Friday 21 February 2020

The Quality of Medical Science. What does this BMJ campaign tell us?

The next time a doctor tell you that a pharmaceutical drug or vaccines is safe, ask them to read the British Medical Journal's (BMJ) campaign "to produce better evidence".

And the next time you are told the conventional medicine is 'evidence based', and supported by medical science, tell them about the BMJ's opinion on the quality of that science.

What follows are passages taken direcctly from the BMJ website.  It concerns the BMJ's campaign to produce "better medical evidence" for such claims. What the campaign proves, without any doubt, is that the conventional medical establishment are aware of the situation that has led to so much patient harm over the last 70 years, and demonstrates that the BMJ, at least, are trying to do something about it.

     "The BMJ believes that the design, conduct, and reporting of healthcare research should better serve the needs of patients and the public: better evidence leads to better healthcare. To produce better evidence the BMJ aims to:

     • Expand the role of patients, health professionals, and policy makers in research and healthcare
     • Increase the systematic use of existing evidence for better decision making
     • Make research evidence relevant, replicable, and accessible for healthcare professionals, patients,

  and the public
     • Take a stand on financial interests by reducing questionable research practices, bias, and conflicts 

of interests.
What are the problems with current research evidence?
Patients are being let down by serious flaws in the creation, dissemination, and implementation of 
medical research. Too many research studies are poorly designed or executed. Too much of the 
resulting research evidence is withheld or disseminated only piecemeal. As the volume of clinical 
research has grown the quality of evidence has often worsened, which has compromised medicine’s 
ability to provide affordable, effective, high value care for patients. There are many problems. 
In our editorial launching the manifesto we describe the following:
     • Results from half of all trials are never published, and positive results are twice as likely to be 
published as negative ones.
     • 85% of research spending currently goes to waste.
     • Over four fifths (86%) of a sample of Cochrane reviews did not include data on the main 
harm outcome.
     • A systematic review of 39 studies found no robust studies evaluating shared decision making 
strategies.
     • The drug industry has been fined for criminal behaviour and civil infringements, but little 
happens to prevent such problems occurring again.
     • Despite repeated calls to prohibit or limit conflicts of interests among authors and sponsors of 
clinical guidelines, the problem persists.
     • A third of scientists report questionable research practices, including data mining for statistically 
significant effects, selective reporting of outcomes, switching outcomes, publication bias, protocol 
deviations, and concealing conflicts of interest.
     • More than one in 10 authors and reviewers has first-hand knowledge of inappropriate adjustment, 
alteration, or fabrication of data. More than one in 20 admits having lied in authorship statements.
These flaws have been known about for many years. I wrote about them in my E-Book, 
"The Failure of Conventional Medicine".  Ben Goldacre wrote about them in his book, "Bad Pharma". 

So it remains to be seen if the BMJ campaign will make any difference on this long-standing problem.