Medical Research Studies & “Spin”

May 30, 2010

By, Robert A. Wascher, MD, FACS

Updated: 05/30/2010

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.

Welcome to Weekly Health Update

“A critical weekly review of important new research findings for health-conscious readers

I would like to take the occasion of this Memorial Day weekend to sincerely thank the millions of active duty service members, veterans, and families of The Fallen, for their selfless and courageous service to our nation, and for their many sacrifices.

Robert A. Wascher, MD, FACS

Colonel, US Army, Retired

MEDICAL RESEARCH STUDIES & “SPIN

2010 marks the fourth year that I have been writing this column, and despite the diverse range of health-related topics that I’ve reviewed over the years, each weekly column has been written with the same basic goal in mind: to bring cutting-edge health research findings to the public in as objective and honest a manner as possible.

We would all like to believe that research studies that have been successfully published in highly regarded medical and scientific journals have been so thoroughly vetted prior to publication, that we can readily accept their findings and conclusions. However, as with any other endeavor that is undertaken by humans, flaws in research hypotheses or methodologies, errors in the actual conduct of research, and erroneous conclusions drawn from the resulting research data can all lead research scientists and clinicians astray. It is because of these inherent weaknesses associated with research that standardized checks and balances are supposed to be observed in the conduct of all research studies, in an effort to reduce the risk of bias and error in the conduct of research, and in the analysis of the data that they generate.

Despite all of the safeguards that are supposed to be observed while conducting research, and with research studies involving human subjects in particular, bias and error cannot be completely eliminated in every case, and this reality must be accepted. However, a more worrisome cause of erroneous conclusions in health-related research has been of growing concern to medical journal editors and medical ethicists, lately. While many clinical research studies produce important new findings that improve our understanding of the diagnosis and treatment of human disease, many other studies result in non-significant findings that do not really advance our understanding in any meaningful way. In view of the enormous pressure upon research scientists and clinicians to publish clinically meaningful and statistically significant research findings, it is probably not too surprising to learn that some researchers can succumb to the pressure of “fudging their conclusions when their research data fails to yield any clinically (or statistically) significant findings. Although the overly optimistic interpretation of research results by researchers is a well-known phenomenon, the extent to which this routinely occurs has been unclear. Now, a newly published study in the Journal of the American Medical Association reveals the apparent extent to which this disturbing trend contaminates the published findings of clinical research studies.

In this study of “researcher spin, the authors analyzed 72 prospective randomized clinical research trials, out of a total of 616 randomized controlled research study papers published in peer-reviewed medical journals in December of 2006. These 72 studies were selected because their treatment findings failed to reach scientifically accepted levels of statistical significance (which is usually defined as a less than 5 percent probability of the observed outcome occurring by chance).

The results of this analytic study are disturbing, to say the least:

In 18 percent of cases, the authors of these “negative studies chose a title for their study that clearly implied statistically or clinically significant results, despite the lack of significant primary research findings.

Within the abstract section (a brief summary of the entire study), 38 percent of the authors either exaggerated or minimized their results in such a way as to imply that their results were actually significant. An incredible 58 percent of authors also “spun the conclusions in their abstracts to suggest clinically meaningful outcomes that were not supported by their own published research data.

Within the main body of these 72 research papers, additional “spin was identified in 29 percent of the Results sections, 43 percent of the Discussion sections, and 50 percent of the Conclusions sections!

Among these 72 research papers, more than 40 percent of the authors engaged in “spin in at least 2 sections of the main body of their research papers.

The findings of this study, that research authors are routinely exaggerating or otherwise embellishing their research outcomes, are not surprising to me, as a former cancer research scientist, nor would they be surprising to most other research scientists. However, the sheer scale of “spin on the part of research scientists, as revealed by this study, is a real eye-opener. Despite all of the safeguards that have been enacted, over the past 30 to 40 years, to promote objective and honest research, to think that at least half of all authors are routinely engaging in “spinning their nonsignificant research results, in an intentional effort to imply that their findings are significant, is disturbing (to say the least).

These highly disappointing findings also further validate the primary purpose of this global health research update column: to objectively and critically present cutting edge clinical and laboratory health-research findings to the hundreds of thousands of my regular readers around the world. While this method of health journalism may not be as sensational or as sexy as that presented by the non-physician and non-scientist columnists in the mainstream media, it is, nonetheless, a more honest and informative approach than that used by traditional media companies seeking to lure new readers with their hyperbole and their breathless (but superficial) reporting.

For other columns related to this topic, please see:

Publication & Citation Bias in Favor of Industry-Funded Research?

Drug Company Marketing & Physician Prescribing Bias

Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer

To read more objective, in-depth, and factual research-based information related to cancer prevention, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race, in the summer of this year.

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 new and returning readers who visit our premier global health information website every month. As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.

Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author

For a different perspective on Dr. Wascher, please click on the following YouTube link:

https://youtube.com/watch?v=7-Tdv7XW0qg

(Anticipated Publication Date: Summer of 2010)

(Click above image for TV36 interview of Dr. Wascher)