The reason why I, as a surgeon, look critically at ‘medical papers’: commercialization of papers and wise medical consumption
When talking with patients inside and outside the clinic or seeing numerous hospital promotional materials on the Internet, “A treatment whose effectiveness has been proven in SCI-level academic journal papers.”Or “Unrivaled technology listed in world-class academic journals” You come across the same fancy phrase very often.
As a surgeon who has undergone training based on strict evidence-based medicine, and as a surgeon who currently holds a scalpel and cannula every day in the field of body plastic surgery and cosmetic surgery, I would like to share an honest and essential story today. We will take an in-depth look at the structural aspects of how medical papers are actually made, and why medical consumers should not take all claims labeled 'papers' at face value.
1. Why should medical consumers know the other side of the paper?
Every day, every time we open a portal site, we come across papers related to psychology, diet, and health that are frequently cited in gossip articles. Articles that exaggerate provocative one-line conclusions while omitting complex research prerequisites or sample limitations are often consumed as our daily knowledge.
Obesity treatment that has recently become a global craze WegovyWow MounjaroThe same goes for the flood of information surrounding us. If you do not carefully consider what patient group and strictly controlled environment the clinical trial was conducted in, and what the yo-yo effect or metabolic limitations are after discontinuation of medication, it is easy to be deceived by fragmentary figures. Also, just a few years ago, the entire human race experienced COVID-19 pandemic situation At that time, I still vividly remember how numerous medical papers coming out every day from around the world were overturned to completely opposite conclusions in a short period of time, causing great social confusion.
Medical papers are by no means limited to the laboratory. From deciding on plastic and cosmetic procedures to entrusting your body to routine health checkups and general hospital treatment, information based on theses has a direct impact on the judgment of medical consumers. In order to protect your precious health and costs, it is essential to be able to look beyond the phrase 'paper citation'.
2. Commercialization of medical papers and the shadow of ‘paper factories’
By nature, medical papers should be purely a tool of academic advancement to identify disease mechanisms and improve treatments. However, unfortunately, many medical papers today are intended to immediately increase the lack of public trust in hospital advertisements or specific medical devices, medicines, and health products. Highly commercial marketing toolis being adopted.
In fact, the international academic community produces so-called false data and fake papers in large quantities in exchange for money for the purpose of commercial promotion or inflating research performance. ‘Paper mill’ The problem is being pointed out as a serious threat to the academic ecosystem. [1. Report on the status of fake paper factories]. The world's most authoritative scientific journal NatureAccording to investigative reporting, data manipulation and poor peer review resulted in More than 10,000 research papers have been officially retracted.An unprecedented situation in history was recorded. [2. Record of more than 10,000 paper withdrawals per year].
3. Structural limitations of medical papers: statistical and humanistic and social insights
Even if no intentional manipulation was involved, medical papers are inherently difficult to become absolute truths that are always and everywhere the same as pure sciences such as physics and chemistry or mathematics. Here, there are both medical statistical limitations and humanistic and social structural issues.
① Medical and statistical perspectives
② Insight from humanities and sociology
Furthermore, today, not only within academia but also in society at large, We are rapidly transitioning to a society where the words of popular YouTubers who use provocative and decisive speech methods are more easily recognized by the public and exert a much greater influence than the cautious opinions of orthodox authorities in the field who have devoted their entire lives to research.It is done. This is because true academic authorities use more careful and restrained expressions because they have a deeper understanding of medical exceptions and limitations, while YouTubers and influencers riding media algorithms make clear and confident assertions that the public wants to hear.
4. Reasons for differences in reliability of medical papers by department
If we apply the commercialization of the paper (Chapter 2) and the statistical and sociological limitations (Chapter 3) mentioned above to actual clinical practice, we can clearly understand why the qualitative weight of the papers published varies greatly between the essential medical department centered on university hospitals and the aesthetic and plastic surgery department centered on private practitioners.
| Evaluation items | Essential medical subjects centered on university hospitals (Internal medicine, surgery, neurosurgery, etc.) |
Private practice-centered aesthetic medicine and plastic surgery Latest treatment papers |
|---|---|---|
| Research environment and motivation | Focused on employed doctors and faculty at university hospitals and large hospitals, and is unrelated to sales of private businesses, so the temptation for commercial distortion is relatively small. | The majority operate private businesses (practitioners); As soon as business viability surpasses professional conscience, use it as a marketing tool. |
| data size and design level |
Large-scale case/control group alignment, strict randomization (RCT), and sufficient sample size (n) secure | Simple case report (case report) level based on other specialties, control group sorting/random placement and patient nFrequently falling below par |
| Academic journal verification method | Active accumulation of multicenter cross-validation and subsequent replication studies | Review focused on formal procedures and completeness of sentences and composition, original data Absence of verification or due diligence verification at the journal level |
| Descriptive tone and Sponsorship |
Moderate statistical description, transparent disclosure of research limitations and conflicts of interest (COI) | Hiding sponsorship ‘Key Doctor (sponsored advertising influencer)’Packaged as authority, many expressions of comparative and superiority are used to show off. |
① Structural differences between self-employed doctors at university hospitals and private practitioners operated as private businesses
Essential medical specialties such as internal medicine, surgery, and neurosurgery have relatively less commercial temptation because the subjects researching technological superiority are salaried doctors and professors working at large hospitals, mainly university hospitals, rather than business owners running private businesses. On the other hand, in aesthetic medicine and plastic surgery, regardless of whether in the East or the West, the majority of experts run private clinics or work at commercial clinics, so it is physically difficult to write a purely academic paper by strictly organizing a large amount of data in the midst of busy medical treatment and surgery. And above all, since the hospital is operated for personal business purposes, ‘Business > Professional conscience as a doctor’The moment you go beyond that, even your thesis becomes a good tool to grow your business.
② The reality of ‘Key Doctor’ and exaggerated description at the level of a case report
In some of the latest technologies in aesthetic and plastic surgery, manufacturers' sponsorship is hidden or cleverly told differently for personal commercial success, so that in reality, they are the equivalent of advertising influencers sponsored by medical device companies. ‘Key Doctor’ Titles are often promoted as if they are recognized as having great academic authority. Additionally, due to the nature of aesthetic and plastic surgery journals, it is safe to say that, strictly speaking, there are no academic journals that conduct rigorous, objective due diligence verification. Most of them only review formal procedures or the structural completeness of the paper. original dataThere is no process for verifying or conducting on-site inspection at the academic journal itself. As a result, when viewed from other specialties, it is at the level of a simple case report, including the sorting and randomization of patient and control groups, and the nAlthough there are many papers where the numbers themselves are substandard, the comparative tone (statement for bragging) that shows off the superiority of other methods appears much more frequently.
The most representative example of what happens when a researcher's desire for fame and commercial and social interests obscure the truth is the incident that shook Korea and the world's scientific community in the past. Hwang Woo-seok incidentis [3. Science Stem Cell Paper Manipulation and Retraction]. Furthermore, at the time of the COVID-19 pandemic, the world's most authoritative medical journal The Lancetand NEJMThis is an unprecedented case in which a large paper related to COVID-19 drug treatment was canceled (retracted) after the fact.occurred [4, 5. Lancet·NEJM publication cancellation due to failure to verify original data]. Even the most authoritative journals are submitted by researchers. original dataThis is an incident that clearly shows that serious distortions cannot be filtered out if direct due diligence cannot be verified.
5. Surgeon’s conclusion: Which paper should I believe and which doctor should I choose?
In conclusion You don't have to trust everything that's a medical paper. Compared to pure science or mathematics papers that allow for strict experimental control and repeatability, medical papers involving human subjects are inherently less reliable. Still, if we were to summarize the areas of medical papers that medical consumers can relatively trust and refer to, they are as follows.
📌 4 areas of relatively trustworthy medical papers
Even if you do not have complex statistical knowledge, the clearest standards that you can apply in your daily life are simple. “Even if I think about it, I would be tempted by money, right?” You can look at the topic from a slightly critical perspective.
Additionally, what I would like you to remember is: Just because someone is famous for their papers doesn't mean they're a good doctor, and just because they're famous internationally doesn't mean they're good at performing surgery.It is. Just because you were good at studying in school does not mean that you will always be a great teacher to your students, and there are countless cases where you achieved great success as an athlete during your active career but failed as a manager or coach. I personally believe that academic research capabilities and actual operating room surgical skills will probably be separate variables with only a slight similarity if objective research is conducted in the future.
[Surgeon Dr. Han Gru (Chief Surgeon)'s medical principles: truthful treatment without exaggeration and compliance with basic principles]
“We do not rely on the names of expensive expensive equipment, commercially inflated numbers of papers, or promotional slogans from provocative YouTubers. We honestly diagnose the patient’s body condition as it is, transparently explain the limitations of the surgery, and prove it only with the results in the operating room.”
In my opinion, a good procedure or surgery has far more advantages than disadvantages based on basic physiological, human physical, pathological, and anatomical principles.
Rather than being deceived by fancy thesis titles or conference records, I sincerely hope that you will meet a doctor who honestly diagnoses the patient's anatomical condition, transparently explains the limitations and side effects of the surgery, and above all, a doctor who silently proves the results with the results in the operating room.
Q&A: Medical papers and hospital selection
You should not blindly trust it. The paper itself is more important than the fact that it was published in an academic journal. Is the paper poorly based in terms of research design or data?, or whether it is a rigorously verified study with sufficient patient samples and an objective control group. In particular, in the field of non-benefit beauty and plastic surgery, there are many studies designed for the purpose of marketing and securing public trust with financial support from medical device companies or companies, so it is wise to look at them with a critical eye.
It is easy for general consumers to misunderstand 'Key Doctor' as the best medical doctor recognized by academia, but in the field of aesthetic medicine, Key Doctor is a person who mass-introduces equipment from a specific manufacturer or takes the lead in promotional lectures. Sponsored Advertising Influencer It's often a personality trait. The commercial title granted by the equipment company must be judged separately from the surgeon's pure anatomical surgical skills.
Public awareness, presentation skills, and thesis writing skills are completely different from the fingertip skills of delicately handling a scalpel and cannula in an operating room. Just as a star athlete does not necessarily become a famous coach, instead of external publicity and media activities, a solid specialist who silently interacts with the patient's tissue in the clinic and operating room every day to produce results often produces more precise and safer results.
Rather than emphasizing only popular new technologies or exaggerated before-and-after changes, we honestly diagnose each patient's flesh, fat layer, and anatomical structure. A doctor who recommends only surgeries in which the advantages to the patient far outweigh the disadvantages in light of basic physiological and anatomical principlesPlease check if it is correct. The safest and most trustworthy hospital is one that transparently explains limitations that cannot be improved through surgery and even possible side effects.