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  3. This is the golden age of medical research. And many medical discoveries have made real differences to the lives of many people,

This is the golden age of medical research. And many medical discoveries have made real differences to the lives of many people,

admin2013-09-16  47
问题     This is the golden age of medical research. And many medical discoveries have made real differences to the lives of many people, but could the research be done better?
    【F1】It seems self-evident that we should encourage high-quality work, but what makes for high quality is a matter of opinion, which hardens over the years into an arbitrary belief on the assumption that the most established and most respectable got there for a reason, so if one wishes their good opinion then one should do as they did. Take experiments that use animals to model human diseases. Empirical study of the quality of these experiments is an emerging field, but it does suggest that all is not well. The most reliable animal studies are those that: use randomization to eliminate systematic differences between treatment groups; induce the condition under investigation without knowledge of whether or not the animal will get the drug of interest; and assess the outcome in a blinded fashion. Studies that do not report these measures are much more likely to overstate the efficacy of interventions.
    In the face of pressures to reduce the number of animals used, investigators often do studies that are too small to detect a significant effect.【F2】To guard against such ’ underpowered ’ studies, researchers should calculate the number of animals required to have a reasonable chance of detecting the anticipated effect given the expected change of the data. Fewer than one in one hundred such publications report sample-size calculations.
    Fewer still define beforehand the most important outcome.【F3】As a result, they tend to report only the outcomes that happen to show statistical significance, reducing a rigorous, hypothesis-testing experiment to something more like observational research.
    The tendency to publish only positive results is another flaw in animal research. Such bias not only prevents scientists from getting credit for high-quality research that happens to be neutral, but also gives a false impression of efficacy.【F4】As long as cheap, underpowered studies are more likely to have exciting positive(if false)results than expensive, well conducted, large studies — and as long as journals don’t seem to know the difference — the pressure will remain to do what everyone else does.
    So we need to change the rules. If publication in high impact journals continues to be a yardstick, then the review process must do much more to assess bias. There must also be better ways to publish neutral studies【F5】At the very least, we should look for ways to register all experiments — so that investigators can receive credit for work done and so that those seeking to summarize what is known have access to all relevant data.
【F4】
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答案只要那些便宜的、费力少的研究比那些昂贵的、有效开展的大型研究更能取得令人兴奋的阳性(可能错误)结果一一只要期刊辨别不出差异——就总会有压力驱使着大家去做别人都做的事。
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