Government-Funded Medical Research Is Hazardous to Your Health
The problem is not unique to medical research. Many physicists and climate scientists have warned of a similar self-reinforcing dynamic resulting in unsound scientific and policy conclusions with respect to “global warming.”
However, one unique danger of the growing corruption of medical research is that it will lead to a corruption of medical practice.
Under ObamaCare, physicians will be increasingly pressured with financial carrots and sticks to adhere to centralized “practice guidelines” established by “comparative effectiveness research.” But any such practice guidelines are only as good as the underlying science.
Even worse, the investigators in the New York Times piece found that, “The higher a journal’s impact factor… the higher its retraction rate.” Some of the most prestigious medical journals (such as the New England Journal of Medicine) had the highest retraction rates. Yet these are supposed to be the most authoritative sources for practice guidelines.
A 2009 article in the Journal of the American Medical Association reviewed 53 cardiology practice guidelines and 7196 recommendations issued between 1984 and 2008. The authors found that these guidelines were too often based on potentially biased opinions from experts, without solid scientific foundation. And they warned that this problem has steadily worsened over the years. In their words, “The proportion of recommendations for which there is no conclusive evidence is also growing.”
The science is becoming demonstrably less trustworthy. And there’s no reason to think this problem is confined solely to cardiology.
Furthermore, compelling physicians to practice according to centralized guidelines is not some “unintended consequence” of ObamaCare but rather an explicitly desired goal. As Dr. Donald Berwick (President Obama’s former head of Medicare) wrote:
The primary function of regulation in health care, especially as it affects the quality of medical care, is to constrain decentralized, individualized decision-making.
Hence, the combination of government-funded research and government-mandated practice guidelines based on that research will increasingly foist bad medical treatments onto unsuspecting patients.
Fortunately, the solution to this problem of government corruption of medical research and practice is simple — get government out of the way.
In a recent Atlantic article, Shaywitz describes how privately funded research foundations can promote clinically relevant research free from the corrupting influence of government money. For instance, he cites the Myelin Repair Foundation as an entrepreneurial “contract research organization for multiple sclerosis, capable of validating and robustifying preclinical assays, and developing and analyzing potential biomarkers for use in clinical studies.”
Such privately funded organizations are accountable to donors for money spent in a way that creates a powerful incentive for them to ensure there’s no scientific fraud or misconduct. In contrast, the recent GSA scandal has shown how government bureaucrats in charge of taxpayer dollars can too easily allow that money to be wasted. Privatizing biomedical research won’t completely eliminate the problems of flawed science, but it would be a step in the right direction.
Similarly, the problem of government-mandated clinical guidelines can be addressed by limiting the role of government in physician decision-making. This will require electing politicians committed to repealing ObamaCare in its entirety (unless the US Supreme Court overturns it first).
Just as Americans have become increasingly skeptical of “global warming” policy proposals based on questionable government-funded climate science, they should be skeptical about mandatory medical practice protocols based on increasingly questionable government-funded medical research. You don’t want Michael Moore and Al Gore telling you what kind of car you can drive or what kind of “green” light bulbs you must purchase. Why should you let their bureaucratic equivalents tell you and your doctor what kind of medical care you can receive?
My god, what a chilling situation. And once again, the light at the end of the tunnel comes from private funding, private enterprise.
Except of course, the government does tell us what light bulbs we can use and government regulations do shape the way cars are designed, often in ways that makes cars worse or simply more expensive.
The trouble is, no one can stop the government once it gets the power to do something. Other than maybe gun control, what has the government rolled back on? (And even in the case of the “Assault” Rifle ban, there was a sunset clause, it wasn’t actually repealed)
Consider the saga of the HeLa line of cancer cells, the subject of Rebecca Skloot’s book, The Immortal Life of Henrietta Lacks. They get everywhere, and researchers have not been effective in keeping them from contaminating their research.
So biomedical research is not perfect and its scientists make mistakes. We’re so lucky that bloggers and journalists are perfect and never err. But who do trust the most?
Congratulations on:
1. Completely missing the point.
2. Committing the “Yeah, and so are you!” fallacy.
3. Sounding like a spoiled fifth grader.
You might want to take note that the article points not to just mistakes but cover-ups. The MD’s doing the research, take an oath to, “First Do No Harm!” That puts them in a different catagory.
“The MD’s doing the research, take an oath to, “First Do No Harm!””
Er, no. They don’t. And they’re not necessarily MDs in any case.
There is a naivete running through this article. Science is part of the same Liberal War as is the media and are the social sciences. It is neither less blatant nor more blatant in science as elsewhere.
It is simply a mistake to think of science as a commitment to rationality in a pursuit of knowledge and verifiable theories. The entire purpose of the Left in Western Civilization is to corrupt rationality and protect an untested, and untestable idealism hostile to any rationality.
It’s an endemic disease where individual steadfastness has been usurped by appeasing the providers-of-funding, where character has been usurped by desires to be recognized by peer groups and where ethics have been usurped by an agenda.
The people in the background trying to do good science get shafted and crucified for holding up a higher standard or for bringing to light the fallacies in poor data, probably because it “made the whole department look bad” or “made the department HEAD look bad”. But ignores that it’s the department head who went full-tilt into the agenda for reasons of their own instead of for the passion of finding out how to help others.
The question I have for both you and Lawrence is, What then is to be done?
It’s a hard road. To rebuild the foundation of credibility and character can take a generation. It’s maybe similar to the “attaboy/awe-sh*t” corollary where one awesh*t can wreck years worth of attaboys.
I’m certain there are credible and reliable scientists who are just as annoyed as we are to see all this activity first-hand. It would be hard to be a person of strong moral character and of generally honest credentials watch as department heads and tenured scientists flop like fish in a rowboat over trying to get funding and selling out to do so.
In some respects, I can give them a bit of a pass, not that it’s up to me, of course but temptation is a tough thing at times. Back-seat driving their decisions and taking the moral high ground against them may seem unfair but at the same time, they are usurping the very charter upon which modern science has made such progress.
Perhaps the hardest thing to fight is ridicule. All of the great scientists I have read about and watched films about were at one time ridiculed or shunned for whatever reason(s). It’s perhaps one of the least attractive human traits. Galileo…jeez…
Copernicus..he remained mostly unscathed but didn’t let his works be published until after his death. But he had to endure some derision.
Isaac Newton. Sure, made it to head mathematician…invented calculus..but thought to be “very odd” by his peers. But then, he probably had no peers in the real sense of the word.
One has to be of paramount strength in character to handle such ostracizing. Few people raised in the modern, post 1950′s era are capable of such independence. And ridicule can drive otherwise decent people to harm themselves.
So, I defend them in the sense that they are weak by nature. But it would be nice to see the strength of will put forth that say, Galileo did at first before he was put on house arrest for the last nine years of his life.
Perhaps though, they see the agony that such men went through and find it’s simply easier to go along to get along. Doesn’t advance science any but maybe it’s just the world we live in these days.
But someday, the pendulum will swing the other way. Hopefully science will enjoy another surge and discovery will become common once again.
As icky as it sounds to liberals and those wishing to be protected throughout life by big brother government, what we need to do is to get back to free markets and individual “buyer-beware” repsonsibility. Put evolution and survival of the fittest back into the equation. Over time, bad, inefficient and politically motivated research will get punished and sound and effective work will get rewarded. Some may get hurt in the process but overall many less than within a government corrupted system.
“The proportion of recommendations for which there is no conclusive evidence is also growing.”
How true. Scientists, companies, government and the media are all complicit in this. Each group has a stake in shaping the narrative to suit their ends, and so that’s what they do.
“The whole ethos of science is to strive for the truth and produce a balanced argument about the evidence. Yet, all this crap is being produced.”
This should be chipped in stone, in large letters above every US technical library, the US Capitol, the Supreme Court, and White House entrances.
If taken to heart, it would revolutionize America, particularly in energy and environmental practices.
So who didn’t know?
Anything the bureau-rats do is crap. Think H1N1 flu scam.
Cancer is a HUGE career and money maker.
Read Suzanne Somers’ book “Knockout”
…and yet this is the same “Scientific Community” that feeds the “Governmental/Pharma/Healthcare Administration Community”, which in turn berates physicians for their reluctance reluctance to follow the dictates of “Evidence-Based Medicine”.
Google “Sepsis” and read the s/storm over recent studies that fail to back up prior studies on efficacy of certain Pharma drugs for sepsis – one of the concerns/horrors was that failure to show progress would lead to funding going to other topics.(!)
And we thought we could dispense with old-fashioned ideas such as morality and the existence of absolute truth, and be better off for it?
Scientists are only human. They can be corrupted as easily as the next ( maybe not as easily as our politicians ).It still does not make it right.
Yes, than can be, but the point of the article is the ACCOUNTABILITY they endure.
Try and tell that to some people in academia!
Are they trying to cure cancer with stalinized wheat extract?
I wonder, as well, if a healthier, more finely grained high school experience would proof the scientists against that much fraud- it’s not “them, the horrible ignorant masses who locked me in my locker”- it’s “us, my friends and colleagues.”
“To constrain decentralized, individualized decision making”… In other words to crap on the scientific method. Maybe Michelle Obama, a sociologist lawyer, could revamp the food pyramid… oh wait… nevermind. Maybe Kathleen Sebelius could just declare that birth control pills can cure all diseases. All we need are free birth control pills and then the world can live as ONE. YAY!
Medical science is difficult but the ignorance behind climate hysteria is quite different.
Somewhere, Thomas Kuhn is looking down on this and smiling…
He spoke of defending paradigms and normal science and here you have it right out there in the open, just as he described it.
“…[T]here’s often a circular quality to academic research, where a particular model system, or particular enzyme, or particular brain region, or particular analytical approach becomes very trendy, and then it takes on a life of its own.”
Dr. Hsieh’s article describes a problem that is prevalent not only in medical research, but in the education, social sciences, and humanities research in universities. A particular approach or model in a field becomes trendy, and what then happens is that researchers using that trendy approach or model get their research published in scholarly journals and those researchers who question that trendy approach or model or who don’t adhere to it cannot get their research published. I spent 35 years in academia and saw this corruption start in the 1980s–why it started then is unclear to me. Maybe the corruption in academia has something to do with political correctness.
I think that the commenters here who have mentioned a decline in people’s adherence to morality or truth are probably correct. Ultimately a researcher–in any field–has to sincerely love truth in order to do good research. Love of the thing you study as a researcher must outweigh personal ambition.
I would echo this comment, based upon the experience of my father. A experimental particle physicist (who tested theories via experimentation), he once told me that he was considered a bit of a troublemaker in his field. Apparently he was a lone wolf who was trying to disprove the existence of some theoritical sub atomic particle; he claimed to be practically the the ONLY scientist working on the ‘no’ side, every other researcher was out to prove that the particle existed. I asked him if he was just stubborn or (even) stupid (!); that is, was the evidence for the existence of that particle so strong that no intelligent scientist would be trying to disprove its existence. His answer was that the scientists who had the ear of the goverment officials doling out the money had convinced them that the particle existed, so thats where the grant money went. Therefore, the ‘herd mentalitiy’ governed the research that was done. The fear was that if you asked for a grant to prove non-existence, you didnt get one. (Though he did, apparently)
Bear in mind these expirements take 2-3 years and cost quite a bit, assuming you even get time on one of the big particle beam accelerators (which cost tens of millions to build), so without grant funding there was no expirement. But the point my Pop made to me was that human bias was a significant factor that had to be considered in assessing the actual quality of any ‘scientific’ finding under review.
Let’s see, private enterprise tried something called the HMO. They got slapped up side the head for it, and rightly so, when they tried to come between doctor and patient.
Now we have Obamacare, which is one gigantic HMO. And how exactly is this any different?
Um, no. HMOs are the bastard child of Teddy Kennedy. They did not come out of free enterprise.
A friend recently told me about a tanning bed company that sent its own “scientists” to promote the use of tanning beds for teenagers. As most people know the medical community is convinced tanning beds for teenagers is a serious cause of melanoma and want tanning beds banned and urge all adults to refrain from the use. Reminds one of the doctors cigarette companies hired to promote the health of smoking and the fight of car companies against seat belts because they were to expensive. When will citizen stop with the silly idea that everything private is saintly and evderything public is from the devil. Most humans understand problems cannot just be solved with one approach. It takes input from the profit hungry and from those that actually care about our society and not merely a bigger house and fancier clothes.
Our government intruded into the market for medical research, with the predicted result that
1) the overall amount of research spending would decline because private money would flee the market; and
2) the quality of research would decline because spending decisions would be based on something other than the upside potential demonstrated by experimental results.
Wow! Twenty (20) comments and no one has made the connection between medical research and the incredibly corrupt (see: ClimateGate)”research”.
Actually, Dr Hsieh himself mentions the similarity in his last paragraph. The alarmists have long been dismissive of research that does not endorse AGW citing biased ‘industry funding’ but have been unwilling to apply the same standards to their own government funded scientists. Hypocrisy – an inconvenient truth.
Let’s hope the government gets out of our personal lives so that we can see the medical industry uncapped before one of our loved ones needs medical attention that would otherwise be impossible.
There is way more to this than the good doctor’s view from the perspective of medical practice. I am preparing a blog response that unfortunately can’t be scheduled before Monday, but in brief: Government funding for science accounts for 30-80% of research, depending on whose numbers you use. NIH, NSF and DOD funding for research last year was around $40 billion out of a nearly $4 trillion federal budget. BTW, Medicare and Medicaid alone had funding levels of 20x over the federal research budget. Research grants to individual researchers run from $50,000 to $250,000 depending on source, with private funding typically in the $50-100k range, NSF in the $100-150k range, and NIH in the $150-$250k range per year. Those funds pay for the personnel (typically students and lab techs), supplies and research equipment. Generally, 75% of a budget is necessary to pay salaries, and the typical professor gets less than 25% of his pay from any given research grant.
This is not to say that there are not problems, but it’s not a get-rich scheme and it’s not a situation that government funding can be removed and research still survive, not the way it is currently funded. Continued funding is essential not only to new findings, but also to repeat and confirm results. When a scientist runs their experiment, they typically repeat 2-5 times then analyze, write up their results and publish. However, even that is not enough, the researcher may have particular conditions in the lab that are not universal. It is only when other researchers can get the same result that the findings are validated. This costs money, and is considered “Basic research”.
We also need better science education of the public. In fact, the latter point may very well be the solution to the former. Informed, scientifically educated public to be able to understand the difference between scientifically confirmed fact and mere conjecture without relying on interpretation by third parties.
I agree w/everything stated in this article but 1 thing that has not been mentioned is the quality of researcher in the American labs whether it is in the university or private world. I’m also thinking about those researchers who are not proficient in the English language. How many mistakes were made because directions weren’t read &/or understood correctly.
For many years there has been many scientists paid to LIE. Isn’t it time to find out who and why did that? Through our gov.
Excellent article, Dr. Hsieh. You’ve collected solid references to relate a disturbing trend that more people should know about. Thanks!
I second this….
I believe that the program referred to would not be solved by repelaling Obamacare, because it was part of the earlier stimulus bill. See Mary M (former NY Lt. Gov.) various articles on Obamacare, in Amspec and elsewhere, several years ago.
In my 1992 book SCIENCE FUNDING: POLITICS AND PORKBARREL, I argued that federal funding had corrupted the American scientific establishment. Everything I’ve seen since then confirms the conclusion of my book.
I recently retired after 40 years as the associate editor of a high impact factor international scientific journal. I can recall only one paper in that time that had to be retracted. However, virtually all of our papers came from industrial or academic sources, without government funding. The authors were not under pressure to publish in a hurry, nor to protect their pet ideas.
This is classic throwing out the baby with the bathwater. Only 8% of NIH grant proposals are being funded these days, and Germany, S Korea, China, and Taiwan will soon kick our ass in the sciences. Private funding as it stands would fund probably about 0.1% of the need for scientific research. Buffett and Soros could be funding their fare share of research, but they have other priorities. Obamacare doesnt need to rely on research for recommendations, they just get an army of ethicists to lie repeatedly, and a lie becomes fact