BrainWaves: A Neurology Podcast

#122 I wonder: Bias in clinical research

BrainWaves: A Neurology Podcast

As the name suggests, "evidence-based medicine" is dependent on published evidence to support our clinical practice and medical decision making. Implicit in this is the notion that all published evidence reflects the truth that underlies the biology, pathophysiology, and pharmacology of our health.

This is not the case.

Clinical research and published findings can be extremely limited, and what you read in Lancet and NEJM should be interpreted with caution. In this week's episode of the "I wonder" series, where Jim Siegler speaks with Ali Hamedani on various topics in medicine and neurology, the speakers review the major biases inherent to the practice and interpretation of clinical research.

Produced by James E. Siegler. Music by Jahzzar, Kai Engel, and Lee Rosevere. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making.

REFERENCES

  1. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Lancet. 1988;2:349-60.
  2. Smith GC and Pell JP. Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. Bmj. 2003;327:1459-61.
  3. Kazui H, Miyajima M, Mori E, Ishikawa M and Investigators S-. Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. The Lancet Neurology. 2015;14:585-94.
  4. Montalban X, Hauser SL, Kappos L, Arnold DL, Bar-Or A, Comi G, de Seze J, Giovannoni G, Hartung HP, Hemmer B, Lublin F, Rammohan KW, Selmaj K, Traboulsee A, Sauter A, Masterman D, Fontoura P, Belachew S, Garren H, Mairon N, Chin P, Wolinsky JS and Investigators OC. Ocrelizumab versus Placebo in Primary Progressive Multiple Sclerosis. The New England journal of medicine. 2017;376:209-220.

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