Saturday, March 31, 2018

Conflicts of interest..........................

Back in the 1960's, the scientific community was at odds about whether sugar or fat was the culprit in the increasing rates of heart disease.  In 1967, three Harvard scientists conducted a comprehensive review of the research to date, published in the New England Journal of Medicine, that firmly pointed the finger at fat as the culprit.  The paper was, not surprisingly, influential in the debate on diet and heart disease.  After all, the NEJM is and was a prestigious publication and the researchers were, all three, from Harvard.  Blaming fat and exonerating sugar affected the dies of hundreds of millions of people for decades, a belief that caused a massive shift in eating habits that has been linked to the massive increase in obesity rates and diabetes.
     The influence of this paper and its negative effects on America's eating habits and health provides a stunning demonstration of the imperative of disinterestedness.  It was recently discovered that a trade group representing the sugar industry had paid the three Harvard scientists to write the paper, according to an article published in JAMA Internal Medicine in September 2016.  Not surprisingly, consistent with the agenda of the sugar industry that had paid them, the researchers attacked the methodology of studies finding a link between sugar and heart disease and defended studies finding no link.  The scientists' attacks on and defenses of the methodology of studies on fat and heart disease followed the same pro-sugar pattern.
     The scientists involved are all dead.  Were they alive, it's possible, if we could ask them, that they may not have even consciously known they were being influenced.  Given human nature, they likely, at least, would have defended the truth of what they wrote and denied that the sugar industry dictated or influenced their thinking on the subject.  Regardless, had the conflict of interest been disclosed, the scientific community would have viewed their conclusions with much more skepticism, taking into account the possibility of bias due to the researchers' financial interest.  At the time, the NEJM did not require such disclosures.  (That policy changed in 1984.)    That omission prevented an accurate assessment of their findings, resulting in serious harm to the health of the nation.

-Annie Duke, Thinking In Bets: Making Smarter Decisions When You Don't Have All the Facts

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