Want a change from watching the turds circle the drain in the Kavanaugh confirmation circus? Let me bring you a nasty academic spat between high-minded medical researchers. This is how learned gentlemen stab each other in the back! With a couple of serious morals. Everybody named below is a highly credentialed professional; I leave the titles out to avoid repetition.
The milieu is the Cochrane collaboration. Inspired by and named after the epidemiologist Archibald Cochrane (d. 1988), the Cochrane people promote evidence-based medicine through meta-analyses of randomised clinical research trials using methods as rigorous and objective as they can make them. (Our own Keith Humphries has been a Cochrane reviewer.) [Update] The very solid proposition is that if you can analyse correctly a handful of properly conducted trials, you are in effect adding the sample sizes, so you can draw much more statistically reliable conclusions than by cherry-picking one. There is of course a lot of art here behind “correctly”, “properly”, and “in effect’. [/update] They are not the only researchers carrying out meta-analyses, but a Cochrane review is widely regarded as the gold standard. Depressingly often, the answer is “we don’t know”.
One recent Cochrane review (lead author Marc Arbyn) was on vaccines against human papilloma virus (HPV), which causes much cervical cancer among women and lesser numbers of anal and penile cancers in men. This is not a trivial health issue. Fortunately there are vaccines sold by Merck (Gardasil) and GSK (Cervarix). Do these work? Short answer: yes. Are they dangerous? Short answer: no. (Please DO NOT quote me, read and cite the report, they do provide a summary for dummies.)
So far so routine. But then an article was published in the journal BMJ – Evidence-Based Medicine by Lars Jørgensen, Peter Gøtzsche, and Tom Jefferson, alleging that the vaccine review was sloppy on several counts and hinting that it was influenced by pressures from the Big Pharma vaccine vendors. (Note that while they argue that the side-effects are greater than the review says, the critique does not recommend stopping or curtailing vaccination programmes.) This naturally provoked a rebuttal from the Cochrane management (David Tovey and Karla Soares-Weiser), saying the criticism is wrong on all counts.
It did not stop there. Gøtzsche is, or rather was, a member of the Cochrane board, indeed a founder member of the organisation. He could presumably have raised his concerns there first rather than publicly. After a presumably furious board meeting, Gøtzsche was expelled and four other board members quit. The great collaboration is now in existential danger. Will donors, including the Gates Foundation, keep the funding flowing? Will Gøtzsche set up a breakaway fitzCochrane, applying his own higher standards? Will anti-vaxxers and misogynists exploit the row to attack the vaccination campaign? Only 27 % of American men under 26 are vaccinated.
It’s important that the crisis be resolved quickly and the collaboration continue. There’s not much outsiders can do to help this in the short term, and I am quite unqualified to take sides. I have though one reflection and one suggestion for the future. Continue Reading…