Medical studies mostly rubbish
by Andy Whyman
Medical Observer
24 July 1998
The editor of one of Britain’s leading medical journals has castigated the quality of scientific papers he and his colleagues receive, saying only 5% of published articles reached minimum standards of scientific soundness and clinical relevance.
Richard Smith, editor of the British Medical Journal and a professor of medical journalism, told a conference that the studies reported in the 20,000 medical journals around the world were not of sufficient calibre nor sufficiently wide in their scope to serve as the foundation stone of evidence-based medicine.
Only 5% of scientific papers came up to scratch, according to Professor Smith.
“In most journals it’s less than 1 per cent. Many trials are often too small to be relevant, and may of the studies that are published are the positive ones-there is a lot of negative evidence that never sees the light of day,” he said.
But, apart from the inadequacy of the research, “what works on a particular population of people has little or no impact on the patient sitting in front of the doctor”.
Speaking at the annual conference of the Royal College of Psychiatrists, the professor said that too many scientific papers contradict each other, the good ones were almost impossible to find and doctors were not trained to asses which were the most effective treatments for patients.
Few doctors visited medical libraries, he added, and medical books and journals were “very primitive information tools” and of little use during a consultation when a patient might ask questions the doctor was unable to answer.
“The Internet opens up possibilities and most doctors are hoping someone will devise a means of accessing the answers to such questions instantly on the Internet.”
He was critical even of the peer review system which is used to vet every journal put forward for his own journal and the Lancet. The system was “slow, expensive, [and] prone to bias and abuse”. MO
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