Fake facts and alternative truths in medical research

Abstract

BackgroundFake news and alternative facts have become commonplace in these so-called “post-factual times.” What about medical research - are scientific facts fake as well? Many recent disclosures have fueled the claim that scientific facts are suspect and that science is in crisis. Scientists appear to engage in facting interests instead of revealing interesting facts. This can be observed in terms of what has been called polarised research, where some researchers continuously publish positive results while others publish negative results on the same issue – even when based on the same data. In order to identify and address this challenge, the objective of this study is to investigate how polarised research produce “polarised facts.” Mammography screening for breast cancer is applied as an example.Main bodyThe main benefit with mammography screening is the reduced breast cancer mortality, while the main harm is overdiagnosis and subsequent overtreatment. Accordingly, the Overdiagnosis to Mortality Reduction Ratio (OMRR) is an estimate of the risk-benefit-ratio for mammography screening. As there are intense interests involved as well as strong opinions in debates on mammography screening, one could expect polarisation in published results on OMRR. A literature search identifies 8 studies publishing results for OMRR and reveals that OMRR varies 25-fold, from 0.4 to 10. Two experts in polarised research were asked to rank the attitudes of the corresponding authors to mammography screening of the identified publications. The results show a strong correlation between the OMRR and the authors’ attitudes to screening (R = 0.9).ConclusionMammography screening for breast cancer appears as an exemplary field of strongly polarised research. This is but one example of how scientists’ strong professional interests can polarise research. Instead of revealing interesting facts researchers may come to fact interests. In order to avoid this and sustain trust in science, researchers should disclose professional and not only financial interests when submitting and publishing research.Electronic supplementary materialThe online version of this article (10.1186/s12910-018-0243-z) contains supplementary material, which is available to authorized users.

Nudging in screening: Literature review and ethical guidance

“…The third lesson is that when there is disagreement on the evidence for either benefits or harms, we should be very cautious and careful. For example, a recent study shows that the published outcomes of mammography screening are highly polarized [120]. When nudging is used in cases where research data is polarized, the tool of nudging may be misused for the pursuit of one or the other goals of the contradicting "poles".…”

Recomendaciones de prevención del cáncer. Actualización PAPPS 2018

“…Asimismo, el balance beneficio-riesgo es diferente para cada grupo de edad. Algunos autores que sitúan la mamografía de cribado como ejemplo de investigación extremadamente polarizada y con fuertes intereses profesionales 32 piensan que los científicos también pueden tomar decisiones sobre la base de intereses falsos y hechos alternativos 32 .…”

Too much medicine? Scientific and ethical issues from a comparison between two conflicting paradigms

“…In many countries (and in my experience, it is certainly the case in Italy), it is not possible to speak against screening; according to [11], even some scientists have sacrificed sound scientific principles to arrive at politically acceptable results. Finally, many health operators can distort the judgment about the utility of screening owing to their particular interests in the field (e.g., as radiologists, surgeons, breast specialists) [12].…”