Publicar o morir

OXFORD – Hace unos años, dos investigadores noruegos presentaron su versión de una pendiente resbaladiza de la investigación científica, con errores honrados (observaciones y análisis equivocados) en la parte de arriba y fraude intencionado (plagio, falsificación e invenciones) en la parte de abajo. Colocaron el “sesgo de publicación” hacia la mitad de la escala, pero debería haber estado mucho más abajo. De hecho, la no publicación de los resultados de investigaciones es la forma más común y preocupante, con mucho, de conducta poco ética en materia de investigaciones de salud… y ha tenido consecuencias letales.

Hace mucho tiempo que existen pruebas anecdóticas del sesgo de publicación, pero, a medida que los requisitos para el registro de ensayos clínicos se han vuelto más rigurosos, su magnitud ha llegado a ser cifrable: los resultados de al menos la mitad de los ensayos clínicos con pacientes y voluntarios sanos permanecen inéditos durante años después de su realización. Los estudios con resultados “negativos·” son los que tienen menos probabilidades de ver la luz del día, pero la falta de información sobre investigaciones puede propiciar recomendaciones tergiversadas sobre prácticas clínicas, sufrimiento y muerte.

Por ejemplo, los medicamentos contra las arritmias fueron prescritos en gran escala –con la aprobación de la Administración de Alimentos y Medicamentos de los Estados Unidos– a víctimas de ataques cardíacos durante más de un decenio, con la suposición de que la reducción de las anormalidades del ritmo cardíaco disminuiría las tasas de mortalidad, pero, como informó el periodista investigador Thomas J. Moore en su libro Deadly Medicine (“Medicina mortal”), en el momento de mayor utilización, dichos medicamentos estaban matando todos los años a más americanos que durante toda la guerra del Vietnam.

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