presentation of full ratio of
emotion as you see and in this
moment here today my highest point
curriculum certainly serve as a
reference to Ana who joined this
wonderful people here discussing ideas
sharing stories right?
so I’m very proud to do
part of this event today and my
question that for you is I wanted
to know if it does not cause strangeness
Which medical guidelines do I
I’m a doctor, they change from year to year.
it’s so often
I why would this happen and I would
I’ll start by telling a story to
you
to try to explain from my point of view
view and then share with you
I’ll start this idea by telling the
History of a Vitamin E Vitamin
vitamin AE was recognized by its
antioxidant properties and
believed that she could even
to prevent heart disease and it was
that an observation study in the
beginning of the 1990s demonstrated the
people who had high intakes of
vitamin E in your diet
had a frequency an incidence
lower infarction in 1996 was performed
a clinical trial study with a group
of men with cardiovascular disease who
received vitamin E supplementation
through a pill and was compared
with another group of similar men
the control group that received only perceived
a flour pill resulted in
reduced the risk by almost 50%.
of heart attack
wow the vitamin and it really became
powerful and 1997 44% of cardiologists
Americans already prescribed
routinely the vitamin E to its
patients
however several clinical trials
have failed to reproduce
the cardiovascular benefits of
supplementation of vitamin E from that
first
study in 1996 and finally in 2005 a
review of 19 papers published in the
medical literature with 135 thousand patients
concluded that in fact the high doses of
vitamin E and increased mortality and its
use should be abandoned
You certainly know other
Similar stories with others
medicines and even other vitamins
its members of vitamin c
we could write a treaty here
on the rise and fall of vitamin c
how the drugs are released
as better or more effective or with
less side effects on the market for
not showing up in the
better than medicines previously
available and weekly studies
contradictory are published in the
respect of the association of a food
with a certain disease
without ever reaching a conclusion
specific will be that the studies joão
poorly conducted or uncontrolled
This may even happen and cause
if you change your mind but it does not seem to be
case here if we were to make a
review of the cream of clinical research
published in scientific journals of
prestige high impact calls
we will see that only 44% or less of
half of the studies had their
results reproduced from the other 14%
were contradicted by studies
posterior
another 14% showed results
inflation and 24% had not been
never put to the test
the scientific method should be
the best way to test the
The effectiveness of a theory I have a
hypothesis or a developed idea
method to test this hypothesis
easy study as planned and
concludes
based on evidence and the hypothesis
if sustained, this is not how the
science and medicine and our
knowledge
about nature develops what
would be happening then would be fraud
it is also likely that it will not cheat
deliberate in science is very small
it is estimated that around 0.01 per
would never explain the profusion of
results of studies that later
are proven
what then it is seems that the
answer is in the current form of
funding and publication of research
before scientific
the scientific journals and the
researchers prioritize the results
positive
then the more positive the result
more chance should be published in a
high-impact magazine
I’m going to give you an example for you sd here
agency that regulates
clinical trials between 1987 and 2004
74 studies on the efficacy of
of antidepressants 51% of studies 38
were positive in favor of
antidepressants
of these all but 137 were published
and what happened to the other 36
studies that presented
negative of these only three were
published as such 22 never left the
drawer and or if they have been published
but with a different analysis of the
expected to show results as well
positive
Now, think about me if I have one.
I am patient medical you heard the
Miguel speaking and if I have one
patient is thinking of treating you
with the antidepressant
I think I ‘m a good doctor.
I’ll do a literature review of the
I will find 48 studies in favor of
antidepressant and only three
Then I go there and I decide
treat my patient and in fact I
I’m being deceived by my patient.
being fooled because I only had
access to half the information
available on that or better
half of the information about that
medicine was not available
It’s difficult, it’s very difficult for us.
understand what happens in science
because it happens in our society
also
we privilege only success
in fact although each of us
know in your heart that we learn
much more with mistakes than with
hits
however, this surplus value applied to
science has a disastrous effect is a
system that only deserves to be published
those positive jobs creates a
incentive system that is dangerous
So, with this story that
I told you, it’s possible.
actually manipulate data because what
happens is that in ours in our
system of scientific analysis
often the analysis is not
There is more than one way to
do the data analysis and for example
if I have an analysis that was
expected to develop a
determined research and evaluate the
results and analyzes by negative and
if I have another analysis analysis
b that was not planned but has
a significant result or not
scientist may resolve to publish
analysis b which is positive to the detriment of
of the area that was initially planned
uses a lot of the students I learned
that they need to oppose the search for
the pressure to publish
then there is an academic jargon that
ditch publish or die of English
And that’s what to say
to defend your thesis the student
need to publish there and it will only have
success
if your results were
statistically significant
this is also the case with
researchers are not they
publish their work in
scientific journals of no prestige
only for personal recognition but
also to obtain funding for
and will only succeed in
in fact if your results are
positive and impactful and what about
industry certainly
you will have high profits if you
demonstrate that the medicinal product in
portfolio is both effective and
those sponsored clinical surveys
by the pharmaceutical industry has a
chance
four times to demonstrate a
positive result from a drug of the
sponsor than other studies
independent and will it be that when a
pure vegetable scientist or researcher
opt for an analysis that is beneficial
Does this represent a one is a
bitchy attitude is priori
not likely to be scientists.
as any of us would like to see
your hypothesis is proven is and has a
tendency to make a kind of analysis
it is from your study that you show a result
positive as it will be then that people
rescues reliability in science
biomedical
you will see that the solution is
complex but already exists in some
attitudes or initiatives that take
one of them is to seek to require
bodies as they are to
make available the study protocols
which record as well as all the data
because we can prove to the
verify that the analysis of the results
was done as planned
Another idea is to stimulate
study published in magazines
systematically
replicated or reproduced
we also need other
platforms
weapons to publicize works
and the internet is one of them.
where scientists could publish the
your work with negative results
or less impactful and also
make your raw data available
studies to be evaluated by
other independent researchers would be
a way of reducing losses
publication bias of the
manipulation of data that we
we mentioned earlier some
scientific journals start today
to register jobs before they are
collected with the commitment of is
to publish the studies in
whatever the results is this
going to help is a paradigm shift
of traditional publication where general
the works are evaluated only after
of finished
then I need to think that we
if we can criticize and if this system
where when one seeks at all costs
the positive result to publish or
to get recognition everyone loses
collectively is called the tragedy of
this is only faced by
individual resignations initiatives
collective
starts here because a dilemma for
example of the preservation of the planet
passes for the same type of solution
so I think here as well as the
art to science imitates life at least
the one portrayed by staff
fernando person in the first two
verses from his poem straight
I never knew who took
stuck
all my acquaintances have been
champions in everything
scientists are actually reticent
to discuss the reliability of the research
with the lay public and
in the world is understood as our escape
during June for fundamentalism and
dogmas of all kinds
the defense of the scientific method
has been and remains a priority
however we must not
understand the results of articles
scientists as another dogma
undo or deconstruct the myth of
scientifically proven
important for science to be able to
reflect on herself and also
if open, there are questions
not to be infallible but to be able
to mitigate the inevitable errors that
happen just like any of us
thank you so much
[Applause]
[Music]
”
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