Be scared…be very scared—because NPR science journalist Richard Harris’s new book blows the lid off one of the best-kept secrets in all of health care. Those scientific studies that the medical industry touts as fact are, in fact, mostly fiction. In an article published in The Wall Street Journal this past Saturday, Harris gives a lengthy treatise about the politics and motivations behind much medical research. Most frightening to me are the statistics about how few studies are reliable…how few studies are properly designed…and how few studies’ results can be replicated.
In fact, Harris talks about a paper published in the journal PLOS ONE, in which researchers from the University of Bordeaux found that the results from half of 156 studies had been overturned— that means half the results were later deemed “wrong.” These were studies on very real and very relevant medical issues, including ADHD, genetic connections to breast cancer and a possible link between a virus and autism. What are the implications? Additional researchers in these areas are wasting a lot of money and time doing research based on results that may turn out to be false and lead to dangerous treatment recommendations.
But it gets worse…
Harris’s stats on research by pharmaceutical companies was even more dismal. A paper published in the journal Nature Reviews Drug Discovery in 2011 showed that researchers could replicate only 25% of results from various studies. That means 75% of results could not be proved accurate. Similarly, in 2012, the journal Nature published a report in which only six out of 53 studies regarding cancer research could be replicated. That’s 11.3% reliable—so 88.7% were NOT reliable!
Yet drugs are being approved and doctors are making recommendations based on reported results. Perhaps not on these specific studies, but what Harris makes clear is that this is an epidemic throughout the medical world. Your doctor is recommending drugs and medical procedures based on research that very likely is wrong.
Do you remember Vioxx? The blockbuster painkiller that took the world by storm in 1999 after eight studies demonstrated it eased pain with fewer of the gastrointestinal side effects associated with other painkillers? The problem was that no one was paying attention to the heart attack risk that the drug was also causing. It took five years…hundreds of thousands of heart attacks…and tens of thousands of deaths due to heart attack/stroke before Vioxx was pulled from the market. During those five years, doctors believed Merck’s marketing materials and prescribed the drug for assorted pain issues, including rheumatoid arthritis. Merck made billions of dollars, and hundreds of thousands of people’s lives were damaged by poor research.
One of my medical mentors, Dr. Andrew Rubman, a naturopathic doctor and contributing medical editor to Bottom Line, told me years ago that for all the bravado that medical researchers and doctors like to display about the science of medicine, it is, in fact, an art. It requires experience, judgment and the consolidation of assorted pieces of information in order to properly diagnose and treat a patient. Yet if mainstream doctors are basing their recommendations on the results of scientific studies that are poorly designed and have bias inherent in the results, then neither science nor art can be utilized effectively. Surprisingly, according to Harris, most researchers don’t even have adequate training in proper study design! And this is what the medical community says is “reliable data.” Hogwash.
Natural medicine often is knocked by the mainstream medical community because there are no large quantitative, double-blind, longitudinal studies on most of its treatment protocols. The vitamin and herbal manufacturers cannot afford the hundreds of thousands of dollars required for these studies because they don’t have big drug-company and government funding, and remedies such as vitamin C and digestive enzymes simply do not have the same profit potential as antibiotics and acid-suppressing medications. But that doesn’t mean that natural medicine doesn’t have research and proven experience. Natural medicine has centuries of time-tested treatments that have been used by practitioners. Natural medicine simply doesn’t have competitive, ambitious researchers and financially driven corporate leadership pushing for fast and significant results.
Meanwhile, in one of the greatest moments of irony, I attended a speech last year given by Yale cancer researchers talking about their new breakthrough in cancer treatment—“N-of-1 research,” in which a given research study had only one participant. The researchers’ logic was that these studies were measuring results of personalized treatments that were theoretically tailored to the individual genetic and physiological makeup in an effort to better attack that specific cancer manifestation.
Only two problems in my humble opinion: If part of the premise of quantitative research is to provide statistically significant and replicable learning, then how could individualized treatment protocols be considered statistically significant and how could they be replicated in different bodies with different circumstances? These researchers have twisted their definition of “reliable research” in order to fit their narrative of personalized medicine. True, there have been some exciting advances in the area of genetic and personalized medicine, but can you see the falsehood of the presumption of science when, in fact, it flies in the face of the principles that Western medicine has touted for so long?
I gave a speech at the Metropolitan Club in New York City last September about the high cost of medical errors and how it was critically important that every patient ask his/her doctor “why” at every turn. The speech was summarized in a blog on The Huffington Post. In the speech, I talked about the hundreds of thousands of deaths each year caused by medical errors and the enormous amount of time and money wasted on diagnostic testing that is of little or no value. However, doctors are recommending these drugs, surgeries, tests, and treatments based, theoretically, on some type of research.
As Mr. Harris is making so incredibly clear, no wonder we have hundreds of thousands of medical errors each year—the research is wrong, and the entire system is flawed. Which leads me back to the bottom line of my speech—it is vitally important that every patient ask “why” at every juncture of his/her health care. Why do I need that test? Why do I need that drug? Why do you think what you are recommending is better than other options? What is your experience with these recommendations? With research that is wrong far more than it is right, we cannot blindly trust the recommendations coming out of the system.
Is it possible to get quality health care? Absolutely. But it requires active participation and inquiry by every patient. Doctors very much want to help you feel well, but it is clear that the toolkit they are being given is inadequate and putting you at risk. “Trust, but verify,” as Ronald Reagan use to say. Create a relationship with your health-care provider, and have a conversation every step of the way so that he/she fully understands you and you fully understand what and why he is making a recommendation.