In science we trust — or do we?

3 Aug 2019

Originally published at CrossFit Health

By Maryanne Demasi, PhD

History is punctuated with evidence of drug companies hiding scientific trial data, leading to litigation, wasting billions on useless medications, and putting lives at risk.

One of the most egregious examples of wrongdoing is the case against GlaxoSmithKline in 2012. The drug manufacturer agreed to pay US$3 billion in fines and pleaded guilty to criminal charges for illegal marketing and failing to report safety data. It was the biggest health-care fraud settlement in U.S. history.

Not surprisingly, a recent analysis showed public trust in pharmaceutical companies has reached a new low. It slumped from 51% to 38%, the biggest drop in five years, with much of it blamed on the opioid crisis, the rising cost of medicines, and companies putting profits ahead of patients.

Scientific research has been plagued by conflicts of interest, data dredging, and bias, leading some researchers to assert that approximately 90% of published research relied upon by doctors is flawed.

It is difficult for people to know what to believe. Single studies often contradict one another, as demonstrated by one analysis that showed many of the foods we eat both cause and prevent cancer, depending on which study you pick.

Confidence in the medical profession also seems to be eroding. A resurgence of measles and low uptake of the vaccine has been attributed to escalating “incredulity and hostility” toward doctors.

This worrying trend stems from the 1980s, when former U.S. President Ronald Reagan slashed government funding to the National Institutes of Health. The change in funding allowed private industry to take over. As a consequence, drug companies now fund the vast majority of human clinical trials.

Marketing firms, sometimes known as “medical communication firms,” are often hired to ghostwrite articles in preparation for peer review, effectively putting a marketing spin on the trial results. This practice has been referred to as “manuscript laundering” and pollutes the medical literature. While these unscrupulous practices may seem unethical, they are entirely legal.

And it is not just industry spin that erodes public trust; our lauded experts are accountable too. For example, it is widely known that statin proponent Sir Professor Rory Collins has publicly stated statins are very well tolerated and myopathy (muscle weakness) occurs in only 1 in 10,000 people taking the drugs.

But The Times U.K. revealed Collins owns a patent on a diagnostic test for statin intolerance, the marketing of which claims that muscle pains from statins are up to 29% (2,900 in 10,000) — a far cry from 1 in 10,000. Collins has tried to distance himself from the debacle, but the manufacturer of the test has stood by the marketing claims.

Further, U.K. Professor Colin Baigent, who advocates the wider use of statins, has recently made several claims in the media suggesting “everyone over the age of 75 should be considered for a statin” because “statin drugs benefit all ages with minimal risk” and giving statins to the elderly “could save up to 8,000 lives a year.”

The only problem is that Baigent’s own data does not support these claims. An analysis he co-authored instead showed statins do not reduce death from vascular disease in people over the age of 70. More surprising, when Baigent was called out in the BMJ for his misleading claims, he remained defiant and would not recant his comments.

In an age when fake news is virtually indistinguishable from fact, we should expect a higher standard from researchers who are speaking from the pulpit of eminent institutions and universities. Otherwise, public trust in science will continue to diminish.