Discussing the accuracy and trustworthiness of medical research, challenges of evidence-based vs. science-based medicine, exploring the complexities of conducting rigorous medical research, analyzing 'The Walking Dead' from a storytelling perspective, and examining the epidemiology of a fictional zombie pandemic.
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Quick takeaways
Medical research faces reliability issues with a high percentage of studies providing incorrect or exaggerated claims.
Importance of scrutinizing evidence in medical research, even randomized trials show significant problems.
Science-based medicine integrates Bayesian analysis for prior plausibility assessments, critical in evaluating treatments like homeopathy.
Deep dives
Conflicting Reliability of Medical Research
Medical research, as highlighted in an Atlantic article, exposes significant issues with the reliability of existing studies. Research by John Irenitis reveals a troubling trend where numerous published studies provide incorrect answers to critical medical questions over the years. This discovery raises concerns about the overall reliability of medical practices and emphasizes the systematic problems inherent in medical research, leading to questions about the science-based nature of medicine.
Doubts in Medical Studies Accuracy
The article mentions alarming statistics, like 80% of non-randomized studies having inaccuracies, suggesting a prevalent issue in medical research. Even well-controlled randomized trials, considered the gold standard, show around 10% with significant problems. This challenges the perception of medical research accuracy and emphasizes the importance of scrutinizing the evidence base before relying on medical interventions.
Bayesian Analysis in Medicine
The podcast delves into the difference between evidence-based and science-based medicine, highlighting the use of Bayesian analysis in the latter. While evidence-based medicine aims for neutrality before analyzing evidence, science-based medicine integrates prior plausibility assessments and scrutinizes research with low prior probabilities. Incorporating Bayesian principles helps in evaluating the effectiveness of treatments, especially in cases like homeopathy where prior plausibility is near zero.
Challenges of Meta-Analysis and Quality Research
The discussion extends to the limitations of meta-analysis, showcasing how such approaches might dilute the overall findings due to varying study qualities. Drawing parallels from ecology and evolutionary biology, the conversation underscores the importance of scrutinizing research methodologies, especially in areas like natural selection where poor studies could obscure reliable data. The emphasis lies on conducting rigorous reviews to filter out methodologically insufficient studies and extract credible insights.
Pharmaceutical Influence and Research Integrity
Concerns about the influence of pharmaceutical funding are highlighted, pointing out biases that can unconsciously affect study outcomes. The discussion acknowledges the challenges posed by industry-funded research and stresses the need for transparent practices, exemplified by clinical trial registration requirements. While acknowledging the complexities of funding sources in medical research, the conversation underscores the significance of independent scrutiny and adherence to evidence-based guidelines for reliable outcomes.
Our Guest, Dr. Steven Novella discusses a recent article in The Atlantic in which researcher John Ioannidis shows that 40% of papers published in top medical journals are either wrong or make exaggerated claims (and those are the top journals!). He also discusses the difference between Science and Evidence based medicine. Also, Zombies: are they epidemiologically possible?
Steven Novella is an academic clinical neurologist at the Yale University School of Medicine. He is the host of the Skeptics Guide to the Universe podcast, author of the Neurologica blog, and co-editor of the Science Based Medicine blog.
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