In this episode, I had the privilege of speaking with John Ioannidis, a renowned scientist and meta-researcher whose groundbreaking work has shaped our understanding of scientific reliability and its societal implications. We dive into his influential 2005 paper, Why Most Published Research Findings Are False, explore the evolution of scientific challenges over the past two decades, and reflect on how science intersects with policy and public trust—especially in times of crisis like COVID-19.
We begin with John taking us back to 2005, when he published his paper in PLOS Medicine. He explains how it emerged from decades of empirical evidence on biases and false positives in research, considering factors like study size, statistical power, and competition that can distort findings, and why building on shaky foundations wastes time and resources.

“It was one effort to try to put together some possibilities, of calculating what are the chances that once we think we have come up with a scientific discovery with some statistical inference suggesting that we have a statistically significant result, how likely is that not to be so?”

I propose a distinction between “honest” and “dishonest” scientific failures, and John refines this. What does failure really mean, and how can they be categorised?
The discussion turns to the rise of fraud, with John revealing a startling shift: while fraud once required artistry, today’s “paper mills” churn out fake studies at scale. We touch on cases like Jan-Hendrik Schön, who published prolifically in top journals before being exposed, and how modern hyper-productivity, such as a paper every five days, raises red flags yet often goes unchecked.

“Perhaps an estimate for what is going on now is that it accounts for about 10%, not just 1%, because we have new ways of massive… outright fraud.”

This leads to a broader question about science’s efficiency. When we observe scientific output—papers, funding—grows exponentially but does breakthroughs lag? John is cautiously optimistic, acknowledging progress, but agrees efficiency isn’t what it could be. We reference Max Perutz’s recipe for success:

“No politics, no committees, no reports, no referees, no interviews; just gifted, highly motivated people, picked by a few men of good judgement.”

Could this be replicated in today's world or are we stuck in red tape?

“It is true that the progress is not proportional to the massive increase in some of the other numbers.”

We then pivot to nutrition, a field John describes as “messy.” How is it possible that with millions of papers, results are mosty based on shaky correlations rather than solid causal evidence? What are the reasons for this situation and what consequences does it have, e.g. in people trusting scientific results?

“Most of these recommendations are built on thin air. They have no solid science behind them.”

The pandemic looms large next. In 2020 Nassim Taleb and John Ioannidis had a dispute about the measures to be taken. What happened in March 2020 and onwards? Did we as society show paranoid overreactions, fuelled by clueless editorials and media hype?

“I gave interviews where I said, that’s fine. We don’t know what we’re facing with. It is okay to start with some very aggressive measures, but what we need is reliable evidence to be obtained as quickly as possible.”

Was the medicine, metaphorically speaking, worse than the disease? How can society balance worst-case scenarios without paralysis.

“We managed to kill far more by doing what we did.”

Who is framing the public narrative of complex questions like climate change or a pandemic? Is it really science driven, based on the best knowledge we have? In recent years influential scientific magazines publish articles by staff writers that have a high impact on the public perception, but are not necessarily well grounded:

“They know everything before we know anything.”

The conversation grows personal as John shares the toll of the COVID