While I'm perfectly happy to admit - without even blushing ! - that a lot of your book goes over my head, Anthony, there is enough therein I'm able to comprehend that confirms all the opinions I'd formed since reading Malcolm Kendrick's somewhat similarly entitled work. [grin]
"Blaming cholesterol for atherosclerosis is every bit as stupid as blaming paramedics for causing the carnage at an accident scene they are attending" is something I would dearly like to have the courage to say to my GP, but that I like everything ELSE about her care of me. :\
Not sure why anyone would be surprised these days of the complete and utter lack of scientific rigor on the part of any group.
Not only should participants be "blind" in a study, the researchers should also be "blind" as to the funders and present what they see and have some integrity. Not ever going to happen, but one can still hope.
(Not sure why all my sentences started with the word "Not"... peculiar. 😉 )
totally agree that the current system needs an overhaul, and that measures to blind researchers to funding source are needed. Currently, industry gets to pick and choose who conducts its studies. Researchers with the temerity to honestly present their non-supportive data report being threatened and blacklisted.
This kind of criminal-level behavior is totally unacceptable. They dramatically weakened the mob in the USA with RICO laws, yet drug companies are not only allowed to behave like criminal enterprises, but receive active assistance from entities like the FDA, CDC and NIH.
Your sentences begin with "Not" because they are a contraction of "I am not...," that is, your opinion which is what we want. But, on the second, I don't think you are correct. The principle -- admittedly not always adhered to -- is that if the authors say that they were not influenced by the funding agency, you must take them at their word. You must criticize their science but accusing them of influence is a very serious charge (unless you have evidence). Otherwise, we have nothing. If you can criticize the authors for their funding (again, unless you have proof) then no study is meaningful. (Or can be funded). Who is going to fund the "Macadamia nuts cure diabetes" (made up) except the Macadamia Foundation (made up, I hope). OTOH, in many such arrangements, the sponsors go out of their way to be hands off because it can come back to haunt them. It is now the current joke but "Hanlon's Razor" is real.
"The principle -- admittedly not always adhered to -- is that if the authors say that they were not influenced by the funding agency, you must take them at their word. "
After decades of reading research and observing extremely shady behavior from far too many researchers, I'm not prepared to take anything at face value.
Yes, a certain amount of trust must inevitably be placed in the researchers conducting these studies, because we aren't there watching over their shoulders when they perform the research.
This doesn't mean we stick our heads up our posteriors and deny reality.
The reality is that industry-funded studies are far more likely to reach conclusions supportive of their funders than non-industry funded studies. This is not a controversial claim, it is a fact of life that has been shown time and time again in the literature:
"Adjusted analyses showed that trials funded by for-profit organizations
were significantly more likely to recommend the experimental drug as treatment of
choice (odds ratio, 5.3...) compared with trials funded by nonprofit organizations. This association did not appear to reflect treatment effect or adverse events."
In nutrition studies dealing with soft drinks, juice or milk, "Funding source was significantly related to conclusions when considering all article types ... For interventional studies, the proportion with unfavorable conclusions was 0% for all industry funding versus 37% for no industry funding ... The odds ratio of a favorable versus unfavorable conclusion was 7.61 ... comparing articles with all industry funding to no industry funding."
"Among the 162 randomized, double-blind, placebo-controlled studies examined, those that reported conflict of interest were 4.9 times more likely to report positive results; this association was significant only among the subset of pharmaceutical industry-funded studies."
Everyone insists that they are of impeccable character and would never let their personal views sway their research outcomes. The research shows otherwise.
Als-Nielsen et al 2003 hit it on the head when they concluded:
"Conclusions in trials funded by for-profit organizations may be more positive due to biased interpretation of trial results. Readers should carefully evaluate whether conclusions in randomized trials are supported by data."
That is what I do in this article. I don't outright accuse the researchers of malfeasance, but I do believe their conclusions to be absurd and I firmly believe we have every right to suspect the financial COIs in this study may have played a major role in that.
If a judge has a conflict of interest in a case (eg knows the defendant, or has some other family, financial, social tie to them) he/she must declare this and recuse themselves from the case. If they do not do this and the defendant receives an inexplicably lenient sentence or acquittal, we have every right to question the veracity of the decision. In fact, we'd be idiots not to.
Like a legal case, the evidence must be viewed in its totality. If researchers present conclusions unsupported by the data (in this case, cardiovascular and environmental benefits), and they have financial COIs, we would be idiots not to to question the role of those conflicts.
You've written below that you know one of the authors of the Twins study and have attempted to engage him in discussion, but to no avail. That someone you know refuses to field critical commentary from you also does little to inspire confidence in the authors.
I am in agreement with what you wrote. What I mean by "take them at their word" is analyze or otherwise address the work on its scientific merits -- regardless of what you think the author's motivation is. This is what you are expected to do in reviewing a paper for a journal or grant application. (Again, we agree there are often violations). That's the job. And, often, it is because we are unwilling to actually confront the authors. In the Twins case, I know Gardner, I think he's biased in the sense that his personal experience as vegan or vegetarian affects his opinion. I was not being disingenuous when I said he is not overly doctrinaire he has also supported keto in some way. I do not think he is in influenced by the sponsors -- frequently it's the other way around. I was surprised that he didn't want to discuss things. One fault that many in nutrition have is that you they take criticism personally. He used the wrong statistic. I don't mind being corrected on that. In fact, that I am correcting somebody on statistic is a really amusing part of the whole thing.
No to mention that in the largest nutrition trials in existence, such as PREDIMED, total LDL levels were useless to predict cardiovascular health (hided in the Supporting Information).
This is just brilliant. I listened to it, twice this morning to understand your fantastic research and analysis. When I watched the documentary on Netflix, the word propaganda just kept coming into my head, but you take it one step further and give a logical, rational and balanced approach to it all so that we can make up our own minds. Thank you for sharing.
While I'm perfectly happy to admit - without even blushing ! - that a lot of your book goes over my head, Anthony, there is enough therein I'm able to comprehend that confirms all the opinions I'd formed since reading Malcolm Kendrick's somewhat similarly entitled work. [grin]
"Blaming cholesterol for atherosclerosis is every bit as stupid as blaming paramedics for causing the carnage at an accident scene they are attending" is something I would dearly like to have the courage to say to my GP, but that I like everything ELSE about her care of me. :\
Superb critical review of the study.
Not sure why anyone would be surprised these days of the complete and utter lack of scientific rigor on the part of any group.
Not only should participants be "blind" in a study, the researchers should also be "blind" as to the funders and present what they see and have some integrity. Not ever going to happen, but one can still hope.
(Not sure why all my sentences started with the word "Not"... peculiar. 😉 )
Hi PB,
totally agree that the current system needs an overhaul, and that measures to blind researchers to funding source are needed. Currently, industry gets to pick and choose who conducts its studies. Researchers with the temerity to honestly present their non-supportive data report being threatened and blacklisted.
This kind of criminal-level behavior is totally unacceptable. They dramatically weakened the mob in the USA with RICO laws, yet drug companies are not only allowed to behave like criminal enterprises, but receive active assistance from entities like the FDA, CDC and NIH.
Your sentences begin with "Not" because they are a contraction of "I am not...," that is, your opinion which is what we want. But, on the second, I don't think you are correct. The principle -- admittedly not always adhered to -- is that if the authors say that they were not influenced by the funding agency, you must take them at their word. You must criticize their science but accusing them of influence is a very serious charge (unless you have evidence). Otherwise, we have nothing. If you can criticize the authors for their funding (again, unless you have proof) then no study is meaningful. (Or can be funded). Who is going to fund the "Macadamia nuts cure diabetes" (made up) except the Macadamia Foundation (made up, I hope). OTOH, in many such arrangements, the sponsors go out of their way to be hands off because it can come back to haunt them. It is now the current joke but "Hanlon's Razor" is real.
Hi Richard,
"The principle -- admittedly not always adhered to -- is that if the authors say that they were not influenced by the funding agency, you must take them at their word. "
After decades of reading research and observing extremely shady behavior from far too many researchers, I'm not prepared to take anything at face value.
Yes, a certain amount of trust must inevitably be placed in the researchers conducting these studies, because we aren't there watching over their shoulders when they perform the research.
This doesn't mean we stick our heads up our posteriors and deny reality.
The reality is that industry-funded studies are far more likely to reach conclusions supportive of their funders than non-industry funded studies. This is not a controversial claim, it is a fact of life that has been shown time and time again in the literature:
Bekelman et al 2003 https://www.researchgate.net/publication/10946397_Scope_and_Impact_of_Financial_Conflicts_of_Interest_in_Biomedical_Research_A_Systematic_Review
Found "a statistically significant association between industry sponsorship and pro-industry conclusions (pooled Mantel-Haenszel odds ratio, 3.60)"
Als-Nielsen et al 2003
https://www.semanticscholar.org/paper/Association-of-funding-and-conclusions-in-drug-a-of-Als-Nielsen-Chen/8abd3cd0718b0fb1eb5b3eb382f0140287d5f794
"Adjusted analyses showed that trials funded by for-profit organizations
were significantly more likely to recommend the experimental drug as treatment of
choice (odds ratio, 5.3...) compared with trials funded by nonprofit organizations. This association did not appear to reflect treatment effect or adverse events."
Lesser et al 2007
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0040005
In nutrition studies dealing with soft drinks, juice or milk, "Funding source was significantly related to conclusions when considering all article types ... For interventional studies, the proportion with unfavorable conclusions was 0% for all industry funding versus 37% for no industry funding ... The odds ratio of a favorable versus unfavorable conclusion was 7.61 ... comparing articles with all industry funding to no industry funding."
Perlis et al 2005
https://www.researchgate.net/publication/7565069_Industry_Sponsorship_and_Financial_Conflict_of_Interest_in_the_Reporting_of_Clinical_Trials_in_Psychiatry
"Among the 162 randomized, double-blind, placebo-controlled studies examined, those that reported conflict of interest were 4.9 times more likely to report positive results; this association was significant only among the subset of pharmaceutical industry-funded studies."
Everyone insists that they are of impeccable character and would never let their personal views sway their research outcomes. The research shows otherwise.
Als-Nielsen et al 2003 hit it on the head when they concluded:
"Conclusions in trials funded by for-profit organizations may be more positive due to biased interpretation of trial results. Readers should carefully evaluate whether conclusions in randomized trials are supported by data."
That is what I do in this article. I don't outright accuse the researchers of malfeasance, but I do believe their conclusions to be absurd and I firmly believe we have every right to suspect the financial COIs in this study may have played a major role in that.
If a judge has a conflict of interest in a case (eg knows the defendant, or has some other family, financial, social tie to them) he/she must declare this and recuse themselves from the case. If they do not do this and the defendant receives an inexplicably lenient sentence or acquittal, we have every right to question the veracity of the decision. In fact, we'd be idiots not to.
Like a legal case, the evidence must be viewed in its totality. If researchers present conclusions unsupported by the data (in this case, cardiovascular and environmental benefits), and they have financial COIs, we would be idiots not to to question the role of those conflicts.
You've written below that you know one of the authors of the Twins study and have attempted to engage him in discussion, but to no avail. That someone you know refuses to field critical commentary from you also does little to inspire confidence in the authors.
I am in agreement with what you wrote. What I mean by "take them at their word" is analyze or otherwise address the work on its scientific merits -- regardless of what you think the author's motivation is. This is what you are expected to do in reviewing a paper for a journal or grant application. (Again, we agree there are often violations). That's the job. And, often, it is because we are unwilling to actually confront the authors. In the Twins case, I know Gardner, I think he's biased in the sense that his personal experience as vegan or vegetarian affects his opinion. I was not being disingenuous when I said he is not overly doctrinaire he has also supported keto in some way. I do not think he is in influenced by the sponsors -- frequently it's the other way around. I was surprised that he didn't want to discuss things. One fault that many in nutrition have is that you they take criticism personally. He used the wrong statistic. I don't mind being corrected on that. In fact, that I am correcting somebody on statistic is a really amusing part of the whole thing.
No to mention that in the largest nutrition trials in existence, such as PREDIMED, total LDL levels were useless to predict cardiovascular health (hided in the Supporting Information).
https://onlinelibrary.wiley.com/doi/10.1002/mnfr.201601015
This is just brilliant. I listened to it, twice this morning to understand your fantastic research and analysis. When I watched the documentary on Netflix, the word propaganda just kept coming into my head, but you take it one step further and give a logical, rational and balanced approach to it all so that we can make up our own minds. Thank you for sharing.
I love Your detailed analyses, and the facts You offer. Pretty amazing what People will do for money.
Quantifying Wealth (article): https://amaterasusolar.substack.com/p/quantifying-wealth
Money Motivates the Most Marvelous Manifestations! (article): https://amaterasusolar.substack.com/p/money-motivates-the-most-marvelous
You might be interested in my take on the twin-vegan study
The Crisis. 1. The Identical Twin Vegan Study.
https://richardfeinman.substack.com/p/the-crisis-1-the-identical-twin-vegan
I had hoped to bring out some correct methods of analyzing such studies.
Crisis 2. More on the identical twin vegan study.
https://richardfeinman.substack.com/p/crisis-2-more-on-the-identical-twin
I know The author. In this, I tried to engage the author in discussion but didn't work out.