23 Comments
User's avatar
Epaminondas's avatar

What a loss for the country that Vinay was let go from the FDA. One of the few people in science that I trust to put principles over politics. Unfortunately, that's precisely why he'll likely never work in government again.

reality speaks's avatar

The vast majority of its wasted.

John Mann's avatar

Or perhaps even all of it?

David Masiak's avatar

Like having to fill time in a 24/7 news cycle on cable news, the plethora of medical journals provide more than ample space for nonsense to be published. I used to lament the difficulty in trying to keep up, but when I review the Table of Contents, I find few articles worth the effort. How editors let this much slop get published is an embarrassment.

Andrea Popovich's avatar

Dr. Prasad, you give me hope for humanity! 🫶🫶🫶🫶🫶

Raj Batra's avatar

Perhaps this is precisely where a council of laypeople can accept, modify, or reject the RCT.

If RCTs are the bread and butter for advancing clinical science and interventions, and the primary reason for the very existence of a research infrastructure that includes CTSAs, then having an impartial representation from the public these very expensive studies are meant to serve seems to be warranted.

CAVHMR's avatar

If your funding depends on a certain outcome, I don’t need a randomized controlled study to guess what outcome you conclude.

Brett Forge's avatar

Great article Vinay. Then there's the studies that do get publish and are then ignored. Like the 7 randomised trials in patients with demonstrable ischaemia and coronary disease. These trials all showed that stunting these patients does not reduce myocardial infarction or death when compared with optimal medical treatment. This solid evidence base should prevent a large percentage of stents performed but it is ignored. They often do publish these trials but they are ignored if it affects the income of the relevant medical specialists.

Brett Forge's avatar

Forgot to review! Stenting (not stunting)

Nikita Yakubovich's avatar

There's no question that in an environment like this fraudulent and UNreproducible results will run rampant.

Eric F. ONeill's avatar

I’m convinced that 90+% of the articles in medical journals are blithering nonsense. Same with most presentations at conferences.

Paula Amato's avatar

How are we supposed to address racial/gender/sexual minority disparities if we don't measure them and prove they exist?

Ollie's avatar

Easy peasy: All of it.

B Nuckols's avatar

Classic - dangerous - biased editorialism from the NEJM "She reported that her obstetrician advised her, “If you labor on the plane, leave the placenta inside of you."

Still available online 08/30/26 https://www.nejm.org/doi/full/10.1056/NEJMp2207423

Anthony Michael Perry's avatar

Why is it anyway that our federal government is the major source of medical research funding? That’s not supposed to be one of its designated functions!

George Hanson's avatar

God, I do love your takes so much. Every time I read a NYT piece on some medical study, I think of you.