The “Lies” Of Medical Science: What’s An e-Patient To Do?

Therea??s an extraordinary new article in The Atlantic entitled??a??Lies, Damned Lies, and Medical Science.a?? It echos an excellent article in our Journal of Participatory Medicine (JoPM)??a year ago by Richard W. Smith, 25-year editor of the British Medical Journal, entitled??”In Search Of an Optimal Peer Review System.”

JoPM, Oct 21, 2009: a??a?|.most of what appears in peer-reviewed journals is scientifically weak.a??

The Atlantic, Oct. 16, 2010: a??Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong.a??

JoPM 2009: a??Yet peer review remains sacred, worshiped by scientists and central to the processes of science a?? awarding grants, publishing, and dishing out prizes.a??

The Atlantic 2010: a??So why are doctors — to a striking extent — still drawing upon misinformation in their everyday practice?a??

Dr. Marcia Angell said something just as damning in December 2008 in the New York Review of Books: a??It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.a?? (Our post on Angell is here.)

Whata??s an e-patient to do? How are patients supposed to research if, as all three authorities say, much of what they read is scientifically weak?

More problematic, whata??s an e-patient to do when doctors commonly insult them, saying: a??You dona??t know how to research — stick to peer reviewed journals?a?? You know what reaction patients get when they question those journals? Commonly, doctorsa?? eyes roll. Both are reasons why wea??ve covered this subject forever. See our category “Understanding Statistics.”

I havena??t read the full Atlantic article yet, but it’s been a??buzz on Twitter.??I asked for a post by Peter Frishauf, who authored a great commentary on Smitha??s article last year: “Reputation Systems: A New Vision for Publishing and Peer Review.” Here’s his take on the??Atlantic piece: “Fixing Those Damn Lies.”

EDITOR’S NOTE: Also see a related review by Dr. David Gorski of Science Based Medicine entitled “Lies, Damned Lies, And…Science-Based Medicine?“

                        f