Originally published in United Academics Magazine on June 1, 2012.
Despite the fact that we can thank science for almost all technological advances in human history, it is often misunderstood, misrepresented and misused in the media. In 2003 British doctor Ben Goldacre started writing about this in his Bad Science column in the Guardian and in 2008 he wrote a bestseller book under the same title. With a sense of humor, he demonstrated what’s wrong with most claims of alternative medicine therapists, TV diet guru’s, the pharmaceutical industry and even many journalists. Former Times science editor Mark Henderson argues in his new book The Geek Manifesto: Why Science Matters, that science and politics do not mix well either and he suggests that the geeks take action.
Goldacre, fast talking and self-proclaimed nerd, is a prolific internet user with two active blogs and a barrage of tweets every day. He studied medicine and works full time as an epidemiologist but somehow finds time for his other passion which is picking the evidence behind dodgy claims in the media. Over half of all the science coverage in newspapers is about health, he wrote, and most of it is routinely misleading. He talks in public about the subject almost every week, has been on British radio and television and is about to finish a second book called The Drug Pushers about the misuse of evidence by the pharmaceutical industry.
The aim of his book Bad Science, he wrote, is ‘to future-proof readers against new variants of bullshit’. Take for instance alternative medicine like homeopathy. Like any other medical intervention, we can only know if it works, if its effectiveness can be demonstrated in a fair clinical trial. Such a trial should at least include a control group with a placebo to which you can compare the intervention, preferably random assignment of the study’s participants to either the control or the experimental group (to avoid selection bias) and ideally a so-called double-blind design where both the study’s participants and the experimenters do not know who is assigned to which group (to eliminate effects of expectation and observer bias).
Knowledge about evidence-based medicine like this, is often missing from the alternative medicine community according to Goldacre. Most of their studies turn out to have serious methodological flaws and with homeopathy for instance, it was found that the better the quality of the study, the more likely it was to find that the treatment was no better than placebo.
Most popular nutritional ‘experts’ and the food supplements industry are no better. Goldacre identified a whole range of deceptive techniques they use to bamboozle you into buying their fish oil capsules, antioxidants and organic foods (see How to Mislead your Audience below). Many of these quacks have accused Goldacre in turn of somehow being a pawn of the pharmaceutical industry, as if he was hired to attack their competitors. Ironically, Goldacre is highly critical of big pharma too.
Because the pharmaceutical industry has to convince doctors and academics with clinical trials instead of just the general public, their strategies are more refined but not less pernicious. Their biggest crime is the concealment of negative trial data by only publishing the positive trials, Goldacre says (also known as the file drawer effect). In his 2011 TED talk he called this ‘the single biggest ethical problem facing medicine today’ and he said that doctors and the public cannot make informed decisions when information is being withheld.
How to Mislead your Audience
In his book Bad Science, Ben Goldacre describes the strategies of TV diet guru’s and the food supplements industry to get you buying their products. They include:
- Cherry picking the evidence that support their claim (and ignoring the ten studies that do not)
- Over-extrapolating test results from Petri dishes to humans
- Inferring causation when only observing an association (if healthy people eat much olive oil, it doesn’t necessarily mean olive oil is the cause of their good health)
- Quoting published scientific research that does not exist
The pharmaceutical industry has to convince doctors and academics with clinical trials instead of the general public so their methods are more refined. Some examples:
- Using a too low or too high dose of the competing drug in their trial so their own drug performs relatively better or has fewer side-effects
- Varying the length of their trial until they have positive results
- Manipulating the statistics (many ways of doing this!)
- Concealing negative trial data (e.g. not publishing them)
For a large part the popular media and journalists are to blame. Many of them lack knowledge of the scientific process and have a tendency to portray science as something for nerds, something temporary and changeable, like a transient fad. Goldacre wrote: ‘My basic hypothesis is this: the people who run the media are humanities graduates with little understanding of science, who wear their ignorance as a badge of honour.’ This prevents them from critically appraising the claims from quacks and pill peddlers and, together with a tendency to sensationalize, leads to an endless coverage of wacky, ‘breakthrough’ and scare stories.
A dramatic example of how misleading health information can cause a nation-wide health scare is the MMR affair in the UK. After a very shaky study in 1998, the British doctor Andrew Wakefield suggested that MMR (the vaccine against measles, mumps and rubella) could be causing autism. For no less than nine years British journalists ran stories in support of this practically baseless claim, ignored much counter evidence, covered emotive stories from parents instead of properly explaining the science and in some cases, bizarrely, simply made stuff up. By 2010, it was proven that Wakefield had falsified research results and had acted against the interest of his patients and had been barred from practicing medicine in the UK, but much damage had already been done. The MMR vaccination rate had fallen from 92% in 1996 to 73% in 2008 and the incidence of measles and mumps had been steadily on the rise with even a mumps epidemic in 2005. Goldacre wrote that young doctors had to be reminded of the symptoms of mumps since this disease had been almost eradicated in earlier years.
An even more tragic example of misleading health information concerns the treatment of the AIDS epidemic in South Africa. The German doctor, businessman and vitamin pill entrepreneur Matthias Rath claimed there in the mid-2000s that anti-retroviral drugs against AIDS were poisonous and a conspiracy to kill patients and make money. His multivitamins on the other hand would cut the risk of developing AIDS in half. Unfortunately he got support from Thabo Mbeki, the president of South Africa at the time, and his health minister which resulted in unethical clinical vitamin trials and the refusal to roll out proper treatment programmes. When Goldacre wrote about Rath in the Guardian, he and the newspaper were sued by him for libel. In 2008 Rath dropped the case and was ordered to pay the court costs. In the same year, the Cape High Court banned Rath from conducting his unauthorized clinical trials and from advertising his products and instructed the South African Health Department to investigate his vitamin trials. The South Africans however had already paid a high price. One study estimated that over 343,000 deaths could have been prevented between 1999 and 2007 if the South African national government had used more anti-retroviral drugs as was advised by main stream medicine.
Former Times science editor and writer of the new book The Geek Manifesto: Why Science Matters, Mark Henderson, finds Goldacre’s work important and valuable. In an interview he stated: ‘First, he’s introduced a lot of people who haven’t thought a lot about the value of evidence and the scientific approach to knowledge, to these very important concepts (…) Secondly, he’s given bad science in the media a cost. If a paper gets something badly wrong, either Ben or the legions of bloggers he’s inspired will call it out. This matters. I know that science correspondents have sometimes won battles with news desks about how a story should be covered by pointing out that doing it badly could lead to being “Goldacred”.’
In his own book, Henderson argues that an indifference to science and science abuse is found across the political spectrum as well. ‘Ministers and public servants show a troubling reluctance to use science to investigate how best to teach children, prevent crime, fund healthcare or protect the environment,’ he wrote in the Times. In the interview he explained: ‘I don’t think this usually happens because politicians are “anti-science” in any meaningful way. In the UK at least, this isn’t generally so. Rather, it’s because of an indifference to science — they just haven’t thought about it. They haven’t themselves engaged with the scientific approach to thinking, so it’s not something that occurs to them to apply. And of course, there’s also no political cost to doing science and evidence badly.’
Henderson wants those that care about science (the geeks) to take action. ‘We must consider these issues when we vote, and be prepared to lay aside usual political loyalties to reward politicians who do science well, and to punish those who do it badly,’ he stated. ‘We need to lobby more effectively. If we write to them, see them at constituency surgeries, use our rights as citizens more effectively, we can persuade more MPs to engage with science and how it might help more effective policy-making.’
Considering Goldacre’s and Henderson’s work as a whole, good advice for the average media consumer would be the old adage ‘don’t believe everything you read’. Before you stop drinking coffee because it causes cancer (or start drinking it because it prevents it), go online and find some extra sources of information, follow up on some references, check the claimer’s credentials. Of course, you might not always find your answer quickly, and the quality of online information varies, but some fact checking and a little critical thinking go a long way.
Goldacre, B. (2008). Bad Science. London: Fourth Estate. ISBN: 9780007240197
Ben Goldacre’s main blog: http://www.badscience.net/
Henderson, M. (2012). The Geek Manifesto: Why Science Matters.London: Bantam Press. ISBN: 9780593068236
Mark Henderson’s blog: http://geekmanifesto.wordpress.com/