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How Reliable is Medical Literature?

Some people are skeptical when I tell them that there’s a problem with the vast database of medical information out there, particularly articles appearing in medical journals and purporting to be based on sound science.  Too often I have seen cases where drug manufacturers have “ghost written” articles for a doctor’s signature, or where authors advocating for a product have omitted important adverse event information, for example.  See article.
 
It can’t really be that bad, people say.
 
Don’t take my word for it. 
 
Check out the latest from the JAMA Internal Medicine, which in its February 10, 2015 issue published a study showing that in sixty different clinical trials it examined, serious violations were found that called into question the accuracy of the information, but the information was published anyway.
The problems were not trivial; they included:
 
• 22 trials with falsified information.
• 14 trials where researchers failed to report adverse events.
• 42 trials with violations of the trial’s protocols.
• 35 trials with record-keeping errors.
• 30 trials in which researchers failed to protect patient safety or acquire informed consent.
 
How are doctors supposed to make good clinical decisions when the information they are reviewing is not what it purports to be?
 
With all the discussion going on about free flow of information, wouldn’t it be nice if we were really talking about the free flow of accurate and reliable information?