While you’ve probably read the poetry of Edgar Allan Poe – perhaps killing and chilling with Annabelle Lee or certainly Nevermore with the blackbird – you may not have encountered his persuasion concept, the Fortunato Persuasion Play®™© as described in his research paper, The Cask of Amontillado.
The unfortunate Fortunato, connoisseur of wine and Amontillado, insults the wrong panther, Montresor, who devises the Fortunato Persuasion Play®™©. Imagine a catacomb, dark, deep, and dank with racks of wine and a pipe of rare sherry, a cask of Amontillado. Montresor lures Fortunato to the wine cellar and gets him drunk on good bottles of Bordeaux, a Medoc, then a Graves. Then Montresor inveigles the stuporous fool, ironically dressed in jester’s motley for a festival, deeper into a corner of the catacomb to sample the rare sherry. Now.
In an instant he had reached the extremity of the niche, and finding his progress arrested by the rock, stood stupidly bewildered. A moment more and I had fettered him to the granite. In its surface were two iron staples, distant from each other about two feet, horizontally. From one of these depended a short chain, from the other a padlock. Throwing the links about his waist, it was but the work of a few seconds to secure it. He was too much astounded to resist. Withdrawing the key I stepped back from the recess . . . I soon uncovered a quantity of building stone and mortar. With these materials and with the aid of my trowel, I began vigorously to wall up the entrance of the niche.
Holy Immurement, vampires and panthers! Fortunato chained then walled into oblivion, brick by brick, the truth buried alive and hidden from detection. Now, consider the Fortunato Persuasion Play®™© today. Let’s play Poe and do Clinical Trials.
A Clinical Trial is a formal research project aimed at testing the safety and effectiveness of some treatment (drug, surgery, diet, exercise, prayer, insurance status, and on and on) for its effect on mortality or morbidity. Tooth Fairy Tales can be Clinical Trials as can Steve’s Beloved Randomized Controlled Trials. It just a test in the broadest sense of the term, test. In the US almost everyone doing a Clinical Trial is required to register the research plan with the FDA and make a formal, public notification of the research effort. Go visit ClinicalTrials.gov to verify this.
A Clinical Trial is a big deal and it requires a large crew of specialists to conduct, which also means you’re talking serious money with many of these projects costing in the millions. Sometimes the projects are funded by your tax dollars through the National Institutes of Health, sometimes they are funded by your venture capital through Big Pharma, Inc. The science of Clinical Trials is serious.
Except for this.
Main outcome measures The frequency of non-publication of trial results and, among unpublished studies, the frequency with which results are unavailable in the ClinicalTrials.gov database.
Results Of 585 registered trials, 171 (29%) remained unpublished. These 171 unpublished trials had an estimated total enrollment of 299 763 study participants. The median time between study completion and the final literature search was 60 months for unpublished trials. Non-publication was more common among trials that received industry funding (150/468, 32%) than those that did not (21/117, 18%), P=0.003. Of the 171 unpublished trials, 133 (78%) had no results available in ClinicalTrials.gov.
Researchers simply went through the database of registered studies at ClinicalTrials.gov. They then searched for publications based on those registrations. And they could find no formal scientific communication – the publication – on 29% of these Clinical Trials, virtually all of them funded by your venture capital at Big Pharma, Inc.
You see our new persuasion play. Clinical Trials are expensive, time consuming, and difficult. You do them strategically, not just for the tactical fun of them, but because the information from the Trial will produce a benefit beyond the immediate test. Trials are inherently important, diagnostic, probative, just damn useful. And the registration before the research makes the researchers state their bets before they throw the dice. But, we see here that in almost 1 in 3 studies, the researchers don’t tell us the outcome of that bet and instead run the Fortunato Persuasion Play®™©. Just immure the results in the modern catacomb called the file drawer.
This is the greatest time in the history of civilization to conduct science . . . as persuasion. Put on the lab coat, put up a Power Point slide, and put out p < .05 and you can pass your persuasion as science without problem. And, if you can’t even manage p < .05, then just play Fortunato!
Jones CW, Handler L, Crowell KE, Keil LG, Weaver MA, Platts-Mills TF. Non-publication of large randomized clinical trials: cross sectional analysis. BMJ 2013;347:f6104
Of course! The Cask of Amontillado from Alan Parsons (YouTube)!
P.S. My favorite Poe poetry is The Bells.
Poe practiced the tyranny of relentless meter and rhyme in his poetry, rendering it almost satiric through inadvertence. Nothing Sincere, just his Theory of Art. The poetry sounds better than it reads. You can vocally vary the sounds and timing to escape the sing-song. Contrast Poe to Whitman or Dickinson for a painful comparison.
However, with The Bells, the discipline of meter and rhyme makes the poem almost musical in performance. Most persuasive!
P.P.S. Musical bonus: The Raven! Alan Parsons Project (YouTube).