I’ve been reading Ben Goldacre’s book Bad Science lately. It’s not only incredibly informative, but also entertaining and inspirational. I usually consider myself a fairly skeptical person, but I had no idea how much of what I’ve heard around me and in the media is pure nonsense. I am now even more encouraged to be more critical about everything I hear.
But the book is not just about the media, but also the less than honest methods of some researchers, especially the ones whose work is intended to make money. One issue that really bothered me is how many of the studies conducted are never published or even registered. If the outcome isn’t what they researchers hoped for then it’s simply discarded. A negative outcome isn’t useless information. Whatever you find out, be it what you expected or not, is valid information and should be easily accessible to all. Especially when it comes to medical trials.
I have been thinking about my thesis for the last few months. I will likely study whether public health in Iceland has changed in the last few decades since globalization reached Iceland. I’m not 100% sure how I’ll go about it, but I will likely look at statistics of particular diseases and see whether they have changed significantly. I took a course last semester where for one project we had to come up with an idea for a study, plan it and then present it to our classmates. Some of them asked me “what if you find out there hasn’t been any change?” I got the feeling that they thought that if the result were no then the study were useless. I don’t think so. It would mean that something’s been done right in the Icelandic health care system and that’s important information.
In light of this I find this blog entry interesting. Larry Husten at Cardiobrief says that mandatory registration of clinical trials hasn’t worked as it should have.
They found that less than half the trials (45.5%) were adequately registered, which they defined as being registered before the end of the trial and with the primary outcome clearly specified. More than a quarter of the trials were not registered at all, while 13.9% were registered after the study was finished. In the trials that were adequately registered, the French investigators found “discrepancies between the outcomes registered and the outcomes published.” In the papers where they were able to assess the discrepancies, the investigators found that “statistically significant results were favored in 82.6%.”
So it’s clear that even initial attempts to address the problem have not been very successful. Hopefully a stricter policy will be implemented in the future.