This is the second time scientific results are being questioned on a very deep level in a very short time. It’s a very disturbing trend.
In just the last two months, two pillars of preventive medicine fell. A major study concluded there’s no good evidence that statins drugs like Lipitor and Crestor help people with no history of heart disease. The study, by the Cochrane Collaboration, a global consortium of biomedical experts, was based on an evaluation of 14 individual trials with 34,272 patients. Cost of statins: more than $20 billion per year, of which half may be unnecessary. Pfizer, which makes Lipitor, responds in part that “managing cardiovascular disease risk factors is complicated”. In November a panel of the Institute of Medicine concluded that having a blood test for vitamin D is pointless: almost everyone has enough D for bone health 20 nanograms per milliliter without taking supplements or calcium pills. Cost of vitamin D: $425 million per year.
Ioannidis, 45, didn’t set out to slay medical myths. A child prodigy he was calculating decimals at age 3 and wrote a book of poetry at 8, he graduated first in his class from the University of Athens Medical School, did a residency at Harvard, oversaw AIDS clinical trials at the National Institutes of Health in the mid-1990s, and chaired the department of epidemiology at Greece’s University of Ioannina School of Medicine. But at NIH Ioannidis had an epiphany. “Positive” drug trials, which find that a treatment is effective, and “negative” trials, in which a drug fails, take the same amount of time to conduct. “But negative trials took an extra two to four years to be published,” he noticed. “Negative results sit in a file drawer, or the trial keeps going in hopes the results turn positive.” With billions of dollars on the line, companies are loath to declare a new drug ineffective. As a result of the lag in publishing negative studies, patients receive a treatment that is actually ineffective. That made Ioannidis wonder, how many biomedical studies are wrong?
His answer, in a 2005 paper: “the majority.”