‘Spin’ found in over half of clinical trial abstracts published in top psychiatry journals

Findings raise concerns about potential impact on doctors’ treatment decisions

BMJ

‘Spin’–exaggerating the clinical significance of a particular treatment without the statistics to back it up–is apparent in more than half of clinical trial abstracts published in top psychology and psychiatry journals, finds a review of relevant research in BMJ Evidence Based Medicine.

The findings raise concerns about the potential impact this might be having on treatment decisions, as the evidence to date suggests that abstract information alone is capable of changing doctors’ minds, warn the study authors.

Randomised controlled trials serve as the gold standard of evidence, and as such, can have a major impact on clinical care. But although researchers are encouraged to report their findings comprehensively, in practice they are free to interpret the results as they wish.

In an abstract, which is supposed to summarise the entire study, researchers may be rather selective with the information they choose to highlight, so misrepresenting or ‘spinning’ the findings.

To find out how common spin might be in abstracts, the study authors trawled the research database PubMed for randomised controlled trials of psychiatric and behavioural treatments published between 2012 and 2017 in six top psychology and psychiatry journals.

They reviewed only those trials (116) in which the primary results had not been statistically significant, and used a previously published definition of spin to see how often researchers had ‘spun’ their findings.

They found evidence of spin in the abstracts of more than half (65; 56%) of the published trials. This included titles (2%), results sections (21%), and conclusion sections (49%).

In 17 trials (15%), spin was identified in both the results and conclusion sections of the abstract.

Spin was more common in trials that compared a particular drug/behavioural approach with a dummy (placebo) intervention or usual care.

Industry funding was not associated with a greater likelihood of spinning the findings: only 10 of the 65 clinical trials in which spin was evident had some level of industry funding.

The study authors accept that their findings may not be widely applicable to clinical trials published in all psychiatry and psychology journals, and despite the use of objective criteria to define spin, inevitably, their assessments would have been subjective.

Nevertheless, they point out: “Researchers have an ethical obligation to honestly and clearly report the results of their research. Adding spin to the abstract of an article may mislead physicians who are attempting to draw conclusions about a treatment for patients. Most physicians read only the article abstract the majority of the time.”

They add: “Those who write clinical trial manuscripts know that they have a limited amount of time and space in which to capture the attention of the reader. Positive results are more likely to be published, and many manuscript authors have turned to questionable reporting practices in order to beautify their results.”

###

Peer reviewed? Yes
Evidence type: Cross sectional review; observational
Subjects: Psychology/psychiatry research

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Tom Halla
August 6, 2019 10:25 am

Hinky abstracts are false advertising, as most journals have a paywall, and a deceptive abstract might prompt someone to buy a study that is not what the abstract claimed.

Rocketscientist
Reply to  Tom Halla
August 6, 2019 12:52 pm

Click bait for science papers?

HotScot
Reply to  Rocketscientist
August 6, 2019 1:14 pm

Rocketscientist

97%

Samuel C Cogar
Reply to  Tom Halla
August 7, 2019 7:46 am

‘Spin’–exaggerating the clinical significance of a particular treatment without the statistics to back it up–is apparent in more than half of clinical trial abstracts published in top psychology and psychiatry journals, finds a review of relevant research in BMJ Evidence Based Medicine. ”

And thus the reason I more often than not, refer to psychiatrists and psychologists as being psychobabblers.

ColMosby
August 6, 2019 10:29 am

Psychiatry/clinical psychology have no scientific theories worth a crap. These people bamboozle the govt by claiming that a person’s mental problems are due to “a chemical imbalance” (which can NEVER be corrected) and they prescribe tranquilizers and weekly or bi weekly “sessions” , for which they bill Medicare. But if the problem is chmical imbalance, what possible reason can there be for these frequent, and expensive, session s? Psychiatry /Clinical Psychology is a joke. Any court strategy to declare a criminal insane is met by the prosecutors “expert” opinion that the person is not insane.
The judicial system is a joke by assuming that Psychiatry/Clinical Psychology are competent scientific disciplines

Eric Stephan
Reply to  ColMosby
August 6, 2019 2:30 pm

Actually some imbalances can be fiddled with. Some drugs reduce the production of neurotransmitters, for example, which can flood the receiving dendrites in those whose conditions have led them to a place where the normal maintenance/replacement of dendrites has been diminished, causing over-stimulation and a lack of the ability to discern appropriate thoughts.

As the father of a daughter with bi-polar disease with psychotic manic features (I also have a minor in psychology), I can confirm that everything else you said is 100% on target. I quit pursuing the field when I realized they still cannot even describe what a thought is, how it stored nor how it is recalled. Her time spent in psychiatric lock-down was right out “One Flew Over the Cuckoo’s Nest”, right down to Nurse Cratchet. (Note: she’s doing well now, just graduated college). The drugs are each a shot-in-the-dark suggestions until a good combination is found. Along the way, the bad combinations might put in the hospital for a good while and in a haze for months/years after. And all they can say is, “oops, we tried.”

Weylan McAnally
Reply to  Eric Stephan
August 6, 2019 3:17 pm

I feel your pain. My father was bipolar with heavy manic tendencies. He once was manic for over 18 months and started having psychotic delusions. Due to his reluctance to get help, he was not diagnosed until the age of 53. When he died five years ago, he had been manic over 9 months. Medication did help him somewhat, but when a manic phase kicked in he loved how he felt and stopped all meds.
I have a psychology degree, but went into pharmacy instead. In psychiatry, almost all treatments are trial-and-error situations. The only factor that somewhat predicts if a treatment will work for a patient is if a close relative has had success with it. Otherwise, it is a crap shoot.

GMiller
Reply to  ColMosby
August 6, 2019 4:39 pm

I beg to differ. My experience with a family member has shown that cognitive therapy can restore a non-functional person suffering from extreme anxiety to a fully functional, contributing member of society.

Philo
Reply to  GMiller
August 7, 2019 5:29 pm

Like many of the observations here, cognitive therapy is another bullet to try. Some folks have great success with it, other spend months or years in therapy with little result.

That is my wife’s experience.

Samuel C Cogar
Reply to  ColMosby
August 7, 2019 4:33 am

ColMosby – August 6, 2019 at 10:29 am

Psychiatry/clinical psychology have no scientific theories worth a crap.

And the reason for that is, ……. most all present day psychiatry/clinical psychology is “rooted” in the writings and teachings of a late 19th Century heroin addicted author named Sigmund Freud.

Dan Cody
August 6, 2019 10:45 am

Patient: Doc,do you think I’m crazy?

Psychiatrist: yes

Patient: Can I have a second opinion?

Psychiatrist: OK. You’re ugly too.

ResourceGuy
Reply to  Dan Cody
August 6, 2019 11:56 am

That’s a keeper.

Michael S. Kelly LS, BSA Ret.
Reply to  Dan Cody
August 6, 2019 5:33 pm

My doctor gave me six months to live. I said “Doc, I can’t pay your bill!” He gave me six more months.

Greg
August 6, 2019 11:01 am

In an abstract, which is supposed to summarise the entire study, researchers may be rather selective with the information they choose to highlight, so misrepresenting or ‘spinning’ the findings.

As with Jevrejava’s 2014 where found no acceleration in 20th sea level change but manage NOT to put the “detail” in the abstract. That was just one sentence if you took the time to read the whole paper line by line.

I don’t know whether this was motivated by wanting to avoid publishing the “inconvenient truth” of by fear of the paper being rejected if it got clearly stated in the abstract.

Ed Zuiderwijk
Reply to  Greg
August 6, 2019 2:11 pm

This is not ‘spinning’ but understating the findings. In the current PC climate that is indeed a strategy to get your paper past the reviewers. For instance, if you wrote a paper demonstrating that climate models are crap because of X, Y and Z, then writing that plainly in the abstract will get a reject because, for instance, the ‘tone is too dramatic’. What you then can try is to understate your conclusions by proposing that because of X etc, projections by current climate models could have been overestimated.

Mike McHenry
August 6, 2019 11:11 am

There seems to be far too many academics in the paper chase. In Nature July 25 issue there is an article titled “The Data Detective” in a similar vane. A doctor spends spare time analysing papers on clinical trials and founds a lot of this stuff.

ozspeaksup
Reply to  Mike McHenry
August 7, 2019 3:47 am

i looked at a pschy drug trial some time back, just curious.
they used just 12 people and a max time of one month
the drug was approved for use in spite of little real results and serious side effects
the “urgent need” for “intractable” patinmts was their excuse
and this drug was being targeted at young kids 12 to 20s or so it appeared.
it will be saved in a drive somewhere because it really had me stunned they got away with it.

commieBob
August 6, 2019 11:21 am

So, why would a professional scientist/clinician exaggerate her findings? She won’t get published unless she can convince the editor that her results are ‘interesting’. ‘Publish or perish’ is a very real thing. What do you think is going to happen?

Latitude
Reply to  commieBob
August 6, 2019 1:26 pm

“They found evidence of spin in the abstracts of more than half “….

…that’s cause they didn’t look hard enough

Sheri
August 6, 2019 11:31 am

The same thing seems to be true in many fields. It would be interesting if studies were conducted in climate research, etc, as to the spin in the abstract.

Rocketscientist
Reply to  Sheri
August 6, 2019 12:55 pm

Some of the climate research papers have been spun up to such an extent they are generating their own gravitational field!

John
Reply to  Rocketscientist
August 6, 2019 7:50 pm

Rocketscientist : I think the high spin given to climate “research” papers is known as perpetual (e)motion and infinite energy (drain).

HotScot
Reply to  Sheri
August 6, 2019 1:21 pm

It’s already been done.

The result was 70+ abstracts, selected from 11,000 abstracts mentioning climate change = 97% consensus.

No spin there at all.

ResourceGuy
August 6, 2019 11:56 am

I thought it was 97 percent.

ResourceGuy
August 6, 2019 12:18 pm

Get a grant to study what’s wrong…

https://www.eurekalert.org/pub_releases/2019-08/uota-rts080619.php

Despite the crises of faith that has struck the field in recent years, Poldrack believes psychological science has a lot to say that is very reliable about why humans do what they do, and that neuroscience gives us ways to understand where that comes from.

“We’re trying to understand really complex things,” he said. “It has to be realized that everything we say is probably wrong, but the hope is that it can get us a little bit closer to what’s right.”

Enginer
August 6, 2019 12:52 pm

Spin! That’s the word! I was trying to figure out how news reporting had degraded so badly since I was a child.
The answer is spin—everything has spin, an attempt to plant an opinion in your mind.
I used to appreciate Dow Jones., The Wall Street Journal, because they use to do a good job of showing both sides, explaining the alternatives.

ResourceGuy
Reply to  Enginer
August 6, 2019 2:36 pm

A lot of industries like newspapers and TV stations would have gone out a long time ago without spin, or so they thought from their consultants.

It’s just taking longer to play out with technology, as usual.

August 6, 2019 12:53 pm

Thank God that I don’t have to read the medical literature any more being retired. Here is a non-psychiatric/psychologic example from Johns Hopkins published in the very reputable Archives of Internal Medicine, along with an example of missing something of extreme significance from the New England Journal of Medicine

Low socioeconomic status in the first 5 years of life doubles your chance of coronary artery disease at 50 even if you became a doc — or why I hated reading the medical literature when I had to

[ Proc. Natl. Acad. Sci. vol. 106 pp. 14716 – 14721 ’09 ] is an interesting paper which performed gene profiling on (easily obtainable) white blood cells in 103 healthy adults ages 25 – 40. Half of them were of low socioeconomic status (SES) in the first 5 years of life (as judged by what their parents did). All were of the same socioeconomic status at the time of testing (again judged by occupation). They found differences in gene expression between the two groups which didn’t correlate with lifestyle or perceived stress at the time of testing.

It took a lot of work (and probably money). People don’t do this sort of thing for fun. Why were they interested in the first place? Because of an even more interesting paper from Johns Hopkins [ Arch. Int. Med. vol. 166 pp. 2356 – 2361 ’06 ]. This work followed 1131 male Hopkins medical students for FORTY years. 19% came from backgrounds of low socioeconomic status (again judged by what their parents did). The striking conclusion was that there was a 240% increased risk of coronary artery disease by age 50 if you came from a background of low SES. This, in spite of the fact that for the duration of the study MDs were living a high SES existence. Impressive no?

As a practicing MD, I had to plow through this stuff year after year. Very quickly you begin reading papers in the medical literature with the attitude ‘how are they lying to me’. Well, maybe not actually lying, but drawing conclusions not warranted from the data or, worse, missing the forest for the trees. Some scientific training helps but isn’t necessary. My cousin’s boy wrote an absolutely brilliant article for his high school newspaper dissecting the methodology behind the annual college rankings in US News and World Report and he wants to be a writer.

What’s wrong with this paper? Certainly nothing is amiss with the data, painstakingly acquired year after year. Also, they were quite careful to control for lifestyle issues such as weight, smoking, exercise, alcohol consumption etc. etc. However they plotted two curves of coronary artery disease incidence vs. age (one for the low SES and the other for the 81% of the classes not of low SES) and cherrypicked the age at which the curves separated the most (e.g. 50). Also to be noted is that there wasn’t much coronary artery disease at 50 in either group — 13/218 in the low SES and 23/(1141 – 218) in the rest.

Also stated in the paper is that the mortality at age 70 was the same for both groups, even though the low SES group continued to have more coronary artery disease (and death from it). This implies that low SES in childhood actually protects against other fatal diseases (cancer perhaps?). They had to die of something after all. Which way would you want to go? That could have been the title of the paper, but wasn’t.

Even more interesting is the comparison they didn’t make –e.g. with the expected mortality and morbidity of a group of young men who remained in low SES throughout their working lives. This data is likely available. We are always reading about increased morbidity and mortality in one disadvantaged group or another (usually as a way of slamming the current system). My guess is that it would be much worse. That being the case the paper could have been titled, “A high SES in adult life negates the disadvantage of growing up poor”.

Reading the summary of the paper would have missed all this. What the authors chose to present was certainly an attention getter, and they made no attempt to hide their data. However, what your patients are paying for is your ability to evaluate data like this, think about it, and apply it to them. There’s nothing wrong with thinking, but dissecting paper after paper like this becomes tedious after a time. Chemistry, math and molecular biology are so much cleaner intellectually (but far less immediately important to your patients).

A truly awful example of missing the forest for the trees is the following: [ J. Am. Med. Assoc. vol. 259 p. 3158 ’88 ] An overview of the Physicians’ Health study in which 22,000 American physicians took either one adult aspirin or a placebo every other day. It’s pretty old but the study was widely cited and was very well worth doing because it dealt with a potentially simple (and cheap) way of preventing heart attack and stroke.

The study was double blind so identical packets of aspirin or placebo had to be prepared and delivered to all 22,000 docs in a timely fashion. Cardiovascular mortality was cut by aspirin, but overall mortality was not. Severe stroke was increased slightly, and there were 80 strokes in the aspirin group versus 70 in the placebo group. However the group experienced just 88 deaths when 733 would have been expected. The authors noted that low numbers of deaths made the data more difficult to interpret. Their discussion focused on whether the aspirin was adding anything extra. The conclusion was that this dose of aspirin probably wasn’t doing much.

Where’s the forest?

It’s the EIGHTFOLD reduction in mortality from what was expected. It could be due to a beneficial life style (money, social class) but the paper never discussed it. What we need is to reduce mortality in our patients eightfold and then worry about giving aspirin.

William Astley
August 6, 2019 12:59 pm

It is worst than you think. Science only works if those doing it are unbiased and honest.

There is an astonishing story concerning the history of the use of psychoactive drugs comparing the patient outcomes before the drugs were used and after and the monkey business associated with the testing and lack of testing of the drugs.

An example is the most common mental ‘illness’, depression.

Prior to the use of psychoactive drugs, 80% of the people who had depression, recovered after time, with no reoccurrence. Our mind/body has natural mechanisms that spontaneous naturally cures depression.

Depression is not caused by a chemical imbalance.

The drugs prescribed for depression preformed in initial testing, no better than a placebo which is a scandal.

The initial tests ignored the increase in suicides as those who had adverse reactions were removed from the study and the studies were too short to find the long term brain damage and other serious long term health affects of the chemicals.

Depression has been reclassified to be a recurring ‘disease’ as those are treated with drugs, have recurring depression.

This is a long list of the sever health problems that have been linked to the use of a class of drugs that have been used to treat depression, in addition the so called off label use of the drugs which should be illegal.

https://www.seegerweiss.com/drug-injury/prozac-lawsuit/

The general public’s beliefs concerning the mind and psychoactive drugs is primarily based urban legends, on industry created propaganda.

There are almost a hundred different books that have been written concerning the scandal. Whitaker’s book is one the best written.

https://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/1491513217

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

“This plague of disabling mental illness has now spread to our children, too. In 1987, there were 16,200 children under eighteen years of age (William: In the US) who received an SSI (William: SSI social security disability insurance) payment because they were disabled by a serious mental illness.

But starting in 1990, the number of mentally ill children began to rise dramatically, and by the end of 2007, there were 561,569 such children on the SSI disability rolls. In the short span of twenty years, the number of disabled mentally ill children rose thirty-five fold (William: and the prescriptions of psychoactive drugs to children has also risen by 35 times).

Mental illness is now the leading cause of disability in children, with the mentally ill group comprising 50 percent of the total number of children on the SSI rolls in 2007.”

Comment: The number of adults in the US on social disabled insurance for mental ‘illness’ has increased by a factor of 4 for the same period which roughly matches the increase in prescription of psychoactive drugs.

https://en.wikipedia.org/wiki/List_of_largest_pharmaceutical_settlements

Healy’s book explains in detail how research is manipulated to hide side effects, to push drugs that are in some cases no more effective than placebos and less effective that older drugs that are no longer patent protected.

Pharmageddon
https://www.amazon.com/Pharmageddon-David-Healy/dp/0520270983/ref=pd_sim_14_9?ie=UTF8&dpID=51NRLBEXsDL&dpSrc=sims&preST=_AC_UL160_SR105%2C160_&psc=1&refRID=N9XGMY2JH6ZH09JPXX8D

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

https://www.amazon.com/Bad-Pharma-Companies-Mislead-Patients/dp/0865478066/ref=cm_cr_arp_d_product_top?ie=UTF8

http://www.nybooks.com/articles/2009/01/15/drug-companies-doctorsa-story-of-corruption/

“Take the case of Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and chief of pediatric psychopharmacology at Harvard’s Massachusetts General Hospital. … children as young as two years old are now being diagnosed with bipolar disorder and treated with a cocktail of powerful drugs ….

… revealed that drug companies, including those that make drugs he advocates for childhood bipolar disorder, had paid Biederman $1.6 million in consulting and speaking fees between 2000 and 2007. Two of his colleagues received similar amounts.

Samuel C Cogar
Reply to  William Astley
August 7, 2019 9:49 am

William Astley, ……. great post, ……

August 6, 2019 at 12:59 pm

the most common mental ‘illness’, depression.

Prior to the use of psychoactive drugs, 80% of the people who had depression, recovered after time, with no reoccurrence. Our mind/body has natural mechanisms that spontaneous naturally cures depression.

Depression is not caused by a chemical imbalance.

It is MLO that depression is a self-nurtured “emotional” reaction to an unresolved subconscious mind activity which cannot be “resolved” or “cured” via use of psychoactive drugs. Depression is akin to that “tune” or “song” that keep “popping up” in your subconscious thoughts that ya can‘t seem to put a stop to.

Said psychoactive drugs are only useful at masking the “effects” of depression and when the “masking” effect of said drug wears off the depression resurfaces. And given the fact that “depression” is self-nurtured, ….. the person themselves has to, … per se, … un-nurture it to cure it.

August 6, 2019 at 12:59 pm

But starting in 1990, the number of mentally ill children began to rise dramatically,………………. In the short span of twenty years, the number of disabled mentally ill children rose thirty-five fold (William: and the prescriptions of psychoactive drugs to children has also risen by 35 times).

Mental illness is now the leading cause of disability in children, with the mentally ill group comprising 50 percent of the total number of children on the SSI rolls in 2007.”

Likewise, in 1970, the diagnosed autism rate in children was “1 in 30,00” when said autism rate began to rise dramatically, ……… and by 2018 the diagnosed autism rate in children was “1 in 59”.

August 6, 2019 at 12:59 pm

children as young as two years old are now being diagnosed with bipolar disorder and treated with a cocktail of powerful drugs ….….

“YUP”, and students in the Public Schools were being indiscriminately diagnosed with ADD (autism) and forced-fed Ritalin by their Teachers and parents …. who were being paid to do so by the State government.

BCBill
August 6, 2019 12:59 pm

The gold standard for trials is not randomised/ controlled, it is double-blind/randomised/controlled. Far too little attention is paid to how the researchers biases can affect the outcome of a trial. Sadly, I estimate that most researchers now don’t even know what a controlled experiment is. As far as I can tell most people (researchers included) think that one of the treatments (usually a nil treatment) is a control. Controls are not one of the treatments, they are used to remove the effects of confounding variables. So, for exmple, if you thought that a tractor driving over a field to apply a herbicide might be affecting the result, you would control for tractor by having it drive over the field where you didn’t apply herbicide. A double blind experiment is a special kind of control where the experiments tries to control for the behaviour of the clinician on the outcome of the treatment. Part of the cause of the reproducibility crisis may be that statisticians have displaced biometricians as the designers of trials. Does anybody even know anymore what biometrics is (and I don’t mean measuring the size of body parts)?

August 6, 2019 1:26 pm

Low socioeconomic status in the first 5 years of life doubles your chance of coronary artery disease at 50 even if you became a doc — or why I hated reading the medical literature when I had to

[ Proc. Natl. Acad. Sci. vol. 106 pp. 14716 – 14721 ’09 ] is an interesting paper which performed gene profiling on (easily obtainable) white blood cells in 103 healthy adults ages 25 – 40. Half of them were of low socioeconomic status (SES) in the first 5 years of life (as judged by what their parents did). All were of the same socioeconomic status at the time of testing (again judged by occupation). They found differences in gene expression between the two groups which didn’t correlate with lifestyle or perceived stress at the time of testing.

It took a lot of work (and probably money). People don’t do this sort of thing for fun. Why were they interested in the first place? Because of an even more interesting paper from Johns Hopkins [ Arch. Int. Med. vol. 166 pp. 2356 – 2361 ’06 ]. This work followed 1131 male Hopkins medical students for FORTY years. 19% came from backgrounds of low socioeconomic status (again judged by what their parents did). The striking conclusion was that there was a 240% increased risk of coronary artery disease by age 50 if you came from a background of low SES. This, in spite of the fact that for the duration of the study MDs were living a high SES existence. Impressive no?

As a practicing MD, I had to plow through this stuff year after year. Very quickly you begin reading papers in the medical literature with the attitude ‘how are they lying to me’. Well, maybe not actually lying, but drawing conclusions not warranted from the data or, worse, missing the forest for the trees. Some scientific training helps but isn’t necessary. My cousin’s boy wrote an absolutely brilliant article for his high school newspaper dissecting the methodology behind the annual college rankings in US News and World Report and he wants to be a writer.

What’s wrong with this paper? Certainly nothing is amiss with the data, painstakingly acquired year after year. Also, they were quite careful to control for lifestyle issues such as weight, smoking, exercise, alcohol consumption etc. etc. However they plotted two curves of coronary artery disease incidence vs. age (one for the low SES and the other for the 81% of the classes not of low SES) and cherrypicked the age at which the curves separated the most (e.g. 50). Also to be noted is that there wasn’t much coronary artery disease at 50 in either group — 13/218 in the low SES and 23/(1141 – 218) in the rest.

Also stated in the paper is that the mortality at age 70 was the same for both groups, even though the low SES group continued to have more coronary artery disease (and death from it). This implies that low SES in childhood actually protects against other fatal diseases (cancer perhaps?). They had to die of something after all. Which way would you want to go? That could have been the title of the paper, but wasn’t.

Even more interesting is the comparison they didn’t make –e.g. with the expected mortality and morbidity of a group of young men who remained in low SES throughout their working lives. This data is likely available. We are always reading about increased morbidity and mortality in one disadvantaged group or another (usually as a way of slamming the current system). My guess is that it would be much worse. That being the case the paper could have been titled, “A high SES in adult life negates the disadvantage of growing up poor”.

Reading the summary of the paper would have missed all this. What the authors chose to present was certainly an attention getter, and they made no attempt to hide their data. However, what your patients are paying for is your ability to evaluate data like this, think about it, and apply it to them. There’s nothing wrong with thinking, but dissecting paper after paper like this becomes tedious after a time. Chemistry, math and molecular biology are so much cleaner intellectually (but far less immediately important to your patients).

A truly awful example of missing the forest for the trees is the following: [ J. Am. Med. Assoc. vol. 259 p. 3158 ’88 ] An overview of the Physicians’ Health study in which 22,000 American physicians took either one adult aspirin or a placebo every other day. It’s pretty old but the study was widely cited and was very well worth doing because it dealt with a potentially simple (and cheap) way of preventing heart attack and stroke.

The study was double blind so identical packets of aspirin or placebo had to be prepared and delivered to all 22,000 docs in a timely fashion. Cardiovascular mortality was cut by aspirin, but overall mortality was not. Severe stroke was increased slightly, and there were 80 strokes in the aspirin group versus 70 in the placebo group. However the group experienced just 88 deaths when 733 would have been expected. The authors noted that low numbers of deaths made the data more difficult to interpret. Their discussion focused on whether the aspirin was adding anything extra. The conclusion was that this dose of aspirin probably wasn’t doing much.

Where’s the forest?

It’s the EIGHTFOLD reduction in mortality from what was expected. It could be due to a beneficial life style (money, social class) but the paper never discussed it. What we need is to reduce mortality in our patients eightfold and then worry about giving aspirin.

Mike McHenry
August 6, 2019 1:44 pm

Clearly the problem is accountability. There is no moral hazard in academia to producing shoddy work.

William Astley
Reply to  Mike McHenry
August 6, 2019 3:03 pm

It is bigger than academic accountability. It is sort of system failure.

An example is Ritalin, which has been found to turn young boys who had wiggly bum syndrome into young men who have front lobe damage and are prone to psychotic tendencies … …. and a bonus if you make money selling pharmaceutical drugs, clinical depression.

Ritalin when given to apes turns warming, kissing, touching, kind, group animals into solitary animals who will effective do obsessive tasks … which in the long term is not good …

The tests for Ritalin, on humans, were all short term … hiding the long term effects … such as permanent brain damage… and oddly enough growing up to be a shooter.

https://www.thefix.com/content/research-shows-ritalin-causes-long-term-brain-injury

As reported in The New York Times, three million children in this country take drugs for ADHD. In the past 30 years, there has been a 2,000 percent increase in the consumption of drugs for attention-deficit disorder. Among many children, the abuse of Ritalin has become commonplace. When their peers are prescribed these drugs, peer pressure leads to abuse.

The result of the damage done by Ritalin in the brain is similar to frontal lobe syndrome. Over time, frontal lobe syndrome can render a person increasingly incapable of inhibiting impulsive behaviors. In addition, such damage contributes to the onset of clinical depression.

nw sage
Reply to  William Astley
August 6, 2019 6:26 pm

A good question to ask would be if any of the recent ‘mass’ shooters ever took Ritalin.

ozspeaksup
Reply to  nw sage
August 7, 2019 3:59 am

almost all seem to have been on ssri meds or coming off them
conveniently not mentioned by msm of course cos pharmas pay for their airspace/adverts etc

mt gp wants me to quit smoking
champix a failed anti dep has known suicidal tendency effects
the other alternative?
has same/worse and also causes cardiac arrythmias etc
I happen to have arrythmia issues which doc knew BUT obviously didnt even read the mimms precautions before writing a script
luckily I DO always read before taking pharmas.
most times I decide its safer to have the problem than the supposed cure.

kakatoa
Reply to  William Astley
August 6, 2019 7:43 pm

“It is sort of system failure.”

I concur. Thanks for providing some specific examples. Any suggestions, or recommendations, on how to provide some corrective feedback into the system.

Flight Level
August 6, 2019 2:19 pm

Back then tar and feathers were a socially acceptable response to snake oil promotion campaigns.

J Mac
August 6, 2019 2:37 pm

“Dreidel, dreidel, dreidel, I made it out of clay and when it’s dried and ready, oh dreidel we will play.”
Spin on, spin meisters! Spin On!

Michael H Anderson
August 6, 2019 2:39 pm

Haven’t you folks heard? It’s ALL down to microflora! Boom, mic drop, done and dusted.

Look it up: our psyches are controlled by gut bacteria. Exactly like the climate’s main driver is anthropogenic CO2. Really, what more do we need to know? – this is SCIENCE, people! 😀

n.n
August 6, 2019 3:55 pm

Science is only credible in the near-domain, where phenomena are observable and reproducible, and arguments from deduction, not inference.

Ulric Lyons
August 6, 2019 4:57 pm

With the way so many psychiatrists have lost their marbles over global warming-heating, I would be wary of their patient diagnoses being an emotional projection. Greta’s quack comes to mind. Talk about spin.

Herbert
August 6, 2019 6:21 pm

From memory, statistician John Ioannidis (2005) writing in a medical journal found that up to 90% of published research papers in medicine were wrong.
Writing later, he opined that up to 70% of earth science, including climate science, papers were similarly flawed, if my recollection is correct.

August 6, 2019 7:55 pm

Wait until psychiatrists find out that consciousness isn’t a product of the brain, or that memories aren’t stored in the brain, either. They will most likely resist. But it’s a cult, isn’t it, really? Courts have to be allowed to dismiss psychiatric assessments.

As for psychology, there is hope, but many psychologists are too materialistic.

The shame is that people will take the ‘quick fix’ (which isn’t quick, and isn’t a fix) and not solve their problem.

AWM
August 6, 2019 8:24 pm

Psychiatry, a bigger scam than the rest of the medical industry which does offer some value.
Any group that invents diseases by a show of hands, then decides to treat it with our most addicting and abusable drugs and multiplies the number of patients by assigning this a lifetime “disability” complete with bonuses out of the taxpayer’s pocket for the “victims” of this disease is not a disease of “victims” at all, but “volunteers.”
After 38 years in community pharmacies, you won’t change my mind.
And yes, I’m glad I don’t have to read anymore of that crap anymore, one thing they taught us in school was how to evaluate these studies, and I haven’t seen a real one in decades.

A short story which actually alerted me to had bad it had gotten. These was this young sweet nurse I was interested in, and her older sister was the school nurse at the local high school. She asked me if I had any EZ open tops for the Rx bottles her sister had to open every day for the ADHD meds. Sure, I gave her a full bag of one hundred tops, wanting to make a good impression. The next day this smiling beauty comes into the pharmacy with a chicken sandwich and fries, courtesy of her sister, she gave me a big kiss, then said “You know those tops you gave me yesterday, well my sister sends her thanks and, well, you got any more?”

Samuel C Cogar
Reply to  AWM
August 7, 2019 10:21 am

AWM – August 6, 2019 at 8:24 pm

A short story which actually alerted me to had bad it had gotten. These was this young sweet nurse I was interested in, and her older sister was the school nurse at the local high school. She asked me if I had any EZ open tops for the Rx bottles her sister had to open every day for the ADHD meds.

“Shur nuff”, and you realized that it was just one (1) of the thousands of School Nurses …… in just one (1) of the thousands of Public School in the US …….. that was feeding Ritalin to way more than 100 students each school day.

Like I stated in an above posting, …… the diagnosed ADHD (autism) rate in children increased from “1 in 30,000” in the 1970’s, ……… to “1 in 59” in 2018.

AWM
Reply to  Samuel C Cogar
August 7, 2019 9:29 pm

Samuel, this was from 1985 (4th year Pharmacist) and a school in rural South Carolina with a total High School student body of 591. I didn’t realize anything but I did do the needed research. My surprise was that none of the other health care professionals gave a shit.

I am a little confused by your post, you do know that ADHD and Autism are different don’t you?

Samuel C Cogar
Reply to  AWM
August 8, 2019 6:59 am

AWM – August 7, 2019 at 9:29 pm

I am a little confused by your post, you do know that ADHD and Autism are different don’t you?

AWM, ….. I realize that the “psychobabblers” claim they are different …… because they have “coined” forty-eleben different names for classifying all of the different “variations” they claim is prevalent in the populace. …… More types = more masking prescriptions = more money for services.

And AWM, …… the only difference between ADHD and Autism is the semantics, Specifically the “H” part of ADHD, …. the “Hyperactivity” part.

Of, course there are those who will disagree with me, ….. and claim that a child diagnosed with “Autism” …… does not suffer with an “Attention Deficient” problem. Are you one of them?

Parents and guardians, especially school teachers, are responsible for causing children to be diagnosed with said ADHD. One should not expect a child with an “inquisitive” mind to sit quietly still and stare at a blank wall or ceiling …… just because their guardian refuses to address their “curiosities”.

And it is also of my opinion that Autism is a “nurturing problem” that a parent(s) or guardian is the direct fault of. The Autism rate took its massive leap from “1 in 30,000” in the 1970’s, ……… to “1 in 59” in 2018 because of a societal “nurturing” problem (lack thereof) …… and NOT because of a biological or inherited genetic problem. “DUH”, great public speakers are not born, they are nurtured. Great pharmacists are not born, ……. they are also nurtured

AWM
Reply to  Samuel C Cogar
August 8, 2019 11:39 am

Glad you have got it all figured out.

Samuel C Cogar
Reply to  Samuel C Cogar
August 9, 2019 4:09 am

If you have any proof, evidence or logical reasons that I am wrong, …… then say so, post it.

AWM
Reply to  Samuel C Cogar
August 9, 2019 7:21 am

I’ll pass on further comment, Samuel.

Richie
August 7, 2019 6:47 am

Confirmation bias? What the frack does this article have to do with climate science? That the “social sciences” are a hotbed of phony, ginned up research is not news (see RetractionWatch).

This website has gone off the rails since I first started coming here years ago for the lively debate it hosted over the science, or lack of it, behind the global warming scam. The injection of knee-jerk politics has corrupted what seemed to me originally to be an actual honest debate of “climate science’s” merit. In recent years, pro-Trump “spin” that is neither scientific (like the decision to use this article) nor even particularly credible has replaced that debate and tainted the site’s credibility.

Now I wonder: Was Anthony Watts always an asset of the crypto-fascists behind Trump, or was the site co-opted after he stepped back? Was there ever actually “an honest debate” on this site or was it only smoke and mirrors to hide a political agenda from the get-go?

It’s damned hard persuading friends to give my anti-AGW reasoning any credence as it is, without politics queering everything.

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