12 ms·

There is a worrying amount of fraud in medical research

296 points by martincmartin 4y ago

pella 4y ago
https://archive.md/KsZJL https://archive.md/KsZJL
_fol8 4y ago
The major journals have absolutely no accountability. In any other market, if the product doesn't work or harms someone the company goes out of business or the maker is sued. Not so in journals. So, why do we accept it? Because there's no other way for the layman to determine what makes a good professor, because by definition, they are smarter than us (or at least they're supposed to be), and so we (the general public) are not able to tell if they are good at what they do or not. So - the answer we have is peer review, which is just the foxes guarding the hen house. There's no other solution that's been proposed that makes any sense in a self reinforcing market manner. Having some post-docs suddenly become concerned about this and hire a bunch of undergraduates to start using to comb excel with spreadsheets will be useful until everyone loses interest. The price of a can of Coca-Cola isn't useful until people lose interest - it's market priced by millions of customers at every minute of every day. Until there's a solution to this problem that makes sense this will keep happening over and over again.
- sjkoelle 4y ago
  could start by paying journal reviewers
  - jrumbut 4y ago
    This is an underrated idea. Putting a very smart and motivated person on the other side of the proble is better than any static set of incentives that can be gamed.
    - sjkoelle 4y ago
      some sort of discount consultant rate might be justified... author pays the reviewers rather than the random publishing fees.... want your paper reviewed, pay $2k
- stocknoob 4y ago
  Prediction markets may be an option: https://www.pnas.org/doi/10.1073/pnas.1516179112 https://www.pnas.org/doi/10.1073/pnas.1516179112 Similar to how charities (ostensibly) can be rated by Charity Navigator, and colleges (ostensibly) can be rated by US News, the credibility of various studies (and the journals that publish them) can be measured.
- patientplatypus 4y ago
  [dead]
- projektfu 4y ago
  It matters to people who are actually doing science because they replicate findings in their own labs before relying on them. Hopefully they will get control of this problem because it's incredibly wasteful to chase red herrings that were never actually true findings in any lab. Labs that try to stand on previous work without verifying it are standing on a house of cards
- moremetadata 4y ago
  > In any other market, if the product doesn't work or harms someone the company goes out of business or the maker is sued. Not strictly true, here in the UK you wont get refunds for drug treatments that dont work if seeing a private gp (or vet), thats why the NHS exists, its harder to sue the NHS in those conditions. NICE who decide what drugs to use, is veiled in secrecy unless you can attend one of their public meetings, just like its impossible to attend every court case, its a form of resource burning which only the rich entities can afford. IF you do challenge any drugs, you'll get passed from pillar to post until you under up in the govt's lap and they make the rules up as they go along, but its very hard to get any recourse unless you can afford expensive lawyers who know the technicalities to use as an approach vector.
- patientplatypus 4y ago
  [dead]
ubj 4y ago
Retraction Watch [1] is a great source of additional examples of unethical behavior in scientific research. [1]: https://retractionwatch.com/ https://retractionwatch.com/
- Yorch 4y ago
  WOW. I was reading in that webpage that also exists advertising authorships of scientific papers for sale.
apienx 4y ago
> "Going by these numbers, roughly one in 1,000 papers gets retracted [..] that something more like one in 50 papers has results which are unreliable because of fabrication, plagiarism or serious errors." I'd say these are underestimates. Let me add that 80%+ of papers are useless. The only "value" they provide is to the person getting academically promoted and/or building their publishing portfolio/cred.
- ska 4y ago
  > The only "value" they provide is.. As far as I can see this is mostly an incentives problem. Bureaucratic control of academic hiring has ended up emphasizing the short term measurable (e.g. #of pages published, so-called impact factors, etc.) over the long term, with pretty predictable results. Medical research in particular is fraught with another set of problems; the default clinical pathway gives a weak at best grounding in science, and even the MD/PhD programs have been gamed to some degree. There are definite counterexamples (lots!) but there are also a lot of clinicians with incentive to produce research but little skill in it and even less time available...
  - opportune 4y ago
    I think zooming further out, the incentive for academia is to churn out degrees + get grants. Getting a PhD is supposed to require doing something that nobody has done before. Most people getting PhDs/in academia are not actually good enough to do this (it’s really hard! There’s not a ton of low hanging fruit, and you’re “competing” with many others), which is why we end up with tons of garbage papers nobody will ever care about. Medical research may be performed by MDs but the incentives are still basically the same: papers are resume builders. It looks better when applying to a fellowship/job to have a nice publication history. Obviously the best case is to have worked on some really groundbreaking stuff - still really hard - but the next best case is to have a ton of meh publications, since that beats having a few publications, or no publications. In medical programs the grant thing is a lot bigger too because there is, rightfully, tons of money to throw to that area. You need grants as an academic to progress. You won’t keep getting grants if you take grants and then don’t publish anything, so even if you have nothing good come out of it, you need to publish something. That incentivizes fraud in the worst case and noise in the best. The better-best case would be if academia were more open to accepting null results
i-use-nixos-btw 4y ago
I recall reading -somewhere - about a similar problem in psychology journals. The problem there is worse, in terms of correctness, because the journals don’t publish negative results, including when the negative results disprove a previously published paper. In medical journals, though, the problem is worse because it is more likely to kill someone.
- PaulKeeble 4y ago
  A lot of the medicine paper fraud is in Psychology papers. They are notorious for badly setup studies with intentionally leading questionaires for data. No amount of peer review seems to improve them and a journal somewhere will always publish it. The volume is quite staggering as well, ~40 Psychologists are responsible for an insane amount of papers all with the same methodology problems showing it can cure everything. Apparently every disease has Psychology problems. In practice no one is getting better from their proposed and trailed treatments and patients repeatedly complain about it, but they are everywhere in Europe and the vast majority of doctors believe in these specialist even though the papers are universally review as very low quality even when they aren't faking data or manipulating the stats to produce an outcome.
  - quickthrowman 4y ago
    > A lot of the medicine paper fraud is in Psychology papers. Psychology is not medicine, it’s an academic discipline. Psychiatry is the branch of medicine that deals with mental health.
    - PaulKeeble 4y ago
      A common misconception, here is one of the famous 40 at Kings College: https://www.kcl.ac.uk/people/professor-trudie-chalder https://www.kcl.ac.uk/people/professor-trudie-chalder They probably shouldn't be in medicine, certainly not running departments in hospitals but they are.
- nradov 4y ago
  There is a reproducibility (replication) crisis in psychology. Much of what psychologists accepted as settled for years has turned out to be bunk. While there are some researchers doing excellent work, much of the field remains no more scientific than phrenology. https://www.theatlantic.com/science/archive/2018/11/psychologys-replication-crisis-real/576223/ https://www.theatlantic.com/science/archive/2018/11/psycholo...
deleted 4y ago
[deleted]
corbulo 4y ago
P hacking more generally has been an issue for some time. Its difficult to trust really almost any study even if you find parts of it to be reliable. Take one or a few stats courses to find out how easy it is to smudge data with no one being the wiser. Its a real problem.
- krona 4y ago
  For the reasons you say, I regard papers that report p-values without effect sizes to be at most interesting, but probably irrelevant for making actual real-life decisions.
bmacho 4y ago
Who would you trust? People that -are-doing-it-their-whole-life- that have an interest to lie to you, or a correct sounding reasoning and the wisdom of billions of people for milleniums?
- uoaei 4y ago
  Wisdom like what? "Sky daddy solves everything"? For the record, there's lots we can learn from ancient and indigenous knowledge, but let's not pretend that everything would be better if we cast off the whole lot of modern society.
pedalpete 4y ago
I feel this is an area where AI could be helpful in recognizing suspected fraudulent, or potentially just poorly studied research.
- eep_social 4y ago
  Why do you say that?
- anitil 4y ago
  I used to follow a blog (possibly retraction watch? I can't remember now) where they would go through basic biology papers and find photoshopped/edited images and ask the author about them. Sometimes this would lead to retractions etc. They did mention other people had tried and failed to build tools for this, but the current state of the art was drinking-a-coffee-and-looking-at-it-real-hard. This was before the current explosion of AI, so maybe it's different now? Anyone else able to chime in? Edit: Found it! https://scienceintegritydigest.com https://scienceintegritydigest.com
etidorhpa 4y ago
No surprise here. Just put together a bunch of data and make up the statistics. No one's the wiser. "Now hurry and let me sell Oxycontin to children" -FDA
- m00x 4y ago
  This is highly misleading. The FDA requires a lot more than a few medical papers. They have their own guidelines for studies, and you have to follow them to the letter. They also have investigators present to make sure data isn't mislabeled or incorrect. The Oxycontin issue wasn't that the medicine wasn't safe, is that it was deemed safe by the FDA for its intended use, then it was pushed to doctors to go beyond its intended use. The FDA was too late to respond to this, but it was undetected by the majority of the medical field because people went to the streets for re-ups, and doctors didn't want to admit fault. This is mostly due to improper regulation in how drug companies are allowed to interact with doctors, and the lack of healthcare resources.
  - sammalloy 4y ago
    "How FDA Failures Contributed to the Opioid Crisis" https://journalofethics.ama-assn.org/article/how-fda-failures-contributed-opioid-crisis/2020-08 https://journalofethics.ama-assn.org/article/how-fda-failure... 1. Failure to Properly Enforce Marketing Regulations 2. Failure to Obtain Evidence of Long-term Safety and Effectiveness 3. Failure to Manage Conflicts of Interest And my personal favorite: > An FDA official who led the approval of OxyContin got a $400,000 gig at Purdue Pharma a year later Special mention: > A former senior U.S. Drug Enforcement Administration official who spent three decades at the DEA, specializing in preventing the diversion of prescription drugs like OxyContin, is now paid to advise one of the largest opioid manufacturers in the country, Purdue Pharma
    - m00x 4y ago
      Yes, I read that part. It doesn't counter any of my points, they actually enforce them. Oxycontin was safe to use for their intended purposes, but they were not used that way. It wasn't the approval process that was problematic, just the follow-up.
PicassoCTs 4y ago
Im advocating for "You keep what you kill" rules in science. If you disprove a paper or proof a study can not be replicated, you get the funds of the scientist, subtracted from his/her current funding. Make bad science fund the good science and make de-replication a for profit endeavor. There can be all funding in the world for quack science, but if it can be debunked and is debunked, it will finance real science.
- deleted 4y ago
  [deleted]
- bobmaxup 4y ago
  How would this stop fraud? Wouldn't there be a possibility of endless cycles of fraud?
- LeonB 4y ago
  As a thought experiment I think that’s brilliant. As an actual plan though I think it would be terrible. There are so many ways to fail to reproduce an experiment. Incentivising the failure to reproduce is just a very out there idea.
- avs733 4y ago
  It would be far more effective if you got their citation count instead.
  - PicassoCTs 4y ago
    But the untruth of one system, makes the truth of the other not a given. So, transferring funds makes more sense, as it just shifts the chance to be true, towards the more "scientific" part of the system. It also adds lag to the system, so you do not get a constant switching reward functions.
    - avs733 4y ago
      Oh I’m in no way suggesting it’s truth, just that it’s a more tangible reward in current system of academia. I should have added the inevitable /s. When I transitioned from grad student to faculty, one thing that struck me most was when faculty candidates were discussed in my first year and the first slide about all of them was a histogram of citations. You can hear it all you want but seeing it just crushed my soul a little bit.
parton 4y ago
If you were to ask experts in a given subfield which papers are reliable, I'm sure they would be able to tell you. The problem is that there's no process in science for expert consensus to make it to out to doctors/laypeople. People assume that peer review means a paper is good, which couldn't be farther from the truth. Science journalists aren't any better, they care more about hype than consensus. Honestly, it's dangerous to give a random peer reviewed article to someone who doesn't have broad knowledge of the field. Maybe we need middle-ground journals that publish review articles at the level of a Scientific American reader?
- epgui 4y ago
  That’s pretty bang on (biochemist).
- AlotOfReading 4y ago
  That's one of the intended purposes of review journals like Annual Reviews (https://www.annualreviews.org/ https://www.annualreviews.org/). There are some pretty big practical issues with them though: 1. Sometimes the latest article on a subject was written 2/5/10 years ago. Depending on quickly the field is moving, that review could be perfectly acceptable, completely obsolete, or anywhere in between. 2. Sometimes the author themselves is just out of date with the field. It's difficult to identify this without deep prior familiarity. 3. Paywalls. I don't know what the solutions are beyond "making experts accessible for questions" and other public outreach things.
- pella 4y ago
  > People assume that peer review means a paper is good ... "Conclusions: Parachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention." https://www.bmj.com/content/363/bmj.k5094 https://www.bmj.com/content/363/bmj.k5094 see the "Peer review" https://www.bmj.com/content/363/bmj.k5094/peer-review https://www.bmj.com/content/363/bmj.k5094/peer-review
  - jnsie 4y ago
    Please tell me this is satire
jszymborski 4y ago
Since we're on the topic of bad science, the first figure in that article (Pants on Fire) is a pretty bad one. The units on the Y-axis are not specified (strike one), but it looks to be the _unnormalized_ number of papers retracted each year. The yearly retraction _rate_ (i.e. the number of retracted paper per number of papers published) is what is relevant here. The number of journals have and papers have exploded since '96.
dadjoker 4y ago
Isn't peer review supposed to catch stuff like this? I mean, that's supposedly the "gold standard" for studies, right?
- tptacek 4y ago
  No, peer review is absolutely not the "gold standard" for studies. Replication is closer to the gold standard, but replication is a scientific project all its own. Peer review is a sanity check before allowing a research contribution to become part of the conversation in its field. (I've done some academic reviewing, but this is a point I've shoplifted from Stefan Savage).
- PeterisP 4y ago
  Peer review is not the "gold standard" but rather table stakes; if some paper can't even pass that, it's probably not worth even skimming the abstract.
ekianjo 4y ago
They only realize it now?
dadrian 4y ago
As a reminder, peer review is not designed adversarially. It is not supposed to catch people who are fraudulent before they publish---that's the point of replication (which happens rarily). Peer review is designed to ensure a the publication as a packaged work of science describes a valid experiment. But you're necessarily assuming that the authors did what they said they did. As a peer reviewer, you're ensuring that what the authors said they did constitutes valid science.
- aggie 4y ago
  In practice, peer review isn't even that. Most referees are not double-checking your statistical analysis. What they focus on is whether the research is interesting and has it appropriately considered relevant literature. Even that is not always done carefully. Here is an argument that peer review is basically a failed experiment: https://experimentalhistory.substack.com/p/the-rise-and-fall-of-peer-review https://experimentalhistory.substack.com/p/the-rise-and-fall...
  - dadrian 4y ago
    I think we're saying the same thing. You're trusting the statistical analysis done by the author. When I peer review, I check to make sure that the conclusions the paper draws are in line with what it says statistical analysis was, and I check to make sure that the analysis used is the right one, but I don't check their math. And also, I'm not a statistician, so I'm not authoritative on the full space of statistical analysis, anyway.
    - nieto915 4y ago
      who really has all of the hours in a day to do it too. I think it'll all come down to the journal's integrity. academia will have to learn to negotiate the premiums of their library subscriptions for better editing/curation for each journal they subscribe to. its already pay to play, might as well get your money's worth.
      - jhbadger 4y ago
renewiltord 4y ago
I've talked about an experience someone in my family had before. Straight up fabrication in a lab, and it wouldn't be really detectable until you attempt to replicate and then check the pictures after. https://news.ycombinator.com/item?id=25926188 https://news.ycombinator.com/item?id=25926188
Gatsky 4y ago
I maintain that the best analogy for life sciences research is naval exploration. Some people tell tales of their great voyages but never set foot on a boat. Some sailed, yet found nothing, and still spin a story to avoid embarrassment. And some actually found America. Science is obsessed with these stories enshrined in journal articles, which are elevated to the status of artefacts of knowledge, complete with Excel spreadsheets in the supplementary info. Creating such artefacts determines everything in your scientific career. That is the actual problem in my opinion. Of course people will want to fake these powerful status symbols.
breck 4y ago
I've been in medical research for 5 years and saw so much fraud and incompetence my guess is 20% of it is honest work. But have hope, we're gonna fix it: https://cancerdb.com/ https://cancerdb.com/
tchvil 4y ago
This blog post from the BMJ wasn't particularly comforting when published in the middle of covid: https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-health-research-is-fraudulent-until-proved-otherwise/ https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-hea... Richard Smith was the editor of The BMJ until 2004. Competing interest: RS was a cofounder of the Committee on Medical Ethics (COPE), for many years the chair of the Cochrane Library Oversight Committee, and a member of the board of the UK Research Integrity Office.
est 4y ago
The funding gotta go somewhere somehow.
refurb 4y ago
I think the one piece people miss is that scientists dont assume the literature is reliable. When i worked in the lab, it was well know that a good part of the literature can not be replicated. On top of that, specific journals and labs have reputations for less-than-quality research. If a paper comes out, its not assumed to be true until proven otherwise (usually expanded upon by others). The only time that's different is if it comes from certain labs that are known to have a good track record. So its not like shoddy research is causing other scientists to waste time except maybe the time spent reading the paper.
bongoman37 4y ago
[dead]
wrp 4y ago
This looks like a good opportunity to ask a question I've had for a long time. In what field(s) of research is it respectable to ask, "Has this paper been peer reviewed?" I've spent nearly four decades working mostly in academia with scientists, engineers, social scientists of various degrees of rigor, and even occasional humanities types. I don't think I have ever been in a group where someone did or would raise the issue of peer review when discussing the quality of a report. In all groups I've associated with, you are expected to know enough about your field to be able to assess for yourself the quality of a paper as you read it. Relying on some anonymous reviewer's judgement to justify your acceptance of a report would cast serious doubt on your own judgement. I've been trying to note just who raises this issue and they appear to be most often in life sciences/medicine. I've never worked in that general area, but my impression is that knowledge of statistics and methodology is rather weaker than in other scientific fields. My (perhaps uncharitable) theory is that peer review has become a gateway for automatic acceptance because the average technical expertise of readers is so low that they cannot evaluate for themselves.
shellfishgene 4y ago
If you look at why papers are found out as fraudulent and retracted it's usually very dumb mistakes, such as the examples from the article, copying data and/or text from elsewhere, making up numbers that are obvously implausible, and cloning/photoshopping figures or parts thereof, even within the paper. Given how easy it is to avoid these beginner mistakes the percentage of fake data must be so much higher than the actual retractions. Especially from the paper mills where faking data is done by professional fraudsters.
machina_ex_deus 4y ago
96% vaccine effectiveness! Into absolute uselessness when deployed to the masses. As someone who believed them and took the vaccine, that was the last time I'm trusting medical research. I won't be fooled again, and from now on research won't be enough to make any personal decision, I'm waiting until independent evaluation in the real world happens and there are enough anecdotes to see that it really works as advertised. The entire coronavirus debacle has corroded the trust in medical establishment to zero. I think it's justified and we've just been ignorant to the fraud, it took a lie so big and obvious to really wake people up.
shellfishgene 4y ago
I wonder if journals, especially medical ones, could be sued if they don't react and redact studies in time once notified of problems, and patients get ineffective or even detrimental treatment based on those papers.

296 points by martincmartin 4y ago

https://archive.md/KsZJL https://archive.md/KsZJL

The major journals have absolutely no accountability. In any other market, if the product doesn't work or harms someone the company goes out of business or the maker is sued. Not so in journals. So, why do we accept it? Because there's no other way for the layman to determine what makes a good professor, because by definition, they are smarter than us (or at least they're supposed to be), and so we (the general public) are not able to tell if they are good at what they do or not. So - the answer we have is peer review, which is just the foxes guarding the hen house. There's no other solution that's been proposed that makes any sense in a self reinforcing market manner. Having some post-docs suddenly become concerned about this and hire a bunch of undergraduates to start using to comb excel with spreadsheets will be useful until everyone loses interest. The price of a can of Coca-Cola isn't useful until people lose interest - it's market priced by millions of customers at every minute of every day. Until there's a solution to this problem that makes sense this will keep happening over and over again.

sjkoelle 4y ago
could start by paying journal reviewers
- jrumbut 4y ago
  This is an underrated idea. Putting a very smart and motivated person on the other side of the proble is better than any static set of incentives that can be gamed.
  - sjkoelle 4y ago
    some sort of discount consultant rate might be justified... author pays the reviewers rather than the random publishing fees.... want your paper reviewed, pay $2k
stocknoob 4y ago
Prediction markets may be an option: https://www.pnas.org/doi/10.1073/pnas.1516179112 https://www.pnas.org/doi/10.1073/pnas.1516179112 Similar to how charities (ostensibly) can be rated by Charity Navigator, and colleges (ostensibly) can be rated by US News, the credibility of various studies (and the journals that publish them) can be measured.
patientplatypus 4y ago
[dead]
projektfu 4y ago
It matters to people who are actually doing science because they replicate findings in their own labs before relying on them. Hopefully they will get control of this problem because it's incredibly wasteful to chase red herrings that were never actually true findings in any lab. Labs that try to stand on previous work without verifying it are standing on a house of cards
moremetadata 4y ago
> In any other market, if the product doesn't work or harms someone the company goes out of business or the maker is sued. Not strictly true, here in the UK you wont get refunds for drug treatments that dont work if seeing a private gp (or vet), thats why the NHS exists, its harder to sue the NHS in those conditions. NICE who decide what drugs to use, is veiled in secrecy unless you can attend one of their public meetings, just like its impossible to attend every court case, its a form of resource burning which only the rich entities can afford. IF you do challenge any drugs, you'll get passed from pillar to post until you under up in the govt's lap and they make the rules up as they go along, but its very hard to get any recourse unless you can afford expensive lawyers who know the technicalities to use as an approach vector.
patientplatypus 4y ago
[dead]

ubj 4y ago

Retraction Watch [1] is a great source of additional examples of unethical behavior in scientific research. [1]: https://retractionwatch.com/ https://retractionwatch.com/

Yorch 4y ago
WOW. I was reading in that webpage that also exists advertising authorships of scientific papers for sale.

apienx 4y ago

> "Going by these numbers, roughly one in 1,000 papers gets retracted [..] that something more like one in 50 papers has results which are unreliable because of fabrication, plagiarism or serious errors." I'd say these are underestimates. Let me add that 80%+ of papers are useless. The only "value" they provide is to the person getting academically promoted and/or building their publishing portfolio/cred.

ska 4y ago
> The only "value" they provide is.. As far as I can see this is mostly an incentives problem. Bureaucratic control of academic hiring has ended up emphasizing the short term measurable (e.g. #of pages published, so-called impact factors, etc.) over the long term, with pretty predictable results. Medical research in particular is fraught with another set of problems; the default clinical pathway gives a weak at best grounding in science, and even the MD/PhD programs have been gamed to some degree. There are definite counterexamples (lots!) but there are also a lot of clinicians with incentive to produce research but little skill in it and even less time available...
- opportune 4y ago
  I think zooming further out, the incentive for academia is to churn out degrees + get grants. Getting a PhD is supposed to require doing something that nobody has done before. Most people getting PhDs/in academia are not actually good enough to do this (it’s really hard! There’s not a ton of low hanging fruit, and you’re “competing” with many others), which is why we end up with tons of garbage papers nobody will ever care about. Medical research may be performed by MDs but the incentives are still basically the same: papers are resume builders. It looks better when applying to a fellowship/job to have a nice publication history. Obviously the best case is to have worked on some really groundbreaking stuff - still really hard - but the next best case is to have a ton of meh publications, since that beats having a few publications, or no publications. In medical programs the grant thing is a lot bigger too because there is, rightfully, tons of money to throw to that area. You need grants as an academic to progress. You won’t keep getting grants if you take grants and then don’t publish anything, so even if you have nothing good come out of it, you need to publish something. That incentivizes fraud in the worst case and noise in the best. The better-best case would be if academia were more open to accepting null results

i-use-nixos-btw 4y ago

I recall reading -somewhere - about a similar problem in psychology journals. The problem there is worse, in terms of correctness, because the journals don’t publish negative results, including when the negative results disprove a previously published paper. In medical journals, though, the problem is worse because it is more likely to kill someone.

PaulKeeble 4y ago
A lot of the medicine paper fraud is in Psychology papers. They are notorious for badly setup studies with intentionally leading questionaires for data. No amount of peer review seems to improve them and a journal somewhere will always publish it. The volume is quite staggering as well, ~40 Psychologists are responsible for an insane amount of papers all with the same methodology problems showing it can cure everything. Apparently every disease has Psychology problems. In practice no one is getting better from their proposed and trailed treatments and patients repeatedly complain about it, but they are everywhere in Europe and the vast majority of doctors believe in these specialist even though the papers are universally review as very low quality even when they aren't faking data or manipulating the stats to produce an outcome.
- quickthrowman 4y ago
  > A lot of the medicine paper fraud is in Psychology papers. Psychology is not medicine, it’s an academic discipline. Psychiatry is the branch of medicine that deals with mental health.
  - PaulKeeble 4y ago
    A common misconception, here is one of the famous 40 at Kings College: https://www.kcl.ac.uk/people/professor-trudie-chalder https://www.kcl.ac.uk/people/professor-trudie-chalder They probably shouldn't be in medicine, certainly not running departments in hospitals but they are.
nradov 4y ago
There is a reproducibility (replication) crisis in psychology. Much of what psychologists accepted as settled for years has turned out to be bunk. While there are some researchers doing excellent work, much of the field remains no more scientific than phrenology. https://www.theatlantic.com/science/archive/2018/11/psychologys-replication-crisis-real/576223/ https://www.theatlantic.com/science/archive/2018/11/psycholo...

deleted 4y ago

[deleted]

corbulo 4y ago

P hacking more generally has been an issue for some time. Its difficult to trust really almost any study even if you find parts of it to be reliable. Take one or a few stats courses to find out how easy it is to smudge data with no one being the wiser. Its a real problem.

krona 4y ago
For the reasons you say, I regard papers that report p-values without effect sizes to be at most interesting, but probably irrelevant for making actual real-life decisions.

bmacho 4y ago

Who would you trust? People that -are-doing-it-their-whole-life- that have an interest to lie to you, or a correct sounding reasoning and the wisdom of billions of people for milleniums?

uoaei 4y ago
Wisdom like what? "Sky daddy solves everything"? For the record, there's lots we can learn from ancient and indigenous knowledge, but let's not pretend that everything would be better if we cast off the whole lot of modern society.

pedalpete 4y ago

I feel this is an area where AI could be helpful in recognizing suspected fraudulent, or potentially just poorly studied research.

eep_social 4y ago
Why do you say that?
anitil 4y ago
I used to follow a blog (possibly retraction watch? I can't remember now) where they would go through basic biology papers and find photoshopped/edited images and ask the author about them. Sometimes this would lead to retractions etc. They did mention other people had tried and failed to build tools for this, but the current state of the art was drinking-a-coffee-and-looking-at-it-real-hard. This was before the current explosion of AI, so maybe it's different now? Anyone else able to chime in? Edit: Found it! https://scienceintegritydigest.com https://scienceintegritydigest.com

etidorhpa 4y ago

No surprise here. Just put together a bunch of data and make up the statistics. No one's the wiser. "Now hurry and let me sell Oxycontin to children" -FDA

m00x 4y ago
This is highly misleading. The FDA requires a lot more than a few medical papers. They have their own guidelines for studies, and you have to follow them to the letter. They also have investigators present to make sure data isn't mislabeled or incorrect. The Oxycontin issue wasn't that the medicine wasn't safe, is that it was deemed safe by the FDA for its intended use, then it was pushed to doctors to go beyond its intended use. The FDA was too late to respond to this, but it was undetected by the majority of the medical field because people went to the streets for re-ups, and doctors didn't want to admit fault. This is mostly due to improper regulation in how drug companies are allowed to interact with doctors, and the lack of healthcare resources.
- sammalloy 4y ago
  "How FDA Failures Contributed to the Opioid Crisis" https://journalofethics.ama-assn.org/article/how-fda-failures-contributed-opioid-crisis/2020-08 https://journalofethics.ama-assn.org/article/how-fda-failure... 1. Failure to Properly Enforce Marketing Regulations 2. Failure to Obtain Evidence of Long-term Safety and Effectiveness 3. Failure to Manage Conflicts of Interest And my personal favorite: > An FDA official who led the approval of OxyContin got a $400,000 gig at Purdue Pharma a year later Special mention: > A former senior U.S. Drug Enforcement Administration official who spent three decades at the DEA, specializing in preventing the diversion of prescription drugs like OxyContin, is now paid to advise one of the largest opioid manufacturers in the country, Purdue Pharma
  - m00x 4y ago
    Yes, I read that part. It doesn't counter any of my points, they actually enforce them. Oxycontin was safe to use for their intended purposes, but they were not used that way. It wasn't the approval process that was problematic, just the follow-up.

PicassoCTs 4y ago

Im advocating for "You keep what you kill" rules in science. If you disprove a paper or proof a study can not be replicated, you get the funds of the scientist, subtracted from his/her current funding. Make bad science fund the good science and make de-replication a for profit endeavor. There can be all funding in the world for quack science, but if it can be debunked and is debunked, it will finance real science.

deleted 4y ago
[deleted]
bobmaxup 4y ago
How would this stop fraud? Wouldn't there be a possibility of endless cycles of fraud?
LeonB 4y ago
As a thought experiment I think that’s brilliant. As an actual plan though I think it would be terrible. There are so many ways to fail to reproduce an experiment. Incentivising the failure to reproduce is just a very out there idea.
avs733 4y ago
It would be far more effective if you got their citation count instead.
- PicassoCTs 4y ago
  But the untruth of one system, makes the truth of the other not a given. So, transferring funds makes more sense, as it just shifts the chance to be true, towards the more "scientific" part of the system. It also adds lag to the system, so you do not get a constant switching reward functions.
  - avs733 4y ago
    Oh I’m in no way suggesting it’s truth, just that it’s a more tangible reward in current system of academia. I should have added the inevitable /s. When I transitioned from grad student to faculty, one thing that struck me most was when faculty candidates were discussed in my first year and the first slide about all of them was a histogram of citations. You can hear it all you want but seeing it just crushed my soul a little bit.

parton 4y ago

If you were to ask experts in a given subfield which papers are reliable, I'm sure they would be able to tell you. The problem is that there's no process in science for expert consensus to make it to out to doctors/laypeople. People assume that peer review means a paper is good, which couldn't be farther from the truth. Science journalists aren't any better, they care more about hype than consensus. Honestly, it's dangerous to give a random peer reviewed article to someone who doesn't have broad knowledge of the field. Maybe we need middle-ground journals that publish review articles at the level of a Scientific American reader?

epgui 4y ago
That’s pretty bang on (biochemist).
AlotOfReading 4y ago
That's one of the intended purposes of review journals like Annual Reviews (https://www.annualreviews.org/ https://www.annualreviews.org/). There are some pretty big practical issues with them though: 1. Sometimes the latest article on a subject was written 2/5/10 years ago. Depending on quickly the field is moving, that review could be perfectly acceptable, completely obsolete, or anywhere in between. 2. Sometimes the author themselves is just out of date with the field. It's difficult to identify this without deep prior familiarity. 3. Paywalls. I don't know what the solutions are beyond "making experts accessible for questions" and other public outreach things.
pella 4y ago
> People assume that peer review means a paper is good ... "Conclusions: Parachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention." https://www.bmj.com/content/363/bmj.k5094 https://www.bmj.com/content/363/bmj.k5094 see the "Peer review" https://www.bmj.com/content/363/bmj.k5094/peer-review https://www.bmj.com/content/363/bmj.k5094/peer-review
- jnsie 4y ago
  Please tell me this is satire

jszymborski 4y ago

Since we're on the topic of bad science, the first figure in that article (Pants on Fire) is a pretty bad one. The units on the Y-axis are not specified (strike one), but it looks to be the _unnormalized_ number of papers retracted each year. The yearly retraction _rate_ (i.e. the number of retracted paper per number of papers published) is what is relevant here. The number of journals have and papers have exploded since '96.

dadjoker 4y ago

Isn't peer review supposed to catch stuff like this? I mean, that's supposedly the "gold standard" for studies, right?

tptacek 4y ago
No, peer review is absolutely not the "gold standard" for studies. Replication is closer to the gold standard, but replication is a scientific project all its own. Peer review is a sanity check before allowing a research contribution to become part of the conversation in its field. (I've done some academic reviewing, but this is a point I've shoplifted from Stefan Savage).
PeterisP 4y ago
Peer review is not the "gold standard" but rather table stakes; if some paper can't even pass that, it's probably not worth even skimming the abstract.

ekianjo 4y ago

They only realize it now?

dadrian 4y ago

As a reminder, peer review is not designed adversarially. It is not supposed to catch people who are fraudulent before they publish---that's the point of replication (which happens rarily). Peer review is designed to ensure a the publication as a packaged work of science describes a valid experiment. But you're necessarily assuming that the authors did what they said they did. As a peer reviewer, you're ensuring that what the authors said they did constitutes valid science.

aggie 4y ago
In practice, peer review isn't even that. Most referees are not double-checking your statistical analysis. What they focus on is whether the research is interesting and has it appropriately considered relevant literature. Even that is not always done carefully. Here is an argument that peer review is basically a failed experiment: https://experimentalhistory.substack.com/p/the-rise-and-fall-of-peer-review https://experimentalhistory.substack.com/p/the-rise-and-fall...
- dadrian 4y ago
  I think we're saying the same thing. You're trusting the statistical analysis done by the author. When I peer review, I check to make sure that the conclusions the paper draws are in line with what it says statistical analysis was, and I check to make sure that the analysis used is the right one, but I don't check their math. And also, I'm not a statistician, so I'm not authoritative on the full space of statistical analysis, anyway.
  - nieto915 4y ago
    who really has all of the hours in a day to do it too. I think it'll all come down to the journal's integrity. academia will have to learn to negotiate the premiums of their library subscriptions for better editing/curation for each journal they subscribe to. its already pay to play, might as well get your money's worth.
    - jhbadger 4y ago

renewiltord 4y ago

I've talked about an experience someone in my family had before. Straight up fabrication in a lab, and it wouldn't be really detectable until you attempt to replicate and then check the pictures after. https://news.ycombinator.com/item?id=25926188 https://news.ycombinator.com/item?id=25926188

Gatsky 4y ago

I maintain that the best analogy for life sciences research is naval exploration. Some people tell tales of their great voyages but never set foot on a boat. Some sailed, yet found nothing, and still spin a story to avoid embarrassment. And some actually found America. Science is obsessed with these stories enshrined in journal articles, which are elevated to the status of artefacts of knowledge, complete with Excel spreadsheets in the supplementary info. Creating such artefacts determines everything in your scientific career. That is the actual problem in my opinion. Of course people will want to fake these powerful status symbols.

breck 4y ago

I've been in medical research for 5 years and saw so much fraud and incompetence my guess is 20% of it is honest work. But have hope, we're gonna fix it: https://cancerdb.com/ https://cancerdb.com/

tchvil 4y ago

This blog post from the BMJ wasn't particularly comforting when published in the middle of covid: https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-health-research-is-fraudulent-until-proved-otherwise/ https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-hea... Richard Smith was the editor of The BMJ until 2004. Competing interest: RS was a cofounder of the Committee on Medical Ethics (COPE), for many years the chair of the Cochrane Library Oversight Committee, and a member of the board of the UK Research Integrity Office.

est 4y ago

The funding gotta go somewhere somehow.

refurb 4y ago

I think the one piece people miss is that scientists dont assume the literature is reliable. When i worked in the lab, it was well know that a good part of the literature can not be replicated. On top of that, specific journals and labs have reputations for less-than-quality research. If a paper comes out, its not assumed to be true until proven otherwise (usually expanded upon by others). The only time that's different is if it comes from certain labs that are known to have a good track record. So its not like shoddy research is causing other scientists to waste time except maybe the time spent reading the paper.

bongoman37 4y ago

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wrp 4y ago

This looks like a good opportunity to ask a question I've had for a long time. In what field(s) of research is it respectable to ask, "Has this paper been peer reviewed?" I've spent nearly four decades working mostly in academia with scientists, engineers, social scientists of various degrees of rigor, and even occasional humanities types. I don't think I have ever been in a group where someone did or would raise the issue of peer review when discussing the quality of a report. In all groups I've associated with, you are expected to know enough about your field to be able to assess for yourself the quality of a paper as you read it. Relying on some anonymous reviewer's judgement to justify your acceptance of a report would cast serious doubt on your own judgement. I've been trying to note just who raises this issue and they appear to be most often in life sciences/medicine. I've never worked in that general area, but my impression is that knowledge of statistics and methodology is rather weaker than in other scientific fields. My (perhaps uncharitable) theory is that peer review has become a gateway for automatic acceptance because the average technical expertise of readers is so low that they cannot evaluate for themselves.

shellfishgene 4y ago

If you look at why papers are found out as fraudulent and retracted it's usually very dumb mistakes, such as the examples from the article, copying data and/or text from elsewhere, making up numbers that are obvously implausible, and cloning/photoshopping figures or parts thereof, even within the paper. Given how easy it is to avoid these beginner mistakes the percentage of fake data must be so much higher than the actual retractions. Especially from the paper mills where faking data is done by professional fraudsters.

machina_ex_deus 4y ago

96% vaccine effectiveness! Into absolute uselessness when deployed to the masses. As someone who believed them and took the vaccine, that was the last time I'm trusting medical research. I won't be fooled again, and from now on research won't be enough to make any personal decision, I'm waiting until independent evaluation in the real world happens and there are enough anecdotes to see that it really works as advertised. The entire coronavirus debacle has corroded the trust in medical establishment to zero. I think it's justified and we've just been ignorant to the fraud, it took a lie so big and obvious to really wake people up.

shellfishgene 4y ago

I wonder if journals, especially medical ones, could be sued if they don't react and redact studies in time once notified of problems, and patients get ineffective or even detrimental treatment based on those papers.