David Ancell / Saturday September 09, 2006
I have been somewhat known and often criticized for being rather doubtful of the work of so-called “experts.” Having spent quite a bit of my time in situations that required evaluation of academic literature, I have an idea of some things that can affect one’s research. That’s why I wrote this article when I was in pharmacy school and had to make more use of medical literature.
This article by James Fitzpatrick captures the problem well. People tend to look for things that support their ideas. Many of the people who sponsor studies, by the way, have some kind of interest (possibly financial) in a certain outcome. They may not publish the study if they don’t achieve it. Also, the literature in general has a tendency of “publication bias.” This means that studies with positive results are more likely to be published. Few want to read mountains of studies saying that “Drug X doesn’t do anything.” It is often not a big deal, but if there are studies that contradict the positive results that are being published, then we really need to know about them.
Also, the study results in clinical trials can vary by the kind of patient used. One study may show a drug as a miracle worker. A second study may show that people who get the drug die just as much as people who don’t get the drug. However, it may be that the patients in the second study were sicker than the ones in the first.
Finally, the endpoint of the study, the very thing one is trying to find out (to simplify the definition), may not be as significant as it appears to be. For example, drug X may have superior results to other drugs on the market for lowering blood pressure. However, it may turn out that the drug is rather toxic, and it kills people faster than the high blood pressure would have. So, looking only at blood pressure wouldn’t give a complete picture. How do people get away with this? Well, mortality studies are usually long and very, very expensive to conduct, so people have to do what they can to see if the drug has an effect that we believe correlates with longer and healthier life. In the fictional example I cited, we were wrong.
So, I am not particularly eager to embrace the latest trend cited by “experts.” Our culture seems to think that whatever is newest is always best. However, new does not always mean improved. Expertise does not mean that the knowledge one gains is correct. After all, how many people do you suppose have advanced degrees in theology from schools that are Catholic in name only. I don’t know about you, but I wouldn’t assume that they know their stuff.
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