Fake facts and alternative truths in medical research

Abstract

Background: 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.

Main body: 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).

Conclusion: 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.

Keywords: Breast cancer; Conflict of interest; Mammography screening; Mortality; Overdiagnosis; Polarized research.

Fig. 1

Scatter plot of the relationship between OMRR and attitudes to screening. (1: Very negative to screening, 2: Negative to screening, 3: Neutral to screening, 4: Positive to screening, 5: Very positive to screening)