Biomedicine Crisis Looming

Why is it, do you suppose, that for all the billions and billions spent on research that is directly or indirectly supposed to cure cancer, we so little in the way of cures? Skeptical scientists have long been saying that throwing more money at the problem won't solve it, because there is only so much good research to be done and only so many people qualified to do it. Now these voices are getting louder:

The deeper problem is that much of cancer research in the lab—maybe even most of it—simply can’t be trusted. The data are corrupt. The findings are unstable. The science doesn’t work.

In other words, we face a replication crisis in the field of biomedicine, not unlike the one we’ve seen in psychology but with far more dire implications. Sloppy data analysis, contaminated lab materials, and poor experimental design all contribute to the problem. Last summer, Leonard P. Freedman, a scientist who worked for years in both academia and big pharma, published a paper with two colleagues on “the economics of reproducibility in preclinical research.” After reviewing the estimated prevalence of each of these flaws and fault-lines in biomedical literature, Freedman and his co-authors guessed that fully half of all results rest on shaky ground, and might not be replicable in other labs. These cancer studies don’t merely fail to find a cure; they might not offer any useful data whatsoever. Given current U.S. spending habits, the resulting waste amounts to more than $28 billion.

The underlying problems are well understood: the need to spend huge amounts of time and effort competing for and then administering grants; the refusal of journals to publish negative findings; the huge pressure to get publishable findings quickly, so as to secure one's job and win more grants; the career-ruining consequences of not finding something publishable, which leads people to massage their results until something publishable pops out; the great danger of trying something really novel and risky, since if you fail your career may be over. Because these problems are so well known, various actors have tried to somehow short out the grant-investigation-publication-more grants circuit. This is the idea behind Obama and Biden's "cancer moonshot" and billionaire Sean Parker's $250 million pledge for immune system research, that by acting outside the flawed system they can achieve dramatic results.

But the system doesn't exist for no reason; it exists because it is the best one people have come up with. The only serious proposal I have heard to get away from it is to give out grants randomly, and somehow reformers never find that appealing. Once you start saying that the money will only go to the most promising radical ideas, you are back in the trap of review boards who want to see publication records etc. Plus, why would anyone expect that $250 million will revolutionize a field that by the count above is already wasting billions every year?

One problem that nobody wants to talk about is that with so much money is being spent on biomedical research all over the world, researchers simply can't keep up. Huge amounts of time and money are being spent solving problems that someone else has already solved, or going down the same blind alleys others have thoroughly explored. The more money you spend, the more likely it is that the solution you want has already been found but nobody knows it, or that the solution would involve putting together two pieces of work done by labs on opposite sides of the world.

I don't know what else to do, really. I continue to hope that since our biomedical knowledge really does seem to be growing, we will eventually arrive at real understanding of how our bodies work and fail to work. And maybe an error rate of 40% or even 50% is just what you have to expect when you undertake such a massive and open-ended endeavor. But I have grown very skeptical of calls for more and more and more money from the backers of scientific research; the system is failing in fundamental ways, and right now it seems to me that feeding the system with more resources is as likely to make things worse as better.