The John P. McGovern Award Lectureship was established in 1983 in honor of John P. McGovern, MD, noted physician, educator, author, and medical historian. The award is given to individuals who are significant national or international figures and who may speak on a topic of importance to health sciences librarianship at the association's annual meeting. This year the award was given to Ben Goldacre, physician, academic, and science writer.
Goldacre began his talk by outlining various ways in which the mass media misrepresents science through the use of data. He names this “tabloid science”. This use of data or scientific fact is used to shock audiences or sway their opinions based on “bad” science. He argues that if we look at the evidence behind “tabloid science” it is clear that the claims don't hold and that no systematic review of the literature was done. Goldacre extends this argument to the extensive research he has done on drug companies and clinical trials. His main arguments are that drugs are being tested by the same people who manufacture them in poorly designed trials either because they are too small, have unrepresentative patients, and are analyzed using techniques with flawed designs that exaggerate the benefits of the treatments. The benefits of these treatments are then published in journal articles with misrepresented science that presents pharmaceutical companies and the doctors involved in the clinical trials positively. He argues that when trial results are inadequate for companies they have no problem hiding them from doctors and patients. Goldacre makes the claim that the solution is more randomized trials where limitations of the trial are clearly outlined. In addition to randomized trials he argues that articles must be written in order to present information to doctors in a more structure way to facilitate a more systematic, evidence-based review of the literature. He claims that the current problem is one of information architecture and that proper systematic reviews are needed. As a result of this current poor knowledge management hundreds of people are dying on a biblical scale. To support these arguments, Goldacre presented many examples in the history of medicine including one for the drug Edronax. When Edronax was released on the market, it appeared fine to prescribe in under UK regulations. However Germany refused to allow anyone to use the drug until all trial data was released and made public. When they did release the data it showed that the results were no better than a sugar pill. Goldacre argues this was a clear example of the UK refusing to publish negative clinical trial results. Upon further investigation the FDA found that there were 38 positive result trials and 36 negative results however academic articles showed that there were 48 positive results and only 3 negative results. As a result of these discrepancies it is clear that there is missing data and that when it comes to clinical trials negative results can be turned into positive results depending on how the data is massaged.
The take away from Goldacre's talk is that both clinical trials and academic articles are needed to provide proper evidence for a treatment. He argues that more transparency is needed where clinical trials should be required to register, and provide a summary of their methods and results at the very least. Lastly, he goes even further to say that journals should refuse to publish the academic articles that involve clinical trials that have not been registered.
Health librarians should most definetely pay attention to where Goldacre takes his research next!