Hofmann Bjørn
The Institute for the Health Sciences, Norwegian University of Science and Technology (NTNU), PO Box 1, N-2802, Gjøvik, Norway.
Centre for Medical Ethics, University of Oslo, Oslo, Norway.
BMC Med Ethics. 2018 Jan 27;19(1):4. doi: 10.1186/s12910-018-0243-z.
Fake news and alternative facts have become commonplace in these so-called "post-factual times." What about medical research - are scientific facts fake as well? Many recent disclosures have fueled the claim that scientific facts are suspect and that science is in crisis. Scientists appear to engage in facting interests instead of revealing interesting facts. This can be observed in terms of what has been called polarised research, where some researchers continuously publish positive results while others publish negative results on the same issue - even when based on the same data. In order to identify and address this challenge, the objective of this study is to investigate how polarised research produce "polarised facts." Mammography screening for breast cancer is applied as an example.
The main benefit with mammography screening is the reduced breast cancer mortality, while the main harm is overdiagnosis and subsequent overtreatment. Accordingly, the Overdiagnosis to Mortality Reduction Ratio (OMRR) is an estimate of the risk-benefit-ratio for mammography screening. As there are intense interests involved as well as strong opinions in debates on mammography screening, one could expect polarisation in published results on OMRR. A literature search identifies 8 studies publishing results for OMRR and reveals that OMRR varies 25-fold, from 0.4 to 10. Two experts in polarised research were asked to rank the attitudes of the corresponding authors to mammography screening of the identified publications. The results show a strong correlation between the OMRR and the authors' attitudes to screening (R = 0.9).
Mammography screening for breast cancer appears as an exemplary field of strongly polarised research. This is but one example of how scientists' strong professional interests can polarise research. Instead of revealing interesting facts researchers may come to fact interests. In order to avoid this and sustain trust in science, researchers should disclose professional and not only financial interests when submitting and publishing research.
在这些所谓的“后事实时代”，假新闻和另类事实已变得司空见惯。医学研究又如何呢——科学事实也是假的吗？最近的许多披露加剧了一种说法，即科学事实值得怀疑，科学正处于危机之中。科学家似乎在追求利益而非揭示有趣的事实。这在所谓的两极分化研究中可见一斑，即一些研究人员不断发表积极结果，而另一些研究人员在同一问题上发表消极结果——即使是基于相同的数据。为了识别并应对这一挑战，本研究的目的是调查两极分化的研究如何产生“两极分化的事实”。以乳腺癌的乳房X线筛查为例。
乳房X线筛查的主要益处是降低乳腺癌死亡率，而主要危害是过度诊断及随后的过度治疗。因此，过度诊断与死亡率降低比率（OMRR）是乳房X线筛查风险效益比的一种估计。由于在乳房X线筛查的辩论中涉及强烈的利益以及强烈的观点，人们可能会预期关于OMRR的已发表结果会出现两极分化。一项文献检索找出了8项发表OMRR结果的研究，并显示OMRR的变化幅度达25倍，从0.4到10。两位两极分化研究方面的专家被要求对已识别出版物的相应作者对乳房X线筛查的态度进行排名。结果显示OMRR与作者对筛查的态度之间存在很强的相关性（R = 0.9）。
乳腺癌的乳房X线筛查似乎是两极分化研究的一个典型领域。这只是科学家强烈的职业利益如何使研究两极分化的一个例子。研究人员可能会追求利益而非揭示有趣的事实。为了避免这种情况并维持对科学的信任，研究人员在提交和发表研究时应披露职业利益，而不仅仅是经济利益。
