I should probably kick off this blog with some general comments about its motivation and goals. I’ve spent the last three years working on a book about why experts usually end up misleading us. The book, called WRONG, is just coming out now. (You can learn more about it at www.freedman.com.) Although WRONG looks at all sorts of experts and their highly flawed advice, I think the problem that has the most impact on the most people is the way that published medical research runs off the rails. We’re fairly bombarded on a daily basis with the latest medical findings, typically ripped from the pages of prestigious medical journals, and echoed in our most respected mass media publications and shows, telling us which foods and habits will lower our disease risk, what new pills show promise, which genes predict our health fates, and so on. There’s just one little problem: According to scientists themselves, most of these published findings will turn out to be wrong or highly exaggerated. Eating those foods probably won’t help you much, the pills probably won’t work well, the genes probably won’t tell you much. And this turns out to be true not just of what you read in the newspapers or see on TV or on news websites, but also of the work published in our top medical journals. (Journalists tend to make things worse, but we don’t cause the basic problem.) There are many reasons why most published findings turn out to be flawed, which I explore in detail in WRONG, and will be touching on as the need arises in this blog. But for now, let me just state that there is a wealth of consistent and mostly uncontested evidence from highly respected scientists that the published medical research you hear about is on average not trustworthy. (And if like many people you’ve been led to believe that large, randomized controlled trials can generally be trusted, you’ve been misled.)
You generally won’t hear about problems with the credibility of medical research when you’re alerted to new findings in the mass media, because almost no one has an incentive to focus on the problems or tell you about them. Why would most researchers take the trouble in their papers or in their interviews to highlight why their work is probably wrong? Why would most journalists take up space in their articles and time in their on-air reports to discuss why you probably shouldn’t take the reports very seriously? You might think you could count on your doctor to figure out which published findings really ought to be put into practice, but you probably can’t–most doctors don’t have the training, time or inclination to deconstruct the studies they read about in journals in order to spot the potential problems with them.
I’m not a doctor, I’m not a scientist, I’m not an academic researcher. I’m a journalist. I’ve spent a lot of time speaking to, and reading the work of, a lot of highly regarded scientists who study the problems with medical research, and I think I now know a thing or two about these issues. I’d like to share the insights I’ve gained (and the insights of the many scientists I’ll be interviewing for this blog), and help people apply them to the current news about medical findings, so that we can all make better guesses about which of these findings are really likely to improve our health and possibly save our lives, and which of them ought best be regarded with great skepticism. (Sadly, most of them will fall into the latter category.) You, of course, will use your judgment to decide how much you should trust me and this blog and the people I quote in it, as we all should with all the findings and advice and pronouncements that stream at us from so many sources.
I want to make it very clear that I’m not interested in turning anyone away from science and mainstream medicine–far from it. I’m as appalled as anyone by junk science, and I’m not an advocate of alternative medicine (though I respect its placebo effect, as do many mainstream clinicians). I trust my doctor, and believe many if not most scientists to be among society’s heroes, if highly imperfect ones. I believe that science is exactly the right way to get at truth. But we all need to understand just how messy and biased and flawed a process science is, how slowly and rarely it actually manages to close in on the truth, and how it becomes even further distorted when it’s communicated to us through journals and the media.
David H. Freedman 
Looks like this could be a very interesting blog. You have probably run across this article already, but in case you haven't, see "Why Most Published Research Findings are False" here: http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020124.Cheers,Dana H.
Good call, Dana. The author of that article kicks off my book, and I've written a substantial profile of him that's coming out in a major magazine soon.
I just finished reading your book and loved it! Thanks for following up with this blog, which I'll begin following closely.Incidentally, I read you in China, where this blog is blocked by the government. Not that they are targeting you for anything nefarious (i assume!) but you are publishing with the Blogger platform, which is part of the Google Blogspot network of blogs that are automatically blocked. I wonder if you could ask your publisher (or another friendly helper) to publish and host on your own site, making it accessible from within China.
Thanks, Richard! That's interesting about the Blogspot network being blocked, I should have realized. I was in China recently and was unable to access some online research papers, they had been blocked on a range of websites, very disconcerting. I'm going to look into moving the blog.
Good Morning! I found this blog via the Newsweek article. Great read. Next time I’m near a bookstore, I’ll have to pick up your book, not that this information is new to me – but my opinions are based on personal experience of being a Mom of 4 children. I’m curious to know, in WRONG do you look at how people like me, who don’t believe that the experts know all get along in the medical world? My kid’s docs (and even my own) get annoyed because I don’t always agree with their prescribed treatment, mainly because they want to treat the symptom without finding out the real problem. Case in point, about 6 months ago my (then) 2.5 year old had a horrible rash all over. Poor boy looked like a leper. Two docs said eczema, but I was convinced it was a reaction to food – family history of it. Already familiar with an elimination diet, I opted to remove certain things from his diet. It took two months but we figured out it was caused by cranberry juice. Interestingly enough, his asthma symptoms disappeared, too. If I had followed the doc’s advice, he’d be on steroid creams and inhaling meds every day for most likely all his life.I’m looking forward to following your blog and reading your book – it’ll be refreshing to read some well reasoned common sense
Thanks, Stacy. The question you raise about whether your doctor always knows best is an important one. (And yes, it's one I deal with in WRONG.) Clearly, the short answer is no, your doctor doesn't always know best. That's not a dig against doctors–how could anyone possibly claim to always know how to deal with every patient's problem, given the complexity of disease and environment, and all the flawed research that's published? The medical profession in its own journals often acknowledges the gaps in doctors' abilities to diagnose and treat. On the other hand, I'd never advocate ignoring your doctor–I think everyone should have a doctor they respect and trust. But that doesn't mean you should just be quiet and take whatever your doctor says as the absolute truth. I think good doctors are willing to listen to their patients' ideas about what might be going on, especially if the patient is willing to do some online research at credible sites and be a careful observer. Ideally, diagnosis and treatment decisions are made in partnership between doctor and patient. I listen to my doctor, and recognize that she usually knows more than I do about what might be going on, but I like it that my doctor listens to me, too, when I have my own thoughts.
David – At the risk of sound like an elitist – I think the problem is that the majority of people lack the ability to be a true partner in his or her treatment; all they really want is to pop a pill or get surgery to fix the illness/issue. And to further the problem, there is so much junk science (not to mention fake testimonials) online that unless you are a veteran researcher reading with a highly critical eye chances are you’re going to be using that junk science as the basis of any collaboration you attempt with your doctor and then you’ve just blown any chance that he or she will take you seriously. And as cream on the top, there are those highly unlikely scenarios that occur from time to time. And the cherry – most docs are just too overworked to invest the time to actually listen. But those are my very jaded opinions on the matter… lolp.s. It won't let me post my name without the link otherwise I would have left it blank – my blog isn't what you call "active" lol
Very interesting blog! I am looking forward to reading your book Mr. Freedman.
Hi Andrew,Thanks! Please let me know what you think of the book.
DavidI have just come across what I think is a fascinating stat…..that may interest you. Health spending in America, as a % of GDP, has been been plotted from 1965 through 2010. In 1965 it was 5%. It has been rising steadily over the years to 18% in 2010.