“It is Simply No Longer Possible to Believe”
This piece by Marcia Angell in the New York Review of Books, while very good, mostly consists of stuff that would be familiar and unsurprising to OB readers. But I was somewhat surprised that she went so far as to say this:
The problems I've discussed are not limited to psychiatry, although they reach their most florid form there. Similar conflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices. 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.
That's pretty strong stuff for someone who is enough of an establishment figure to become the editor of the NEJM. It's worth pointing out, though, that most of the biases that she is talking about are the product of plain old financial corruption, not the subtle cognitive biases that we mostly worry about here (though those undoubtedly play a role in allowing physicians to delude themselves into believing that they are not being swayed by the money). So these kinds of problems could probably be mostly eliminated by a conceptually simple (though of course politically very difficult) change in the rules of the game. Getting rid of problems like physician overconfidence would be much harder.
retire urologist:
There's a researcher in town at Johns Hopkins who is developing a test on blood stickiness, which he and apparently some other researchers feel is a better indicator than cholesterol level. Have you heard anything about it? I was pretty interested in it (from a layman's "I'd like to stay alive" standpoint), but Angell's article has dashed the hopes of a lot of recent innovations I've read about. But at least there is some pockets of criticism of accepted protocol.
Aaron
frelkins, re: Taubes: he's considered a lunatic by the medical establishment.
The "medical establishment" is the subject of Balan's post, or rather, their dishonesty, inaccuracy, immorality, and overconfidence. If you prefer to go by the guidelines of the AHA and the pharmaceutical cartel, you live in a free country that is perfectly suited to accommodate you. Every discovery is a departure from previously held notions, and is typically resisted by the "establishment".