Bad Science

Title: Bad Science

Author: Ben Goldacre

Publisher: Harper Perennial 2009 (First published 2008)

ISBN: 978-0-00-732676-1

Pages: 339

A very interesting and appealing book from a doctor-turned-journalist who routinely contribute to newspaper columns. Goldacre dissects the quacks, hacks and pseudo-scientific mumbo jumbo in surgical detail and presents the innards before the readers with a characteristically sharp style. Science reporting in the media is presently in bad shape, with reporters having no clue to the workings of science churns out stories based on their sensational appeal and provoking mass sympathy or hysteria. Often without adequate base for their material, the media feeds on the frenzy of the public. This situation is partly caused by the change in science reporting methods since the second world war. In 1950s, majority of the articles were on engineering and technology, and it was somewhat easier for even the general public to understand. One doesn’t need to be a nerd to understand how a car works or how an AM radio receiver decodes the signals. However, by 1990s, the lot fell on medicine, health and nutrition to attract ever greater number of articles in mass media. Also, the technology got more complicated, resulting in probably a very few being able to explain the working of a mobile phone or a web server. The academic past of journalists remained focussed on humanities, making them unfit for efficient science reporting. Instead of relying on evidence based medicine, the public goes after self-styled nutritionists, ‘expert’ authorities on any object under the sun and scientists portrayed as scapegoats of the big pharma or conventional medical establishment.

Detox methods were widely popularised and kits were sold in large quantities to unsuspecting public. They promise to remove unspecified toxins from the body, sometimes by so ridiculous a way as attaching a piece of medicine-filled sticker to the foot. This is mere eyewash, as is Brain Gym, an exercise program for school students without any scientific basis for the ritualised procedures followed in the program. While it is true that exercise breaks are good for the students, such copyrighted programs don’t do them any good. Homeopathy is another such nonsense, based on the false notion that ‘like cures like’. Homeopaths are not interested, if not hostile, to the idea of conducting randomized, double-blind, clinical trials to establish the effectiveness of their sugar pills in curing people of diseases. A few research papers claiming efficacy are methodologically flawed and the results are not statistically significant. Actual trials showed that the homeo sugar pills work no better than placebo, the author then moves on to describe the placebo effect in another illuminating chapter. Even the colour of the pill is said to infuse a psychological effect, stimulant medication come invariably in red, orange or yellow, while tranquilizers are generally blue, green or purple. In fact, placebo medication has also been shown to be more effective than regular medicines, in some cases. He could have included a reference to Jacques Benveniste, whose paper was the greatest hoax in support of homeopathy. The homeopaths have shown themselves to be not having the maturity nor the professionalism to practice within their limited means. Though homeo pills don’t have effect both ways, their advocacy against vaccination are critical medication are exposing ordinary patients to unnecessary danger.

The nutrition industry, spawning food supplements, is another quackery doing the rounds for the last 20 years. Data from little known, unsubstantiated research papers are blown out of proportions and trumpeted as fact. Beta carotene, promoted aggressively by the industry as an antioxidant to ward off  ageing may in fact cause harmful effects. Eating a lot of vegetables and fruits, avoiding smoking and obesity, doing exercise are some of the most effective ways to leading a healthy life, but people go for medicalizing their lives and follow copyrighted procedures and shamelessly swallow pills for ensuring the same thing. Fish pills was one of the quacks practiced by the industry worldwide. They were thought to increase children’s IQ, and was based on a false study. Goldacre attempts to find out what caused such a barrage of spurious medicine during the last decades of last century. The golden age of medicine was the four decades or so, beginning in 1935, when penicillin, dialysis, organ transplants, intensive care, vaccination and almost all of the now commonly used medicines were invented and put to good use. During the 1980s, the output suddenly slumped and the industry turned its focus to nutrition products and alternative medicine. A company, once established, has to generate income to stay alive whether or not new medicines are invented. Children are inculcated with the notion of consuming a fish pill, three times a day, thereby priming him to be a regular eater of medicine during the rest of his life. Instead of addressing issues like social inequality, disintegration of local communities and breakdown of family and others, they are forced to turn to medicines for behavioural problems.

Not only individuals, but prominent administrators and politicians are falling victim to the trickeries of nutrition industry. In early 2000, South African President, Thabo Mbeki and his health minister, Manto Tshabalala-Msimang refused to administer anti-retroviral drugs to AIDS patients claiming that those would endanger the patients. Their alternative was multi-vitamin pills and nutrition as encouraged and supported by food supplement industry leaders like Matthias Rath. Tshabalala-Msimang even refused to accept that AIDS is caused by HIV and maintained that afflicted people are killed by poverty and not AIDS. She advocated the consumption of beetroot, garlic, lemons and African potatoes by the AIDS victims. Massive campaigns by grassroots organizations in 2005 forced the government to backpedal. Incidentally, it was also shown by trials that African potatoes are harmful to AIDS sufferers.

Goldacre spends considerable effort to address the question of whether modern medicine is indeed evil as claimed by alternative medicine gurus. Evidence-based medicine is the only way forward in a dense jungle covered by such hocus pocus as ritualistic and alternative healthcare. Even trials conducted by big pharma are often not trustworthy due to the bias in them. Pharma-sponsored trials invariably lead to positive results, endorsing the medicine being tested out. As if to cover the cost of R&D, big companies charge premium rates on pills, often denying their use in underdeveloped countries. Statistics however, shows that the industry spends only 14% of their revenue in R&D while lavishing a whopping 31% on advertising and promotionals. Even with all these counterpoints, it can’t be argued that modern medicine is evil.

Another pitfall usually lurking behind the headlines of media is unfamiliarity with the nuances of statistical parameters. Failure to understand the concepts of statistical significance and the probability of occurrence of a rare event confuse people. Sometimes, the logical inference runs counter to intuition. The ignorance sometimes leads to unjustifiable deals like sentencing an innocent person to prison, based on flawed probabilistic assessment that a death or murder is such a rare event to happen naturally, other than by wilful commitment by the accused. Demeonstrations of some cases in England and Denmark proves Goldacre’s point. The book ends with the story of how the media went berserk against the MMR (Mumps, measles and rubella) vaccine claiming that it produces autism in children. No respectable study was behind the assertion, save some authoritative figures bent on offering alternate products. Rates of vaccination fell from 90% in 1999 to 73% in 2005 when the claim was debunked. Measles had started coming back to England during that period, probably caused by the large number of people not getting vaccine during that period. Ignorance, emotion and hysteria were trumpeted against the medical community.

The book is a pleasure to read, though it would have served it well to have some photographs too. The author spells out flaws in our intuition in a very informative way. The flaws are,

1) We see patterns where there is only random noise

2) We see causal relationships where there are none

3) We overvalue confirmatory information for any given hypothesis

4) We seek out confirmatory information for any given hypothesis

5) Our assessment of the quality of new evidence is biased by our previous beliefs. (p.247-250)

Our predisposition to affirmative outcomes are sealed with a good quote from Francis Bacon, “It is the peculiar and perpetual error of the human understanding to be more moved and excited by affirmatives than negatives” (p.247). This book must find a respectable place in the library of a rational-minded person seeking to separate the wheat from the chaff in today’s world full of promotional material of dubious usefulness.

On the negative side, the author’s tirades against leaders of alternative medicine often degenerates to personal attacks targeted to demoralize him rather than demolishing the argument. Accusing a person of not having a medical degree is no answer to his argument that a particular piece of gobbledegook works in a specific case of a disease. The people suffered most from the hands of the author are Matthias Rath, Patrick Holford, Gillian McKeith and Chris Malyzzewicz. They may be charlatans, but the vengeful attack has not helped the truth establish. The author sometimes does not complete the argument or logic as evidenced by his statement that “Evolutionary theory is one of the top three important ideas of our time” (p.229), but he fails to mention the other two! In one chapter, Goldacre continues his all-guns attack on the tests on MRSA swabs hoax, at the same time not even explaining what is MRSA. The hapless readers like me have to search Google for that term, while still not getting an idea of which incident the author was referring to.

The book is highly recommended.

Rating: 4 Star