This article misses the mark completely, both by extrapolating medicine to science as a whole, and by attacking the idea of causation rather than the sketchy practices of medicine.
All of the examples are pulled from medicine, notorious for its lack of experimental rigor. To say that "Science has failed us" implies that either medicine is the the only important science or that all science is equally as sloppy, which is pretty insulting to a scientist in any harder field.
His focus on causation is even more misguided. The very purpose of science is to understand the way the world works; to understand what causes what. To attack the idea of causation is to attack the very idea of science, and in turn all of the advances it's brought about over the past 300 years. Beyond that, we implicitly accept causation in almost every aspect of our lives (Pressing the space bar causes a space to appear, etc). Certainly causes can't be 'seen' like facts, but to suggest that this trivializes them, or somehow makes them less useful is nonsense (and, for what it's worth, is total misreading of Hume).
Complexity isn't a valid reason either. Some very well understood systems are incredibly complex (look at the computer you are using now). What is true is that like all other humans, scientists make mistakes. We often make the incorrect causal links or are influenced by our biases. This is why experiments exist (instead of pure data collection); to make sure the causes we have assumed are correct. To point to a couple of experiments with an unexpected result and then say that all of science has failed isn't even a little bit right.
Agree that the author's extrapolations of the problems of medicine to science are cringe-worthy. The focus on medicine though makes me think it was just a bad editorial decision for the headline.
That said, I think he is correct in his critique of medicine/pharma. The cost of drug development has gone astronomically high these past decades, with billion dollar pipelines to account for the cost of failure.
The pharma drug development model has not really evolved beyond a lottery system of testing random compounds to treat diseases, and going back/forth until the right permutation of a compound is found. This might have worked before for initial "easy" diseases (that had easy drug targets, or single gene mutations), but the problems we face now (Alzheimers, Cancer) are too complex for our lottery-based drug development system.
I would disagree that the pharma drug development model hasn't evolved. There are many recent advances that have helped improve drug development (human cells used in pre-clinical screening, more advanced clinical trial design, etc).
What I think has really changed is the cost of failure. The best example I can think of is the discovery of benzodiazepines (the drug class that includes Valium). The first benzodiazepine (chlordiazepoxide, Librium) was discovered in 1957 (we're talking, the FIRST set of pre-clinical tests) and it was on the market in 1960. 3 years from the first tests to market.
Nowadays, you'd be lucky to get to market in 15 years. A great example is Qutenza. The product is nothing more than a patch that contains a very high level of capsaicin (the stuff that makes peppers hot). When you apply it to the skin, it can reduce the pain that sticks around after an attack of shingles. I can't think of a product with fewer safety issues, yet it took 10 YEARS for the company to get FDA approval.
This is due to a combination of increased FDA scrutiny around safety along with a high standard for efficacy (i.e. we don't care if your drug reduces cholesterol, we want you to prove it reduces heart attacks). So in the past, when a smaller, shorter trial was sufficient for FDA approval, you could take a promising drug all the way to the FDA without a lot of expense. Not so anymore.
Comments
This article misses the mark completely, both by extrapolating medicine to science as a whole, and by attacking the idea of causation rather than the sketchy practices of medicine.
All of the examples are pulled from medicine, notorious for its lack of experimental rigor. To say that "Science has failed us" implies that either medicine is the the only important science or that all science is equally as sloppy, which is pretty insulting to a scientist in any harder field.
His focus on causation is even more misguided. The very purpose of science is to understand the way the world works; to understand what causes what. To attack the idea of causation is to attack the very idea of science, and in turn all of the advances it's brought about over the past 300 years. Beyond that, we implicitly accept causation in almost every aspect of our lives (Pressing the space bar causes a space to appear, etc). Certainly causes can't be 'seen' like facts, but to suggest that this trivializes them, or somehow makes them less useful is nonsense (and, for what it's worth, is total misreading of Hume).
Complexity isn't a valid reason either. Some very well understood systems are incredibly complex (look at the computer you are using now). What is true is that like all other humans, scientists make mistakes. We often make the incorrect causal links or are influenced by our biases. This is why experiments exist (instead of pure data collection); to make sure the causes we have assumed are correct. To point to a couple of experiments with an unexpected result and then say that all of science has failed isn't even a little bit right.
Agree that the author's extrapolations of the problems of medicine to science are cringe-worthy. The focus on medicine though makes me think it was just a bad editorial decision for the headline.
That said, I think he is correct in his critique of medicine/pharma. The cost of drug development has gone astronomically high these past decades, with billion dollar pipelines to account for the cost of failure.
The pharma drug development model has not really evolved beyond a lottery system of testing random compounds to treat diseases, and going back/forth until the right permutation of a compound is found. This might have worked before for initial "easy" diseases (that had easy drug targets, or single gene mutations), but the problems we face now (Alzheimers, Cancer) are too complex for our lottery-based drug development system.
I would disagree that the pharma drug development model hasn't evolved. There are many recent advances that have helped improve drug development (human cells used in pre-clinical screening, more advanced clinical trial design, etc).
What I think has really changed is the cost of failure. The best example I can think of is the discovery of benzodiazepines (the drug class that includes Valium). The first benzodiazepine (chlordiazepoxide, Librium) was discovered in 1957 (we're talking, the FIRST set of pre-clinical tests) and it was on the market in 1960. 3 years from the first tests to market.
Nowadays, you'd be lucky to get to market in 15 years. A great example is Qutenza. The product is nothing more than a patch that contains a very high level of capsaicin (the stuff that makes peppers hot). When you apply it to the skin, it can reduce the pain that sticks around after an attack of shingles. I can't think of a product with fewer safety issues, yet it took 10 YEARS for the company to get FDA approval.
This is due to a combination of increased FDA scrutiny around safety along with a high standard for efficacy (i.e. we don't care if your drug reduces cholesterol, we want you to prove it reduces heart attacks). So in the past, when a smaller, shorter trial was sufficient for FDA approval, you could take a promising drug all the way to the FDA without a lot of expense. Not so anymore.
I would have to disagree that medical research lacks experimental rigor.
If you were to say that medical research _accepts_ a lack of experimental rigor (simply because there is no other option), I would agree with you.