A review of patient outcomes in pharmacological studies from the psychiatric literature, 1966–1993

A literature search was conducted on studies of new drugs used with patients with schizophrenia reported by U.S. and non-U.S. researchers from 1966–1993, yielding 41 U.S., and a total of 24 other non-U.S. studies, among them 11 British studies. Results of the U.S. and non-U.S. studies were pooled separately and compared. Among several comparable conditions discussed, the lack of any data on suicides in the U.S. studies was observed. For a second statistical analysis of suicide rates ‘person-years’ were calculated to adjust for differing washout durations. The results obtained include findings that the percentage of patients relapsing in U.S. studies was slightly lower (37.9%) than in non-U.S. studies (46%); the percentage of patients dropping out in U.S. studies (10.5%) was higher than in non-U.S. studies (7.6%); known location of dropout patients in U.S. studies was 1.7%, compared to 2.6% in non-U.S. studies. The most interesting finding was that no suicides were reported in U.S. studies, compared to 0.6% of patients reported in British studies. Some U.S. studies used ‘challenge doses’, such as amphetamines or L-dopa; no non-U.S. studies reported their use. Compared to U.S. studies, those by non-U.S., and particularly British, researchers appeared to report adverse events in their studies. ‘Challenge’ drugs were not used; suicides were reported. It is estimated that the probability that no patients suicided who participated in the U.S. is small—one in 500.     

Use and misuse of metrics in research evaluation

This paper addresses some critical issues in the applicability of quantitative performance measures (including bibliometric, economic, and co-occurrence measures) to the assessment of basic research. The strengths and weaknesses of metrics applied as research performance measures are examined. It is concluded that metrics have a useful role to play in the evaluation of research. Each metric employed, whether bibliometric, economic, co-occurrence, or others, brings a new dimension of potential insight to the complex problem of research assessment. However, when used in a stand-alone mode, metrics can be easily misinterpreted and result in misleading conclusions. Metrics should be an integral part of a more comprehensive approach to research evaluation, in which the leading role is assumed by expert peer review. Under this structure, the reviewers must be broadly constituted, so that the technical correctness of the research approaches being taken (doing the job right) can be evaluated by technical experts and the correctness of the research target (doing the right job) can be evaluated as well. This comprehensive approach insures quality in the implementation of existing research paradigms and allows the introduction of revolutionary new research paradigms as well. The views contained in this paper are solely those of the author and do not represent the views of the Department of the Navy. Ronald Kostoff received a Ph.D. from Princeton University, performed technical and economic research at Bell Laboratories, managed energy programs at U.S. Department of Energy, was Director of Technical Assessment at the Office of Naval Research for many years and presently manages the Navy’s In-House Laboratory Independent Research Program.     

Forbidden Suffering: The Pollyanna Syndrome of the Disabled and Their Families

Has suffering become an ugly word in the normalization debate? Are the disabled and their families forced into a Pollyanna ¹ 1 Pollyanna is the heroine in Eleanor Porter's book (1913), which has since been published in countless editions. Pollyanna received a pair of crutches when all she wanted was a doll. Because she didn't need to use her crutches, she was so happy that she played “being-happy” games for the rest of her life.
culture in order to be acknowledged and accepted in good company as the worthy disabled? This essay poses a controversial question: I would like to start a debate and ask whether normalization also has an unseen, ideological downside.