Medical Research: What Is Wrong with this Picture?

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Vance W Berger
Kaitlin Elizabeth Palys


Abstract:There is a fundamental disconnect between the perception and the reality of the rigor and validity of medical research.  The basic flaws that run rampant in the design and analysis of clinical trials belie the commonly held view that clinical trials are beyond reproach by virtue of occupying the top level of evidence-based medicine.  This fact has been amply demonstrated in the literature, and, for the most part, ignored by those who continue to praise the virtues of randomized evidence, without qualification.  When a machine produces too many broken widgets, it becomes clear that it is the machine itself, and not just the widgets, that require attention.  The machine that produces medical research is broken, and needs our collective attention.  We will frame some of the problems with medical research in terms of moral hazard, unfunded mandates, conflicts of interest, and incentives.  These perspectives will give rise to suggestions that, if adopted, would reduce the conflicts, and could also go on to greatly improve the integrity of medical research, which in turn would improve the overall quality of medical care.

Article Details

Regular Articles
Author Biography

Vance W Berger, National Cancer Institute, National Institutes of Health

Biometry Research Group, Mathematical Statistician



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