In regard to GLP-1 RA drugs, a previous post asked a lot of questions about which questions most urgently need to be asked. That was only a few months ago, and maybe nothing major has happened, but the briefest web search assures us that plenty of people are working on it, and coming up with some startling possibilities.
The type of long-term research needed to settle all the questions must, obviously and unfortunately, be carried out over the long term — and by looking at the case files of many thousands of patients. Depending on variables, it must in some instances be extremely difficult for researchers to keep track of so many facts about so many people, over a span of years.
It may happen that some of the people under scrutiny develop conditions that take them outside the predetermined research parameters. They get pregnant, or move halfway around the world. Communication becomes difficult, or they just get tired of being totally conscious of and recording every detail of their existence.
Subjects may develop a reluctance to overshare, which morphs into an intense craving for privacy, especially if they are children entering adolescence, or teenagers turning into adults. Any individual might fall into a delusional wish to make the scientists happy; or feel the need, for whatever reason, to be less than honest with them.
You lookin’ at me?
When a subject is recruited, the research concerns literally every cell of their body. Tracking what they put into it and what comes out of it, is only the start. To live under a microscope can be taxing in ways that the subjects did not anticipate. Under those circumstances, some folks get antsy. They can fall into, or away from, religious or political convictions, or be caught up in an unhealthy emotional relationship, or be influenced by an individual who exerts control. They might be drafted into military service. In the worst case, some subjects die.
Over the long months that such observations should be expected to take, even the experience of mental or emotional growth could shake a person loose and make them unable to tolerate their participation for one more day. Just as some citizens will go to great lengths to avoid jury duty, a person who is really fed up with being part of an experiment will find a way out.
Ideally, a significant long-term study encompasses a very large number of participants. They might need to give up many informational tidbits, starting with simple ones like, “How much did your mother weigh when you were conceived?” and, “Now, 30 or 50 years later, how much do you weigh?” But gathering basic data is only the beginning.
Academia = intellectual rigor in lab coats
It all becomes fiendishly complicated, with linear miles of charts and suchlike. Another layer of complexity includes underlying philosophical assumptions and aspirations. According to what standards and rules must medical research be performed? What is seen as important, and what should be treated as even more important?
One thing we discover from research is how to do better research. Does the thinking on these matters advance, or has it solidified? When researchers write up their results, can they weasel without actually telling a lie? Why would anyone do that?
For a scientific researcher or anyone else, questions should never cease. Once a large number of 20-year studies of semaglutide, for instance, have been compiled, someone will come along and say, “Not good enough. This can’t be definitively judged until more evidence comes in — like for instance, a pile of 30-year studies.”
And quite rightly. Mistakes have been made. Science does not always progress in an immaculate, untarnished linear fashion. There have been errors and oversights, and that is unlikely to change.
Your responses and feedback are welcome!
Image by Beckie/Attribution 2.0 Generic
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