Dr. John Ioannidis on Clinical Trials Issues, Cost and Inappropriate Care
Since 1949, the NIH has provided a biweekly newsletter for employees of the National Institute of Health. Mostly the NIH Record announces talks to be given on-campus, but also summarizes some of the talks. In a recent issue the Record summarized a recent talk on bias in healthcare trials, delivered by Dr.John Ioannidis, director of the Stanford Prevention Research Center. Some of his key points are quite thought-provoking and relate to our our huge problem of costly and inappropriate care. Here is some food for thought from Dr Ioannidis:
- Most statistically significant findings are not real at all—they’re just false positives
- Many of these false positives are revealed when larger-scale studies attempt to replicate the findings of smaller studies
- One of every four such trials is refuted when a larger trial is conducted
- Journal editorial policies are responsible for much of this trend— editors want to see research that is novel and will have a large impact on the field. This generally means that editors are looking for papers that report very large, statistically significant effects.
- An important safeguard is “repeatability” of positive findings
- Individuals with a track record for doing high quality research should be recognized and given priority in publishing.
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