Research Fraud

Research fraud:

The other day one of my grad students asked e a question-“how do you know the data the put up in research study (journal article) is true”. Even though the answer for the question can be simple from- I don’t know, to  complex “well the researchers will have academic integrity” and so on.   That got me thinking- can i answer the question of do i believe the data- in the Indian context. So, I just thought -well let’s just think about it. 

I went and looked into some research studies published in some journals from India (especially PT journals). I have some knowledge on how Phd is done in our country. I have been also privy to some raw data also collected by people who are doing Phd or finished it.  From these i can honestly say many of these data look very iffy and some downright fradulent.

Why- well many of them send their PG dissertation and it takes few days to publish in some of the Indian journal especially in PT or rehabilitation.  Again, you may ask what is wrong with it. Well most of PG dissertation is just cooked up data sitting in the loo or while watching cricket match. 

We all knew for long time PG data many a time was cooked up. We all just sat there and watched as PTs started cooking data and plagiarising the content. We all thought well this is victim less crime- no one is hurt and the guy wants to finish the course.

However, this all changed with many of us got into the rat race of publishing. People started sending their dissertation, data which they dreamed up to some journal which wanted content desperately.  PTs doing PhD – well most of them just write some numbers and they also publish it.

 The mafia of cooked data (the drug peddler if you think them as cooking meth) and the journal (the police who have to control the peddlers) became strong. Along come databases like CINAHL, PEDro etc which started to index these journals with it came, the victim in the crime.

As more and more people started to look into all the published data either as part of EBM practice or doing a systematic review, these data (cooked or uncooked) became vital.  What happens if i want to look into say- Burnstromm  or electrotherapy for pain- most of the data which is published in these journals give a positive result (sometimes huge) unlike the other published data.  Akin to saying crows in my town are white unlike other crows which are black.  This skews the answer or for people who do SR.  Which by the, way ruins the whole idea of science of medicine and EBM. We may also be coming to the wrong conclusion, a useless treatment like Brunstrom for stroke as useful.

PTs in India must develop – research and academic integrity and stop the crime we may perpetrate in making medicine unscientific.   The editors of the journals should be more vigilant, tougher peer review moreover; the PTs who know he/she was fraudulent in his/ her data collection should never publish it.

Facts are meaningless. You could use facts to prove anything that's even remotely true! --Homer Simpson

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Random thoughts

Random thoughts 

The natural question I get when I turn back – is physiotherapy evolving in India?  When I went to college the treatment was simple, do your exercise – no fancy names (but of course the exercise where not adequate), and over emphasis on equipments.  Neuro-rehabilitation, was more advanced in the 90s at least were I went to college. Even though there was undue importance to passive movements. The treatment was always active, “Hands off” when making them walk and stand, train upper limb activity. We even have community walking as many of my classmates could agree. No nonsense key point, no synergistic movement nonsense. Back pain surprisingly my friend a EBP in LBP would have been proud, - consisted of exercise, and (over emphasis on) SWD (which come to think about has as good an evidence as any other up to date fancy named therapies like- SMT, MET and what other crap workshop you attended last week.

But sadly all went south as more and more crap crept into our thinking. Many PTs seem to think yes- we are learning manual therapy –written by every idiot and intelligent people. The Idiots I mean are the osteopaths and chiropractors and well some PTs. NDT, PNF, this exercise that exercise, eccelctive approach- that horrible quotation- “these are my tools in my tool box” , 1001 special test (hate the word makes me feel I am ordering dosai in the mess I ate when I went to college- I special dosai).

But sadly, zero importance is given to physiology, motor control ideas and theory, pain theories etc.  The other day I heard a idiot- a instructor in NDT saying normal movement of gait need core muscle strength- I was about to say to him- get the hell out our country and stop making my people more dumb (we are there to help them not learn anything keep them dumb we don’t need any help from you). Well he is an expert in CP- good save the children of India from NDT trained idiots.  

Let’s get back to basics- I mean emphasis- on educating the patient, active treatment, hand off the patient and understanding the disease and patient rather than some point or techniques.  

It's all over, people! We don't have a prayer! -Reverend Lovejoy  from The Simpons

The intelligent therapist guide to being intelligent

The intelligent therapist guide to be intelligent

In the ever increasing list of workshop starting from pure crap like chiropractic, osteopathy and dry needling (acupuncture masquerading as new age Babel)  and modern pseudo-science like NDT, SI, MET etc. how to can a intelligent therapist keep his sanity?

These are the check list the “The Indian Centre for Evidence Based Neuro-Rehabilitation” ICEBNR people have come up with before and during the workshop you need to look for:

1.       Read the brochure – if the “expert is certified in the technique” other than a university well just avoid it- probably a waste of reading beyond it. Universities are leaning centers (even some of it is useless) and centers which certifies you are well you can fill in the blanks

2.       Alternate in treating, holistic are all catch phrase of modern  pseudoscience science- be careful

3.       Become a expert – after doing the course- well if you see the expert who claims that- kick him – no one can become a expert in anything in 2 days or 6 weeks except my cat which became a expert in shiting in 2 days

4.       "Hands on" are more than theory than kick yourself for wasting your time. Remember any monkey can learn the technique, but you can learn or teach science to a monkey

5.       See change in the same day, immediate relief- these are red flags if the expert or brochure claims this.

6.       Ask them for evidence- if they quote an article –go and read them- most of them will say the technique is not working - they have not read it so they are depending on you to not read it.  Classical example – go and read the NDTA associations page on evidence most of them will say it is not working except some half ass study they themselves did which says well we are not sure.

7.       Remember if the expert has done 25 courses in 25 countries that will not make him an expert automatically.

8.       If they claim it sure will work- and give you didactic advice be careful

9.       Red flag- if you haven’t heard of the physiology in your life- example cranio-scaral therapy- well it is a suture idiot – we know it can’t be moved. Kick him in his nuts.

10.   Don’t keep your mouth shut and come out and start complaining – start asking questions while in the course.

11.   Remember it is not rude to disagree with the resource person – it is good manners to keep the resource person and yourself honest.

12.   Well – the easiest of all things is to learn by yourself and all together not listen to any half assed expert.

Operator! Give me the number for 911! – Homer Simpson