Tag Archives: medicine

Dealing with being wrong in science

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A doctor who challenges the faulty research of his peers is profiled in the latest issue of Atlantic. His conclusion is that expectations about science, specifically reactions to being wrong, need to be changed:

We could solve much of the wrongness problem, Ioannidis says, if the world simply stopped expecting scientists to be right. That’s because being wrong in science is fine, and even necessary—as long as scientists recognize that they blew it, report their mistake openly instead of disguising it as a success, and then move on to the next thing, until they come up with the very occasional genuine breakthrough. But as long as careers remain contingent on producing a stream of research that’s dressed up to seem more right than it is, scientists will keep delivering exactly that.

Negative findings, typically meaning that an alternative hypothesis is rejected, tend to receive less attention. Yet they are still useful as they advance science by ruling out alternatives. Both positive and negative findings are needed to build science (and any of its disciplines in the natural or social sciences).

But this doctor also suggests that the incentive system for scientists needs to be changed. As long as breakthroughs and big findings are what are rewarded, that is what scientists will look for and claim to find.

Seeing Alzheimer’s as a social problem

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The cover story in the current issue of Time is about Alzheimer’s research. The main story is set up in a typical way: the condition affects a lot of people and yet research into a cure is underfunded. What is interesting is that Time employs two statistics that suggest the cover story should really be about how people could make Alzheimer’s a social problem worthy of more attention.

The first statistic is an actual dollar amount: one expert says $500 million a year is spent on researching Alzheimer’s while $1 billion is spent on heart disease, and $5.6 billion on cancer. The second measure concerns public perception: 48% of Americans think “a great deal or some progress has been made in curing” the disease while 81% say the same about heart disease and 74% say the same about cancer. With these two statistics, Time suggests Alzheimer’s has a certain public image: it doesn’t attract the same kind of research dollars as other diseases and the public is pretty pessimistic about progress.

While the rest of the story concerns itself with the medical and scientific advances, perhaps it should be about how the public could be convinced that the disease deserves more attention. Some ways the public image could be enhanced: it needs more fund-raisers, more celebrity supporters, more support for research from public officials, and more stories that demonstrate how many people are affected by Alzheimer’s. Look at the public image of other conditions: diseases like breast cancer (where are those “edgy” Facebook campaigns for Alzheimer’s?) have effectively been cast as critical social problems that everyone should care about.

Perhaps this cover story is itself intended to help raise the profile of Alzheimer’s. While real medical progress is the true goal and it is what will ultimately benefit people, Alzheimer’s as a social problem is another important issue to be considered.

The “friendship paradox” and the spread of disease

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The social dimensions of diseases and medical conditions continue to draw research attention, particularly for those interested in mapping and understanding fast-spreading illnesses. A recent study, undertaken by a sociologist and medical geneticist/political scientist, explores how the flu spreads:

The persons at the center of a social network are exposed to diseases earlier than those at the margins states the paradox. Again, your friends are probably more popular than you are, and this “friendship paradox” may help predict the spread of infectious disease. However, Christakis and Fowler found that analyzing a social network and monitoring the health of members is an optimal way to predict a wave of influenza, detailed information simply doesn’t exist for most social groups, and producing it is time-consuming and expensive…

[Sociologist Nicholas] Christakis states: We think this may have significant implications for public health. Public health officials often track epidemics by following random samples of people or monitoring people after they get sick. But that approach only provides a snapshot of what’s currently happening. By simply asking members of the random group to name friends, and then tracking and comparing both groups, we can predict epidemics before they strike the population at large. This would allow an earlier, more vigorous, and more effective response.

This sounds like it has more promise than recently proposed techniques like monitoring Google searches or Twitter feeds.

Additionally, more and more research suggests that monitoring and analyzing social networks is critical for understanding the complex world. Rather than simply examining individuals, we now have some tools to map and model more complex social relationships.

Social factors as part of a medical diagnosis

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This story from the Chicago Tribune tells of Dr. Saul Weiner who has been studying the effect of social circumstances, such as socioeconomic concerns, on medical diagnoses. After one of his own cases, Weiner decided to study the issue further:

Weiner arranged to send actors playing patients into physicians’ offices and discovered that errors occurred in 78 percent of cases when socioeconomic concerns were a significant factor, according to a paper published Monday in the Annals of Internal Medicine.

Weiner recommends adding a “contextual history” to the physical history that physicians usually document with first-time patients.

Treating the whole person seems like it would produce better results for the patient.