People don’t want to talk’: The taboo ‘zombie’ problem in medical science

Yes. Listings of detailed research results have always been taken on trust. But trust is often betrayed these days. So the need for replication is greater than ever now. I did a lot of semi replications and my results usually did not replicate previous findings. So I think crooked results go back a long way

Medical research has a major problem: an alarmingly high number of trials are based on fake, fraudulent or misinterpreted data.

Research misconduct sleuths call them “zombie” studies. They look like real research papers but they’re rotten to the core. And when these studies go on to influence clinical guidelines, that is, how patients are treated in hospitals and doctors’ rooms, they can be dangerous.

Professor Ben Mol, head of the Evidence-based Women’s Health Care Research Group at Monash University, is a professional zombie hunter. For years, he has warned that between 20 and 30 per cent of medical trials that inform clinical guidelines aren’t trustworthy.

“I’m surprised by the limited response from people in my field on this issue,” he says. “It’s a topic people don’t want to talk about.”

The peer review process is designed to ensure the validity and quality of findings, but it’s built on the assumption that data is legitimate.

Science relies on an honour system whereby researchers trust that colleagues have actually carried out the trials they describe in papers, and that the resulting data was collected with rigorous attention to detail.

But too often, once findings are queried, researchers can’t defend their conclusions. Figures such as former BMJ editor Richard Smith and Anaesthesia editor John Carlise argue it’s time to assume all papers are flawed or fraudulent until proven otherwise. The trust has run out.

“I think we have been naive for many years on this,” Mol says. “We are the Olympic Games without any doping checks.”

Now, however, Mol has presented a compelling solution.

How bad science gets into the clinic

Untrustworthy papers may be the result of scientists misinterpreting their data or deliberately faking or plagiarising their numbers. Many of these “zombie” papers emerge from Egypt, Iran, India and China and usually crop up in lower-quality journals.

The problem gets bad when these poor-quality papers are laundered by systematic reviews or meta-analyses in prestigious journals. These studies aggregate hundreds of papers to produce gold-standard scientific evidence for whether a particular treatment works.

Often papers with dodgy data are excluded from systematic reviews. But many slip through and go on to inform clinical guidelines.

My colleague Liam Mannix has written about an example of this with the hormone progesterone. Official guidelines held that the hormone could reduce the risk of pre-term birth in women with a shortened cervix.

But those guidelines were based on a meta-analysis largely informed by a paper from Egypt that was eventually retracted due to concerns about the underlying data. When this paper was struck from the meta-analysis, the results reversed to suggest progesterone had no preventative effect.

There’s a litany of other examples where discounting dodgy data can fundamentally alter the evidence that shapes clinical guidelines. That’s why, in The Lancet’s clinical journal eClinical Medicine, Mol and his colleagues have reported a new way to weed out bad science before it makes it to the clinic.

Holding back the horde

The new tool is called the Research Integrity in Guidelines and evIDence synthesis (RIGID) framework. It mightn’t sound sexy, but it’s like a barbed-wire fence that can hold back the zombie horde.

The world-first framework lays out a series of steps researchers can take when conducting a meta analysis or writing medical guidelines to exclude dodgy data and untrustworthy findings. It involves two researchers screening articles for red flags.

“You can look at biologically implausible findings like very high success rates of treatments, very big differences between treatments, unfeasible birth weights. You can look at statistical errors,” says Mol.

“You can look at strange features in the data, only using rounded numbers, only using even numbers. There are studies where out of dozens of pairs of numbers, everything is even. That doesn’t happen by chance.”

A panel decides if a paper has a medium to high risk of being untrustworthy. If that’s the case, the RIGID reviewers put their concerns to the paper’s authors. They’re often met with stony silence. If authors cannot address the concerns or provide their raw data, the paper is scrapped from informing guidelines.

The RIGID framework has already been put to use, and the results are shocking.

In 2023, researchers applied RIGID to the International Evidence-based Guidelines for Polycystic Ovary Syndrome (PCOS), a long misunderstood and misdiagnosed syndrome that affects more than 1 in 10 women. As a much maligned condition, it was critical the guidelines were based on the best possible evidence.

In that case, RIGID discounted 45 per cent of papers used to inform the health guidelines.

That’s a shockingly high number. Those potentially untrustworthy papers might have completely skewed the guidelines.

Imagine, Mol says, if it emerged that almost half of the maintenance reports of a major airline were faked? No one would be sitting around waiting for a plane to crash. There would be swift action and the leadership of the airline sacked.

Breaking the taboo

With the publication of the RIGID guidelines in a high-impact journal and the PCOS example, Mol hopes this “taboo” subject will be talked about more in scientific circles. Many scientists are reluctant to speak up.

“It brings a lot of negative energy. It brings risk. It doesn’t bring you any positivity in terms of extra credits for your academic career like high-impact publications,” Mol says of calling out dodgy research.

But the honour system of science is broken, and it’s time to clean it up. Mol hopes many other medical researchers and journals take up the RIGID tool.

“There are many systems in society where trust is not enough. Paying tax, sports, traffic checks, speed cameras. If you don’t follow the rules there, then you’re at risk of being caught.

“That never happens in medicine or in scientific research.”

https://www.smh.com.au/national/people-don-t-want-to-talk-the-taboo-zombie-problem-in-medical-science-20240715-p5jtp8.html

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WFH could be WRECKING your health, study suggests... as experts find that 'active commuters' have a 47 per cent reduced risk of death

I thought that some of the claims below sounded a bit fishy so I looked up the underlying journal article. Its full citation is below:

Health benefits of pedestrian and cyclist commuting: evidence from the Scottish Longitudinal Study, BMJ Public Health (2024). DOI: 10.1136/bmjph-2024-001295

But it appears to have been withdrawn. It is offline. It no longer exists anwhere on the net. So there must have been something REALLY fishy about it!

Working from home really is unhealthier, it seems, as a new study reveals 'active commuters' have up to a 47 per cent reduced risk of death.

People who cycle or walk to and from work have lower risks of mental and physical ill health compared to those who don't rely on these options, a large, long-term study suggests.

Active travel is considered to be one of the easiest ways to increase the amount of daily physical activity we do, and there is mounting evidence in favour of its health benefits.

Researchers from the Glasgow Centre for Population Health analysed data from 82,000 people in Scotland aged between 16 and 74.

Participants were asked questions including which mode of travel they used for the longest part, by distance, of their journey to work.

Nearly all people who walked to work had a commuting distance of less than 5km.

Four-fifths of cyclists also travelled less than 5km, while 14 per cent travelled 5-9.9km to work.

Meanwhile, 58 per cent of inactive commuters travelled further than 5km to get to work.

Over the 18-year study period, participants' health data was also collected.

The researchers found that compared with inactive commuters who drove or took public transport to work, those who walked or cycled had lower risks of death and mental and physical ill health.

Commuting by bike was linked with a 47 per cent lower risk of death and a 10 per cent lower risk of any hospital admission.

It was also associated with a 30 per cent lower risk of being prescribed a drug to treat cardiovascular disease, a 51 per cent lower risk of dying from cancer, and a 20 per cent lower risk of being prescribed drugs for mental health problems.

Meanwhile, walking to work was linked with an 11 per cent lower risk of hospital admission for any cause, a 10 per cent lower risk of being prescribed drugs to treat cardiovascular disease and a 7 per cent lower risk of being prescribed drugs for mental health issues.

The authors said active commuting has clear health benefits and can be an effective way to accommodate physical activity into everyday working life.

While the study did not directly compare the health of those working from home and active commuters, previous research has shown that working from home is linked with more sedentary behaviour and less physical activity.

Writing in the journal BMJ Public Health the researchers said: 'This study strengthens the evidence that active commuting has population-level health benefits and can contribute to reduced morbidity and mortality.

'That cyclist and pedestrian commuting is associated with lower risks of being prescribed medication for poor mental health is an important finding.

'This study has wider global relevance to efforts to reduce carbon emissions and to shift to more active and sustainable travel modes.'

While the study did not determine the ideal commuting distance, the researchers pointed out that national guidelines suggests adults should spend 30 minutes a day being moderately physically active.

Cycling and walking briskly would both count. Therefore, someone cycling at 14km/h would reach this with a 3.5km return journey to work.

Meanwhile, a pedestrian walking at 4.8km/h would achieve this guideline level after 2.4km.

https://www.dailymail.co.uk/health/article-13640327/WFH-health-commuters-death.html

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Alarming death-rate of restaurants

Sorry to hear of shutdowns by Denny's. I particularly liked them last time I was in the States: Good food at moderate prices

Since the start of 2024, numerous well-known restaurant chains have announced sizable closures and incrementally more drastic restructuring efforts. TGI Fridays has closed numerous locations across the US and sold eight corporate-owned locations to strengthen its franchise model and close underperforming stores. Denny’s shut down 57 restaurants in 2023 and announced additional closures for 2024 due to inflationary pressures. Boston Market drastically reduced its number of restaurants from around 300 to just 27 by March 2024, driven by landlord evictions, unpaid bills, and state shutdowns due to unpaid sales taxes. Mod Pizza abruptly closed 27 locations across the US, including five in California, just before the new minimum wage law took effect.

Also, suddenly, Coco’s Bakery and Carrows chains closed 75 locations, leading to a federal lawsuit by former employees due to the lack of notice provided for the layoffs. PDQ, a regional restaurant chain, closed eight restaurants across North and South Carolina in February 2024 due to market conditions. Outback Steakhouse’s parent company, Bloomin’ Brands, announced the shuttering of 41 locations of Outback Steakhouse, Carrabba’s Italian Grill and Bonefish Grill in February 2024 as part of a major financial restructuring. Subway has been undergoing a massive drawdown, closing over 400 underperforming locations since last year alone. Applebee’s has been selectively closing locations since the start of 2024, focusing on optimizing its restaurant portfolio by shutting down low-revenue stores.

In 2024, Buffalo Wild Wing will eliminate sixty locations in the United States. IHOP (International House of Pancakes) will wind down 100 locations. Other firms that are eliminating locations include Pizza Hut, Red Lobster, Hooters, and Chili’s. A handful of others may close down entirely.

COVID lockdowns significantly weakened chain restaurants by drastically reducing their customer base and revenue streams. This disruption made it difficult for many restaurants to sustain operations, some of which took on more debt in the face of depleted financial reserves. At the start of 2024, FSR (Full Service Restaurant) Magazine summarized:

Another after-shock of COVID was the debt pile. Going back to August 2020, the James Beard Foundation released survey data that suggested only 66 percent of independent bars and restaurants expected to survive the fall season without direct aid. Frothing to the top of this fear was the fact that close to 75 percent reported taking on new debt obligations north of $50,000. Moreso, 12 percent tagged the number at $500,000 and above. Growing debt, and the deterioration in operating performance required to service it, forced heightened levels of investor and debt-holder concern and oversight[.] … This increased debt between 2019 and the last 12 months 2020 by 8.1 percent for limited-service units and 15.7 percent for full-serves. The former, by the fall, sat at more than four times as much debt, while full service was at nearly 50 percent more than 2008 levels … [In] the current environment … 68 percent of full-service restaurants reported carrying some amount of debt. On average, it was $51,863.20—a number that could creep up as interest rates continue to rise.

FSR continues:

“If debt is a piece of the profit puzzle, food costs are another. In fact, they appear to be an even bigger, more widespread concern … than the year before. This year, 58 percent of operators in the survey said rising inventory costs was their No. 1 source of financial strain, up from 54 percent in 2022.”

The total and annual percentage changes in the index prices of six key ingredients of restaurant and diner menu items from 2010 to 2020 and then from 2021 to the present are shown below; in most cases, over the last three years, prices have risen at multiples of their annual increases over the prior decade.

Those higher prices have translated into falling foot traffic. As costs of living have risen and pandemic savings have dissipated, eating outside the home has become more costly. Where meals continue to be purchased, order sizes are falling, or cheaper items are purchased. A small handful of massive firms with tremendous economies of scale are experimenting with lower priced options, but most eateries have cost structures that preclude similarly priced offerings. In fact, some franchisees of those huge restaurant chains are claiming that the depth of those discounts is financially untenable for them.

Recent data highlights a decline in restaurant visits, with several factors contributing to this trend. A report from Bar and Restaurant points out that many top revenue-generating restaurants experienced significant year-over-year declines in customer traffic in late 2023 and early 2024, with a further pronounced drop in January 2024. This decline is attributed to consumers curtailing their restaurant expenditures and opting for more cost-effective alternatives, such as cooking more meals at home due to high menu prices driven by inflation and wage increases. (This is also behind recently emerging controversies over tipping quantities and imperatives.)

Similarly, Produce Blue Book reports that same-store sales growth for restaurants was negative in February 2024, marking the worst-performing month since February 2021. Despite a slight improvement in sales growth compared to January, the data suggests that consumers are pulling back on restaurant visits and spending due to financial pressures such as growing credit card balances, high interest rates, and inflation. The expected slowdown in restaurant sales is attributed to these economic factors, which are leading consumers to moderate their restaurant consumption. Additionally, QSR Magazine notes that US traffic for limited-service chains fell by 3.5 percent year-over-year in the first quarter of 2024, further illustrating the challenges faced by the restaurant industry in attracting customers.

More recently, atop the compounded challenges of inflation and falling consumer demand are substantial jumps in state minimum wages. Since the start of 2024, more than half of all US states have, or planned to, to raise minimum wages:

California’s minimum wage, which rose to $16.00 on January 1st, increased again on April 1st, after which all fast food restaurant employees covered by the new law must be paid at least $20.00 per hour.

On July 1, Nevada and Oregon raised their minimum wages to $12 per hour while Washington, DC, increased theirs from $17 to $17.50 per hour for non-tipped workers and from $8 to $10 per hour for tipped workers. Florida’s minimum wage will rise to $13 per hour on September 30.

For traditional restaurants, profit margins are generally low, typically ranging between 3 to 5 percent, while in the fast food industry, profit margins are comparatively higher, generally lying between 5 and 8 percent. Estimating the impact of a minimum wage increase on the profitability of these establishments requires a nuanced understanding of their current profit margins and cost structures. Given these average profit margins, labor costs are a major expense, significantly affecting profitability. Any increase in the minimum wage substantially raises costs, squeezing the already narrow profit margins. For traditional restaurants with lower margins, even a small increase in labor costs could result in operations becoming unprofitable if prices aren’t adjusted accordingly or if cost-saving measures aren’t effectively implemented. Even before the substantial rise in wages and the slowing disinflation of the first quarter of 2024, food service industry strains were mounting.

According to the National Restaurant Association (NRA) Restaurant Business Conditions Survey, nearly all full-service restaurant owners—92 percent—consider rising food costs a significant challenge. Increased labor costs are not far behind at 90 percent, and 67 percent percent say utilities present a significant challenge. But they’re also spending more on the same things you’re spending more on—dishwasher detergent, hand soap, paper products, linens, laundry services, plates, silverware, and on and on.

A little over two and a half years ago, I wrote about the breakdown of the NYC Pizza Principle as prices began to rise. Restaurants nationwide are now grappling with a financial maelstrom, including rising prices, higher minimum wages, falling sales, and, in many cases, higher debt costs. The health of the industry is summed up by comparing the stability of the National Restaurant Association Performance Index from 2010 through the pandemic with its trajectory since 2021, as the general price level hit four—decade highs and remains elevated to this day.

The cumulative impact of these pressures is straining the industry from single-location establishments to nationwide and international chains. If accelerating US unemployment registers the impact of contractionary monetary policy measures on the broader economy, the current difficulties faced by the restaurant sector are likely to escalate. And insofar as those economic conditions persist, all but the stoutest and most well-capitalized food service industry interests may find it increasingly challenging to serve customers, the impact of which will be felt by employees, investors, and peripheral businesses alike.

https://blog.independent.org/2024/07/12/the-end-of-restaurants-as-we-know-them/

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DEI at work



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All my main blogs below:

http://jonjayray.com/covidwatch.html (COVID WATCH)

http://dissectleft.blogspot.com (DISSECTING LEFTISM)

http://edwatch.blogspot.com (EDUCATION WATCH)

http://antigreen.blogspot.com (GREENIE WATCH)

http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH)

http://australian-politics.blogspot.com (AUSTRALIAN POLITICS)

http://snorphty.blogspot.com (TONGUE-TIED)

https://immigwatch.blogspot.com (IMMIGRATION WATCH)

http://jonjayray.com/short/short.html (Subject index to my blog posts)

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