One of the world’s foremost experts on the credibility of medical research, John Ioannidis, MD, DSc, has made a career out of challenging the framework of medical investigation. An article published online today in Newsweek examines Ioannidis’s research and its implications for doctors and policymakers:
Ioannidis’s first targets were shoddy statistics used in early genome studies. Scientists would test one or a few genes at a time for links to virtually every disease they could think of. That just about ensured they would get “hits” by chance alone. When he began marching through the genetics literature, it was like Sherman laying waste to Georgia: most of these candidate genes could not be verified. The claim that variants of the vitamin D-receptor gene explain three quarters of the risk of osteoporosis? Wrong, he and colleagues proved in 2006: the variants have no effect on osteoporosis. That scores of genes identified by the National Human Genome Research Institute can be used to predict cardiovascular disease? No (2009). That six gene variants raise the risk of Parkinson’s disease? No (2010). Yet claims that gene X raises the risk of disease Y contaminate the scientific literature, affecting personal health decisions and sustaining the personal genome-testing industry.
The situation isn’t hopeless. Geneticists have mostly mended their ways, tightening statistical criteria, but other fields still need to clean house, Ioannidis says. Surgical practices, for instance, have not been tested to nearly the extent that medications have. “I wouldn’t be surprised if a large proportion of surgical practice is based on thin air, and [claims for effectiveness] would evaporate if we studied them closely,” Ioannidis says. That would also save billions of dollars. George Lundberg, former editor of The Journal of the American Medical Association, estimates that strictly applying criteria like Ioannidis pushes would save $700 billion to $1 trillion a year in U.S. health-care spending.
Learn more about what Ioannidis views as the major problems with biomedical research and ways to strengthen how research is planned, carried out and reported in this 1:2:1 podcast.