The scandal of poor medical research

Douglas Altman, a professor of statistics in medicine at the University of Oxford , recently died at the age of 69. He waged a long-running campaign to improve the use of statistics in medical research. He was revered for his work to develop best practices for clinical studies. One example of this campaign was his well-read editorial, "The scandal of poor medical research," published in the The BMJ in 1994.

In 1998 Altman described the problem in this way: “The majority of statistical analyses are performed by people with an inadequate understanding of statistical methods. They are then peer reviewed by people who are generally no more knowledgeable. Sadly, much research may benefit researchers rather more than patients, especially when it is carried out primarily as a ridiculous career necessity.”

With his long-time collaborator Martin Bland, Altman published some 100 papers. Their 1986 Lancet paper “Statistical methods for assessing agreement between two methods of clinical measurement”, came about because both men had come across an instance in which biological measurements had been made using different techniques which, perplexingly, seemed not to give the same result. They presented their resolution of the paradox at a conference. “Several people said you should produce a version with a worked example for medical researchers”, says Bland, “so that’s what we did”. Their Lancet paper set a new record at the time for the number of its citations. What they thought must be an issue of limited concern turned out to be anything but. “We were stunned”, Bland recalls.1

In 2006, Altman cofounded the EQUATOR Network (Enhancing the QUAlity and Transparency Of health Research), a group that works to develop best practices for reporting clinical research. Altman helped lead a number of initiatives to improve the quality of studies, such as CONSORT (guidelines for randomized clinical trials) and ARRIVE (standards for preclinical experiments).

1 Watts G. Obituary: Douglas Graham Altman. Lancet. 2018 Jul 7;392:24.

Posted: June 11, 2018