Cherry Picking; Systematic Reviews; Weight of the Evidence

In a paper prepared for one of Professor Margaret Berger’s symposia on law and science, Lisa Bero, a professor of clinical pharmacy in the University of California San Francisco’s School of Pharmacy identified a major source of error in published reviews of putative health effects:

“The biased citation of studies in a review can be a major source of error in the results of the review. Authors of reviews can influence their conclusions by citing only studies that support their preconceived, desired outcome.”

Lisa Bero, “Evaluating Systematic Reviews and Meta-Analyses,” 14 J. L. & Policy 569, 576 (2006). Biased citation, consideration, and reliance are major sources of methodological error in courtroom proceedings as well. Sometimes astute judges recognize and bar expert witnesses who would pass off their opinions, as well considered, when they are propped up only by biased citation. Unfortunately, courts have been inconsistent, sometimes rewarding cherry picking of studies by admitting biased opinions[1], sometimes unhorsing the would-be expert witnesses by excluding their opinions[2].

Given that cherry picking or “biased citation” is recognized in the professional community as a rather serious methodological sin, judges may be astonished to learn that both phrases, “cherry picking” and “biased citation” do not appear in the third edition of the Reference Manual on Scientific Evidence. Of course, the Manual could have dealt with the underlying issue of biased citation by affirmatively promoting the procedure of systematic reviews, but here again, the Manual falls short. There is no discussion of systematic review in the chapters on toxicology[3], epidemiology[4], or statistics[5]. Only the chapter on clinical medicine discusses the systematic review, briefly[6]. The absence of support for the procedures of systematic reviews, combined with the occasional cheerleading for “weight of the evidence,” in which expert witnesses subjectively include and weight studies to reach pre-ordained opinions, tends to undermines the reliability of the latest edition of the Manual[7].

[1] Spray-Rite Serv. Corp. v. Monsanto Co., 684 F.2d 1226, 1242 (7th Cir. 1982) (failure to consider factors identified by opposing side’s expert did not make testimony inadmissible).

[2] In re Zoloft, 26 F. Supp. 3d 449 (E.D. Pa. 2014) (excluding perinatal epidemiologist, Anick Bérard, for biased cherry picking of data points); In re Accutane, No. 271(MCL), 2015 WL 753674, 2015 BL 59277 (N.J.Super. Law Div. Atlantic Cty. Feb. 20, 2015) (excluding opinions Drs. Arthur Kornbluth and David Madigan because of their authors’ unjustified dismissal of studies that contradicted or undermined their opinions); In re Bextra & Celebrex Mktg. Sales Practices & Prods. Liab. Litig., 524 F.Supp. 2d 1166, 1175–76, 1179 (N.D.Cal.2007) (holding that expert witnesses may not ‘‘cherry-pick[ ]’’ observational studies to support a conclusion that is contradicted by randomized controlled trials, meta-analyses of such trials, and meta-analyses of observational studies; excluding expert witness who ‘‘ignores the vast majority of the evidence in favor of the few studies that support her conclusion’’); Grant v. Pharmative, LLC, 452 F. Supp. 2d 903, 908 (D. Neb. 2006) (excluding expert witness opinion testimony that plaintiff’s use of black cohash caused her autoimmune hepatitis) (“Dr. Corbett’s failure to adequately address the body of contrary epidemiological evidence weighs heavily against admission of his testimony.”); Downs v. Perstorp Components, Inc., 126 F. Supp. 2d 1090,1124-29 (E.D. Tenn. 1999) (expert’s opinion raised seven “red flags” indicating that his testimony was litigation biased), aff’d, 2002 U.S. App. Lexis 382 (6th Cir. Jan. 4, 2002).

[3] Bernard D. Goldstein & Mary Sue Henifin, “Reference Guide on Toxicology,” in Reference Manual on Scientific Evidence 633 (3d ed. 2011).

[4] Michael D. Green, D. Michal Freedman, and Leon Gordis, “Reference Guide on Epidemiology,” in Reference Manual on Scientific Evidence 549 (3d ed. 2011).

[5] David H. Kaye & David A. Freedman, “Reference Guide on Statistics,” in Reference Manual on Scientific Evidence 209 (3d ed. 2011).

[6] John B. Wong, Lawrence O. Gostin, and Oscar A. Cabrera, “Reference Guide on Medical Testimony,” in Federal Judicial Center and National Research Council, Reference Manual on Scientific Evidence 687 (3d ed. 2011).

[7] See Margaret A. Berger, “The Admissibility of Expert Testimony,” in Reference Manual on Scientific Evidence 11, 20 & n.51 (3d ed. 2011) (posthumously citing Milward v. Acuity Specialty Products Group, Inc., 639 F.3d 11, 26 (1st Cir. 2011), with approval, for reversing exclusion of expert witnesses who advanced “weight of the evidence” opinions).

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