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Dr. Michael Fulks MDApr 7, 2020 11:08:00 AM2 min read

Medical Journal Articles: A Caution on Trustworthiness & Reproducibility

We know not to put too much trust in medical reporting that originates on the internet or in popular press, but there is a deeper issue beyond these sources. Even for articles in highly rated medical journals, fewer than two-thirds of conclusions may be reproducible. Electronic-only medical journals with minimal or no article review have sprung up as of late, providing catchy fodder for the daily news and internet blogs. As a result, carefully peer-reviewed articles are seen less.

Below are two examples.

1. Misleading Results: A reviewed article in a respected journal suggested that mortality increases linearly with as little as one drink per day. However, this finding does not align with other studies — and typical underwriting practice — which is based on the lowest risk level at 1–2 drinks per day that show a “J”-shaped risk curve. A later published review of this article then focused on underreporting of alcohol consumption, which underwriters see in applicants. If only 30% of those who consume 2+ drinks per day are claiming 1–2 drinks, you would see linear mortality rates.

2. Conflicting Key Points & Placebo: A second example comes from an electronic article with a “key points” summary that purports that acupuncture was shown to prevent dry mouth caused by head and neck radiotherapy. The full article revealed three treatment groups: acupuncture, sham acupuncture and no treatment. Sham acupuncture and acupuncture treatments delivered similar relief, with only the no treatment group doing worse. In other words, placebo treatment was as effective as acupuncture treatment.

Laboratory and medical resources are always available at CRL to give a “second opinion” on any provocative research results you may find. If you have any immediate questions or articles for the CRL expert team to review, please email

About the Author

Michael Fulks, MD, Consulting Medical Director, is board-certified in internal and insurance medicine. After leaving practice, he served as a medical director, creating or editing several underwriting manuals and preferred programs. For the past 13 years, Dr. Fulks has consulted for CRL, participating in its mortality research on individual tests and all laboratory test results, BP and build in combination. He is also involved in the development and implementation of automated screening tools for non-laboratory data.