Peter Tennant Profile picture
Apr 7 12 tweets 6 min read
Most people don't realise that academic science is a very long way from healthy.

In fact, all good academic scientists must, at some point, go through a reckoning. When they awaken from the 'dream of science' to realise just how broken things are.

🧵 1/11
#ScienceInCrisis
My own crisis happened during my PhD. It was gradual, but at some point I realised academic science wasn't driven by truth, quality, or collectivism, but ego, opportunism, and exploitation. I couldn't believe it. It seemed so wrong and unfair.

2/11
#ScienceInCrisis
It hit me like grief. Anger, depression, bargaining. Years later & I'm still struggling. It hurts when I see bad science or a bad scientist getting celebrated.

I've been been told my 'problem' is I 'care about doing good science'. But I refuse to give in.

3/11
#ScienceInCrisis
95%+ of health research can be put straight in the bin. Flawed from the start. Yet it still gets funded, published, & shared.

That wouldn't matter if we 'self corrected'. But those who raise concerns are often branded jealous, negative, or bullies.

4/11
#ScienceInCrisis
I used to assume it was enough to show something was wrong for things to change. In fact, you need power, influence, & luck. But most power is claimed by those who seek it. And they'll use their power to protect their ego & reputation.

5/11
#ScienceInCrisis
This is why Max Plank said 'science advances one funeral at a time'. The old guard are very good at defending their old ideas. They block or isolate those pushing against them.

But death doesn't guarantee progress; the culture breeds more of the same.

6/11
#ScienceInCrisis
Academic science needs a revolution. Some of this might come from the #OpenScience movement. But it can't manage alone. Even open science can be done 'cynically'. Where bad research is done for the wrong reasons, yet ticks all the 'open' boxes.

7/11
#ScienceInCrisis
The #Covid pandemic offers an insight & chance to change. The flood of research was unheard. Some good. Most rubbish. We were overwhelmed with opportunistic research; chasing the COVID coin. Some exemplified #OpenScience, except when criticisms were raised.

8/11
#ScienceInCrisis
The truth is we can't improve academic science until we improve #academia. And that means changing the culture within #HigherEd itself. We must move away from rewarding self promotion & 'income generation' to collectivism & truth seeking.

9/11
#ScienceInCrisis
Changing #academia starts & ends with unionisation. Nothing can change without fighting the toxic precarity & exploitation that spits out the best scientists.

After that, we must manage our grief. I tell myself 'I hate academia but love science'.

10/11
#ScienceInCrisis
I'm hopeful things will change. Part is because the alternative is too depressing. But I also believe most people who enter science are good people with good values. So it won't take *that* much. Just effort & patience. And we scientists are good at that!

11/11
#ScienceInCrisis
PS Many have pointed out that trade unions cannot fix the problem of #ScienceInCrisis alone. This is true.

Like any complex problem, it'll need a multi-prongued approach; applying pressure from inside & outside. That starts with telling the story about the scale or the problem.

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More from @PWGTennant

Sep 17, 2021
A thread on our study in @BJOGTweets, which uses a regression discontinuity approach to estimate the separate effects of fasting plasma glucose and diagnosis of gestational diabetes in women screened during pregnancy
/1

#EpiTwitter
There's a lot of debate surrounding the screening and treatment of pregnant women for gestational diabetes.

In most existing research, women with gestational diabetes have only modestly increased risks of adverse outcomes, such as large-for-gestational-age.

2/
#EpiTwitter
In England, women are diagnosed with gestational diabetes if they have a fasting glucose above 5.6mmol/L. This is a higher than other countries, including Scotland, where the threshold is 5.1mmol/L. It's thought women with 'mild' hyperglycaemia have low risk.

3/
#EpiTwitter
Read 9 tweets
Aug 20, 2021
It's worrying for a new NICE guidance to be delayed and undermined on the grounds it doesn't match 'clinical experience'.

If the scientific evidence always matched 'clinical experience', there'd be no point to research or evidence based medicine... 🤔

#EBM #EpiTwitter
If 'evidence based medicine' is working there should be REGULAR occasions when the 'evidence' not only disagrees with 'clinical experience' but actively contradicts it.

Wherever 'clinical experience' is allowed to overrule 'scientific evidence', we return to quackery.
'Clinical experience' can be extremely misleading, and history is littered with examples. That's why we take a wider dispassionate view and aim to update practice based on science. This principle is the main distinction between contemporary medicine and 'medicine' of old.
Read 8 tweets

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