There's a bad smell coming from medical research

The middle of the Covid-19 pandemic is not an auspicious moment to cast doubt upon the reliability of scientific research. However, writing in a BMJ blog, Richard Smith, who was editor of the prestigious medical journal The BMJ until 2004, launched a withering attack, saying that the system is riddled with fraudulent studies.

“It may be time to move from assuming that research has been honestly conducted and reported to assuming it to be untrustworthy until there is some evidence to the contrary,” he says.

Dr Smith does not mention the pandemic, but it would come as no surprise if Covid-19 research did not have its own problems. A study published in the journal Scientometrics found that 87,000 papers had been published about Covid-19 between the beginning of the pandemic and October last year. Tens of thousands must have been added to that figure by now. The highly-respected blog Retraction Watch is keeping a tally of retracted Covid-19 papers – so far there are well over 100.

In a recent webinar (see below) conducted by Cochrane, an independent group which reviews healthcare data, Professor Ian Roberts, of the London School of Hygiene & Tropical Medicine, said that he has become sceptical about all systematic reviews, particularly those that are mostly reviews of multiple small trials.

The gold standard for fraud is a Japanese researcher in anaesthetics, Yoshitaka Fujii, of Toho University. By the time he came unstuck about 10 years ago, he had published around 200 articles – and 183 of them have been retracted because he had falsified the data. “If someone can publish 183 fabricated trials,” said Roberts, “the problem is not with him, the problem is with the system.”

Roberts was withering in his criticism of the state of research: “I realized that I was working in an organization [Cochrane] that made very dramatic claims for itself – trusted evidence, informed decisions, better health – and it had no policy on fraud whatsoever. … Now I know what ‘trusted evidence’ means – it’s all taken on trust.”

He went on: “The Cochrane idea was that every randomized trial was a little diamond that we must find and draw together … [but] for me we are raking through rubbish and most randomized trials should simply be thrown away.”

In 2015 Roberts published an article in The BMJ entitled, “The knowledge system underpinning healthcare is not fit for purpose and must change”. He even quoted an article published 20 years before that in which another reputable scientist had groaned that “much poor research arises because researchers feel compelled for career reasons to carry out research that they are ill equipped to perform, and nobody stops them.”

Roberts complains that his gripes were ignored for six years. Cochrane finally published its policy on fraudulent scientific research in July. “That tells you how seriously the world takes this problem,” he jibed.

An American critic of scientific fraud who appeared in the same seminar, Barbara K. Redman, summarized her view in a blistering soundbite: the roots of fraud “lie in the barrel, not in the bad apples that occasionally roll into view.”

Reason journalist Ronald Bailey recently cited years of research which suggest that this issue is nothing new:

How bad is the false-positive problem in scientific research? As I earlier reported, a 2015 editorial in The Lancet observed that "much of the scientific literature, perhaps half, may simply be untrue." A 2015 British Academy of Medical Sciences report suggested that the false discovery rate in some areas of biomedicine could be as high as 69 percent. In an email exchange with me, [Stanford professor John P.A.] Ioannidis estimated that the nonreplication rates in biomedical observational and preclinical studies could be as high as 90 percent.

There are bad apples everywhere, not just in medical research. In 2013 a behavioural economist at Duke University, Dan Ariely, published a New York Times best-seller, The Honest Truth About Dishonesty: How We Lie to Everyone--Especially Ourselves.

It’s hard to imagine that an expert on dishonesty would use faked data to prove his point. Alas, that is what has happened, reports The Economist. Last week analysts published a critique of claims which found that at least some of the data used by Ariely was clearly fabricated. “We have worked on enough fraud cases in the last decade to know that scientific fraud is more common than is convenient to believe,” write the authors, “and that it does not happen only on the periphery of science.”

Fraud by no means invalidates science. But there are immense problems with the scientific method of which most people are blissfully unaware. Science is done by human beings and human beings can be crazy, corrupt and careless. Now that society is being turned upside down to combat Covid-19, we need to be sure that we can trust the science when politicians tell people “Trust the science!”.

John Ioannides says that “Science is the best thing that can happen to humans, but doing research is like swimming in an ocean at night.” As Otto von Bismarck might have said: “If you like science and sausages, you should never watch either one being made.”


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