Jan 10th, 2013 / Reuters Health
Doctors relying on studies published in top journals for guidance about how to treat women with breast cancer may not be getting the most accurate information, according to a new analysis.
“Investigators want to go overboard to make their studies look positive,” said Dr. Ian Tannock, the senior author of the new study in the Annals of Oncology.
In two-thirds of the 164 studies Tannock and colleagues scrutinized, toxicities and serious side effects from chemotherapy, radiation or surgery were not listed in the paper’s abstract summary.
That’s important, said Tannock, of Princess Margaret Hospital in Toronto, because “most of us (doctors) are so damn busy, we only read the abstract and skim the tables and figures.”
A fifth of the studies didn’t include toxicities in results tables, and about a third failed to mention them in either the abstract or the discussion section.
Most surprising, said Tannock, was that in a third of studies, if the treatment didn’t work as well as one might hope, researchers moved the goalposts, reporting results that weren’t what the study was originally designed to test.
Often, those so-called “secondary endpoints” may be less important and meaningful. There is a difference, for example, between showing people lived longer overall, and simply lived longer without their cancers coming back.
Researchers “gain more influence with positive studies,” said Tannock, whose team analyzed reports of late-stage trials of the kind used by the U.S. Food and Drug Administration to decide whether to approve drugs.
There are various pressures on researchers to make their results “look better than they really are,” Tannock told Reuters Health, including drug companies, which often sponsor trials. However, in the new study, who paid for a study didn’t have any relationship with how the results were presented.
Scientists may also spin their results to increase their chances of publishing in the top journals surveyed by the new study. Such marquee publications can improve the chances for tenure, promotion and grants.
One of the journals whose studies Tannock and his colleagues looked at, the New England Journal of Medicine, declined to comment, saying they don’t typically comment on other studies. Another, the Journal of Clinical Oncology, could not provide a comment by deadline.
Journals can help, Tannock said, by insisting that authors include toxicities in abstracts. “Even in 250 words, everybody can get that in there,” he said.
Tannock and colleagues concluded: “These reports were biased and used spin in attempts to conceal that bias. A possible explanation for this could be that the investigators, sponsors or both, prefer to focus on the efficacy of the experimental treatment and downplay toxicity to make the results look more attractive.”
My Comments
I have a love/hate relationship with studies like this.
I hate them because they uncover the seedy underbelly of the cancer treatment industry which includes ignoring or omitting critical information. This is despicable and infuriating.
I love them for the same reason, because it give me another, “I told you so”.
The pharmaceutical industry is corrupt and they control the medical industry, from the cirriculum aspiring doctors are taught in med school all the way to the drug studies published in the latest medical journals that practicing doctors read and trust.
All ye who worship science take heed. Research science can be biased.
It’s interesting how they uncovered that some researchers would ignore the negative findings of the primary focus of the study and highlight a smaller less significant aspect because it was positive in some way.
Speaking of “positive”. The scientific jargon they use in these studies is incredibly subversive. Instead of saying, “Drug X made the tumor grow”. They will say something like “There was a positive association of proliferation” or whatever.
There are two major incentives behind the scenes for researchers to make drugs look good:
Incentive #1 When researchers produce positive results for drug companies, they get more research assignments. That means mo’ money. We’ve all got bills to pay. Mo’ money helps with that.
Incentive #2 Getting research papers published adds to your prestige and credibility in the scientific community. That also leads to more assignments and more money.
This of course doesn’t include bribery, fraud, and deliberate data manipulation, which also happens.
Here are consequences of “research spinning” in the real world:
Oncologists are reading these research summaries on new drugs and prescribing them without knowing how toxic and damaging it can be to the patient.
If doctors don’t know the side effects, they aren’t going to warn you about them.
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