Failed clinical trials, unpublished research and other health stories you may have missed
Plus a closer look at a wait times report and why Batman should be worried, in this week's Second Opinion
News, by definition, is about something that happened. But sometimes nothing happens. Experiments fail. New drugs are no better than old drugs; sometimes they're worse. Scientists call it "publication bias" — where only the positive results of studies end up being reported. But knowing what failed can be as important as knowing what worked. And this week we have a few important failures to report as well as an analysis of what happens if the failures never see the light of day.
Also this week: Remember those headlines warning about historically high wait times for health care? It turns out the survey was based on a brief questionnaire which most doctor's didn't bother to answer. Plus a couple of other juicy bits from the medical sciences bin — including an analysis of superhero head injuries.
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Clinical trials ... and tribulations
Two high-profile clinical trials were dealt major setbacks this week.
On Wednesday, drug-maker Eli Lilly announced its experimental treatment for Alzheimer's had failed to work better than a placebo. The drug had already failed in two large studies in people with mild to moderate forms of the disease, but researchers held out hope that it could work for those with the mildest symptoms. Now they wonder if the damage to the brain is too extensive by the time symptoms of Alzheimer's first appear.
On the same day, Juno Therapeutics had to halt its clinical trial testing a new approach to treating cancer after two patients in the study died. The treatment involved cutting-edge immunotherapy in which the patient's own immune cells are reprogrammed to target tumours. It could be the final straw for the trial, which was already suspended last summer following the deaths of three other patients. There are questions about why the trial was even allowed to continue.
So what happens to the results when a clinical trial fails?
It turns out almost half of them never see the light of day — and that's a lot of valuable research that is lost. Ben Goldacre and his colleagues at the University of Oxford want to see that change. Earlier this month, they launched a site called TrialsTracker, which tallies the number of missing trial results from research organizations around the world. We were surprised to see several Canadian universities and institutions were among the worst offenders, and that had us asking why.
Aftermath of a scientific revolt
About 70 per cent of Canada's health scientists who responded to an informal survey say they're scaling back their research after federal research funding changes. One-third said they are thinking of walking away from their research altogether.
The survey was circulated by Liisa Galea, a researcher at the University of British Columbia, after a revolt by Canadian scientists earlier this year that made international headlines.
Galea admits there's a risk of participation bias — that the scientists who responded are the ones who are most concerned about the funding climate. But she says the report has been widely circulated in the scientific community. She also sent it to the president of the Canadian Institutes of Health Research, Dr. Alain Beaudet, who was at the centre of the scientific storm this summer after a series of funding and grant reforms abandoned the traditional face-to-face peer review and instead used a computerized review system that crashed in the middle of the process.
A similar survey of young scientists found most reporting that the current funding climate was delaying their research. Almost a third said they were considering leaving science and starting a new career in some other area.
The Fraser Institute wait-time survey: Whose opinion is it really?
Alarming headlines this week about wait times for health care are a seasonal feature. For almost 25 years the Fraser Institute think-tank has been releasing an annual wait-time report, and the news is almost always bad. But does the survey count if most doctors don't even fill in the questionnaire? Even with a chance to win a $2,000 prize, most doctors ignored it. We ask what that means for the survey's results, and speak to one health policy consultant who calls its methodology "an abomination."
A first for gene-editing technique CRISPR
Chalk one up for China. In the fierce race over CRISPR, that country has used the revolutionary gene-editing technique in a human for the first time. According to the journal Nature, researchers removed cells from an individual with aggressive lung cancer, edited those cells using CRISPR and then re-injected them into the patient in hopes they would target the cancer. Not to be outdone, a U.S. trial is set to begin in the new year. Earlier this week, we spoke with scientists who are watching the race with amazement.
Holy concussions, Batman!
If you've ever watched a Batman movie, you've seen him take a beating. But the repeated blows to the head don't seem to ever affect him, so what gives?
That's the question two researchers from the University of Victoria ask in their paper Can Concussion Constrain the Caped Crusader?, published recently in the British Journal of Sports Medicine. They combed the 10 movie versions of Batman — starting way back in 1943 and ending with this year's Batman v Superman — and found he's been exposed to a whopping 176 potentially concussive events. If they're right, Batman should probably be very worried about chronic traumatic encephalopathy (CTE), the degenerative brain disease found in the brains of many former football players — although we doubt that would be a very popular plot twist in the superhero's next movie.
Making the rounds
Here are some other stories we found interesting this week:
- Do cancer clinical trials exaggerate the real-world benefits of drugs? | STAT
- This new study may explain why peer review in science often fails | VOX
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