At Least a Quarter of Medical Randomized Controlled Trials Are Faked or Flawed
July 18th, 2023Via: Nature:
For years, a number of scientists, physicians and data sleuths have argued that fake or unreliable trials are frighteningly widespread. They’ve scoured RCTs in various medical fields, such as women’s health, pain research, anaesthesiology, bone health and COVID-19, and have found dozens or hundreds of trials with seemingly statistically impossible data. Some, on the basis of their personal experiences, say that one-quarter of trials being untrustworthy might be an underestimate. “If you search for all randomized trials on a topic, about a third of the trials will be fabricated,” asserts Ian Roberts, an epidemiologist at the London School of Hygiene & Tropical Medicine.
The issue is, in part, a subset of the notorious paper-mill problem: over the past decade, journals in many fields have published tens of thousands of suspected fake papers, some of which are thought to have been produced by third-party firms, termed paper mills.
But faked or unreliable RCTs are a particularly dangerous threat. They not only are about medical interventions, but also can be laundered into respectability by being included in meta-analyses and systematic reviews, which thoroughly comb the literature to assess evidence for clinical treatments. Medical guidelines often cite such assessments, and physicians look to them when deciding how to treat patients.
It is like the situation for MD’s when Covid came along: give the people who pay you whatever they want or get fired and lose your job, income, house, car, maybe spouse and kids… I had a friend whose husband was a medical researcher at a famous university. His lab mice weren’t reacting to his experimental cancer treatment as the sponsoring drug company wanted. He tried everything, but no results. So he cheated by altering the mice himself so they’d look like they improved. Got caught. Sure enough, lost his job etc. But I can see why he thought it was worth a try: it works for so many others. It’s as though the system of training and employing MD’s pushes them into lavish lifestyles on credit, entrapping them in produce-or-go bankrupt, treat-as-we-tell-you-to-or-go-bankrupt careers. For at least the past 40 years, MD’s have committed suicide at a higher rate than the general population. During and after COVID, the rates have gone up. Maybe feeling forced to do things that hurt people to save themselves is part of the reason.