Sunday, November 23, 2014

Uncertain Health in an Insecure World - 11

“The Agony and the Ecstasy”

In both 15th century art and modern bio-medical research, these are inseparable.

In 1410 Florence, Donatello revealed his wooden crucifix at the church of Santa Croce to his contemporary Brunelleschi, who countered with his own creation in the Santa Maria Novella. Michelangelo saw both carvings, preferring Donatello's plowman Christ to Brunelleschi's more ethereal figure, which "was so slight that it looked as thought it had been created to be crucified".

With great art, the eye of the beholder is the crucial variable.

Whether in the film adaptation of Irving Stone’s 1961 Michelangelo biography, or in the translation of fundamental laboratory research into new treatments for patients, transformation is fraught with few successes and many failures.

True genius is rare.

Just what does the world get for its annual US$240 billion investment in science? Not much, according to Nobel Prize winners and high-impact research journal publishers. A 2009 Lancet article claimed that 85% of this investment is wasted.

Does science need a forensic audit?

In a rush to generate a "health dividend", thereby achieving profit or re-election, the private and public sector sponsors of bio-medical research pervert the slow deliberate process of discovery.

Science is a marathon, not a sprint.
Academics assume that bio-medical literature publishing is methodologically sound… innovative… reproducible. However, the 2013 Nobel Laureates in Medicine & Physiology have recently boycotted so-called “luxury journals” (i.e., Nature, Science, Cell) due process integrity issues.

That’s a troubling sign.

Like Renaissance artists competing for a wealthy patron’s eye or critical acclaim, scientists see the selective peer-review vetting process as noble… cleansing… robust…  The 2013 Nobel Laureate in Physics described himself as an “embarrassment” to his university for having so few research papers published.

Several funding fundamentals are wrong.

The average age of researchers receiving their first National Institutes of Health (NIH) operating grant is now over forty years. Only 60% of NIH-sponsored clinical research trials are published within 3 years of completion, at a cost to publish of more than US$200,000 per paper. The impact of a research paper is measured by the number of times it is cited by others - the cost of generating a citation now exceeds US$11,000!

Increasingly, academic rewards are misdirected and difficult to connect to true quality.

The very essence of top quality bio-medical research – what renders it important work – is often lost in the seeing for a lack of careful looking.

So whether you're standing in Piazza Santa Croce or in The Square, keep a critical eye!

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