Clinical Tests Are Based on Artificial Reality and Yield Suboptimal Results

Clinical medical tests are developed in an artificial reality and can’t be effectively applied in the clinical setting, says Morten Sodemann. That’s why he’s encouraging doctors to swallow their pride and start researching alongside social- and human science professionals.

Between 2003 and 2017, 396 of the 3.000 drugs that had passed FDA approval were withdrawn. This is the conclusion of a 2019 meta-study on the randomized clinical trials featured in 3 leading medical journals.

Their conclusion isn’t just that the clinical studies are being conducted in a poor fashion. According to Morten Sodemann, a clinical professor of infectious diseases at the University of Southern Denmark, the entire approach to clinical tests – from inception to implementation in the hospital setting – is faulty:

“What’s being tested is an artificial reality. Researchers are testing healthy young men in their prime – not pregnant women, the elderly, children, or people with multiple diseases or mental illnesses. Real patients are being left out of the studies, and this has created an artificial reality, one where the results are measurable in a lab but not applicable to the real world.”

 

We know how hard it is to move the ­behaviour of obese and ­smokers, and the study shows, that it might be because of something else than we thought
Morten Sodemann

While this approach to clinical testing makes it easier for authorities and white-collar workers to justify the economics of their choices, most of the research doesn’t make a difference to patients, according to Morten Sodemann:

“As long as we’re focusing on how the study benefits the scientist’s credentials, we won’t get studies which are really changing things. Patients won’t feel a difference between 2 pills that can only be measured in a lab.”

And this isn’t just an isolated issue bearing on the drugs that are being withdrawn from the market after their clinical tests. It is a symptom of what’s going on in health research generally.

Advancing the field requires swallowing pride

Clinical scientists tend to operate as though they are best positioned to know what patients need, often without meaningfully engaging them. This makes it difficult, if not impossible, to apply the solutions in practice. For Sodemann, the solution is to cross the medical professions with other professionals from human- and social sciences:

“Doctors hate to collaborate with other professionals, and so do anthropologists, but maybe we should meet in the middle and explore the interdisciplinarity of our respective fields. It sometimes pays off, but we have to swallow our pride to do this – and that might be the hardest part.”

After all, doctors have a craftsman-like approach to their research and practice. Generally speaking, if an answer or a result doesn’t fit the predefined box – or questionnaire – it is challenging to navigate. On the other hand, intersectional collaborations can help them to negotiate and balance several truths at once.

Data is a valuable resource – but not on its own

Adding human- and social sciences into this equation will not resolve the problem on its own. Data must be used in the right way, combined with proper clinical testing and new discoveries from the research. On that note, Sodemann highlights a study that combined the big data from Facebook networks and social science skills with data from the Danish healthcare system and knowledge about health behaviour from medical scientists:

“The results show that obese people have obese friends, and even their friends-friends weigh more than the average person. The same goes for smokers. This indicates that lifestyle diseases spread in a different way than we thought: through networks.”

In other words, both productive and counterproductive traits are spread in social networks, and this could alter our understanding of how to fight lifestyle diseases. This would have been hard to recognize without professionals pooling their knowledge from different fields. Moreover, it may inspire researchers to work constructively instead of continuing to “knock people in the head with the obvious health advice that they shouldn’t overeat and smoke,” Sodemann explains.

Optimistically, he points out that research funds play a pivotal role in defining agendas and areas of inquiry, and he sees a change from funding basic research deep under­ground to something that can actually be applied to the real world.