发表或消亡

牛津——几年前,两名挪威科研人员提出了自己心目中的科研滑坡效应,他们把诚实的错误(错误的观察和分析)排在最前面而把故意欺诈(剽窃、篡改和伪造)放在最后。他们将“发表偏倚”放在中间偏后的位置——但实际情况应当比这低得多。其实,未公布研究成果是医疗研究中最常见、也最令人担忧的不当科学及道德行为——而且会造成致命的后果。

传说中发表偏倚的证据已经不只存在一天两天了。但随着注册临床试验的要求越来越严格,已经可以量化统计相关影响规模:至少有半数患者和健康志愿者参与的临床试验结果在完成数年后仍被束之高阁。结果不那么令人鼓舞的研究尤其难以得见天日。但忽视报告研究成果可能导致临床实践建议被扭曲,更有可能带来痛苦和死亡的严重后果。

比方说美国食品药品管理局批准的抗心律失常药物广泛应用于治疗心脏病患者达10年之久,假设前提是减轻心律异常能够降低死亡率。但据调查记者托马斯·摩尔在《致命药物》一书中的报道,在其使用高峰期,每年被这种药物夺去生命的美国人比越南战争中丧生的人还要多。

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