There's research and then there's research.
Yes, all approved medicines are the result of medical research. But approving medicines isn't the entirety of medical research.
I'm sure you've heard of the adage: egos are large when the stakes are low. This is related to that. The push to "get published" is so great that if you know that your research has no practical effect or that it won't affect anyone, you can kind of make up whatever results you want. As long as it publishes. The goal isn't to find the truth or to answer a question, the goal is to get a byline in a paper. And you get more and better bylines by discovering something radical and novel rather than by saying "Nope, doesn't work, just like expected".
On the flip side, when the results really matter, you'll find people do proper due diligence. Especially when your results will be essentially confirmed practically by billions of people on the planet. When the stakes are high, we wind up being way more cautious.
Of course, I hear your meta-concern. Because, yes, people will use this paper to pull the "Science is a lying bitch"* card. But it is also an issue that must be dealt with or at the very least acknowledged. As the article itself notes, someone did notice it in the 80s, but due to very concern of casting doubt on medical research, they kind of just hoped it wouldn't be an issue. And now the issue is too great to deal with simply.
In the end, medical, and really all scientific, research cannot be "hit driven". Failure must be an option. And if this month's issue of The BMJ is a bit "boring" or "thin", then so be it. The focus must be more on finding the correct answer rather than the flashier answer. Even when the stakes are small.
*Science is a lying bitch: From the It's Always Sunny in Philadelphia episode "Reynolds vs. Reynolds: The Cereal Defense". One of the characters uses the fact that certain noted scientists had incomplete ideas about certain scientific phenomenon or weren't completely right on every subject as proof that science itself was flawed and couldn't be trusted on the subject of evolution and therefore one should believe the biblical account of creation because the bible hasn't been changed since it was written.
Believing in science means believing in falsification and sceptism. This was published during the ongoing replication crisis in medicine where we're finding that more than half of cancer studies don't replicate [1]. This replication crisis hasn't been put on hold and all science is now deemed irrefutable or you are VACCINE HESISTANT and DANGEROUS.
I'm mostly confident in the COVID vaccines because we're at billions of doses and there is so much uncorrelated data about the vaccines, and they're so controversial and their safety/efficacy is being looked at by so many people that one can be relatively confident about their efficacy and safety (so long as you look at uncensored information to avoid systemic bias). We don't need to be science denialists and start denouncing scepticism on safety grounds, we can point out there are special reasons to be confident in the vaccines.
[1] https://www.npr.org/sections/health-shots/2017/01/18/5103048...
I'm mostly confident in the COVID vaccines <- Is this "mostly" qualifier not the dangerous front end of misinformation and vaccine hesitancy?
I say "mostly confident" because we have literally zero data of effects after 3 years and can only make inferences, and it's foolish to feign knowledge you do not have to avoid being called "hesitant", but my lack of confidence does not make me hesitate to recommend the vaccine. I also lack knowledge of long term effects of COVID itself which may in fact be worse than the long term effects of any vaccine given COVID does most of what the vaccines do plus extra nasty stuff.
Which vaccines were in "both vaccines?" An mRNA and J&J, or just both administrations of a two-shot mRNA vaccine?
(Not OP but) Yes. Reasoning despite uncertainty is entirely possible; if you want a mathematical formalism, look into Bayesian statistics.
Are you doing this on purpose?
You seem to be concerned that I don't maintain a state of complete agnosticism in any matter which I lack data for, but it's really hard to do so in practice in a world of distinct choices. Most everybody will either get vaccinated or not get vaccinated and at least have made an implicit prediction about the future. Since I was pressured into making that choice it seems hardly surprising that I'm willing to opine on this issue where I lack data.
I do not understand. HN forum are places where "question everything" should be the norm, especially about science, and more especially about health when so much money is at stake.
It seems we are in a religious quest, with virtue signaling signs everywhere, to laudate the vaccine COVID-19 miracle. Everything is "magic". Somehow one could make a parallel with the state of the economy and the stock market. We are printing our way to prosperity as we are saving the world with "methode Coué" and of course brutal coercition (mandatory vaccination at state level).
What part of "you can not buy time" don't you understand ?
You may throw billions, no, trillions, quadrillons, bazillions to all the Silicon Valleys startups and brains to developp a vaccine in a matter of months ; but you can not buy a 3, 5, 10 years study with this money. You can't even buy one month or one second, you just have to wait, this is life and bio-trans-human thinking still can't and never will overcome nature, space and time.
So you might be "mostly" confident about the vaccine, I would say that this is the absolute maximum optimism best case scenario adjective you can use. Moderna, Pfizer sure are, "risk big, win big".
But we'll have to wait a few years more to completely assert something like "safe and effective" for the COVID vaccines, that is not a fact anybody can deny.
And the "dangers of misinformation" have been high for a long time now (perhaps since antiquity). Modern climate change denial has its roots in the 90s, and modern vaccine skepticism is similarly old.
How do you know your medical provider agrees with you about what is "blatantly fraudulent?"
One way is to assume that all health research is fraudulent, unless proven otherwise through replication by multiple unrelated parties.
It's like someone writes an article about drought in the west, and you're saying that they must really be talking about El Centro, California. Yes, it probably includes El Centro, but it's also talking about Phoenix, and LA, and Salt Lake City, because it's really talking about the west as a whole. Trying to make it be "about" El Centro is missing the point.
Take your straw elsewhere.
> Is this some vaccine hesitancy in disguise from BMJ?
Why, in an article that's about all of medicine, do you ask about BMJ's stance on vaccines? Why not ask about their stance on chemotherapy? Why single out vaccines? And, in the current climate, are you talking about all vaccines, or are you really talking about vaccines for one particular disease?
That question you asked is your innuendo, not my strawman. Maybe you should take that somewhere else.
Maybe it has nothing to do with vaccines but rather maintaining the BMJ brand ahead of some new fraud they know will come to light, or a warning to researchers who might publish elsewhere. Why publish and why publish now?
0. https://abcnews.go.com/Politics/president-biden-facebook-soc...
Also I haven't seen anyone bring up the perverse incentive of capitalism in this thread. Like.. let's just pretend this is moral failing rather than the literal race to the bottom of capitalism.
0. https://en.wikipedia.org/wiki/Whaling_in_the_Soviet_Union_an...
1. https://en.wikipedia.org/wiki/Instrumental_convergence#Paper...
Stephen Lock, my predecessor as editor of The BMJ, became worried about research fraud in the 1980s, but people thought his concerns eccentric. Research authorities insisted that fraud was rare, didn’t matter because science was self-correcting, and that no patients had suffered because of scientific fraud. All those reasons for not taking research fraud seriously have proved to be false, and, 40 years on from Lock’s concerns, we are realising that the problem is huge, the system encourages fraud, and we have no adequate way to respond.