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At a British Journal of Medicine blog, a former editor says, …

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… medical research is still a scandal:

Twenty years ago this week the statistician Doug Altman published an editorial in the BMJ arguing that much medical research was of poor quality and misleading. In his editorial entitled, “The Scandal of Poor Medical Research,” Altman wrote that much research was “seriously flawed through the use of inappropriate designs, unrepresentative samples, small samples, incorrect methods of analysis, and faulty interpretation.” Twenty years later I fear that things are not better but worse.

The author, Richard Smith, was the editor who published the critique.

Sadly, the BMJ could publish this editorial almost unchanged again this week. Small changes might be that ethics committees are now better equipped to detect scientific weakness and more journals employ statisticians. These quality assurance methods don’t, however, seem to be working as much of what is published continues to be misleading and of low quality. Indeed, we now understand that the problem doesn’t arise from amateurs dabbling in research but rather from career researchers.

Lots of good stuff here, and it is public access. Also:

I reflect on all this in a very personal way. I wasn’t shocked when we published Altman’s editorial because I’d begun to understand about five years’ before that much research was poor. Like Altman I thought that that was mainly because too much medical research was conducted by amateurs. It took me a while to understand that the reasons were deeper.

Two questions:

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Is the state of medical research a worse scandal than the state of other research, or does it just receive more scrutiny because our own guts are at stake?

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Is the problem part of the general crisis I have been outlining in Science Fictions, in that the conflict is between what is described as “science” and reality-based thinking. See, for example, “But who needs reality-based thinking anyway? Not the new cosmologists

See also: Nobelist Randy Shekman is boycotting Nature, Cell, and Science

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