6 ms·

"I know I'm not going to trust the Lancet or the NEJM ever again. It's all political now." This is an absurd reaction and I suspect you know it. There isn't a

"I know I'm not going to trust the Lancet or the NEJM ever again. It's all political now." This is an absurd reaction and I suspect you know it. There isn't a single scientific journal in the world not subject to some bias, trend, or failure of one form or another. To dismiss an entire platform because of an imperfect record amounts to an abdication of your own responsibility to form your own opinions about scientific matters. This is a responsibility for which journal reviewers can only ever take partial responsibility for both practical and intrinsic reasons. Peer review is not a rubber stamp which blesses anything which passes through it as "TRUTH." It is a minimal standard and subject, at any rate, to all the uncertainties and biases implicit in any human endeavor. It is entirely possible this paper represents a political bias. Almost everything does. It still falls to us to make reasonable judgments about science. What doesn't make sense is to reject the entire process because it fails to meet some unreachable expectation of perfection.

deleted 6y ago
[deleted]
eric_b 6y ago
> This is a responsibility for which journal reviewers can only ever take partial responsibility for both practical and intrinsic reasons. So what you're saying is we should never fully trust these journals? We should always be skeptical? That's what I'm saying too...
- macintux 6y ago
  No, you said you wouldn’t trust it at all and that it was 100% political. HN isn’t the ideal venue for hyperbole.
- seesawtron 6y ago
  But you argued as if you were always trustworthy of these Journals before but from now on, you plan to be skeptical. Your future intentions are similar but for the wrong reasons. One should always be skeptical of research and have dicsussions on the reported data and to what extent and in what context it makes sense. The media outlets summarizing the research papers very often fail to do that so as to skip the details and keep the readers happy because they assume "readers just want to know the superficial abstract knowledge, they can't possibly be interested in the critical analysis of the figures and the numbers so let's exclude that".
  - eric_b 6y ago
    But in this case the media is acting very dishonestly. I remember every major outlet posting articles about how now HCQ was debunked by this study. I have yet to see a single retraction of those articles or any new articles mentioning this. Only the science publications are covering this part of it so far.
    - cma 6y ago
      https://www.bloomberg.com/news/articles/2020-06-03/france-seeks-answers-on-lancet-s-hydroxychloroquine-study https://www.bloomberg.com/news/articles/2020-06-03/france-se... https://www.reuters.com/article/brief-the-lancet-editors-issue-expressio/brief-the-lancet-editors-issue-expression-of-concern-about-paper-on-hydroxychloroquine-covid-19-idUSFWN2DF0KT https://www.reuters.com/article/brief-the-lancet-editors-iss... https://www.theguardian.com/science/2020/may/28/questions-raised-over-hydroxychloroquine-study-which-caused-who-to-halt-trials-for-covid-19 https://www.theguardian.com/science/2020/may/28/questions-ra... https://www.wsj.com/articles/the-lancets-politicized-science-on-antimalarial-drugs-11591053222 https://www.wsj.com/articles/the-lancets-politicized-science...
    - JadeNB 6y ago
      But why should the actions of the media change your perspective on the trustworthiness of the journals?
- PiggySpeed 6y ago
  If you're healthcare, you're taught not to trust results because it was published under a brand-name journal. YES, you should be skeptical, but mostly not at the journal-level. You need to be skeptical at the article-level. That is why it's so important to be actually TRAINED to interpret the studies. The abstract of a trial is like an "advertisement" for the study. You quickly scan it to see if the study is worth reading. If it is, you make multiple passes of the article, identifying biases, understanding the study context, calculating ratios and numbers, reading through the lens of your own practice, and a bunch of other things.
  - panabee 6y ago
    i am in the process of compiling a list of ways to quickly spot flawed studies. do you mind sharing your best tips?
    - raphlinus 6y ago
      There is a course on this (taught Autumn 2019 at U Wash) that will also soon be published as a book: https://callingbullshit.org/ https://callingbullshit.org/
  - rscho 6y ago
    Healthcare pros are minimally trained in research paper interpretation and are almost all unable to perform the most basic statistical or critical review work. So yes, I'd argue that brand names are a big problem. You just have to see how proud people are when they are accepted in one of the major publication venues, and the prestige that results. I think you are not being objective.
  - cm2187 6y ago
    Except that it on the sole basis of this publication that the WHO and many other health organisations suspended ongoing trials of this molecule. So let's not pretend they would have done the same based on some random obscure journal.
- DiogenesKynikos 6y ago
  No one in science places 100% blind trust in any paper, even if it is published in a prestigious journal. In fact, scientists often say, somewhat tongue-in-cheek, "It's published in Nature, so it's probably wrong" (the more revolutionary a result, the more likely it is to be wrong, but also the more likely it is to get into one of the top journals).
  - natechols 6y ago
    Repeating what I've said in the past, anyone that has worked in scientific research for at least five years probably has a list of high-profile papers in their field that never should have made it past peer review. There's definitely at least one Nature paper in my personal hall of fame, and I'm still pissed off about it after six years.
- JoeAltmaier 6y ago
  Journals are, after all, a filter for high-correlation results using small data sets. By definition that includes every coincidental result out there. You can probably create a distribution of accuracy with enough historical data.
- ardy42 6y ago
  > So what you're saying is we should never fully trust these journals? We should always be skeptical? I think that exactly how good scientists proceed. This isn't my field, but my understanding is that research groups don't "fully trust" peer reviewed research, so they usually attempt to replicate the key results they plan to cite in their new research.
  - macinjosh 6y ago
    I agree, but if you do this you are usually labeled a ‘denier’ of some sort in regards to the topic at hand.
- lbeltrame 6y ago
  Andrew Gelman put it very well: "No, the real scandal is that the respected medical journal Lancet aids and abets in poor research practices by serving as a kind of shield for the authors of a questionable paper, by acting as if secret pre-publication review has more validity than open post-publication review." [1] [1] https://statmodeling.stat.columbia.edu/2020/06/01/this-ones-the-lancet-editorial-board-a-trolley-problem-for-our-times-involving-a-plate-of-delicious-cookies-and-a-steaming-pile-of-poop/ https://statmodeling.stat.columbia.edu/2020/06/01/this-ones-...
rayiner 6y ago
And the Lancet and the NEJM have also been willing to publish lots of studies that don’t necessarily go with their politics. It’s one of the few places you can read about the facts of the healthcare system, not just the political narratives. So it seems unfair to take the anger at the media out on these journals specifically.
- koheripbal 6y ago
  > lots of studies that don’t necessarily go with their politics. Can you provide examples? I'm sure it'll be hard, if not impossible, to provide an example that's as emotionally satisfying as directly contradicting Trump, but I'd love to see which studies you're thinking of.
  - majormajor 6y ago
    Somehow people are able to turn Trump's sheer ridiculousness and lack of credibility into a positive - they can say "you're just irrationally attacking Trump" and try to drop things there, instead of having to make the argument that Trump is right.
  - rayiner 6y ago
    Random example: hospital mergers don’t have a negative impact on patient outcomes: https://www.nejm.org/doi/full/10.1056/NEJMsa1901383 https://www.nejm.org/doi/full/10.1056/NEJMsa1901383
mhh__ 6y ago
It's much easier to throw your arms up and say "Conspiracy" than actually assess things on a case by case basis. Peer Review gone wrong -> https://www.youtube.com/watch?v=wLlA1w4OZWQ https://www.youtube.com/watch?v=wLlA1w4OZWQ
- koheripbal 6y ago
  On the other hand, we've seen so many cases of people more interested in contradicting Trump than being logical about their positions, that I don't think such theories qualify for "conspiracy" territory. ...just emotionally charged bad decisions.
  - throwaway_pdp09 6y ago
    > ...of people more interested in contradicting Trump than being logical... Precisely the way trump himself behaves, but you don't point that out.
    - koheripbal 6y ago
      ...because his stupidity isn't relevant to the point I'm making. You illustrate my point by assuming that I'm supporting him, just because I'm not criticizing him.
      - throwaway_pdp09 6y ago
        Valid point. Upvoted.
  - mhh__ 6y ago
    > On the other hand, we've seen so many cases of people more interested in contradicting Trump than being logical about their positions, Examples? His list of gaffes - that would be considered career ending for anyone - else boggles the mind e.g. Making fun of a disabled person, McCain, the Khans, accusing Joe Scarborough of murder, go back to your country, not knowing a verse from the bible, david duke etc. etc. (My point being there's enough to go on that being anti-trump on a case to case basis is almost indistinguishable from what you say for many topics in the news)
ppod 6y ago
Do you think this study would have been published if Trump had loudly proclaimed that Hydroxychlorine was dangerous and should be avoided?
- potta_coffee 6y ago
  No, but the folks here will just downvote rather than engage with you.
- BFatts 6y ago
  I still believe it would have. The information regarding COVID-19 has been evolving since the beginning, 24/7 which has lead to the "truth" changing repeatedly. Also, Trump has huge support from his business buddies, including Big Pharma so I would have to assume they would have either protected him or they would have warned him. If your implication is that the media and the science community conspired to make the president look stupid, I think you've got a big hill to climb to prove that.
  - koheripbal 6y ago
    No conspiracy is necessary. There is a mass emotional desire to contradict anything Trump says. Agreeing with something Trump says has become very taboo, particularly in academic social circles. ...and I think it's possible that's what we see here. An emotional decision to publish, and then no one wanted to contradict because no one wanted to be viewed as a Trump sympathizer.
pacala 6y ago
It is an abdication of responsibility from Lancet / NEJM editors. Everyone not living under a rock is well aware hydroxychloroquine has, unfortunately, become a political hot potato. In this context, a paper purporting results counter to decades of clinical practice should warrant a modicum of additional scrutiny. This incident comes in the middle of the replication crisis, with 50%-70% of studies failing replication, including in the medical sciences field. Furthermore, many suspect that BigPharma pushes inconclusive garbage as peer reviewed science to promote commercial interests. Then there is the response to covid19, which, justified or not, some regard as catastrophic overreaction. The BigScience enterprise is in peril of losing public trust. Which is a terrible loss. Lancet / NEJM editors failed. There are no excuses. The right course of action is to apologize, not to further antagonize the public. Try humility for a while.
joshuakelly 6y ago
Lancet is different than other scientific journals - it is the pinnacle. Publishing something so bad is reputationally harmful in ways that might not be so severe in other cases. Of course, this isn't the first incident Lancet has had (recalling the Wakefield incident in particular), but it should not be excused - just as Wakefield shouldn't - and should be judged rather harshly.
- salmon30salmon 6y ago
  Edit: As OP mentioned, this is the "wakefield incident" Don't forget, The Lancet is also the journal which published the paper that kicked off the anti-vax movement: https://en.wikipedia.org/wiki/Lancet_MMR_autism_fraud https://en.wikipedia.org/wiki/Lancet_MMR_autism_fraud
  - andrepd 6y ago
    This is what GP means by "Wakefield".
  - gamblor956 6y ago
    That is the Wakefield incident he was referring to.
- yaj54 6y ago
  TIL about the Wakefield incident. TY.
- OJFord 6y ago
  It also published [0] which seemed to be the ultimate source for the 'ibuprofen kills COVID-19 patients' scare, every article I found on ibuprofen+coronavirus led back there, which matter-of-factly states: > ACE2 can also be increased by thiazolidinediones and ibuprofen. The closest thing I could find [2] to a source for that was [1]: > NSAIDs [Non-Steroidal Anti-inflammatory Drugs, which includes ibuprofen] might affect how Covid-19 binds to human cells, according to Dr. Yogen Kanthi, assistant professor of cardiology at the University of Michigan, who studies inflammation. > “There is data from basic science studies that have shown that Covid-19 itself binds to a protein at the surface of cells called ACE2,” he said. “There is a hypothetical risk that giving NSAIDs like ibuprofen could increase levels of ACE2 shown in animal models, but not in patients.” [0] - https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(20)30116-8.pdf https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600... [1] - https://kvia.com/health/2020/03/17/france-says-ibuprofen-may-aggravate-coronavirus-experts-say-more-evidence-is-needed/ https://kvia.com/health/2020/03/17/france-says-ibuprofen-may... [2] - https://news.ycombinator.com/item?id=22611363 https://news.ycombinator.com/item?id=22611363
Alex3917 6y ago
> This is an absurd reaction and I suspect you know it. Why? They knew the data was fake when they published it, but they published it anyway to boost sales of Remdesivir. They're literally trying to make money by killing people. If you wouldn't trust someone if you saw them run over someone else with their car, why would you trust Lancet?

deleted 6y ago

[deleted]

eric_b 6y ago

> This is a responsibility for which journal reviewers can only ever take partial responsibility for both practical and intrinsic reasons. So what you're saying is we should never fully trust these journals? We should always be skeptical? That's what I'm saying too...

macintux 6y ago
No, you said you wouldn’t trust it at all and that it was 100% political. HN isn’t the ideal venue for hyperbole.
seesawtron 6y ago
But you argued as if you were always trustworthy of these Journals before but from now on, you plan to be skeptical. Your future intentions are similar but for the wrong reasons. One should always be skeptical of research and have dicsussions on the reported data and to what extent and in what context it makes sense. The media outlets summarizing the research papers very often fail to do that so as to skip the details and keep the readers happy because they assume "readers just want to know the superficial abstract knowledge, they can't possibly be interested in the critical analysis of the figures and the numbers so let's exclude that".
- eric_b 6y ago
  But in this case the media is acting very dishonestly. I remember every major outlet posting articles about how now HCQ was debunked by this study. I have yet to see a single retraction of those articles or any new articles mentioning this. Only the science publications are covering this part of it so far.
  - cma 6y ago
    https://www.bloomberg.com/news/articles/2020-06-03/france-seeks-answers-on-lancet-s-hydroxychloroquine-study https://www.bloomberg.com/news/articles/2020-06-03/france-se... https://www.reuters.com/article/brief-the-lancet-editors-issue-expressio/brief-the-lancet-editors-issue-expression-of-concern-about-paper-on-hydroxychloroquine-covid-19-idUSFWN2DF0KT https://www.reuters.com/article/brief-the-lancet-editors-iss... https://www.theguardian.com/science/2020/may/28/questions-raised-over-hydroxychloroquine-study-which-caused-who-to-halt-trials-for-covid-19 https://www.theguardian.com/science/2020/may/28/questions-ra... https://www.wsj.com/articles/the-lancets-politicized-science-on-antimalarial-drugs-11591053222 https://www.wsj.com/articles/the-lancets-politicized-science...
  - JadeNB 6y ago
    But why should the actions of the media change your perspective on the trustworthiness of the journals?
PiggySpeed 6y ago
If you're healthcare, you're taught not to trust results because it was published under a brand-name journal. YES, you should be skeptical, but mostly not at the journal-level. You need to be skeptical at the article-level. That is why it's so important to be actually TRAINED to interpret the studies. The abstract of a trial is like an "advertisement" for the study. You quickly scan it to see if the study is worth reading. If it is, you make multiple passes of the article, identifying biases, understanding the study context, calculating ratios and numbers, reading through the lens of your own practice, and a bunch of other things.
- panabee 6y ago
  i am in the process of compiling a list of ways to quickly spot flawed studies. do you mind sharing your best tips?
  - raphlinus 6y ago
    There is a course on this (taught Autumn 2019 at U Wash) that will also soon be published as a book: https://callingbullshit.org/ https://callingbullshit.org/
- rscho 6y ago
  Healthcare pros are minimally trained in research paper interpretation and are almost all unable to perform the most basic statistical or critical review work. So yes, I'd argue that brand names are a big problem. You just have to see how proud people are when they are accepted in one of the major publication venues, and the prestige that results. I think you are not being objective.
- cm2187 6y ago
  Except that it on the sole basis of this publication that the WHO and many other health organisations suspended ongoing trials of this molecule. So let's not pretend they would have done the same based on some random obscure journal.
DiogenesKynikos 6y ago
No one in science places 100% blind trust in any paper, even if it is published in a prestigious journal. In fact, scientists often say, somewhat tongue-in-cheek, "It's published in Nature, so it's probably wrong" (the more revolutionary a result, the more likely it is to be wrong, but also the more likely it is to get into one of the top journals).
- natechols 6y ago
  Repeating what I've said in the past, anyone that has worked in scientific research for at least five years probably has a list of high-profile papers in their field that never should have made it past peer review. There's definitely at least one Nature paper in my personal hall of fame, and I'm still pissed off about it after six years.
JoeAltmaier 6y ago
Journals are, after all, a filter for high-correlation results using small data sets. By definition that includes every coincidental result out there. You can probably create a distribution of accuracy with enough historical data.
ardy42 6y ago
> So what you're saying is we should never fully trust these journals? We should always be skeptical? I think that exactly how good scientists proceed. This isn't my field, but my understanding is that research groups don't "fully trust" peer reviewed research, so they usually attempt to replicate the key results they plan to cite in their new research.
- macinjosh 6y ago
  I agree, but if you do this you are usually labeled a ‘denier’ of some sort in regards to the topic at hand.
lbeltrame 6y ago
Andrew Gelman put it very well: "No, the real scandal is that the respected medical journal Lancet aids and abets in poor research practices by serving as a kind of shield for the authors of a questionable paper, by acting as if secret pre-publication review has more validity than open post-publication review." [1] [1] https://statmodeling.stat.columbia.edu/2020/06/01/this-ones-the-lancet-editorial-board-a-trolley-problem-for-our-times-involving-a-plate-of-delicious-cookies-and-a-steaming-pile-of-poop/ https://statmodeling.stat.columbia.edu/2020/06/01/this-ones-...

rayiner 6y ago

And the Lancet and the NEJM have also been willing to publish lots of studies that don’t necessarily go with their politics. It’s one of the few places you can read about the facts of the healthcare system, not just the political narratives. So it seems unfair to take the anger at the media out on these journals specifically.

koheripbal 6y ago
> lots of studies that don’t necessarily go with their politics. Can you provide examples? I'm sure it'll be hard, if not impossible, to provide an example that's as emotionally satisfying as directly contradicting Trump, but I'd love to see which studies you're thinking of.
- majormajor 6y ago
  Somehow people are able to turn Trump's sheer ridiculousness and lack of credibility into a positive - they can say "you're just irrationally attacking Trump" and try to drop things there, instead of having to make the argument that Trump is right.
- rayiner 6y ago
  Random example: hospital mergers don’t have a negative impact on patient outcomes: https://www.nejm.org/doi/full/10.1056/NEJMsa1901383 https://www.nejm.org/doi/full/10.1056/NEJMsa1901383

mhh__ 6y ago

It's much easier to throw your arms up and say "Conspiracy" than actually assess things on a case by case basis. Peer Review gone wrong -> https://www.youtube.com/watch?v=wLlA1w4OZWQ https://www.youtube.com/watch?v=wLlA1w4OZWQ

koheripbal 6y ago
On the other hand, we've seen so many cases of people more interested in contradicting Trump than being logical about their positions, that I don't think such theories qualify for "conspiracy" territory. ...just emotionally charged bad decisions.
- throwaway_pdp09 6y ago
  > ...of people more interested in contradicting Trump than being logical... Precisely the way trump himself behaves, but you don't point that out.
  - koheripbal 6y ago
    ...because his stupidity isn't relevant to the point I'm making. You illustrate my point by assuming that I'm supporting him, just because I'm not criticizing him.
    - throwaway_pdp09 6y ago
      Valid point. Upvoted.
- mhh__ 6y ago
  > On the other hand, we've seen so many cases of people more interested in contradicting Trump than being logical about their positions, Examples? His list of gaffes - that would be considered career ending for anyone - else boggles the mind e.g. Making fun of a disabled person, McCain, the Khans, accusing Joe Scarborough of murder, go back to your country, not knowing a verse from the bible, david duke etc. etc. (My point being there's enough to go on that being anti-trump on a case to case basis is almost indistinguishable from what you say for many topics in the news)

ppod 6y ago

Do you think this study would have been published if Trump had loudly proclaimed that Hydroxychlorine was dangerous and should be avoided?

potta_coffee 6y ago
No, but the folks here will just downvote rather than engage with you.
BFatts 6y ago
I still believe it would have. The information regarding COVID-19 has been evolving since the beginning, 24/7 which has lead to the "truth" changing repeatedly. Also, Trump has huge support from his business buddies, including Big Pharma so I would have to assume they would have either protected him or they would have warned him. If your implication is that the media and the science community conspired to make the president look stupid, I think you've got a big hill to climb to prove that.
- koheripbal 6y ago
  No conspiracy is necessary. There is a mass emotional desire to contradict anything Trump says. Agreeing with something Trump says has become very taboo, particularly in academic social circles. ...and I think it's possible that's what we see here. An emotional decision to publish, and then no one wanted to contradict because no one wanted to be viewed as a Trump sympathizer.

pacala 6y ago

It is an abdication of responsibility from Lancet / NEJM editors. Everyone not living under a rock is well aware hydroxychloroquine has, unfortunately, become a political hot potato. In this context, a paper purporting results counter to decades of clinical practice should warrant a modicum of additional scrutiny. This incident comes in the middle of the replication crisis, with 50%-70% of studies failing replication, including in the medical sciences field. Furthermore, many suspect that BigPharma pushes inconclusive garbage as peer reviewed science to promote commercial interests. Then there is the response to covid19, which, justified or not, some regard as catastrophic overreaction. The BigScience enterprise is in peril of losing public trust. Which is a terrible loss. Lancet / NEJM editors failed. There are no excuses. The right course of action is to apologize, not to further antagonize the public. Try humility for a while.

joshuakelly 6y ago

Lancet is different than other scientific journals - it is the pinnacle. Publishing something so bad is reputationally harmful in ways that might not be so severe in other cases. Of course, this isn't the first incident Lancet has had (recalling the Wakefield incident in particular), but it should not be excused - just as Wakefield shouldn't - and should be judged rather harshly.

salmon30salmon 6y ago
Edit: As OP mentioned, this is the "wakefield incident" Don't forget, The Lancet is also the journal which published the paper that kicked off the anti-vax movement: https://en.wikipedia.org/wiki/Lancet_MMR_autism_fraud https://en.wikipedia.org/wiki/Lancet_MMR_autism_fraud
- andrepd 6y ago
  This is what GP means by "Wakefield".
- gamblor956 6y ago
  That is the Wakefield incident he was referring to.
yaj54 6y ago
TIL about the Wakefield incident. TY.
OJFord 6y ago
It also published [0] which seemed to be the ultimate source for the 'ibuprofen kills COVID-19 patients' scare, every article I found on ibuprofen+coronavirus led back there, which matter-of-factly states: > ACE2 can also be increased by thiazolidinediones and ibuprofen. The closest thing I could find [2] to a source for that was [1]: > NSAIDs [Non-Steroidal Anti-inflammatory Drugs, which includes ibuprofen] might affect how Covid-19 binds to human cells, according to Dr. Yogen Kanthi, assistant professor of cardiology at the University of Michigan, who studies inflammation. > “There is data from basic science studies that have shown that Covid-19 itself binds to a protein at the surface of cells called ACE2,” he said. “There is a hypothetical risk that giving NSAIDs like ibuprofen could increase levels of ACE2 shown in animal models, but not in patients.” [0] - https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(20)30116-8.pdf https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600... [1] - https://kvia.com/health/2020/03/17/france-says-ibuprofen-may-aggravate-coronavirus-experts-say-more-evidence-is-needed/ https://kvia.com/health/2020/03/17/france-says-ibuprofen-may... [2] - https://news.ycombinator.com/item?id=22611363 https://news.ycombinator.com/item?id=22611363

Alex3917 6y ago

> This is an absurd reaction and I suspect you know it. Why? They knew the data was fake when they published it, but they published it anyway to boost sales of Remdesivir. They're literally trying to make money by killing people. If you wouldn't trust someone if you saw them run over someone else with their car, why would you trust Lancet?