One of the stories in the news in the UK this week was the publication of a study by Irving Kirsh from the University of Hull and various colleagues on the efficacy of anti depressant drugs, such as the well known selective serotonin uptake inhibitor, Prozac. (101371_journalpmed0050045-l.pdf) . The researchers gained access to previously unpublished studies. This led them to some interesting conclusions. Although meta-analyses of antidepressant medications report modest benefits over placebo treatment, when the unpublished trial data are included, the benefit falls below accepted criteria for clinical significance. There is a link to a file of a BBC radio podcast on the subject here. There are also some earlier studies by the same group that tell a similar story 1171.pdf
It is easy to see this as a simple example of drug companies being cynically economical with the truth. However even drug companies stand to lose out in the long run if they peddle merchandise that doesn’t do what it says on the can. A more important aspect of the study is its broader implications for the scientific publication process in general. The message is that referees should not reject a study for publication merely on the grounds that “significant” results were not produced. Observational studies in ecology are particularly difficult and statistical significance testing is often quite inappropriate and misleading. I will return to this theme in more detail. Meanwhile here is a link to the web site of the Journal of Negative Results Ecology and Evolutionary Biology.
Another, slightly more subtle lesson to be drawn from this study concerns the general importance of data sharing and data pooling. Real insight into how a process works in an applied context often needs a lot of data. In this case, once enough data had been assembled the researchers not only were able to ask the question “is there a response” but could go further and ask about the shape of the response. The question was meaningful as its answer suggested where the benefit of the drugs effects could lie. This is a critical element of statistical analysis that introductory courses on statistics often overlook. Often the most meaningful questions concern issues such as “is the inclusion of a quadratic term supported by the data” rather than a test of the null hypothesis of no effect. Such questions are often unanswerable by a single study. This is another reason why researchers and organizations that do not make raw data available hold back science.
Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, et
al. (2008 ) Initial severity and antidepressant benefits: A meta-analysis of data submitted to theFood and DrAdministration. PLoSMed 5(2): e45. doi:10.1371/journal. pmed.0050045