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Integrative Health &
Applied Nutrition
magazine (IHCAN)
Editor’s note
September 2023
Has the NHS decided it doesn’t “trust the evidence”?
Many researchers are dismayed at news that the NHS has withdrawn more than £5 million of funding from Cochrane (page 5), formerly the Cochrane Collaboration and home of the systematic review.
We’re not. Cochrane has an arrogant tagline: “Trusted evidence. Informed decisions. Better health” that increasingly hasn’t stood up to scrutiny.
If Cochrane IS on the way out after 30 years, let’s hope the systematic review and its evil twin the meta-analysis are taken off the road for a thorough overhaul.
Just so we’re clear: “A systematic review attempts to gather all available empirical research by using clearly defined, systematic methods to obtain answers to a specific question. A meta-analysis is the statistical process of analysing and combining results from several similar studies” (1).
Systematic reviews are the backbone of so-called “evidence-based medicine”. As we’ve repeatedly pointed out, though, much of the evidence reviewed – and “trusted” – is unreliable.
Prof Peter Gøtzsche, a co-founder of Cochrane who was pushed out when he turned whistleblower, says not only is the outfit inefficient and its reviews irrelevant, but Cochrane has become a pawn of the pharmaceutical industry.
Study after study has revealed the corruption now endemic in medical journals. A 2014 study in the Journal of the Royal Society of Medicine, found that almost half of all authors of published clinical trials had undisclosed conflicts of interest (2, 3).
In 2019, a paper in the BMJ stated that almost 60% of medical research in the US is funded by the pharmaceutical industry. It has been repeatedly shown that published outcomes of industry-sponsored studies tend to favour sponsors’ products, creating a “sponsorship bias” in the evidence base that overplays benefits and underplays harms (4).
This the evidence that Cochrane reviews and labels “trusted”.
In 2021, the former editor of the BMJ Richard Smith famously stated, “…the time may have come to stop assuming that research actually happened and is honestly reported, and assume that the research is fraudulent until there is some evidence to support it having happened and been honestly reported” (5).
Ironically, in that same opinion piece he
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theorised that Cochrane was going to do something about it. That’s because he’d heard from Ian Roberts, professor of epidemiology at the London School of Hygiene & Tropical Medicine, who headed a Cochrane group and was similarly starting to have doubts…”after a colleague asked if he knew that his systematic review showing that mannitol halved death from head injury was based on trials that had never happened… the trials were all published in prestigious neurosurgery journals and had multiple co-authors”.
Smith says that Prof Roberts “compared the original idea of systematic reviews as searching for diamonds, knowledge that was available if brought together in systematic reviews; now he thinks of systematic reviewing as searching through rubbish”.
And meta-analyses? Our own IHCAN Conference research guru Dr Richard Feinman, PhD, author of Nutrition in Crisis, describes them as the “most dangerous” activity plaguing medical literature. “With meta-analysis, no experiment ever fails, and no principle is ever disproved. Sugar causes heart, attacks, cholesterol causes heart attacks, red meat causes heart attacks, and statins prevent heart attacks – it doesn’t matter how many studies show no effect. One winner, and you can do a meta-analysis; just one more expensive trial and we’ll show that saturated fat is bad” (6).
Cochrane may raise alternative funding and stagger on. It would be great, however, if it took the NHS move as a warning and cleaned up its act.
Sorry, Mike…
We know Michael Ash – osteopath, naturopath, nutritional therapist, functional medicine guru, mucosal immunity expert and much more – is embarrassed at the amount of space we gave him in this issue. I told him he shouldn’t be so interesting! There’s a lot to learn from Mike’s evolution as a practitioner and researcher – and it’s a fascinating story.
64 pages for you this month
Another big issue, and 60 or so references (all online) for you to follow up on – some to studies that are so up-to-date that they have barely made it into print or online.
Let’s also flag up the intriguing “endogenous” material stacked in this issue – notably Pippa Campbell putting the PERImenopause front and centre; Eleanor Strang continuing the “let’s get in with the NHS” debate; Elaine Wilkins introducing us to Trauma-Informed Practice; and Janie Perry sharing a chronic fatigue
case study.
SIMON MARTIN, EDITOR
Keep up with Simon on Twitter@simoncamedit
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We’re always fully referenced
We don’t put a big emphasis on being “evidence based” in the conventional sense, mainly because the bulk of the evidence used in meta analyses and systematic reviews and to produce “guidelines” is not to be trusted. As Prof Richard David Feinman puts it, the meta-analysis is the “most dangerous” activity plaguing modern medical literature. And RCTs are of no use in assessing complex conditions that we address with multiple interventions – such as Dr Dale Bredesen’s Alzheimer’s protocol. Likewise, we highly value the hard-won clinical experience of multiple practitioners accumulated over the years and handed down over generations of evolving natural medicine practice. That said, we do put a lot of effort into referencing our features. References are online to save space, available within our members area.
We’re always fully referenced
We don’t put a big emphasis on being “evidence based” in the conventional sense, mainly because the bulk of the evidence used in meta analyses and systematic reviews and to produce “guidelines” is not to be trusted. As Prof Richard David Feinman puts it, the meta-analysis is the “most dangerous” activity plaguing modern medical literature. And RCTs are of no use in assessing complex conditions that we address with multiple interventions – such as Dr Dale Bredesen’s Alzheimer’s protocol. Likewise, we highly value the hard-won clinical experience of multiple practitioners accumulated over the years and handed down over generations of evolving natural medicine practice. That said, we do put a lot of effort into referencing our features. References are online to save space, available within our members area.
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