Most modern medicinal treatments do not work well, and our health will improve and costs will decrease if we resort to using it less often, argues Jacob Stegenga, PhD, a philosopher of science at the University of Cambridge, in his new book Medical Nihilism.
Scientific American published a summary and review of Stegenga’s book written by John Horgan, director of the Center for Science Writings at Hoboken, N.J.-based Stevens Institute of Technology.
Three arguments from Dr. Stegenga's book, based on Mr. Horgan's review:
1. Medical research is biased toward positive results.
Nearly everyone involved in clinical trials wants a positive result: patients want to be cured, and researchers can obtain grants and tenure by developing positive treatments, Dr. Stegenga wrote. Biomedical firms stand to earn billions from each approved drug.
2. More rigorous studies are less likely to find benefits for a given medicine.
Researchers who want positive results can formulate hypotheses and find data to support them after carrying out their studies, a process known as p-hacking. To prevent the practice, federally funded clinical trials started requiring researchers in 2000 to pre-register studies and write out their hypotheses and methods in advance.
Fifty-seven percent of federal trials showed benefits from interventions before 2000, but only 8 percent showed benefits after that year, according to a 2015 study. The results of this and similar studies suggest better research reveals most medicines to be less effective, according to Dr. Stegenga.
3. Harmful side effects are underreported.
Preliminary safety trials are usually not published, Dr. Stegenga wrote, and published studies often fail to include data on patients who withdrew from the study due to negative drug reactions. Ninety-four percent of harms are underestimated in post-approval surveillance, one study found.
Click here for a complete summary of Dr. Stegenga's arguments.