Is research in the eye of the beholder?

Is research in the eye of the beholder, and if so how valid is it?

I read an article showing that Scientific research may be in decline across the globe simply because the scientific study found that many studies contradicted scientific hypotheses.  The findings were that scientific journals tend to reject such research because; a) they attract fewer readers and citations, and b) because of the fierce competition in science is growing and grants are given to scientists who publish frequently in high-ranking journals.

The article rightly predicts that many researchers, therefore, have speculated that scientists will increasingly pursue predictable outcomes and produce positive results through re-interpretation, selection or even manipulation of data.¹

We have certainly seen that within the pharmaceutical industry where not only has the placebo been as affective as the manufactured chemical intervention, but the outcome data manipulated to show otherwise.  Although called evidence based,  the side effects found out some years later show they are anything but safe and people taking the medication have suffered the consequence.^{2-12 Plus others}

What Exactly is Evidence Based?

A peer reviewed article by Barry Dunstan in Counselling Australia says, that it usually means an approach that has established itself better than placebo or treatment as usual in two clinical trials.  Duncan says; “Such demonstrations are nothing to write home about; intervention of nearly any kind has demonstrated its superiority over placebo for 50 years!”

When you say “Evidence-based treatment,” whose evidence is it?  If I were to want to do a research into hypnotherapy, then I would want to show a positive outcome towards hypnosis, after all, it is what I practice and get great results with.  Duncan states that in such circumstances, up to 40% of the results can be attributed to what is called “allegiance effects,” or the researchers’ bias toward their own models.  He doesn’t say that means the researchers are dishonest, but the results should be interpreted with this in mind.

So is research a lot of humbug?  Thousands of studies have found no difference among approaches,  while a few studies have reported a favourable finding for one approach or another.  Duncan pointed an example that Cognitive Behavioural Therapy (CBT) proponents often point to 15 comparisons showing an advantage for CBT – however, there are 2985 comparisons that show no difference (Wampold, 2001).

So, shouldn’t we be seeing the results of all research – or are if not, are we dishonest and providing false evidence?

There is no way that we would be able to include all the research in one article, and as has been stated, how true are they anyway?  The parameters included in one research to the next would take so much work it hardly seems worth the effort. And to be honest, what works in our practice works best.

It also doesn’t mean that we should not write articles about our successes, no matter how small, of those things that have worked in our practices.  Most of us (therapists) go to workshops to learn ‘accepted’ theories and studies, and then mould them to fit our way of doing things.

An example would be that I went to two workshops to learn EFT, yet I use it within the hypnosis trance state where I do the tapping on the client.  When I use EMDR, the only original teaching that I have kept is the movement of the eyes from one side of the head to the other.  I also use this in the hypnosis trance state and have incorporated some simple techniques of my own.  Either one of these can often remove trauma in the one session.  It works for me!  Other therapists I know don’t like working with either of these modalities, yet their practices are working well also.

It is in our own practices that we do our own research however, as all research seems to point out, there are two people in therapy – the therapist and the client.  There are additional considerations such as the client’s belief system, the medication they are on, the situation of their life currently and the alliance with their therapist.

As I say to my clients; “There is no such thing as failures, there are just ways of doing things that don’t work – for you.”  They might work for someone else, and it is the client who should find out what works best for them.

References:

¹University of Edinburgh (2011, September 13). Pressure for positive results puts science under threat, study shows. ScienceDaily. Retrieved September 25, 2011, from http://www.sciencedaily.com­ /releases/2011/09/110912143353.htm

²E. Cho, G. Curhan, S. E. Hankinson, P. Kantoff, M. B. Atkins, M. Stampfer, T. K. Choueiri. Prospective Evaluation of Analgesic Use and Risk of Renal Cell Cancer. Archives of Internal Medicine, 2011; 171 (16): 1487 DOI: 10.1001/archinternmed.2011.356

³B. Tasker, Anti-smoking medication linked to heart problem risk. http://www.medicalsearch.com.au/News/Anti-smoking-medication-linked-to-heart-problem-risk-52723

⁴S. McNamara, Article posted on MJA Insight, 20/6/2011 – Demand for Action on Research Fraud – German anaesthetist, Joachim Boldt, fabricated a published study on colloids.

⁵N. SINGER, New York Times, 1/9/2010. Article – Maker of Botox Settles Inquiry –  Paid $600 million to settle charges that it illegally promoted and sold the drug through 2005 for unapproved uses like treating headaches.

⁶BMJ-British Medical Journal (2010,July 30). Calcium Supplements linked to increased risk of heart attack, study finds. Sciene Daily, Retrieved July 31, 2010 from http://www.sciencedaily.com/releases/2010/07/100729191154.htm

⁷Natalie McGauran, Beate Wieseler, Julia Kreis, Yvonne-Beatrice Schuler, Heike Kolsch, Thomas Kaiser. Reporting bias in medical research – a narrative review. Trials, 2010; 11 (1): 37 DOI: 10.1186/1745-6215-11-37

⁸Medical Search, Australia & NZ News Article. Source: AAP NewsWire – Common osteoporosis drug is linked to heart problems (alendronate)

⁹Joseph S. Ross; David Madigan; Kevin P. Hill; David S. Egilman; Yongfei Wang; Harlan M. Krumholz. Pooled Analysis of Refocoxib Placebo-Controlled Clinical Trial Data: Lessons for Postmarket Pharmaceutical Safety Surveillance. Arch Intern Med, 2009; 169 (21): 1976-1985 – Vioxx Trial Data Shows Early Cardiovascular Risk

¹⁰Stanford University Medical Center (2008, November 26). 14 Drugs Identified As Most Urgently Needing Study For Off-label Use. ScienceDaily. Retrieved November 27, 2008, from Http://sciencedaily.com/releases/2008/11/081124130939.htm

¹¹Source: AAP NewsWire. 21/8/2008 Article: Diabetes patients using GSK’s drugs told to see doctor (Avandia or Avandamet) http://www.medicalsearch.com.au/News/viewrecord.aspx?id=34000

¹²Infectious Diseases Society of America (2008, Aust 13). Adverse Reactions To Antibiotics Send Thousands Of Pattients To The ER. ScienceDaily. Retrieved August 15, 2008, from http://www.sciencedaily/com/releases/2008/08/0612135515.htm

Plus others not shown.