Category: Books

“Flaws in the Peer Review System”

The flaws in the scientific journal peer review system undermine the argument that the freedom of individual patients should be subordinated to the judgements of “science.” A substantial, and not only recent, literature exposes a variety of flaws of the system. A recent impactful example is the failure of major medical journals to act in a timely manner to retract many Alzheimer’s studies where fraudulent images have been documented.

This impactful example is documented in painful detail in Charles Piller’s Doctored. The impact is that approaches to Alzheimer’s besides the mainstream’s amyloid hypothesis, have been suppressed, which may have slowed alternative effective therapies against the dread disease.

(p. C4) Suspicion of science journals was supercharged during the Covid pandemic, when most of them broadly supported mandates and lockdowns. Dr. Jay Bhattacharya, now the head of the National Institutes of Health, was among the most prominent critics of such policies. He gained attention as a co-author of the 2020 Great Barrington Declaration, which advocated letting Covid spread, conferring “herd immunity” on the population, only to see his work shunned by the major science journals.

. . .

The peer review system, in which a paper must go through scrutiny from experts, is intended as a form of quality control. But critics suggest that editors tilt the process toward papers that reflect their own favored results. In a May [2025] interview at the Hoover Institution, Bhattacharya said, “Folks think that if it is published in a top peer-reviewed journal, therefore it must be true, and that’s actually inaccurate.” In reality, he argued, “If I’m lucky the journal editor will send it out to two or three peer review editors, chosen by the editor. If they’re friendly with the editor, they’ll send it to friendly peer reviewers.”

Marty Makary, now the head of the Food and Drug Administration, was another prominent critic of science and medical journals during the pandemic. He said that some journals are captured by industry and others by groupthink. At NEJM and JAMA, “it’s clear that it was a group of like-minded friends, many of whom trained together or worked in the same hospital system,” Makary said. “Why should a small group of people be the gatekeepers of which research is read by most doctors in America?”

A 2023 paper in the journal PNAS on “scientific censorship by scientists” found flaws in the peer review system. A journal editor can quietly kill a submitted paper by sending it to hostile reviewers, who amplify minor methodological issues in order to reject a paper they disapprove of. “Many criteria that influence scientific decision-making, including novelty, interest, ‘fit,’ and even quality, are often ambiguous and subjective, which enables scholars to exaggerate flaws or make unreasonable demands to justify rejection of unpalatable findings,” the PNAS study found.

Often, part of what makes a paper “unpalatable” is its perceived politics. Science journals, like academia in general, have drawn increasing criticism for progressive bias. For example, in 2022 the journal Nature Human Behavior published an editorial stating that “considerations of harm can occasionally supersede the goal of seeking or sharing new knowledge,” including research that “may—inadvertently—stigmatize individuals or human groups” or be “discriminatory, racist, sexist, ableist or homophobic.”

“If anything gets published that doesn’t reflect the expected political view, then there is a public campaign to retract the paper,” said Luana Maroja, a professor of biology at Williams College. “Many times, they are successful.”

“I’ve received an anonymous peer review that said, ‘I’m afraid of what these findings will do for the laudable progressive moral agenda,’” said Cory Clark, a behavioral scientist at the University of Pennsylvania and lead author of the PNAS paper. Many researchers, she found, don’t bother asking questions that might lead to “wrong” answers, and if they do, they often don’t try to publish because they’ll only face resistance and blowback. Clark is now doing a study of journal editors, most of whom, she said, fear getting attacked or ostracized themselves.

. . .

Donald Trump’s campaign for president in 2016 spurred some science journals to make political endorsements for the first time. Nature, a U.K.-based journal, endorsed Hillary Clinton for president. Editorials in the Lancet referred to the first Trump administration as “anti-scientific” and called the 2020 election “a fight for the health of the nation.” In a pre-election editorial in 2020, the NEJM called the Trump administration “dangerously incompetent,” writing: “We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs.”

For the full story see:

Pamela Paul. “How Scientific Journals Became MAGA’s Latest Target.” The Wall Street Journal (Sat., June 14, 2025): C1 & C4.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date June 13, 2025, and has the same title as the print version.)

The PNAS article briefly summarized in a passage quoted above is:

Clark, Cory J., Lee Jussim, Komi Frey, Sean T. Stevens, Musa al-Gharbi, Karl Aquino, J. Michael Bailey, Nicole Barbaro, Roy F. Baumeister, April Bleske-Rechek, David Buss, Stephen Ceci, Marco Del Giudice, Peter H. Ditto, Joseph P. Forgas, David C. Geary, Glenn Geher, Sarah Haider, Nathan Honeycutt, Hrishikesh Joshi, Anna I. Krylov, Elizabeth Loftus, Glenn Loury, Louise Lu, Michael Macy, Chris C. Martin, John McWhorter, Geoffrey Miller, Pamela Paresky, Steven Pinker, Wilfred Reilly, Catherine Salmon, Steve Stewart-Williams, Philip E. Tetlock, Wendy M. Williams, Anne E. Wilson, Bo M. Winegard, George Yancey, and William von Hippel. “Prosocial Motives Underlie Scientific Censorship by Scientists: A Perspective and Research Agenda.” Proceedings of the National Academy of Sciences 120, no. 48 (Nov. 20, 2023): e2301642120.

Piller’s Doctored book that I mention in my introductory comments is:

Piller, Charles. Doctored: Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer’s. New York: Atria/One Signal Publishers, 2025.

F.D.A. to Reduce Phase 3 Drug Trials from Two to One for Approval of Some Drugs

I have read and learned much from books by Marty Makary and Vinay Prasad, who are now high officials in the F.D.A.  I also have suggested that patient freedom and drug innovation would both be served if the F.D.A. cut back regulations to only regulate for drug safety and leave drug efficacy to the judgement of physicians and patients.

Makary and Prasad have now announced that the F.D.A. will only require one clinical trial to satisfy the Phase 3 stage, instead of the currently common two trials. This is a partial, not a full, step toward my suggestion, but it is a step in the right direction. A modest step is better than no step at all.

I also support their announcement of the increased use of A.I. I believe that will increase efficiency, but doubt that it will soon “radically increase efficiency,” as they claim.

(p. A1) The Food and Drug Administration is planning to use artificial intelligence to “radically increase efficiency” in deciding whether to approve new drugs and devices, one of several top priorities laid out in an article published Tuesday [June 10, 2025] in JAMA.

. . .  And officials want to speed up the final stages of making a drug or medical device approval decision to mere weeks, citing the success of Operation Warp Speed during the Covid pandemic when workers raced to curb a spiraling death count.

“The F.D.A. will be focused on delivering faster cures and meaningful treatments for patients, especially those with neglected and rare diseases, healthier food for children and common-sense approaches to rebuild the public trust,” Dr. Marty Makary, the agency commissioner, and Dr. Vinay Prasad, who leads the division that oversees vaccines and gene therapy, wrote in the JAMA article.

. . .

(p. A16) For some cases, the F.D.A. officials proposed speeding major drug approvals by requiring only one major study in patients rather than two, a practice the agency has used in recent years. The pandemic provided a precedent, they said, for accelerating the process.

“We believe this is clear demonstration that rapid or instant reviews are possible,” Drs. Makary and Prasad wrote.

. . .

Last week, the agency introduced Elsa, an artificial intelligence large-language model similar to ChatGPT. The F.D.A. said it could be used to prioritize which food or drug facilities to inspect, to describe side effects in drug safety summaries and to perform other basic product-review tasks. The F.D.A. officials wrote that A.I. held the promise to “radically increase efficiency” in examining as many as 500,000 pages submitted for approval decisions.

For the full story see:

Christina Jewett. “F.D.A. to Seek Faster Process With A.I. Help.” The New York Times (Weds., June 11, 2025): A1 & A16.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date June 10, 2025, and has the title “F.D.A. to Use A.I. in Drug Approvals to ‘Radically Increase Efficiency’.”)

The JAMA article mentioned above is:

Makary, Martin A., and Vinay Prasad. “Priorities for a New FDA.” JAMA (2025) doi: 10.1001/jama.2025.10116.

Correll Managed Georgia-Pacific Well and Then Used Those Skills to Save a Failing Hospital

In my Openness book, I make the case for the many benefits of an economic system of innovative dynamism. One of the lesser, but still important, benefits was first identified by Joseph Schumpeter. He argued for a spillover effect of innovative dynamism. The skills, knowledge, and technologies created by innovative entrepreneurs in the for-profit sector of the economy, are also applied and imitated in the nonprofit and government sectors. So where there is innovative dynamism, not only is the market more creative and efficient, but both the nonprofit and the government sectors are more creative and efficient.

A good example may be Pete Correll who acted entrepreneurially as CEO of Georgia-Pacific to bring more stability to the business by acquiring the James River Corporation, maker of Quilted Northern, and guided the Georgia-Pacific firm through years of lawsuits over asbestos. He eventually sold Georgia-Pacific to Koch Industries, Inc. My impression is that Charles Koch then applied his market-based management system to make the Georgia-Pacific part of his business much more efficient and innovative. [Query: does Koch’s achievement undermine my claim that Pete Correll had acted entrepreneurially in his earlier management of Georgia-Pacific? Or can both Correll and Koch have been good manager/entrepreneurs, but in different ways at different times?]

But according to his obituary in the WSJ, his greatest achievement may have been in taking over a near-bankrupt Atlanta public (aka government) hospital, reorganizing it from government to nonprofit, and modernizing its management and technology.

Carrell’s obituary in the WSJ:

James R. Hagerty. “CEO Helped Save A Public Hospital.” The Wall Street Journal (Sat., June 5, 2021 [sic]): A9.

(Note: the online version of the WSJ obituary has the date June 2, 2021 [sic], and has the title “Retired CEO Saved an Atlanta Public Hospital.”)

For Charles Koch’s entrepreneurial market-based management system see:

Koch, Charles G. The Science of Success: How Market-Based Management Built the World’s Largest Private Company. Hoboken, NJ: Wiley & Sons, Inc., 2007.

My book mentioned in my initial comments is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

It May Take a “Thorny Character” to Be “Willing to Challenge Entire Establishment Belief Systems”

The obituary quoted below misidentifies Richard Bernstein’s main contribution. Yes, it is noteworthy that he was probably the first diabetes sufferer to effectively and continually monitor his own blood glucose level. But his main contribution was that by careful self-monitoring and trial-and-error experimentation he discovered that his health improved when he cutback on both carbs and insulin.

The obituary writer quotes Gary Taubes, but either didn’t read his book or disagrees with it, because Taubes is clear about Bernstein’s main contribution.

I am halfway through Taubes’s book. It is long and sometimes deep in the weeds, but comes highly recommended by Marty Makary and Siddhartha Mukherjee, both of whom I highly respect. The book sadly highlights how mainstream medicine can be very slow to reform clinical practice to new knowledge.

(p. C6) Richard Bernstein was flipping through a medical trade journal in 1969 when he saw an advertisement for a device that could check blood-sugar levels in one minute with one drop of blood. It was marketed to hospitals, not consumers, but Bernstein wanted one for himself. He had been sick his entire life and was worried he was running out of time.

. . .

Since he wasn’t a doctor, the manufacturer wouldn’t even sell him a device. So, he bought one under the name of his wife, Dr. Anne Bernstein, a psychiatrist.

He experimented with different doses of insulin and the frequency of shots. He eased off carbohydrates. He checked his blood sugar constantly to see how it was reacting.

After experimenting for several years, he figured out that if he maintained a low-carb diet, he didn’t need as much insulin and could avoid many of the wild swings in his blood-sugar levels. By checking his blood sugar throughout the day, he learned how to maintain normal levels. It changed his life.

. . .

With his diabetes under control, he tried to spread the word and change the way the disease is treated. In the early years, he was dismissed by much of the medical establishment. His ideas went against accepted wisdom and he was, after all, not a doctor. In 1979, at the age of 45, he enrolled at the Albert Einstein College of Medicine, where he received his M.D.

“I never wanted to be a doctor,” he told the New York Times in 1988. “But I had to become one to gain credibility.”

Bernstein went into private practice in Mamaroneck, N.Y., where he treated diabetics and continued to advocate for his ideas—to his patients, in articles, YouTube videos, letters to the editor, and writing books, including “Dr. Bernstein’s Diabetes Solution.”

. . .

Gary Taubes, the author of “Rethinking Diabetes,” said that it was Bernstein’s work that eventually led to the Diabetes Control and Complications Trial, a landmark study that demonstrated that diabetics could blunt the destructive effects of the disease by keeping their blood-sugar levels nearer normal. Released in 1993, the results led to the kind of self-monitoring and frequent shots of insulin that remains part of the standard treatment plan for Type 1 diabetes today—part of what Bernstein had been pushing for years.

This was only partial vindication for Bernstein. The medical establishment never fully embraced Bernstein or the strict low-carb diet that he prescribed, which some considered unrealistic.

Taubes said that Bernstein was a bit of a “thorny character” who was easy for the establishment to dislike. He also noted that’s something that comes with the territory when you spend your career telling people they’re wrong and you’re right.

“But often it’s the people who are not easy to like,” Taubes said, “who are the ones who are willing to challenge entire establishment belief systems.”

For the full obituary see:

Chris Kornelis. “A Diabetic Who Pioneered Self-Monitoring for Blood Sugar.” The Wall Street Journal (Sat., May 10, 2025): C6.

(Note: the online version of the WSJ obituary has the date May 9, 2025, and has the title “Richard Bernstein, Who Pioneered Diabetics’ Self-Monitoring of Blood Sugar, Dies at 90.”)

Bernstein’s book mentioned above is:

Bernstein, Richard K., MD. Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars. New York: Little, Brown Spark, 2011.

Taubes’s book mentioned above is:

Taubes, Gary. Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments. New York: Knopf, 2024.

Gans Showed That Urban Working-Class Enclaves, and Modern Suburban Housing Developments, Can Contain Vibrant Communities

In my Openness book I argue that, especially in America and Europe, life has generally gotten better in the last couple of hundred years.

Some critics argue, to the contrary, that modern suburban housing developments are boring, conformist locations lacking a sense of community and cultural vibrancy. They then use this argument to advocate that government urban planners adopt regulatory and subsidy policies to “infill the urban core,” i.e., force suburbanites to live downtown.

Herbert J. Gans, quoted below, refuted the critics.

(p. B11) Herbert J. Gans, an eminent sociologist who studied the communities and cultural bastions of America up close and shattered popular myths about urban and suburban life, poverty, ethnic groups and the news media, died on Monday [April 21, 2025] at his home in Manhattan. He was 97.

. . .

His findings were often surprising. For his first book, “The Urban Villagers: Groups and Class in the Life of Italian-Americans” (1962), he immersed himself in the life of Boston’s working-class West End. The area was later bulldozed for “slum clearance,” and he lamented the destruction of a vibrant community. A half-century later, the book still stood as a classic statement against indiscriminate urban renewal.

Similarly, Dr. Gans challenged conventional wisdom about postwar suburbia in “The Levittowners” (1967). For more than two years, he lived in Levittown, N.J., later renamed Willingboro, and concluded that the residents had strong social, economic and political commitments, and that notions of suburbanites as conformist, anxious, bored, cultureless, insecure social climbers were wrong.

For the full obituary, see:

Robert D. McFadden. “Herbert J. Gans, 97, Who Explored American Society Up Close, Dies.” The New York Times (Thursday, April 24, 2025): B11.

(Note: ellipsis, and bracketed date, added.)

(Note: the online version of the obituary was updated April 23, 2025, and has the title “Herbert J. Gans, 97, Dies; Upended Myths of Urban and Suburban Life.”)

Gans’s books mentioned in the passages quoted above, are:

Gans, ‎Herbert J. The Levittowners: Ways of Life and Politics in a New Suburban Community. New York: Columbia University Press, 1967.

Gans, ‎Herbert J. The Urban Villagers: Groups and Class in the Life of Italian-Americans. Glencoe, IL: The Free Press of Glencoe, 1962.

My book mentioned in my initial comments is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

Plenty in Science Still “Just Doesn’t Make Any Sense”

In my Openness book, I argue against those who see a future of inevitable stagnation. One argument for inevitable stagnation says that entrepreneurs build their innovations on science and we have run out of new knowledge to learn in science.

But whenever we keep our eyes open and observe more closely, or in new areas, we see what we cannot yet explain. The passages quoted below give another example. So we still have a lot to learn in science.

(Of course I also point out in the book that much entrepreneurial innovation is not tied to current advances in science–and is done by entrepreneurs who do not know, or who do not hold in high esteem, the current conclusions of mainstream scientists.)

(p. A14) On Dec. 24 [2024], NASA’s Parker Solar Probe swooped closer than it ever had before to the sun, just a few million miles above its blazing hot surface.

The team behind the mission waited nervously, trusting that the probe would survive the encounter. Then, a few minutes shy of midnight on Thursday [Dec. 2?, 2024], Parker phoned home.

. . .

. . ., there was some fear that the probe might not survive this time. Parker’s heat shield is designed so that the front of the vehicle can withstand facing the blistering heat of the sun’s outer atmosphere, which reaches millions of degrees, while the back, which contains the probe’s sensitive instruments, sits at a comfortable 85 degrees Fahrenheit.

“Literally one side is at a temperature that is unfathomable,” Joseph Westlake, the director of heliophysics at NASA, said. “And the back of it is a hot, sunny day.”

. . .

Parker’s data will . . . help scientists understand how the sun’s outer atmosphere, known as the corona, can be hundreds of times hotter than the solar surface below it.

“It’s like if you were standing next to a bonfire and you took a couple of steps back, and all of a sudden it got hotter,” Dr. Westlake said. “It just doesn’t make any sense.”

For the full story see:

Katrina Miller. “After Silence, Solar Probe Signals Earth of Survival.” The New York Times (Sat., December 28, 2024): A14.

(Note: ellipses, bracketed year, and bracketed date, added.)

(Note: the online version of the story was updated Dec. 30, 2024, and has the title “After Days of Silence, NASA’s Parker Solar Probe Phones Home.”)

My book mentioned in my initial comments is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

Medieval English Gentry Did Not Routinely Dine on Meat

In my Openness book, I argue that the distant past was not a lost Golden Age that we should pine for.

Based on novels and TV costume dramas, we suppose the rich gentry in medieval England routinely dined on meat. But bioarcheologists have analyzed the bones of over 2,000 persons for whom social class can be inferred, based on what was buried with the bones. The conclusion was that meat was an occasional luxury for both poor and rich.

This provides one more bit of evidence that, compared with the present, the past was not a Golden Age even for the rich.

Source:

Maria Cramer. “Mutton? Kings of Yore Probably Ate More Greens.” The New York Times, First Section (Sun., May 1, 2022 [sic]): 13.

(Note: the online version of the article was updated May 2, 2022 [sic], and has the title “Anglo-Saxon Kings Made Sure to Eat Their Vegetables, Study Shows.”)

The published academic paper summarized by Maria Cramer in The New York Times is:

Leggett, Sam, and Tom Lambert. “Food and Power in Early Medieval England: A Lack of (Isotopic) Enrichment.” Anglo-Saxon England 49 (2022): 155-96.

My book mentioned in my initial comments is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

Innovative Project Entrepreneur Mike Wood Helped Children Leapfrog the Reading Skills Taught at School

In my Openness book I argue that the kind of entrepreneurs who matter most in changing the world are what I call “project entrepreneurs,” those who are on a mission to bring their project into the world. Mike Wood, discussed in the obituary quoted below was a project entrepreneur.

I sometimes wonder how much formal education would be desirable in a world, unlike our world, that lacked creeping credentialism. Samuel Smile’s biography of George Stephenson says that he had zero formal education, but early-on paid someone from his meagre wages in the mines, to teach him to read. After that, the inventor and innovative entrepreneur read prodigiously to became an exemplary autodidact.

Today, Stephenson could learn to read through phonics technology like the LeapFrog pads developed by Mike Wood.

[By the way, Mike Wood, like Danny Kahneman recently, committed suicide at Dignitis in Switzerland in anticipation of declining health, in Wood’s case Alzheimer’s. As a libertarian, I believe they had a right to do this, but were they right to exercise this right? Harvard psychology professor Daniel Gilbert cites (2006, pp. 166-168) research showing that people generally underestimate their resilience in the face of major health setbacks. They can often recalibrate to their new more limited capabilities, continuing to find challenges they find fulfilling to overcome. If so, then maybe Wood and Kahneman were wrong to exercise their right to end their lives. (More than most of my claims, I very readily admit this one could be wrong.)]

(p. A21) Mike Wood was a young father when his toddler’s struggles to read led him to develop one of a generation’s most fondly remembered toys.

Mr. Wood’s 3-year-old son, Mat, knew the alphabet but couldn’t pronounce the letter sounds. A lawyer in San Francisco, Mr. Wood had a new parent’s anxiety that if his child lagged as a reader, he would forever struggle in life.

So on his own time, Mr. Wood developed the prototype of an electronic toy that played sounds when children squeezed plastic letters. He based the idea on greeting cards that played a tune when opened.

Mr. Wood went on to found LeapFrog Enterprises, which in 1999 introduced the LeapPad, a child’s computer tablet that was a kind of talking book.

The LeapPad was a runaway hit, the best-selling toy of the 2000 holiday season, and LeapFrog became one of the fastest-growing toy companies in history.

. . .

Former colleagues recalled Mr. Wood as a demanding entrepreneur who was driven by a true belief that technology could help what he called “the LeapFrog generation” gain an educational leg up.

He had “famously fluffy hair,” Chris D’Angelo, LeapFrog’s former executive director of entertainment, wrote of Mr. Wood on The Bloom Report, a toy industry news site. “When stressed, he’d unconsciously rub his head — and the higher the hair, the higher the stakes. We (quietly) called them ‘high-hair days.’ It was funny, but also telling. He felt everything deeply — our work, our mission, our audience.”

. . .

A shift in reading pedagogy in the 1990s toward phonics — helping early readers make a connection between letters and sounds — drove interest in LeapFrog’s products among parents and teachers.

. . .

In 2023, his daughter-in-law, Emily Wood, posted a TikTok video of Mr. Wood teaching her daughter to use a forerunner of the LeapPad. The video received 391,000 likes and thousands of comments.

“I owe him my entire childhood,” one viewer wrote. “I spent hours on my LeapFrog with my ‘Scooby-Doo’ and ‘Shrek’ books.”

“I sell books now because of him,” another viewer wrote.

“I’m learning disabled and have a stutter,” wrote a third. “This man helped me learn to speak.”

“I’m 25 and I loved my LeapFrog,” a fourth commented. “Coming from an immigrant family, reading made me have so much imagination. I never stopped reading.”

For the full obituary, see:

Trip Gabriel. “Mike Wood, 72, Dies; Taught a Generation With LeapFrog Toys.” The New York Times (Monday, April 21, 2025): A21.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the obituary has the date April 19, 2025, and has the title “Mike Wood, Whose LeapFrog Toys Taught a Generation, Dies at 72.”)

My book mentioned in my initial comments is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

Smiles’s biography of Stephenson is:

Smiles, Samuel. The Locomotive: George and Robert Stephenson. New and Revised ed, Lives of the Engineers. London: John Murray, Albemarle Street, 1879.

Daniel Gilbert’s book that I mention in my opening comments is:

Gilbert, Daniel. Stumbling on Happiness. New York: Alfred A. Knopf, 2006.

Fraudulently Doctored Images and “Suspect Data” in Many Leading Cancer Research Papers

Charles Piller in his Doctored paints a damning picture of doctored images and suspect data rampant in the leading scientific literature on Alzheimer’s disease. Not only were leading scientists guilty of fraud, but the key institutions of scientific research (journals, universities, and government grant-making agencies) failing their oversight duty, and when outsiders stepped in to provide oversight, delayed and minimized their responses. Practicing and turning a blind eye to fraud matters, since Alzheimer’s patients are depending on this research. And researchers who do not commit fraud suffer because they appear to have worse research records than those compiled by the fraudsters. So the honest get worse academic appointments and fewer grants.

After reading Doctored I was depressed, but I at least hoped that this pathology was limited to this one (albeit an important one) area of medical research. But in the article quoted below, evidence is presented that there is substantial similar doctored images and suspect data in the field of cancer research.

A side issue in the quoted article is worth highlighting. In the absence of credible oversight from the institutions tasked with oversight, oversight is being done by competent volunteers, with the aid of A.I. These volunteers do not receive compensation for their work, and in fact are probably pay a price for it, since they alienate powerful scientists and scientific institutions. But if science is a search for truth, and truth matters for cures, they are doing a service to us all, and especially to those who suffer from major diseases such as Alsheimer’s and cancer.

On the connection with the Doctored book, it is worth noting that the article quotes Dr. Matthew Schrag, who is the most important source in Doctored. The article also quoted Elisabeth Bik, who does not have an MD like Schrag but has a PhD in microbiology, and who is another important source in Doctored.

(p. A1) The stomach cancer study was shot through with suspicious data. Identical constellations of cells were said to depict separate experiments on wholly different biological lineages. Photos of tumor-stricken mice, used to show that a drug reduced cancer growth, had been featured in two previous papers describing other treatments.

Problems with the study were severe enough that its publisher, after finding that the paper violated ethics guidelines, formally withdrew it within a few months of its publication in 2021. The study was then wiped from the internet, leaving behind a barren web page that said nothing about the reasons for its removal.

As it turned out, the flawed study was part of a pattern. Since 2008, two of its authors — Dr. Sam S. Yoon, chief of a cancer surgery division at Columbia University’s medical center, and a more junior cancer biologist — have collaborated with a rotating cast of researchers on a combined 26 articles that a British scientific sleuth has publicly flagged for containing suspect data. A medical journal retracted one of them this month after inquiries from The New York Times.

Memorial Sloan Kettering Cancer Center, where Dr. Yoon worked when much of the research was done, is now investigating the studies. Columbia’s medical center declined to comment on specific allegations, saying only that it reviews “any concerns about scientific integrity brought to our attention.”

Dr. Yoon, who has said his research could lead to better cancer treatments, did not answer repeated questions. Attempts to speak to the other researcher, Changhwan Yoon, an associate research scientist at Columbia, were also unsuccessful.

The allegations were aired in recent months in online comments on a science forum and in a blog post by Sholto David, an independent molecular biologist. He has ferreted out problems in a raft of high-profile cancer research, including dozens of papers at a Harvard cancer center that were subsequently referred for retractions or corrections.

From his flat in Wales, Dr. David pores over published images of cells, tumors and mice in his spare (p. A17) time and then reports slip-ups, trying to close the gap between people’s regard for academic research and the sometimes shoddier realities of the profession.

. . .

Armed with A.I.-powered detection tools, scientists and bloggers have recently exposed a growing body of such questionable research, like the faulty papers at Harvard’s Dana-Farber Cancer Institute and studies by Stanford’s president that led to his resignation last year.

But those high-profile cases were merely the tip of the iceberg, experts said. A deeper pool of unreliable research has gone unaddressed for years, shielded in part by powerful scientific publishers driven to put out huge volumes of studies while avoiding the reputational damage of retracting them publicly.

The quiet removal of the 2021 stomach cancer study from Dr. Yoon’s lab, a copy of which was reviewed by The Times, illustrates how that system of scientific publishing has helped enable faulty research, experts said. In some cases, critical medical fields have remained seeded with erroneous studies.

“The journals do the bare minimum,” said Elisabeth Bik, a microbiologist and image expert who described Dr. Yoon’s papers as showing a worrisome pattern of copied or doctored data. “There’s no oversight.”

. . .

Dr. Yoon, a stomach cancer specialist and a proponent of robotic surgery, kept climbing the academic ranks, bringing his junior researcher along with him. In September 2021, around the time the study was published, he joined Columbia, which celebrated his prolific research output in a news release. His work was financed in part by half a million dollars in federal research money that year, adding to a career haul of nearly $5 million in federal funds.

. . .

The researchers’ suspicious publications stretch back 16 years. Over time, relatively minor image copies in papers by Dr. Yoon gave way to more serious discrepancies in studies he collaborated on with Changhwan Yoon, Dr. David said. The pair, who are not related, began publishing articles together around 2013.

But neither their employers nor their publishers seemed to start investigating their work until this past fall, when Dr. David published his initial findings on For Better Science, a blog, and notified Memorial Sloan Kettering, Columbia and the journals. Memorial Sloan Kettering said it began its investigation then.

. . .

A proliferation of medical journals, they said, has helped fuel demand for ever more research articles. But those same journals, many of them operated by multibillion-dollar publishing companies, often respond slowly or do nothing at all once one of those articles is shown to contain copied data. Journals retract papers at a fraction of the rate at which they publish ones with problems.

. . .

“There are examples in this set that raise pretty serious red flags for the possibility of misconduct,” said Dr. Matthew Schrag, a Vanderbilt University neurologist who commented as part of his outside work on research integrity.

. . .

Experts said the handling of the article was symptomatic of a tendency on the part of scientific publishers to obscure reports of lapses.

“This is typical, sweeping-things-under-the-rug kind of nonsense,” said Dr. Ivan Oransky, co-founder of Retraction Watch, which keeps a database of 47,000-plus retracted papers. “This is not good for the scientific record, to put it mildly.”

For the full story, see:

Benjamin Mueller. “Cancer Doctor Is in Spotlight Over Bad Data.” The New York Times. (Fri., February 16, 2024): A1 & A17.

(Note: ellipses added.)

(Note: the online version has the date Feb. 15, 2024 [sic], and has the title “A Columbia Surgeon’s Study Was Pulled. He Kept Publishing Flawed Data.”)

Piller’s book mentioned in my initial comments is:

Piller, Charles. Doctored: Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer’s. New York: Atria/One Signal Publishers, 2025.

Health Freedom Is a Right AND Can Yield More and Faster Therapies

The headline of the article on the front page of the NYT says “No Evidence for Healing Powers,” and goes on to slam unsophisticated right-wingers as irresponsibly pushing ivermectin as a therapy for cancer. In the article the NYT publishes a ludicrous picture from a right-winger’s Facebook page where he has spread veterinary ivermectin cream on his tongue and says “tastes like dead cancer.”

But this is unfair and tendentious caricature. A friend recently sent me an Instagram post by a chiropractor suffering from glioblastoma who has taken ivermectin and mebendazole. He briefly sketches the hypothesized mechanisms for activity of the two drugs, consistent with research published in scientific papers.

Glioblastoma is a serious, often fatal, brain cancer. He had surgery, but knows that surgery often does not cure, so he threw a Hail Mary and took ivermectin and mebendazole. These drugs have long track-records for safety, having been tested and approved for other uses. Doctors can, and have, prescribed drugs for off-label uses for decades.

Decades ago minoxidil was approved as an blood pressure medicine. I asked my then-doctor to prescribe it for me for its rumored effects as a hair loss cure. He did, so I crushed the tablets and somehow applied them to my scalp, which proceeded to itch, but not grow hair. It was a low-risk, modest-chance-of-success experiment. I think I had a right to try it, and that no government or expert had a right to forbid it. (Eventually minoxidil was approved for hair loss and branded Rogaine–which still didn’t work for me.)

In a free country adults should have wide latitude to make decisions about what risks they take; to scuba dive, to drive NASCAR, to go into space, and yes to take ivermectin and mebendazole. And the ludicrous right-winger? Hey, maybe even he has rights.

The NYT headline says there is “no evidence” for ivermectin. Below I cite a survey article that identifies 24 articles published in scientific journals identifying mechanisms by which ivermectin may be effective against cancer. There’s plenty of evidence, just not from randomized double-blind clinical trials (RCTs). But as long-time readers of this blog may remember, I have posted many entries giving useful actionable evidence that takes forms other than RCTs.

“No evidence”? Maybe the NYT was seeking plausible deniability by running its article on April 1st.

Oh, and by the way, allowing health freedom might sometimes result in better and faster therapies. I am currently reading Rethinking Diabetes by Gary Taubes. He tells the story (pp. 346-356) of Richard K. Bernstein, an engineer with Type 1 diabetes who was suffering from various serious ailments from his diabetes, in spite of the doctors saying it was being well-controlled by insulin. In his 40s, he was only expected to live another 10 years. Well he bought a new device that was not supposed to be bought by patients. The medical profession thought patients could not handle the information. (His wife was an MD, so he ‘bought’ it by asking her to buy it for him.) The device allowed him to get frequent readings of his blood sugar, and thereby to better control it, ultimately through changes in diet. When he tried to share what he had learned, he had trouble finding anyone who would take him seriously, so in his 40s he enrolled in medical school, and started publishing papers and books describing his results.

Richard K. Bernstein died on April 15, 2025 at age 90.

[Below are some relevant quotations from a NYT companion piece to the front-page article. The companion piece provides only slightly less tendentious background information on ivermectin.]

(p. A21) . . . there is not evidence to support people taking ivermectin to treat cancer.

. . .

Scientists do not dispute that ivermectin is powerfully effective — against parasites. The drug was such a breakthrough in the fight against tropical parasitic diseases that two scientists who studied it won the Nobel Prize in 2015.

The Food and Drug Administration has approved ivermectin tablets to treat certain parasitic infections, and the agency has authorized ivermectin lotions to kill lice and creams to help with rosacea. Veterinarians also use the drug to prevent and treat parasitic diseases in animals.

. . .

Studies in human cells suggest that the drug may kill certain types of cancer cells in a way that triggers the immune system, said Dr. Peter P. Lee, chair of the department of immuno-oncology at Beckman Research Institute of City of Hope in Duarte, Calif. In mouse studies, Dr. Lee has seen that the drug, on its own, does not shrink breast tumors. But it’s possible that the drug may have benefits for breast cancer when used alongside existing cancer immunotherapy, he said. Researchers are studying a combination of ivermectin and an investigational cancer drug in people with breast cancer.

While some inaccurate social media posts claim that ivermectin can treat cancer because tumors themselves are parasitic, the promise of ivermectin for cancer has nothing to do with its anti-parasitic effect, Dr. Lee said. Rather, it seems that the drug may be able to modulate a signal involved with cancer growth.

But doctors still need larger, randomized clinical trials to better understand whether ivermectin could treat cancer. Just because a drug seems to work in animals doesn’t mean those results will translate into real-world outcomes, Dr. Johnson noted. There are “hundreds of medications that look to be promising in a preclinical setting” every year, he said, adding, “The vast majority of those will never be shown to be effective in humans.”

. . .

Doctors generally view ivermectin as safe at the doses prescribed to treat parasitic infections.

For the full story, see:

Dani Blum. “What Ivermectin Can and Can’t Do, and What the Dangers Are.” The New York Times (Tues., April 1, 2025): A21.

(Note: ellipses added.)

(Note: the online version has the date March 31, 2025, and has the title “What Ivermectin Can (and Can’t) Do.” In the first quoted sentence, the print version says “no evidence” and the online version says “not evidence.”)

The Blum article that I just quoted and cited, is a secondary companion article to a longer front-page article, also on ivermectin:

Richard Fausset. “No Evidence for Healing Powers, but ‘Tastes Like Dead Cancer’.” The New York Times (Tues., April 1, 2025): A1 & A21.

(Note: the online version has the date March 31, 2025, and has the title “Why the Right Still Embraces Ivermectin.”)

The paper cited below reviewed the published scientific literature as of 2020 on the mechanisms through which ivermectin could have anti-cancer effects, finding 24 articles documenting one or more mechanisms.

Tang, Mingyang, Xiaodong Hu, Yi Wang, Xin Yao, Wei Zhang, Chenying Yu, Fuying Cheng, Jiangyan Li, and Qiang Fang. “Ivermectin, a Potential Anticancer Drug Derived from an Antiparasitic Drug.” Pharmacological Research 163 (Jan. 2021): 105207.

Tang and co-authors are optimistic in their summary section quoted below. [In this quote IVM is “ivermectin” and MDR is “multidrug resistance”.]

. . ., the broad-spectrum antiparasitic drug IVM, which is widely used in the field of parasitic control, has many advantages that suggest that it is worth developing as a potential new anticancer drug. IVM selectively inhibits the proliferation of tumors at a dose that is not toxic to normal cells and can reverse the MDR of tumors. Importantly, IVM is an established drug used for the treatment of parasitic diseases such as river blindness and elephantiasis. It has been widely used in humans for many years, and its various pharmacological properties, including long- and short-term toxicological effects and drug metabolism characteristics are very clear. (Tang et al. Jan. 2021, pp. 7-8)

The paper cited below reviewed the published scientific literature as of 2019 on the effect of mebendazole on cancer, and found 26 in vitro studies showing anti-cancer biological effects, 14 in vivo studies showing anti-tumor effects, and six Phase 1 or Phase 2 clinical trials listed in ClinicalTrials.gov.

Guerini, Andrea Emanuele, Luca Triggiani, Marta Maddalo, Marco Lorenzo Bonù, Francesco Frassine, Anna Baiguini, Alessandro Alghisi, Davide Tomasini, Paolo Borghetti, Nadia Pasinetti, Roberto Bresciani, Stefano Maria Magrini, and Michela Buglione. “Mebendazole as a Candidate for Drug Repurposing in Oncology: An Extensive Review of Current Literature.” Cancers 11, no. 9 (Aug. 2019): article #1284.

Gary Taubes’s book, praised by Marty Makary and Siddhartha Mukherjee, and mentioned by me near the end of my commentary, is:

Taubes, Gary. Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments. New York: Knopf, 2024.

[I thank Ivette Locay for sending me a link useful for my commentary.]

Mark Twain “Dared to State Things That Others Only Thought”

I have read three of Ron Chernow’s massive biographies, the ones on Rockefeller, Washington, and Hamilton. Because they are massive, reading them takes a long time, at least for a slow reader like me. But I learned a lot that is important or useful from them, especially the ones on Rockefeller and Hamilton. Because I am an admirer of both Chernow and Twain, I look forward to also reading Chernow’s biography of Twain.

(p. C7) More than a century after his death, Mark Twain remains one of the most recognizable voices in American literature—the author of “The Adventures of Tom Sawyer” (1876), “Life on the Mississippi” (1883) and “Adventures of Huckleberry Finn” (1884), the latter among the most consequential novels ever written in English and possibly (if you believe Ernest Hemingway) the source of American literature itself.

. . .

In his biography of the famed satirist, Ron Chernow tracks, with patience and care, Twain’s journey over nearly eight tumultuous decades. Mr. Chernow’s tale is enlivened by blazing quotes from Twain’s prodigious interviews, diaries and letters.  . . .  The quotes tend to burn a hole in the page, and it’s difficult for a biographer to recover. Mr. Chernow, whose lives of George Washington, Alexander Hamilton and Ulysses S. Grant are revered for their sound scholarship, clear writing and strong narrative drive, weaves Twain’s sizzling remarks almost seamlessly into his own narrative.

We watch as Twain lunges from coast to coast, rolling up and down the Mississippi (as a riverboat pilot in his early days), moving from country to country, writing books and articles, investing large sums in various hair-brained schemes.

. . .

This was, in Twain’s own phrase, the Gilded Age. He admired, even idealized, those who made huge sums of money through their entrepreneurial energy and acumen. He had the same energy, but he didn’t have the right vehicles for speculation nor the business sense to make his investments pay off. As Mr. Chernow observes, Twain could well have enjoyed an easy life of writing and giving lectures, having married a wealthy woman and published several bestsellers. “Instead, he had started a publishing house and financed a typesetter”—the Paige Compositor, which was supposed to replace manual typesetting but failed spectacularly because of engineering flaws—“before he had the expertise or requisite fortune to bring them to completion.” His expenses soon dwarfed his income and he was forced to abandon his Hartford mansion, never to return.

. . .

Twain was “a man who professed to be chronically lazy,” says Mr. Chernow, yet he left behind him a vast portfolio of writings that included 30 books, several thousand magazine articles and some 12,000 letters. “Mark Twain had not only moved people to laughter and tears with his books,” Mr. Chernow writes, “but had challenged them with unorthodox views as he ventured out from his safe cubbyhole as the avuncular humorist. He had dared to state things that others only thought.” It’s because of this bravery, and his peerless gift for expression, that we still value him and will never stop reading his books, which never grow old.

For the full review see:

Jay Parini. “A Most American Writer.” The Wall Street Journal (Saturday, May 10, 2025): C7.

(Note: ellipses added.)

(Note: the online version of the review has the date May 9, 2025, and has the title “‘Mark Twain’: The Most American Writer.”)

The book under review is:

Chernow, Ron. Mark Twain. New York: The Penguin Press, 2025.