The GOLDEN RULE

From ‘Doc’s Opinion’, another helpful article, at least helpful to me in supporting my cynical attitude to what I consider the adulteration of science and its practices, becoming more obvious each day. Partly more obvious because of the extent of the internet, but seemingly also because of the increasing disregard of correct and moral, scientific standards and practices by practitioners who are adversely influenced by greed and self-interest.

Gross Misconduct (Photo credit: Wikipedia)

Part of ‘Doc’s Opinion’ article ” “You know nothing Jon Snow” – Scientific misconduct in medicine.” linked here.

When it comes to medical knowledge I´m aware that there is very little I know and very much I don´t know. I allow myself to be comforted by the old words of Socrates: “The only true wisdom is in knowing you know nothing”.

However, I know I can improve. Seeking knowledge has always been among my highest priorities. My fountain of information is the medical literature and tons of results from scientific studies. In order to be a better doctor, I can literally bathe every day in a pool of fresh scientific data from peer reviewed medical journals. Afterwards I will sense the strength of increased wisdom in my veins. I will be wiser than yesterday. I will be better suited to take care of my patients and educate my coworkers.

But, today there is foul-smelling from my fountain of medical knowledge. The past week saw some new twists in the tale of a prominent Japanese cardiologist, Dr Hiroaki Matsubara, accused of fabricating and manipulating data for cardiology research later published in a range of cardiology journals. Last year, the American Heart Association (AHA)  issued a notice of concern about five of Matsubara´s papers appearing in three of their journals, Circulation, Circulation Research, and Hypertension, between 2001 and 2004. Recently, the American Heart Association retracted these papers.

Concerns about Dr Matsubara also involve the Kyoto Heart
Study presented at the European Society of Cardiology 2009 Congress and later published in the European Heart Journal. This publication was later retracted by the journal.

A few days ago, Japan’s minister of health, Norihisa Tamura, as well as university officials at Kyoto Prefectural University announced that the Kyoto Heart Study data were “very likely” fabricated.  ”Incomplete” patient data were used in the study, which concluded that the blood-pressure drug Valsartan reduced cardiovascular events via mechanisms unrelated to blood-pressure lowering. Had “complete patient records” been used, the study would have reached “a different conclusion,” the university concluded. Finally, it has also emerged that two employees from the pharmaceutical company Novartis were involved in the conduct and analysis of the Kyoto Heart Study, as well a another trial, the Jikei Heart study. However, their participation was not acknowledged in publications and presentations of the data.

All of us know that the case of Matsubara is not unique. However, we don´t know whether it is just the tip of the iceberg or if this is a rare event. All we know is that scientific  misconduct in medicine should not exist. However, I fear it is much more common than we realize. [My emphasis].

Medical science is about seeking knowledge and testing hypotheses in order to be able to move forward, and increase our understanding of health and disease. But there is another, sometimes darker side to it.
It is characterized by ambition, competition, need for acknowledgement, and an obsession to get there first. The words “greed”, “ruthlessness” and “dishonesty” may even sometimes be appropriate. Obviously, there is risk of foul play.

When I started my blog I thought I was well suited, due to my
education and knowledge, to provide my readers with reliable information about heart disease and cardiovascular prevention. My strength was my knowledge of the medical literature, and how to interpret scientific data. However, if the literature is contaminated with falsified and manipulated data, I wonder: How much do I really know?

The sadness of the author’s realization of the reality of the corruption in extent and depth, is revealed here and must be a warning to the others in this industry who need to also wonder “How much do I really know?”  I suggest, a lesson to be learned by many.

Related articles

• Diovan Data Was Fabricated, Say Japanese Health Minister And University Officials (forbes.com)
• European Heart Guidelines Based On Disgraced Research May Have Caused Thousands Of Deaths (forbes.com)
• Medications: When Newest Isn’t The Best (doctor2008.wordpress.com)
• Is scientific misconduct increasing? Retraction rates may present more questions than answers. (blogs.lse.ac.uk)
• Eggheads Cheat a Lot! (venitism.blogspot.com)
• Exhibit A on how hubris in medicine can be deadly: Let’s take a time out for skepticism (medcitynews.com)
• Novartis AG Admits 2 Ex-Employees Plus Prominent Japanese Doc Involved in Data Scandal (biospace.com)
• Melendez Science paper retracted, making 13 (retractionwatch.wordpress.com)