Health and Medical News and Resources

General interest items edited by Janice Flahiff

[News release] Publication bias and ‘spin’ raise questions about drugs for anxiety disorders

From the 30 March 2015 Oregon State University news release

A new analysis reported in JAMA Psychiatry raises serious questions about the increasingly common use of second-generation antidepressant drugs to treat anxiety disorders.

It concludes that studies supporting the value of these medications for that purpose have been distorted by publication bias, outcome reporting bias and “spin.” Even though they may still play a role in treating these disorders, the effectiveness of the drugs has been overestimated.

In some cases the medications, which are among the most widely prescribed drugs in the world, are not significantly more useful than a placebo.

The findings were made by researchers from Oregon State University, Oregon Health & Science University, and the University of Groningen in The Netherlands. The work was supported by a grant from the Dutch Brain Foundation.

Publication bias was one of the most serious problems, the researchers concluded, as it related to double-blind, placebo-controlled clinical trials that had been reviewed by the U.S. Food and Drug Administration. If the FDA determined the study was positive, it was five times more likely to be published than if it was not determined to be positive.

Bias in “outcome reporting” was also observed, in which the positive outcomes from drug use were emphasized over those found to be negative. And simple spin was also reported. Some investigators concluded that treatments were beneficial, when their own published results for primary outcomes were actually insignificant.

“These findings mirror what we found previously with the same drugs when used to treat major depression, and with antipsychotics,” said Erick Turner, M.D., associate professor of psychiatry in the OHSU School of Medicine, and the study’s senior author. “When their studies don’t turn out well, you usually won’t know it from the peer-reviewed literature.”

This points to a flaw in the way doctors learn about the drugs they prescribe, the researchers said.

“The peer review process of publication allows, perhaps even encourages, this kind of thing to happen,” Turner said. “And this isn’t restricted to psychiatry – reporting bias has been found throughout the medical and scientific literature.”

March 31, 2015 Posted by | Medical and Health Research News | , , , , , | Leave a comment

PubMed Commons – A New Way to Share Information and Research Processes

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From a recent email  by Holly Ann Burt, Outreach and Exhibits Coordinator of the National Network of Libraries of Medicine (NN/LM) Greater Midwest Region

NCBI has released PubMed** Commons, currently in pilot phase, which is a new system that enables researchers to share their opinions about scientific publications indexed in the PubMed database. This is intended to be a forum for open and constructive criticism and discussion of scientific issues.

A new NCBI Insights Blog post provides more information and explains how researchers can join in!

For more information, please see:

PubMed Commons Homepage – http://www.ncbi.nlm.nih.gov/pubmedcommons
NCBI Insights Blog post: “PubMed Commons – a new forum for scientific discourse”-http://ncbiinsights.ncbi.nlm.nih.gov/2013/10/22/pubmed-commons-a-new-forum-for-scientific-discourse/

Here’s a mock-up

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**PubMed  (a US government funded database) is the largest database of biomedical journals in the world. It comprises more than 23 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

October 23, 2013 Posted by | Biomedical Research Resources, Librarian Resources, Medical and Health Research News | , , , , , , | Leave a comment

Are Medical Conferences Useful? And for Whom?

Credit: Wikipedia Commons

A medical doctor (who himself is a big draw at medical conferences) has recently questioned the motives and utility of medical conferences. [Mythbuster Ioannidis: Are Medical Conferences Really Useful?]

He believes much of the presented research findings  are not fully peer-reviewed, and thus cannot  fully educate, train, or contribute to evidence-based practice. Often findings at medical conferences are seized upon by the popular press and prematurely promoted as having sound scientific evidence. Quite often these findings change with peer review and are later published with the revisions and modified findings in scientific journals.

Excerpt from the 4 April 2012 JAMA (Journal of the American Medical Association) article
(The full text of this article is by subscription only, these excerpts came from a related posting at HealthNewsReview.org)

An estimate of more than 100 000 medical meetings per year may not be unrealistic, when local meetings are also counted. The cumulative cost of these events worldwide is not possible to fathom.

Do medical conferences serve any purpose? In theory, these meetings aim to disseminate and advance research, train, educate, and set evidence-based policy. Although these are worthy goals, there is virtually no evidence supporting the utility of most conferences. Conversely, some accumulating evidence suggests that medical congresses may serve a specific system of questionable values that may be harmful to medicine and health care.

The availability of a plethora of conferences promotes a mode of scientific citizenship in which a bulk production of abstracts, with no or superficial peer review, leads to mediocre curriculum vita building. Even though most research conferences have adopted peer-review processes, the ability to judge an abstract of 150 to 400 words is limited and the process is more of sentimental value.

Moreover, many abstracts reported at the medical meetings are never published as full-text articles even though abstract presentations can nevertheless communicate to wide audiences premature and sometimes inaccurate results. It has long been documented that several findings change when research reports undergo more extensive peer review and are published as completed articles.* Late-breaker sessions in particular have become extremely attractive prominent venues within medical conferences because seemingly they represent the most notable latest research news. However, it is unclear why these data cannot be released immediately when they are ready and it is unclear why attending a meeting far from home is necessary to hear them. A virtual online late-breaker portal could be established for the timely dissemination of important findings….

…Power and influence appear plentiful in many of these meetings. Not surprisingly, the drug, device, biotechnology, and health care–related industries make full use of such opportunities to engage thousands of practicing physicians. Lush exhibitions and infiltration of the scientific program through satellite meetings or even core sessions are common avenues of engagement. Although many meetings require all speakers to disclose all potential conflicts, the majority of speakers often have numerous conflicts, as is also demonstrated in empirical evaluations of similar groups of experts named on authorship lists of influential professional society guidelines.”

Ioannidis doesn’t discard the entire notion of conferences.  In fact, he projects what “repurposed” conferences might be like:

“Repurposed conferences could be designed to be entirely committed to academic detailing (ed. note: drug company “educational” outreach to physicians). All their exhibitions and satellite symposia would deal with how to prescribe specific interventions appropriately and how to favor interventions that are inexpensive, well tested, and safe. Such repurposed conferences could also focus on how to use fewer tests and fewer interventions or even no tests and no interventions, when they are not clearly needed.”

 

Related Resources

 

April 10, 2012 Posted by | Biomedical Research Resources | , , , , , | Leave a comment

Open science: change is coming to how scientists communicate research findings

English: Open Access logo and text

Image via WikipediaAuthor - art designer at PLoS, I converted a pdf into svg http://www.plos.org/

How Scientists Communicate Affects How Research Results Are Applied …as FDA approved drugs, nutrition values, violence prevention, and climate change models

Past blog postings (see below) here have often touched on the difficulties of  obtaining recent scientific and medical findings in original biomedical articles.  Most of these research articles are only found in journals that charge high annual subscription rates ($600.00/ year and up) or an access fee of about $20.00 per article.

Not only is this pricing arrangement making it difficult for scientists to get needed information, but it is becoming nearly impossible for even university and research libraries to buy subscription to the journals their customers want. Additionally article authors must pay publication fees to the journals which range from $1,000  to $5,000 per article.

Most stakeholders (researchers, librarians, publishing companies) believe that the relatively high costs of publishing articles is a major flaw of the current publishing system. These publishing costs used to be born by the researcher in centuries past and were relatively cheap and involved much fewer scientists in tight knit groups. But with the sheer numbers of those wanting information, the many biomedical specialities, and the sophistication of article content (images, videos, and audios), the cost per article has dramatically risen.

Some related statistics (from the posting How many science journals at Science Intelligence and InfoPros)

  • Estimation: <> 25-40,000 journals
  • 96% are published online
  • 8-10% are published under Open Access models
  • 20% of science articles are available free of charge
  • How many articles have been published ever (means since 1665)? est. 50 millions
  • Growth: 1.4 million of articles per year
  • There are 2,000 publishers but Top 3 (Elsevier, Springer, Wiley)  account for 42% of articles published

The open science model is one initiative which may reduce costs and increase readership. This approach may well also drastically reduce the time from article completion by the scientist to article publication. It is currently not uncommon for an article in a peer reviewed journal to take up to  1 1/2 years to be published after submission.

In a recent New York Times article (Cracking Open the Scientific Process), the conservative culture of science is outlined, as well as the plausibility of using social media as vehicles of communicating research results. The article also summarizes another fear of scientists. While social media is a less costly and speedier way to communicate research approaches and results, it currently lacks the quality control and trustability of the peer review process in selecting and editing articles for publication.

While Open Science overwhelmingly is geared for  scientist participation only, the way scientists communicate does ultimately affect the application of research. Examples in consumer health  include the drugs we take, the way treatments are prescribed, and the make up of a well balanced diet.  Current questions about the Open Science model include how wise is the scientific equivalent of crowdsourcing? and who will pay for the costs involved and how much?

Some excerpts from the article

The system is hidebound, expensive and elitist, they say. Peer review can take months, journal subscriptions can be prohibitively costly, and a handful of gatekeepers limit the flow of information. It is an ideal system for sharing knowledge, said the quantum physicist Michael Nielsen, only “if you’re stuck with 17th-century technology.”

Dr. Nielsen and other advocates for “open science” say science can accomplish much more, much faster, in an environment of friction-free collaboration over the Internet. And despite a host of obstacles, including the skepticism of many established scientists, their ideas are gaining traction.

Open-access archives and journals like arXiv and thePublic Library of Science (PLoS) have sprung up in recent years. GalaxyZoo, a citizen-science site, has classified millions of objects in space, discovering characteristics that have led to a raft of scientific papers….

…a social networking site called ResearchGate — where scientists can answer one another’s questions, share papers and find collaborators — is rapidly gaining popularity…

ScienceOnline2012  …On Thursday [January 19] , 450 bloggers, journalists, students, scientists, librarians and programmers will converge on North Carolina State University (and thousands more will join in online) for the sixth annual ScienceOnline conference. Science is moving to a collaborative model, said Bora Zivkovic, a chronobiology blogger who is a founder of the conference, “because it works better in the current ecosystem, in the Web-connected world.”…

ResearchGate…[The Research Gate] Web site is a sort of mash-up of Facebook, Twitter and LinkedIn, with profile pages, comments, groups, job listings, and “like” and “follow” buttons (but without baby photos, cat videos and thinly veiled self-praise). Only scientists are invited to pose and answer questions — a rule that should not be hard to enforce, with discussion threads about topics like polymerase chain reactions that only a scientist could love….

Related past postings at Health and Medical News…

January 21, 2012 Posted by | Biomedical Research Resources | , , , , , , , , , , , | Leave a comment

The White House Calls for Information on Public Access to Publications and Data « The Scholarly Kitchen

Office of Science and Technology Policy

The White House Calls for Information on Public Access to Publications and Data « The Scholarly Kitchen.

From the blog article at the Scholarly Kitchen

f you’re reading this blog, you likely have an opinion aboutopen access to journal articles and research results. The White House Office of Science and Technology Policy (OSTP) has put out two formal Requests for Information; one on the subject of “Public Access to Peer-Reviewed Scholarly Publications” and the other on “Public Access to Digital Data.”

While most of us enjoy the seemingly endless back and forth discussion online (or ranting and raving, as the case may be), this is a chance for all stakeholders to have a direct influence where it matters most.  The White House is crafting requirements for recipients of federal research funding and the information received here will be crucial to setting policy.

There are two separate issues here, public access to journal articles from federally-funded research, and the tricky question of how to make the most of the raw data collected in those federally-funded experiments….

December 3, 2011 Posted by | Librarian Resources | , , , | Leave a comment

   

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