Throwing Stones at the House of Research

The rising tide keeps rising against the House of Research.

As reported by numerous news outlets today, another study has come down the pike, this time in the respected journal Cancer. “Breast cancer treatment trials that are funded by drug companies are more likely to show positive results than studies sponsored by other sources, new research suggests. There are also major differences in trial design when the pharmaceutical industry foots the bill, the researchers added,” according to the article.

Some would this as another opportunity to bash the easy, big target — pharmaceutical companies. But I will use this opportunity to bash an even bigger sacred cow in academia and industry — peer-reviewed research. That the current process and business of research (and trust me, research is as much a business as pharma is, even though it’s carried out at university and clinical settings) is misunderstood and seen as “flawed.” But the flaws may be in our perception or expectations of research.

Some people believe that “evidence-based medicine” is the answer. That if doctors simply followed what the evidence showed for a given illness or condition, some of these issues would disappear. The problem, as we are seeing, is that you can’t always trust the “evidence,” even when it appears in peer-reviewed journals (not to mention the negative evidence which never appears anywhere).

It’s like buying a 14-chapter book expecting to get the entire story. But instead of getting the entire story, you find chapters 10-14 are missing, and that chapters 3-9 were written by an author that didn’t appear on the front cover of the book. But it’s not quite so obvious as that. Nobody tells you that chapters 3-9 were written by someone else, and nobody mentions that it’s actually a 14-chapter book that’s missing 5 chapters. It’s no wonder you come away from the book feeling a little confused and betrayed. It’s nothing like you expected or were promised.

That’s where we are with the state of our research today. Even with the best of intentions and all the safety checks in place, research is showing just how biased and flawed the process of research itself is (ah, the irony). Some sit and ponder this, wondering, “How could this be? We work so hard with our double-blind placebo studies to ensure everything is scientific and unbiased!”

Well, psychologists have long understood that when you involve humans in any process, even when you place checks into the system to try and balance against human nature, human nature is going to win out. Why? Because we’re humans! (How’s that for circular reasoning?) No, seriously, human nature basically boils down to that we are emotional creatures with flaws and issues and no matter how black the ink or how white the page, humans will sometimes do things that are unpredictable and very much unscientific. That better their own selves or own lives. That help a friend or colleague. That ensure a future grant from the same foundation. That ensure our research position is renewed. That move a decimal point to show positive results that will get the study published. That will best a research rivalry. Etc. etc. etc.

The point to me is simple and one I’ve always followed — put all research into context, and take research with a healthy grain of salt. Wait about 10 years for a dozen or two studies to show similar results in the same direction and then you have yourself a fairly robust finding that you can take to the bank.

All researchers have an agenda, even if it’s as simple as wanting the study to be published so others in their field will know the results they discovered. That’s still an agenda. The important thing isn’t to deny the agenda or researchers’ humanity, but instead to embrace it. Embrace that pharmaceutical-funded studies are likely to show more positive results than non-pharma funded studies. Embrace that someone who has been researching the same theory or treatment for decades is really, really close to that theory or treatment (and their research may reflect that). Embrace that research is fundamentally a subjective, human process designed to try and arrive at objective, scientific findings.

No amount of spin or marketing or ranting will change the fundamental nature of research. Instead, we need to do a better job of understanding individual studies, placing them into their proper context, and moving on.

Oh, and fix the FDA, because that agency seriously needs an overhaul.