk video alerts us to the fact that "negative" studies are rarely published, and the real world implications. Publication bias is "the technical term...where unflattering data gets lost...unpublished...missing in action."

    Very enlightening.

    "If I flipped a coin a hundred times but then witheld the results from you from half of those tosses, I could make it look as if I had a coin that always came up heads. But that wouldn't mean I had a two headed coin, that would mean that I was a chancer and you were an idiot for letting me get away with it. But this is exactly what we blindly tolerate in the whole of evidence-based medicine...the effect on patients is damning."


    GhostGum and alex3619 like this.
  2. alex3619

    alex3619 Senior Member

    Messages:
    7,183
    Likes:
    11,242
    Logan, Queensland, Australia
    This is a very important topic, though it has been discussed before. Publication bias is part of Zombie Science, and some drug companies contribute their share by doing multiple studies and attempting to publish the most favourable.

    This also goes to the heart of editorial policy and publishing culture, plus failures in the review process. A new blog of mine will detail a publishing scandal on a well known medical journal ... but its not due for some weeks.

    Bye, Alex
  3. Firestormm

    Firestormm Guest

    Messages:
    5,824
    Likes:
    5,974
    Cornwall England
    Thanks Dainty. I mentioned previously that Goldacre has published a new book that looks at this:

    [​IMG]

    He was on Radio 4's Today programme last week I think it was now, and yes it was about how the drug companies are not obliged (or weren't obliged) to publish negative studies or something like that.

    Have the book on me wish list. Not that I've read his previous one yet!!

    http://www.amazon.co.uk/Bad-Pharma-...=sr_1_1?s=books&ie=UTF8&qid=1349076413&sr=1-1
  4. alex3619

    alex3619 Senior Member

    Messages:
    7,183
    Likes:
    11,242
    Logan, Queensland, Australia
    This is why I have suggested drug companies not be permitted to do phase 3 clinical trials themselves. Instead they should pay a regulatory authority to do it for them. A simpler alternative that has been discussed is to require ALL such trials to be registered, and results recorded in a database, regardless of publication status. Bye, Alex

    While I am distrustful of Goldacre I have added this book to my wishlist now Firestormm. Its one thing to read he might not be trustworthy, but I prefer to decide for myself.
  5. Firestormm

    Firestormm Guest

    Messages:
    5,824
    Likes:
    5,974
    Cornwall England
    Good on you Alex.
  6. PhoenixDown

    PhoenixDown Senior Member

    Messages:
    258
    Likes:
    235
    UK
    Funny how Ben Goldacre is no where to be seen when it comes to the mainstream quackery surrounding CFS. The self proclaimed hero of scientific & statistical accuracy accidentally forgets to mention the logical fallacy of assuming psychiatric illness by default whilst forgoing objective tests. He suddenly goes shy when blatant misrepresentation of the PACE trial occurs. Why is that Ben?


    PS: Feel free to prove me wrong but I think he's awfully quiet on the matter. I'll admit I've never read any of his books.
    Jarod, natasa778 and Bob like this.
  7. alex3619

    alex3619 Senior Member

    Messages:
    7,183
    Likes:
    11,242
    Logan, Queensland, Australia
    Hi PhoenixDown, not only does he not cry foul over the psychiatric fallacies, there is a book written about him apparently that describes, apparently, how he is complicit in it. I have not fully investigated this, but its free to download: Cultural Dwarfs and something or other, or something like that, also by Walker the guy who wrote Skewed that I blogged about. However, since I have not investigated these issues in depth just yet, I cannot say I am sure of any of this. Lots of things are claimed, few are proven.

    However from other reading its very clear that psychiatry is even more plagued by inaccuracy and bias than big pharma. If you were a psychiatrist, where would you even begin. I suspect, but have yet to investigate, that Goldacre simply doesn't want to open that can of worms. After all, its his can of worms.

    I will probably have a lot more to say about psychiatric bias over time, its a topic I am interested in.

    Bye, Alex
  8. PhoenixDown

    PhoenixDown Senior Member

    Messages:
    258
    Likes:
    235
    UK
    http://www.badscience.net/2008/09/the-medicalisation-of-everyday-life/

    He seems to be against the reductionist model, and although in this article he's talking about things like anti-social behaviour, overworking, and even sexual problems, I'm guessing he applies the same anti-reductionist pro biopsychosocial mind set to CFS/ME & Fibromyalgia. If that is indeed the case I have this to say: Burden of proof meet Ben, Ben meet Burden of proof.

    and yet he doesn't say the same thing about the fanfare & hype surrounding CBT, possibly enhancing the placebo effect. Nor does he say anything about what's left out of medical literature, guidelines, and even doctor's decisions, when a patient reports permanent worsening of symptoms due to activity or sleep loss, thanks to people like Ben, social & psychological explanations are applied to this illness, resulting in the devastating scenario of people ignoring the damage that the patient reports.
    Jarod and natasa778 like this.
  9. PhoenixDown

    PhoenixDown Senior Member

    Messages:
    258
    Likes:
    235
    UK
    http://www.meassociation.org.uk/?p=5041


    I tried this weekend to highlight the PACE trial/ skewed SMC information and bad journalism on Ben Goldacre’s site, Bad Science, but he actually rejected my comment – with no explanation. It would seem that bad science is only bad if the scientists are not your friends or colleagues.
    http://velo-gubbed-legs.blogspot.com/2011/03/bad-science.html

    More evidence that Ben is biased.

    Edit: It's worth mentioning that it was probably on the Bad Science forum not a comments section so it was probably one of Ben's forum drones (mods) who did the post/thread deleting. The issue has come up before on the big CFS thread there and from what I recall all the pro CBT chaps (most of the regulars there) refused to fully answer criticisms put forward about PACE.

    Attached Files:

  10. natasa778

    natasa778 Senior Member

    Messages:
    1,409
    Likes:
    1,208
    London UK
    Ben Goldacre is also all hush hush on his hero and MMR mass vaccination 'saviour' Poul Thorsen being a fugitive from justice. The guy is wanted by the Feds...


    another big can of worms in there, heh.
    Jarod likes this.
  11. AFCFS

    AFCFS Senior Member

    Messages:
    312
    Likes:
    243
    NC
    I don't mean to get off topic, but I see a similarity with Big Pharma, the FDA, and other forms of manipulation. It may be seen as conspiracy theory but was always amazed at the The FDA Ban of L-Tryptophan occurring within four days of Newsweek's article “Prozac: A Breakthrough Drug for Depression.” It is well summed up in The FDA Ban of L-Tryptophan: Politics, Profits and Prozac. An older article but still good, with note that L-Tryptophan is now available again.

    I was quite happy on L-Tryptophan circa 1989, and remember going to the drug store one day to get my OTC refill. Not there. Not long after, my pdoc, who had initially suggested L-Tryptophan, now prescribed Prozac. I am off it now and simply refuse to go that route again.

    When a current pdoc suggested the "latest and greatest" - Viibryd - I just laughed at him. Fool me once, shame on you; fool me twice, shame on me ... OK, I have been fooled a lot, but am learning.
    heapsreal likes this.
  12. wdb

    wdb Admin

    Messages:
    832
    Likes:
    581
    London
    I have always thought that, he seems to do a great job of tackling quackery in many areas but with the notable exception of the quackery that is rife in psychology/psychiatry. I assume it is because that is an area that he has been working in and so criticizing it would presumably risk damaging his career. I see he has apparently moved into epidemiology now so maybe it is something he would be able to do in the future, I doubt it though.

  13. In Vitro Infidelium

    In Vitro Infidelium Guest

    Messages:
    646
    Likes:
    280
    http://www.slingshotpublications.com/dwarfs.html

    Oh dear; All you need to know about Martin J Walker’s Dirty Medicine The Handbook

    IVI
    barbc56 likes this.
  14. alex3619

    alex3619 Senior Member

    Messages:
    7,183
    Likes:
    11,242
    Logan, Queensland, Australia
    Martin is quick to apply blame. Its a fault I found with Skewed. The events he describes however, to the extent that I have investigated them, were accurate in Skewed. My best guess is that he has built up a framework of explanations, each depending on the last framework. This is also what happens in psychobabble. As the framework expands, errors in the early framework propagate.

    The facts of the issue are however something else. I cannot comment on either version of Dirty Medicine as I have not read them.

    I never presume reviewers are right however. Its as bad as deciding on the value of a research paper by its abstract.

    Not everything in the sceptics movement is dubious. Some of it clearly is. There is no substitute for research and I do not wish to make snap judgements, all I want to do for now is generate questions that need to be answered.Those questions may sound judgemental, but then they should.

    This why I will be getting Goldacre's new book early next year. I don't presume anything about him either. I want to read what he has to say.

    When something is highly controversial, its easy to come down on one side or the other, particularly when the message of one side resonates with ones own perceptions. However almost every controversial argument has a multitude of views, and its important to consider multiple angles.

    Walker's views may be highly controversial, but that doesn't mean they are entirely wrong. The same goes for Goldacre, though his views are clearly more mainstream than Walker's.

    I really wish people would base analysis on facts. Walker tells a story. So do psychobabblers. Each is based on facts and falsehood. Analysis of these positions requires better analysis than just telling a probable or possible story, but its what we have in the record. Trying to do better is not easy.

    Over time I will be trying to verify or refute some of these claims or counter-claims. One thing about the blog by Skepticat, the claims are fairly specific, so I will be able to check them when I get around to it. Walker is equally specific though. On key points (not everything) Walker makes I will be investigating. If it cannot be substantiated then at some point I will be reporting that.

    Bye, Alex
    Valentijn likes this.
  15. barbc56

    barbc56 Senior Member

    Messages:
    1,449
    Likes:
    863
  16. PhoenixDown

    PhoenixDown Senior Member

    Messages:
    258
    Likes:
    235
    UK
    It's wasn't me who tried to comment/post, it's from the first link. So I have no idea.

    Thanks
    Phoen.D.:>)
  17. barbc56

    barbc56 Senior Member

    Messages:
    1,449
    Likes:
    863
    Sorry about that. I will change my post. :rolleyes:
  18. barbc56

    barbc56 Senior Member

    Messages:
    1,449
    Likes:
    863
    Could it be that Goldacre hasn't had the time to comment on CFS? You are presuming he has nefarious motives and truth be known we just don't know why he hasn't written on this.

    It appears people are being really picky about their criticisms. Goldacre is a psychiatrist, even worked/associated(?) in the same place as Wessley. But so what? That's like saying the janitor who worked there at the same time must also be in cohoots with Wessley.

    I admire the writings/views of Goldacre but if you want a book that I think is even better try, Trick or Treatment by Simon Singh and Edzard Ernst.
  19. user9876

    user9876 Senior Member

    Messages:
    754
    Likes:
    1,813
    I think that Goldacre thanked Wessley in one of his books.

    I used to enjoy his column in the Guardian it just got very dull. Same stuff all the time. I don't like the message that he seems to be pushing these days which is everything should be examined by randomised controlled trials. Just seems very unscientific since it lacks the notion of developing theory which is tested via experimentation. In most situations it can be really hard to control for most variables, also an over reliance on statistics and regression modeling with no theory behind it is just bad. David Freeman wrote a good article "statistics and shoe leather" a long time ago talking about the need to develop and test theories and put in the scientific work rather than just relying on a statistical model with various inappropriate assumptions around independance.

    Simon Singhs book should be good. His Code Book was a very good history of cryptography and well written.
  20. PhoenixDown

    PhoenixDown Senior Member

    Messages:
    258
    Likes:
    235
    UK
    CFS has been around his whole career as a knight of anti-quackery and some of the quackery surrounding CFS is the biggest in mainstream medicine. Remember this isn't alternative medicine we're talking about here, nor are the numbers involved small. At the very least he's soft on psychiatry.

    I've no intention of implying he's part of a conspiracy, I just think he's biased and unfair.

See more popular forum discussions.

Share This Page