Australian Doctor 13th Sept Issue | Page 40

News Review

13 SEPTEMBER 2024 ausdoc . com . au

Professor Ben Mol and the

Mohana Basu Australian Doctor reporter .
A true horror story of junk science which refuses to die .

PROFESSOR Ben Mol does not look like a professional zombie hunter .

No blood stains on
his shirt , definitely no firearms .
Instead , his weaponry includes
Excel spreadsheets and emails .
His target ? The horde of
junk research papers , usually
retracted because of a glaring
flaw in their premise , methodology
or results — or because the
datasets on which they are based
are fabricated .
They are called zombies
because they continue to be cited
in research as if they were still
living , valid science .
In medicine , they crop up
in reviews and meta-analyses ,
including those conducted by
Cochrane — the organisation
whose reason for being is to represent
the gold standard of evidence-based
medicine .
a Monash University PCOS guide-
published five years later — the
considerable time conducting
are not completely stupid . They
Most importantly , they some-
line published in 2018 .
suggestion that inositol could be
clinical trials to establish the effi-
don ’ t usually come to conclu-
times underpin real-world clini-
The guideline was endorsed
considered as a possible therapy
cacy of the inositol that — accord-
sions completely out of line from
cal guidelines .
by the NHMRC .
to manage PCOS was ditched .
ing to these latest trials — turns
the current guidelines .”
“ Research was all based on trust until now , but that trust has eroded completely ,” Professor Mol says .
But Professor Mol ’ s team from the Evidenced-based Women ’ s Health Care research group at Monash University in Melbourne
GPs are now advised to prescribe the drug based on “ individual considerations ”.
“ I know this may not be a
out not to work at all .” This is far from the only example . Professor Mol , an obstetrician
Ivermectin and COVID-19
Seemingly benign conclusions —
Wasted time
In his team ’ s most recent work ,
said 45 of these studies should be considered questionable .
Once the zombies were
180-degree change in the recommendations ,” Professor Mol says .
“ But the original recom-
and gynaecologist , has spent years trying to confront what for him is a massive problem .
such as whether increasing doses of supplements improves patient outcomes — can lead research
they examined 101 randomised controlled trials ( RCTs ) listed in
excluded — as they were in a revised version of the guideline
mendations led my colleagues in the Netherlands to spend
Prevalence
So , how prevalent are these zom-
teams to waste time journeying down a futile path of inquiry . Other junk papers have a differ-
bie papers ?
ent impact .
Professor Mol says anywhere
Take the COVID-19 pandemic .
between 20 % and 45 % of RCTs
Arguably the most influential
included in clinical guidelines
zombie paper was a pre-print of a
across different medical fields
large Egyptian hospital study on
may be untrustworthy .
ivermectin .
‘ The researchers who fabricate data for these studies are not completely stupid .’
— Professor Ben Mol
More alarmingly , Cochrane reviews seem to be heavily affected , with a recent analysis suggesting as many as a quarter of the RCTs which Cochrane cites are suspect .
“ I have been knocking at the Cochrane committee doors for years . While there have been some responses , they have been slow to react ,” Professor Mol says .
“ Those researchers who fabricate data [ for these studies ]
Led by Dr Ahmed Elgazzar from Benha University in Egypt , it purported to be an RCT involving 600 patients diagnosed with COVID-19 and concluded that there was “ a substantial improvement and reduction in mortality rate in ivermectin treated groups ” by 90 %.
It quickly ended up in meta-analyses suggesting the drug could have a role in treatment , much to the excitement of