Tuesday, 24 March 2009

Book review: "Bad science", by Ben Goldacre

If science were a person, it would be an old and faded star, living the life of a recluse in some Beverly Hills mansion. Newspapers write sensational stories about his life, caring little for the facts or accentuating what little information they have. Even science's friends do little to help, and instead would stoke the fires by giving inept statements to the media.

If this analogy were to be stretched even further, then Ben Goldacre would be science's chief spokesperson, cutting through the incorrect stories to reach some semblance of the truth. He would be fighting a losing battle.

In 'Bad science', doctor, researcher and Guardian columnist Ben Goldacre details the way that many parties - nutritionists, the media, politicians, even pharmaceutical companies and scientists themselves - are misrepresenting science to the public.

The main interface between science and society, the media, is doing an exceptionally poor job, one that is costing everyone. Instead of reporting science fairly and evenly, they are, as a whole, descending down to the lowest common denominator, their stories aimed solely at increasing their circulation over fair or accurate reporting.

The media, akin to a hungry wolf, needs a free supply of stories with which to feed its ravenous belly. And the wolf cares little for the scientific method. It will report any story, based on the scantiest of evidence or misreading of scientific papers. It is particularly hungry for the current 'in' stories - autism and MMR; the beneficial aspects of antioxidants or the harm or benefits of certain foodstuffs.

It is hard to stress how important this book is. On the front, Charlie Brooker is quoted as saying, "The most important book you'll read this year, and quite possibly the funniest too." Whilst the second part of the statement is debatable, the first is an understatement. Indeed, this might be the most important book you ever read. What is more, it is also easy to read.

There is much wrong with the way the public sees science, and Ben Goldacre, who also writes a 'Bad Science' blog, goes into some of the complex reasons. No-one is spared - the media, the pharmaceutical industry, so-called 'alternative' therapies, and even the public itself - all comes in for criticism.

Is it right that the public are being conned by alternative-health therapists into using alternative medicine rather than conventional? Is it right that the media routinely reports scientific trials incompetently? That the media use 'doctors' who have no real formal qualifications to peddle their own 'treatments'? That the pharmaceutical industry often misrepresents data from trials on its drugs? That the media have put the lives of our children in danger by making a 'scandal' out of the MMR vaccine?

This book contains all the basic tools on how to filter adverts, media reports or scientific advances, in order to get to the truth of the claims. And there are a great deal of claims out there. Indeed, we are bombarded with them every day - a new hoped-for cure for cancer, or a new drug with some silly pseudo-scientific ingredient that will magically give you less wrinkles. All of these are promoted daily in the media, yet the media rarely, if ever, look at the science behind the claims. And, as Goldacre points out, an alarming number of the claims are either hyped-up or plain wrong. The media's obsession with 'new breakthroughs' harms the public's perception of science.

As an example, he gives a simple experiment to show that 'ear candles' do no good at all (yet no journalists have ever tried similar 'research', and continue to promote them). He also mentions that our schools are being filled with a nonsense called 'brain gym', a pseudo-science that claims that movements can aid learning difficulties, yet has no science backing the claims. This leads to the incredible situation where the state is indoctrinating our children with bad science from a young age.

Homoeopathy also comes in for criticism, in particular to the fact that no clinical or scientific research backs it up. Yet despite this, people continue to make vast amounts of money from this con. Ben Goldacre explains some of the reasons behind this very well, including the fallacy that something diluted to 30C (i.e. one part in 10^60) could possibly have an effect.

The book also has a detailed chapter on the placebo effect - the strange fact that giving someone a non-effective treatment can actually improve symptoms. This is a fact long regarded by scientists, and little understood. It is the placebo effect that allows many 'alternative' therapies to show improvements, and allows fraudulent claims of improvements to be made.

Despite what his critics may say, Ben Goldacre is no friend of the pharmaceutical industry, and this too comes in for heavy (and justified) criticism. The chase for profits can 9and often does) get in the way of good science.

There are some funny moments in the book - Ben Goldacre gets his dead cat Hettie to be a 'certified professional member' of the American Association of Nutritional Consultants. This shows that people who use such associations as proof of skills or training can be exceptionally bogus. Additionally, when he contacts the 'academic' institution 'Institute of Optimum Nutrition', he gets told that they are 'a research institute, so they don't have time for academic papers and stuff'. This is how farcical 'alternative' medicine can get - a research institute that admits it does not publish papers!

The book also details several reasons why good scientists and people get things wrong, including cognitive illusions. These are useful when trying to interpret many kinds of evidence, and not just scientific papers.
  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.
These could perhaps be condensed as the following statement: "I've taken drug A, and as expected I feel better. Therefore drug A has cured me. After all, it cured my friend." Did drug A really cure the person, and can an effect really be seen from only one person's experience?

Decades ago, science fiction writers wrote stories of dystopian future worlds, where the Human race has split up into the intelligentsia - the scientists, the artisans and the politicians - and the workers - everyone else. The intelligentsia lived luxury lives, whilst the proletariat toiled away endlessly, unable to change their fate from birth.

In reality a split has occurred, except the scientists are on their own on one side, trying (and generally failing) to explain to the public how science works, and what can be expected of it. In the meantime, the public perceives scientists as nerdy, geeky poindexters with no social skills.

This image, whilst deserved in a few cases, is really far from the truth. We need scientists, and we need to understand science. Failure to do so could be bad for us all.

1 comment:

rfwitch said...

OK, I really wanted to do a review of this book, but now I'm glad I haven't, because you've pretty much touched on all the important points.

One thing I liked about this book is that it stays on topic: the evidence. You won't find ad hominem attacks on practitioners of "alternative medicine", except perhaps in one instance: he recounts the accusation of being in the pocket of "Big Pharma" by the head of a nutritional supplement firm. As I recall, 30% of this firm was owned by a "Big Pharma" company at the time. That must have seriously rankled.

And I also liked the book for hitting all my pet peeves: homeopathy, the so-called "anti-ageing" products and the horrible situation with anti-vaccination sentiment, which pops up in different countries in different guises, and endangers the life and health of so many.

This last alarms me very much. Widespread fear of the polio vaccine in Africa came about because of the rumout that Westeners were trying to sterilize Africans. Poster-girl for the antivax crowd in America, Jenny McCarthy talks about the evil doctors poisoning children in the same breath as praising Botox for being a great invention. It may be that there is a human tendency towards fear of the unknown, and distrust of Authority that says it knows best. But hey, sometimes the Authority does know something, and even if you are suspicious, you owe it to society (and especially your children, if you have any) to educate yourself on something so vital. I have some sympathy with African parents who won't vaccinate their children, but none whatsoever for Ms McCarthy, who, despite money, education and privilege, continues to make a fool of herself and endanger others. It is not like she's never had people willing to explain the evidence to her. I suspect many an appalled doctor tried to change her mind (google "Respectful Insolence" until your girlfriend can be trusted to link correctly)

This is turning into a bit of a rant. Sorry. But I cannot support *any* government money going in to alternative medicine with no evidence for efficacy. Even if homeopathy makes people feel better, how can a scientist promote it? If we the taxpayers are funding rubbish such as Brain Gym, how will we have the moral and scientific authority to teach young people other things: binge drinking is bad, eat your greens, don't go over 40 mph in a 30 zone? I spent the entirety of my childhood convinced grownups were all either batty or stupid. Now that I've grown up (sorta), I feel much the same. Except Ben Goldacre. And maybe you. Sometimes. :-)