Scrutinizing Narratives in Alzheimer's Research

[This is one of the finalists in the 2025 review contest, written by an ACX reader who will remain anonymous until after voting is done. I’ll be posting about one of these a week for several months. When you’ve read them all, I’ll ask you to vote for a favorite, so remember which ones you liked]

“The scientific paper is a ‘fraud’ that creates “a totally misleading narrative of the processes of thought that go into the making of scientific discoveries.”

This critique comes not from a conspiracist on the margins of science, but from Nobel laureate Sir Peter Medawar. A brilliant experimentalist whose work on immune tolerance laid the foundation for modern organ transplantation, Sir Peter understood both the power and the limitations of scientific communication.

Consider the familiar structure of a scientific paper: Introduction (background and hypothesis), Methods, Results, Discussion, Conclusion. This format implies that the work followed a clean, sequential progression: scientists identified a gap in knowledge, formulated a causal explanation, designed definitive experiments to fill the gap, evaluated compelling results, and most of the time, confirmed their hypothesis.

Real lab work rarely follows such a clear path. Biological research is filled with what Medawar describes lovingly as “messing about”: false starts, starting in the middle, unexpected results, reformulated hypotheses, and intriguing accidental findings. The published paper ignores the mess in favour of the illusion of structure and discipline. It offers an ideal version of what might have happened rather than a confession of what did.

The polish serves a purpose. It makes complex work accessible (at least if you work in the same or a similar field!). It allows researchers to build upon new findings.

But the contrived omissions can also play upon even the most well-regarded scientist’s susceptibility to the seduction of story. As Christophe Bernard, Director of Research at the Institute of Systems Neuroscience (Marseilles, Fr.) recently explained,

“when we are reading a paper, we tend to follow the reasoning and logic of the authors, and if the argumentation is nicely laid out, it is difficult to pause, take a step back, and try to get an overall picture.”

Our minds travel the narrative path laid out for us, making it harder to spot potential flaws in logic or alternative interpretations of the data, and making conclusions feel far more definitive than they often are.

Medawar’s framing is my compass when I do deep dives into major discoveries in translational neuroscience. I approach papers with a dual vision. First, what is actually presented? But second, and often more importantly, what is not shown? How was the work likely done in reality? What alternatives were tried but not reported? What assumptions guided the experimental design? What other interpretations might fit the data if the results are not as convincing or cohesive as argued?

And what are the consequences for scientific progress?

In the case of Alzheimer’s research, they appear to be stark: thirty years of prioritizing an incomplete model of the disease’s causes; billions of corporate, government, and foundation dollars spent pursuing a narrow path to drug development; the relative exclusion of alternative hypotheses from funding opportunities and attention; and little progress toward disease-modifying treatments or a cure.

https://www.astralcodexten.com/p/your-review-of-mice-mechanisms-and