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Here at F1000 we’re big fans of John Ioannidis’s work. He continues to be a zealous (in the best sense) promoter of the basic tenets of the scientific method and the design, execution and reporting of clinical studies. His 2005 paper in PLoS Medicine is still the most viewed article on F1000 (and most viewed at PLoS Medicine). Faculty Members have so far evaluated 14 papers of which he has been an author – most recently here.

His latest published paper co-authored with Orestis Panagiotou and published in JAMA, is essential reading for clinicians, researchers and indeed any of us with an interest in science and scientific communication.

In this analysis the authors “examine whether the magnitude of the effect sizes of biomarkers proposed in highly cited studies is accurate or overestimated”; and their conclusion? “Highly cited biomarker studies often report larger effect estimates for postulated associations than are reported in subsequent meta-analyses evaluating the same associations.”

Biomarkers are often used in studies as surrogates for ‘hard’ clinical endpoints such as death (the ultimate endpoint), heart attack, etc. The rationale being that showing an effect of an intervention on the biomarker will have a corresponding effect on the associated clinical endpoint.

Not only that, many biomarkers have been hastily incorporated into clinical practice, adding to the expense of diagnosis and, in some cases, intervention (think of being prescribed a drug because an elevation in biomarker X has been linked to disease Y). I don’t think anyone would argue that the use of properly validated and extensively researched biomarkers isn’t an extraordinary advance in personalised medicine. Such tools to enable earlier diagnosis will benefit all, but practitioners and patients alike should demand proper validation.

This paper raises another issue: surely it would be better to encourage a system where all the data from a study are released for analysis rather than just the main finding in a journal. Currently results may be enshrined as doctrine because of the logistical barriers to others examining or attempting to reproduce the data.

!F1000 plug alert!

Dr Ioannidis also says in the interview on the news@JAMA site that “Clinicians should keep in touch with the literature to the extent they have time to do so”. And how better to do so than by visiting F1000 regularly. There, I’ve said it!

PS. Since writing this I have read Dr Ioannidis’s article in this month’s issue of Scientific American where he calls for the full disclosure of scientific data… and then some!