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Why Negative Medical Studies Are Good

This is a guest column by Ivan Oransky, M.D., who is executive editor of Reuters Health and blogs at Embargo Watch and Retraction Watch.

One of the things that makes evaluating medical evidence difficult is knowing whether what’s being published actually reflects reality. Are the studies we read a good representation of scientific truth, or are they full of cherry-picked data that help sell drugs or skew policy decisions?

That question may sound like that of a paranoiac, but rest assured, it’s not. Researchers have worried about a “positive publication bias” for decades. The idea is that studies showing an effect of a particular drug or procedure are more likely to be published. In 2008, for example, a group of researchers published a New England Journal of Medicine study showing that nearly all — or 94 percent — of published studies of antidepressants used by the FDA to make approval decisions had positive results. But the researchers found that when the FDA included unpublished studies, only about half — or 51 percent — were positive.

A PLoS Medicine study published that same year found similar results for studies long after drugs were approved: Less than half — 43 percent — of studies used by the FDA to approve 90 drugs were published within five years of approval. It was those with positive results that were more likely in journals.

All of that can leave the impression that something may work better than it really does. And there is at least one powerful incentive for journals to publish positive studies: Drug and device makers are much more likely to buy reprints of such reports. Such reprints are highly lucrative for journals. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Medical Journal Retractions: A Transparency Issue

Interesting case study raised by the Retraction Watch blog.

A 2009 journal article in the Proceedings of the National Academy of Sciences (PNAS) – promoted in a news release by the journal and picked up by many news organizations — has now been retracted by the authors. But the journal issued no news release about the retraction — an issue of transparency that the RW blog raises. And you can guess how much news coverage the retraction will get.

And this was all over a molecule that could supposedly “make breast tumors respond to a drug to which they’re not normally susceptible” — as the RW blog put it. But it was also a molecule, RW points out, that wasn’t even in clinical trials yet.

He or she who lives by the journal news release risks one’s long-term credibility.

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Medical Journals: Do Peer Reviewers Get Worse With Experience?

Interesting post by the Retraction Watch blog, pointing to an interesting paper published last week in the Annals of Emergency Medicine. An excerpt from the blog post:

Over 14 years, 84 editors at the journal rated close to 15,000 reviews by about 1,500 reviewers. Highlights of their findings:

…92% of peer reviewers deteriorated during 14 years of study in the quality and usefulness of their reviews (as judged by editors at the time of decision), at rates unrelated to the length of their service (but moderately correlated with their mean quality score, with better-than average reviewers decreasing at about half the rate of those below average). Only 8% improved, and those by very small amount.

How bad did they get? The reviewers were rated on a scale of 1 to 5 in which a change of 0.5 (10%) had been earlier shown to be “clinically” important to an editor. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Retraction Watch: A New Niche Blog To Follow

Ivan Oransky, M.D., executive editor of Reuters Health, somehow found time a few months ago to launch his first blog, Embargo Watch — with the tagline: “Keeping an eye on how scientific information embargoes affect news coverage.”

Now, as evidence he either doesn’t sleep or has roots in Transylvania, Oransky the Impaler launches a new blog, Retraction Watch along with partner Adam Marcus. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

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