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Rapid Responses: Rapid Responses published:
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Medicine rarely provides giant leaps for mankind
- Simon R Maxwell (16 November 2007)
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Identifying the environmental causes of disease
- Sir Michael Rutter CBE FRS FBA FMedSci (27 November 2007)
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Policy making requires overall and not disease specific outcomes.
- Dr C Kevin Connolly (30 November 2007)
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Simon R Maxwell, Senior Lecturer in Clinical Pharmacology Clinical Pharmacology Unit, University of Edinburgh, Edinburgh, EH16 4TJ, UK
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Mark Lawson is absolutely correct when he implies that some researchers are complicit in 'sexing up' their results for public consumption. The potential long term benefits to the researchers are obvious and, when the story is about a drug, the financial gains to the pharmaceutical industry may also be considerable. Isn't it now time that the BBC, who he admits don't do medicine well, started to engage in the tried and tested approach of peer review that successfully eliminates inappropriate hyperbole from most reputable medical journals. If applied viewers (and listeners) would quickly realise that very few of the scare stories represent a major threat and very few of the good news stories amount to a 'giant leap for mankind'. Having eliminated all the irrelevant and misleading stories the question then would be how would the BBC News fill all that extra air time? Competing interests: None declared |
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Sir Michael Rutter CBE FRS FBA FMedSci, Vice-President, The Academy of Medical Sciences 10 Carlton House Terrace, London SW1Y 5AH
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The issue of communicating medical research discussed in Mark Lawson’s article is considered in a recent Academy of Medical Sciences’ report. The report echoes Mr Lawson’s concern that researchers sometimes overstate their findings. A year and half ago the Academy convened an expert working group, which I chaired, to investigate the increasing scepticism amongst professionals and the public that has arisen when claims from one study into the environmental causes of disease are so soon reversed by those of another. For instance, hormone replacement therapy was once thought to protect against heart disease but is now thought to be a risk factor. Nevertheless, in some cases, such as the link between smoking and lung cancer, research into the causes of disease has stood the test of time and clearly been of great value to public health. We found that high quality research into the environmental causes of disease has given rise to robust conclusions many of which have been fundamental to clinical practice and policymaking. Most misleading claims stem from poor quality studies of small biased samples. These are often reported in conferences and not subjected to rigorous review by fellow researchers in scientific journals. We therefore concluded that although research into the environmental causes of disease is of great importance to medical science and the health of public; scientists, their funders and institutions should take care not to overstate the importance of findings and ensure that results are analysed and presented with due diligence. Our report makes five key recommendations to government and research funders to facilitate the generation, communication and use of research into the environmental causes of disease. Since change cannot only come from above, we also offer guidelines tailored to the many groups involved such activities. The challenges inherent to the interpretation of research into the environmental causes of disease mean that everyone has a responsibility to deal with such findings in a considered and balanced fashion. Copies of our report are available from: http://www.acmedsci.ac.uk/publications Competing interests: Sir Michael has engaged in much research to identify possible environmental causes of disease, including the use of natural experiments. He has received multiple grants and contracts from government departments and has served on various governmental advisory groups, including that concerned with SureStart. He has given evidence to various hearings and advisory groups on putative causes of disease, including lead, intrauterine alcohol exposure and vaccines. He has served on grant-giving committees for both Research Councils and charities and has been active in public engagement with research. |
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Dr C Kevin Connolly, retired physician Aldbrough St John Richmond DL11 7TP
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Mark Lawson is absolutely right in his analysis and Sir Michael Rutter and the document to which he refers present the solution to the problem so far as causation is concerned. I have read the latter and do not feel that either it or Sir Michael’s response go far enough so far as impact is concerned. This is of particular relevance when these studies are used to justify policy decisions pertaining to the general population. Proper outcome measures when assessing causation and the immediate effects of the disease may be disease specific mortality and morbidity, but when considering the impact of the disease on the general population and implications for policy making, the primary outcome measure must be overall mortality or morbidity. The former is often not, and the latter very rarely, presented in studies purporting to be relevant to the general population. Editorial policy should demand that this is done, if not in the paper itself then certainly in editorials supporting it. Competing interests: None declared |
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