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CrossFit Health is an investigation into the ills of modern medicine and the wilful abuse of the public’s trust in science. The lessons learned from the legal dismantling of fake science, a crooked journal, and perjuring scientists have given us a forensic view as to how everything might have gone so wrong. We’re calling the combination of runaway medical costs and disease rates — which many profit from but none combat effectively — “The Mess.”

In these contrasting pieces, two authors provide differing argumentation regarding whether the replication crisis, p-hacking, and similar well-documented issues indicate science is broken or working as intended in a self-correcting process.

Read MoreIs Science Broken?

“American taxpayers spend $30 billion annually funding biomedical research. By some estimates, half of the results from these studies can’t be replicated elsewhere — the science is simply wrong. Often, research institutes and academia emphasize publishing results over getting the right answers, incentivizing poor experimental design, improper methods, and sloppy statistics. Bad science doesn’t just hold back medical progress, it can sign the equivalent of a death sentence. ... In Rigor Mortis, award-winning science journalist Richard F. Harris reveals these urgent issues with vivid anecdotes, personal stories, and interviews with the nation’s top biomedical researchers. We need to fix our dysfunctional biomedical system — now.”

Read MoreRigor Mortis: How Sloppy Science Creates Worthless Cures, Crushes Hope, and Wastes Billions

Cristin Kearns was managing dental clinics for Kaiser and researching the link between gum disease and Type 2 diabetes when she came across a brochure with the CDC’s dietary recommendations for diabetics. The bad advice she found in the brochure forever altered the trajectory of her career and led to her development of a large digital archive — a record of instances in which the Sugar Association, a 501(c)6 formerly known as the Sugar Research Foundation (SRF), used public relations campaigns and industry funding to influence scientific research, education, and public policy in support of its mission to promote sugar consumption.

Watch How Big Sugar Influences Nutrition Science: A First Glimpse at Sugar Industry Documents

In October 2013, cardiologist and professor of evidence-based medicine Dr. Aseem Malhotra published an editorial in the BMJ entitled “Saturated Fat Is Not the Major Issue.” There, he contradicted popular wisdom about saturated fat consumption contributing to heart disease and claimed the medical establishment’s focus on lowering cholesterol to improve heart health had led to the overprescription of statin drugs with negative side effects. Though the scientific evidence was on his side, many in the scientific and medical communities were not. Here he describes the history and inner workings of the ongoing conflict and the lessons to be gleaned from it.

Read More The Great Statin Scam – Time to Clean up the Mess

“Two drug companies have argued that the European Medicines Agency (EMA) should stop making public any information on clinical trials that businesses consider commercially confidential. These cases, taken by Merck and by PTC Therapeutics, are now waiting on a final judgment from the European Court of Justice. Yannis Natsis, patient representative on the EMA board, said that the EU was at the forefront of clinical trial data transparency worldwide but that this position was threatened by the pending judgment. He said, ‘This will mean that data secrecy will over-ride the public interest of disclosure which is now the default option. It will be a major blow to patient safety, scientific progress, and society at large. Pharmaceutical companies—one of the most secretive business sectors—have long fought against clinical trial transparency, harming patients. The public interest needs to prevail over narrow commercial interests.’”

Read the articleEuropean drug regulator fears return to days of data secrecy

The benefit of preventive drugs such as statins is often quantified as the “number needed to treat,” or NNT, which reflects the number of subjects who would need to be given a drug for one negative clinical event to be prevented. For example, if the NNT for a statin preventing cardiovascular death is 40, it suggests that for every 40 patients given a statin, one cardiovascular death will be prevented. This number, however, distorts the likely reality of the benefit distribution by suggesting a single subject receives the entire benefit while other subjects receive no benefit. This 2014 review aimed to quantify the clinical impact of statins differently, assessing the mean extension of life due to statin treatment. The analysis found the median benefit associated with statin use was 3.2 days in primary prevention and 4.1 days in secondary prevention. In other words, statins extended life expectancy by less than a week. Separate research suggests if the benefits of statins were explained this way, the majority of subjects would not choose to take them.

Read MoreThe Effect of Statins on Average Survival in Randomised Trials, An Analysis of End Point Postponement

Both clinical behavior and journal editorial decisions are often based on scientific abstracts alone rather than a consideration of the entire study and data. Consequently, any deviations between the content of these abstracts and the actual data — here referred to as “spin” — can distort the impact of the scientific literature. This 2019 paper assessed the frequency and nature of spin in the titles and abstracts of psychiatry research as one form of such distortion, finding that more than half of all psychiatric papers surveyed have titles and/or abstracts that do not accurately reflect the study results and instead present a neutral or negative finding as positive.

Read MoreEvaluation of spin in abstracts of papers in psychiatry and psychology journals

Dr. Jason Fung has grown wary of scientific research that purports to be “evidence based.” A well-known nephrologist and author, Fung often speaks about Type-2 diabetes reversal and the metabolic effects of intermittent fasting, but in this presentation from Dec. 15, 2018, he turns his focus toward the many ways the foundations of evidence-based medicine have become corrupted by financial conflicts of interest. Those corruptions include Big Pharma's habit of buying practicing physicians with gifts, influencing scientific publications by paying off their editors, and skewing the medical research through tactics such as selective publication and changing the trial endpoints — all of which may lead to the unnecessary or even dangerous overprescription of drugs.

WatchDr. Jason Fung: Financial Conflicts of Interest and the End of Evidence-Based Medicine

This review found 396 cases between 2003 and 2017 in which a randomized controlled trial indicated an intervention already in clinical use (such as a drug, procedure, vitamin or supplement, device, or more systemic change) lacked an evidential basis. The reversals spread across a spectrum of medical fields, including cardiovascular disease, preventive medicine, and obstetrics and gynecology. This review reinforces the importance of basing clinical recommendations on randomized controlled trial data rather than less rigorous standards of evidence. It indicates a significant share of treatments — even if they are in widespread use — will be found ineffective when tested in a rigorous clinical trial.

Read MoreA comprehensive review of randomized clinical trials in three medical journals reveals 396 medical reversals

In this 1975 review, Gina Kolata comments on the cost and necessity of two major clinical trial investments by the National Heart and Lung Institute (NHLI, now the NHLBI): the Lipid Research Clinics Primary Prevention Trial (LRC-PPT) and Multiple Risk Factor Intervention Trial (MRFIT). “With the passage of the Heart, Lung, and Blood Act in 1972, several large-scale clinical trials were planned to see whether people can voluntarily decrease their risk of heart disease. Now, 4 years later, screening for participants in the two most extensive and most expensive of these trials is nearly complete, but the trials are turning out to cost far more than anyone anticipated,” Kolata writes. As she notes, “A national obsession with dietary fats and cholesterol seems to have developed despite the fact that there is as yet no conclusive evidence that people can voluntarily decrease their risks of heart attacks by changing their diets.” Nevertheless, the LRC-PPT and MRFIT were seen as significant contributions to the diet-heart hypothesis and reflect the commitment on the part of research funders to find this missing evidence.

Read MorePrevention of Heart Disease: Clinical Trials at What Cost?

This 2013 paper considers the dramatic rise in the rate of retraction for published scientific research since the 1990s. The authors conclude, “The increase in retracted articles appears to reflect changes in the behavior of both authors and institutions.” They list a variety of possible factors for the increase, including a widening scope of reasons for retraction (such as plagiarism and duplicate publication), an increase in the number and proportion of retractions by authors with a single retraction, and greater scrutiny of high-profile publications.

Read MoreWhy Has The Number of Scientific Retractions Increased?

The WHO trial (so named because the international team of principal investigators contained World Health Organization members) tested the potential of clofibrate, a “pre-statin” cholesterol-lowering agent, to reduce heart attack morbidity and mortality. The investigators ultimately concluded that clofibrate "cannot be recommended as a lipid-lowering drug for community-wide primary prevention of ischaemic heart disease.” Nevertheless, clofibrate remained in use until 2002, when it was pulled for increasing cancer rates. In their review of studies such as the WHO trial, Uffe Ravnskov and David Diamond observe, “Despite the largely disappointing findings from 50 years of cholesterol lower[ing] trials, the indictment and conviction of cholesterol as the causal agent in CVD [cardiovascular disease] has stood the test of time. … [Yet] the grand effort to reduce cholesterol as a strategy to improve health has failed.”

Read More The WHO Trial

Dr. Georgia Ede reviews the EAT-Lancet’s global nutrition study, “Food in the Anthropocene—the EAT-Lancet Commission on healthy diets from sustainable food systems,” which envisions a “Great Food Transformation” based on minimizing consumption of animal foods. She concludes, “the report fails to provide us with the clarity, transparency and responsible representation of the facts we need to place our trust in its authors. Instead, the Commission’s arguments are vague, inconsistent, unscientific, and downplay the serious risks to life and health posed by vegan diets.”

Read the article EAT-Lancet's Plant-Based Planet: 10 Things You Need to Know

In “Publish-or-Perish: Peer Review and the Corruption of Science,” pharmacology professor David Colquhoun addresses entrenched practices that reduce the quality of academic publishing and increase the temptation to exaggerate claims, manipulate statistics, and fabricate results. Colquhoun takes specific issue with quotas, significant rewards for publication volume, and the increasing number of academic journals that maintain low publication standards.

Read MorePublish or Perish

Recommendation of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015, as published in the Clinical Journal of Sports Medicine: “Using the innate thirst mechanism to guide fluid consumption is a strategy that should limit drinking in excess and developing hyponatremia while providing sufficient fluid to prevent excessive dehydration.”

Read the paperDrink Only to Thirst

“Peer review is a flawed process, full of easily identified defects with little evidence that it works. Nevertheless, it is likely to remain central to science and journals because there is no obvious alternative, and scientists and editors have a continuing belief in peer review. How odd that science should be rooted in belief.” —Richard Smith, former BMJ editor

Read MorePeer Review: A Flawed Process at the Heart of Science and Journals

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