BMJ Blogs

Worth rereading; "Time to assume that health research is fraudulent until proven otherwise?" from no less a source than the British Medical Journal [0]. Another example; 5-HTTPLPR studies [1] in psychiatric research (over 450, "proving" the effects of the gene on basically every psychological malady) stretching all the way back to 1996. [0]: https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-health-resear… [1]: https://slatestarcodex.com/2019/05/07/5-httlpr-a-pointed-review/

The news suggests they are delaying the second dose, or at least strategising. If there isn't enough vaccine to go around (which there isn't) giving people the recommended 2nd dose is also a gamble. > The UK’s strategy to delay the second dose of both ... vaccines is so that more people can be vaccinated with their first dose rather than giving a smaller number of people both doses. The hope is that this will save more lives -- https://blogs.bmj.com/bmj/2021/01/20/revisiting-the-uks-strategy-for-d… Do you think the advantage of the 1st vaccine is less than that of the 2nd? i.e that it is better to have 1 person with the recommended 2 vaccines, and another with no vaccinations; versus, two people with only the first vaccination.

> However, everybody on this site has decided that they're useless because of a single, incorrectly read, out-of-context tweet from 4 months ago. Actually, they lost any credibility to me when they wanted to appoint Robert Mugabe as an ambassador years ago. In more recent times, their position on the use of masks was criticized as confusing[1]. And let's not forget their equally confusing tweet on immunity to SARS-CoV-2 from a week ago or so (which was ultimately retracted). So not just one from 4 months ago. Of course it's a big organization, so caveats apply. Nevertheless, they didn't do the best job at communication. [1] https://blogs.bmj.com/bmj/2020/03/11/whos-confusing-guidance-masks-cov…

It sounds like a lot but really isn't when you look at where else the money is going, even just within the research community. For example, that is about one year's worth of pointless medical research (the final reports are of no use to anyone due to bad design, terse descriptions, etc): http://blogs.bmj.com/bmj/2016/01/14/paul-glasziou-and-iain-chalmers-is…

I can understand why people feel this way, and in the UK this is also somewhat prevalent. In part, it stems from the poor messaging on COVID risks (at the individual and population level) and control measures we have available. In short, the UK media are somewhat pushing "COVID is over" at the same time as "the only tool is lockdown, and we can't do that again". These two factors, I suspect, mean that people are encouraged by the vaccination-heavy strategy we're pursuing. Children are one group for whom this strategy may be problematic, and is a more significant issue in the UK than US right now given that only 12+ are eligible. This review discusses some of the arguments around this topic: https://adc.bmj.com/content/early/2021/11/01/archdischild-2021-323040 We also have CEV and elderly groups for whom the vaccine still leaves a reasonable degree of risk. Here's an opinion piece that cites research into CEV & vaccine protection: https://blogs.bmj.com/bmj/2021/03/30/vaccinated-yet-still-clinically-e… In addition to the health risk/benefit to the individual, there is also the societal cost to lost productivity. This is where keeping low COVID prevalence may be worth pursuing on a solely economic basis through low-invasiveness NPIs. Of course, there's also the risk of escape variants, and that's just simple maths. As vaccine-only strategies do not keep R(eff) < 1, there is reasonable potential for escape variants like Omicron to surface. Though I am not…

From Wikipedia, on the Great Barrington Declaration: The World Health Organization (WHO) and numerous academic and public-health bodies have stated that the proposed strategy is dangerous and lacks a sound scientific basis.[8][9] They say that it would be challenging to shield all those who are medically vulnerable, leading to a large number of avoidable deaths among both older people and younger people with pre-existing health conditions,[10][11] and they warn that the long-term effects of COVID-19 are still not fully understood.[9][12] Moreover, the WHO says that the herd immunity component of the proposed strategy is undermined by the limited duration of post-infection immunity.[9][12] They say the more likely outcome would be recurrent epidemics, as was the case with numerous infectious diseases before the advent of vaccination.[11] The American Public Health Association and 13 other public-health groups in the United States warned in a joint open letter that the Great Barrington Declaration "ignores sound public health expertise" despite public health experts agreeing "better balance must be found between protecting public health and helping the economy."[8] The Great Barrington Declaration was sponsored by the American Institute for Economic Research, a libertarian free market think tank associated with climate change denial.[13][14][15] More on the AIER: Prominent AIER fellows have run afoul of social media for opposing such measures. For example, Naomi Wolf, the…

Well, about that ... https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-health-resear… "Richard Smith was ... for many years the chair of the Cochrane Library Oversight Committee, and a member of the board of the UK Research Integrity Office." "Stephen Lock, my predecessor as editor of The BMJ, became worried about research fraud in the 1980s, but people thought his concerns eccentric. Research authorities insisted that fraud was rare, didn’t matter because science was self-correcting, and that no patients had suffered because of scientific fraud. All those reasons for not taking research fraud seriously have proved to be false, and, 40 years on from Lock’s concerns, we are realising that the problem is huge, the system encourages fraud, and we have no adequate way to respond. It may be time to move from assuming that research has been honestly conducted and reported to assuming it to be untrustworthy until there is some evidence to the contrary." So a former Chair of the Cochrane Library Oversight Committee thinks medical research is filled with fraud. How reliable can it be really?

"Vaccines or bust" was in reference to the parent comment, which seems to reflect a broader and widely held perception that any generic drugs must be a bad idea, and the only legitimate course of intervention is vaccines. It was not a (flatly absurd) claim that there are zero studies going on into various generic treatments. Some doctors are refusing to use ivermectin to treat seriously ill patients because the FDA will not issue any recommendations regarding its use: https://buffalonews.com/news/local/after-judge-orders-hospital-to-use-… If you include suspected COVID cases (which dwarfed confirmed PCR results) in the Pfizer trials, vaccine effectiveness falls to between 19% and 29%: https://blogs.bmj.com/bmj/2021/01/04/peter-doshi-pfizer-and-modernas-9…

Well, in salmon30salmon's defence: the mainstream media are completely and utterly missing in action when it comes to COVID. They only parrot what the gov tells them and investigate nothing these days. There are countless credible scientists saying that we are getting this incredibly wrong on so many levels yet mainstream media does not mention anything other than government narrative. When did you see any news coverage of criticism of the "vaccine"? I mean, on a scientific level, not government ineptitude at rolling it out. Edit: I can't reply for some reason but here's a video talking about the "vaccine"[0] and here's the Great Barrington Declaration[1]. Here is criticism from the BMJ [2] stating that (according to my maths) it's only 19% effective... in addition, it's designed to TREAT the symptoms, not cure you... what kind of vaccine is that? [0] - https://www.bitchute.com/video/edombs4NcvQ6/ [1] - https://gbdeclaration.org/ [2] - https://blogs.bmj.com/bmj/2021/01/04/peter-doshi-pfizer-and-modernas-9…

Some quick points about this. The British Medical Journal and Royal Society of medicine have published a number of concerns about this vaccine. "Will covid-19 vaccines save lives? Current trials aren’t designed to tell us" https://www.bmj.com/content/371/bmj.m4037 "All these data for the different vaccines are potentially very promising, but none of the phase III trials have been published in peer reviewed journals or analysed by age group, gender and case description... As public health professionals, we believe that the results of clinical trials, whether interim or final, should be subject to an appropriate systematic process, and then published in peer-reviewed professional journals. Reporting the covid-19 vaccine trial results in press releases before publication in journals is neither good scientific practice nor does it help to build public trust in vaccines" https://blogs.bmj.com/bmj/2020/11/27/covid-19-vaccines-where-are-the-d… "When good science is suppressed by the medical-political complex, people die Politicians and governments are suppressing science. They do so in the public interest, they say, to accelerate availability of diagnostics and treatments. They do so to support innovation, to bring products to market at unprecedented speed. Both of these reasons are partly plausible; the greatest deceptions are founded in a grain of truth. But the underlying behaviour is troubling." https://www.bmj.com/content/371/bmj.m4425

In the UK: The doctors come up with a plan. The parents disagree. The doctors need to go to court to get a ruling. In the US: The doctors come up with a plan. The parents disagree. It is the parents who need to go to the courts to get a ruling. Charlie Gard's case has absolutely nothing to do with cost. In the UK children are humans and humans have rights, and those rights are protected by the courts. Parents do not get to own children as possessions. The courts will focus on the child's best interests, because of the Paramountcy Principle which flows from Article 3(3) of the EU Treaty and Article 24 of the Charter of Fundamental Rights of the European Union, which flows from the UNCRC article 3(1). Charlie Gard's case is about someone who cannot make a choice for themself, and the courts focussing on that person's best interests, not on the interests of that person's relatives. Charlie Gard had RRM2B MDS. This has fewer than 50 cases worldwide. There is no cure. There is no treatment. The discussion is whether to allow him to die with pain relief, or allow medical experimentation that has no hope of success but which will cause pain. Unsurprisingly the courts decided it was in his best interests to be allowed to die with pain relief. http://blogs.bmj.com/medical-ethics/2017/07/07/never-let-an-ill-child-… You may wish to read the judgments, because almost everything written by the US press was…

Another similar story recently was a bug found in analysis software used in many 'brain scan' papers. Then there are a continuous stream of scientific retractions going on (see retractionwatch.com). We do science as follows: data is collected, run through some analytic and/or statistical method, and then the results are published. Then those results get cited by other papers. It's a dependency graph. If some flaw is found in the data or the analysis it would be natural to invalidate this paper and automatically flag all downstream dependencies in the chain of inference. Unfortunately the publishing model does not allow this. I think if we'd developed the internet and software engineering practises before we'd developed scientific publishing, what scientists produce would look less like papers and more like Git repositories. Under this fantasy scenario, we'd have metadata that included statistical methods and software for all analyses. The raw, open data in the repositories could be re-analyzed by anyone else at any time. If there were doubt thrown on a method, or if some data were fraudulent, we could instantly assess the impact on all of current knowledge. I wonder if these recurring problems in curating and re-assessing knowledge will eventually lead to a restructuring of science. Researchers are starting to take the idea of a 'post journal world' seriously (http://blogs.bmj.com/bmj/2016/06/15/richard-smith-what-will-the-post-j…

viz. this evergreen gem: https://blogs.bmj.com/bmj/2018/12/13/we-jumped-from-planes-without-par…

You are only seeing them before they are sick...it is well know that too much exertion is as bad as too little. https://blogs.bmj.com/bjsm/2017/04/06/elite-athletes-higher-risk-devel…

evidence-based: the "PARACHUTE trial" ( real + satirical ) "Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial" https://www.bmj.com/content/363/bmj.k5094 "Conclusions Parachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention." Please read the context: https://blogs.bmj.com/bmj/2018/12/13/we-jumped-from-planes-without-par…

BMJ: Time to assume fraud? https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-health-resear… Study claims 1 in 4 cancer research papers contains faked data https://arstechnica.com/science/2015/06/study-claims-1-in-4-cancer-res…

Soon to be an outdated discussion: https://blogs.bmj.com/medical-humanities/2020/03/03/ectogenesis-at-hom…

This blog post from the BMJ wasn't particularly comforting when published in the middle of covid: https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-health-resear… Richard Smith was the editor of The BMJ until 2004. Competing interest: RS was a cofounder of the Committee on Medical Ethics (COPE), for many years the chair of the Cochrane Library Oversight Committee, and a member of the board of the UK Research Integrity Office.

Even big pharma is sometimes guilty of huckstering, see aducanumab, the recently approved treatment for Alzheimer's that does not actually seem to treat symptoms of Alzheimer patients at all. https://blogs.bmj.com/bmj/2021/11/04/nothing-is-right-about-the-approv…

There is also some research suggesting that defaults in organ donation (so called presumed consent) may decrease rates of actual donations in those countries. I can't find the original podcast where I heard about it (I assume related to either Planet Money or Freakonomics), but found this source: https://blogs.bmj.com/medical-ethics/2017/09/25/organ-donation-presume…

First off, I'm not taking anything at face value. My point was that data isn't being kept hidden from the people for 75 years or whatever. And the commenters could have answered their own questions in about 10 seconds using google. As to your statements, I'm sorry but that just isn't how any of this works. Why do you think we have regulatory agencies, like the FDA I mentioned. Not to mention competition among companies and academic researchers. Unfortunately anti-vaccine inclined people aren't interested in facts. https://blogs.bmj.com/medical-ethics/2021/07/07/persuading-anti-vaxxer…

> Yet we are still able to get experimental results supporting talk therapy and no one complains, right? Wrong. https://blogs.bmj.com/bmjebmspotlight/2020/10/07/seeing-is-believing-t… I think this is a problem that is generally recognized. Also the science on psychological interventions is generally quite messy.

You can contrast the odds of getting injured with the health benefits. The cardiovascular benefits would seem to outweigh the risks of getting injured from a mathematical point of view. See e.g. https://blogs.bmj.com/bjsm/2018/12/12/pedal-power-the-health-benefits-…

There have been a lot of scandals in the news lately about low quality research due to these conflicts of interest in the past https://www.npr.org/sections/thetwo-way/2016/09/13/493739074/50-years-… https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-health-resear…

I think more technically it is nocebo effects which cause the (bad) immune response, whereas the placebo effect cancels or at least ameliorates it. Paul Garner has described how worry about covid helped to maintain his long-covid / ME/CFS symptoms, and he was finally able to recover after addressing those fears: https://blogs.bmj.com/bmj/2021/01/25/paul-garner-on-his-recovery-from-… I managed to fully recover from ME/CFS myself 20 years ago with a similar route (with no symptoms since). In my case I don't think there was any significant worry about the illness itself, it was more pre-existing life stressors that I had to deal with, with the viral infection being the final straw for my body.

> Every article I've seen reports at least 90% are unvaccinated Listen to the dog that is not barking. https://blogs.bmj.com/bmj/2021/08/25/significant-proportions-of-people…

the pfizer authorization is based on 4 months of data (https://blogs.bmj.com/bmj/2021/08/23/does-the-fda-think-these-data-jus… your 2nd measles vaccine had 25 years of data since your last one, they probably had enough time to know that it would be fine

Editor of BMJ estimates about 20% of scientific publications are fraudulent. https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-health-resear… Fewer than half replicate. I would estimate a lot of that comes from softer research malpractice. Being confused about the value is a fair reaction. It is high; without scientific research, though, we wouldn't have vaccines or monoclonal antibodies. On the other hand, it is lower than assumed, and trusting individual papers and peer review processes is a mistake. How much value would Facebook have if it were your only source of information? A lot, actually. Imperfect information is valuable too.

Accompanying blog post: https://blogs.bmj.com/bmj/2021/06/08/why-we-petitioned-the-fda-to-refr…

I don't know why you're being downvoted. Established, tenured experts from every single one of the world's top medical institutions have expressed agreement with this statement (and also some in apparent opposition). Examples: * https://blogs.bmj.com/bmj/2021/05/07/covid-vaccines-for-children-shoul… * https://www.youtube.com/watch?v=kbvO4sUg1eA (Gupta is a pioneer of theoretical epidemiology at Oxford and has broken ground on a new platform for generic influenza vaccination which is very exciting) * https://twitter.com/MartinKulldorff/status/1371638485686358018 (note: In addition to his decades at Harvard researching vaccine safety, Kulldorff served two terms on a CDC vaccine technical subgroup - he is certainly in the very top echelon of experts on the topic of your comment)