Confiabilidade da pesquisa na medicina

'Evidence-Based' Medicine: A Coin's Flip Worth of Certainty

Sayer Ji, Contributor
Activist Post

What if 90% of the peer-reviewed clinical research, the holy grail of the conventional medical system, is exaggerated, or worse, completely false?

A seismic shift is occurring in the field of evidence-based medicine that a rare few are aware of, but which will (and likely already does) affect everyone, as the standard of medical care today largely follows from this model.

The very life's blood of 'evidence-based' medicine -- peer-reviewed and published clinical research results – which legitimizes the entire infrastructure and superstructure upon which conventional medical knowledge and practice is erected, has been revealed as mostly and patently false.

Case in point: in a 2005 essay, "Why Most Published Research Findings are False," and which is the most downloaded document of all time on PLoS, the Public Library of Medicine's peer-reviewed, open access journal, John P. A Ioannidis explains in detail how "It can be proven that most claimed research findings are false." And that "for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias."

The Atlantic published a piece on Ioannidis' work, back in 2010, titled "Lies, Damned Lies, and Medical Science," well worth reading, and which opened with "Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors - to a striking extent - still drawing upon misinformation in their everyday practice?"

Ioannidis' work revealed that about half of the most highly regarded research findings within "evidence-based" medicine are either wrong, or significantly exaggerated:
[Ioannidis] zoomed in on 49 of the most highly regarded research findings in medicine over the previous 13 years, as judged by the science community's two standard measures: the papers had appeared in the journals most widely cited in research articles, and the 49 articles themselves were the most widely cited articles in these journals.

...Of the 49 articles, 45 claimed to have uncovered effective interventions. Thirty-four of these claims had been retested, and 14 of these, or 41 percent, had been convincingly shown to be wrong or significantly exaggerated. If between a third and a half of the most acclaimed research in medicine was proving untrustworthy, the scope and impact of the problem were undeniable. That article was published in the Journal of the American Medical Association.

Time magazine wrote about Ioannidis' findings the same year with a piece titled "A Researcher's Claim: 90% of Medical Research is Wrong" -- the title of which speaks resoundingly for itself.