Bad Science

There aren’t many out-and-out good eggs in British journalism but Ben Goldacre (http://en.wikipedia.org/wiki/Ben_Goldacre and http://www.badscience.net/) is one of them. He mounts a ferocious attack on bad science. Currently (2013) he is Wellcome research fellow in epidemiology at the London School of Hygiene and Tropical Medicine, and has, since 2003, doubled as The Guardian’s scourge of sloppy science reporting, statistical illiteracy and public relations hucksterism. He hasn’t been short of material. There’s a chapter in his new book entitled ‘How The Media Promote the Public Misunderstanding of Science’ in which Goldacre claims to have debunked more than 500 news stories since his crusade began. Indeed, the inability of the press and public to evaluate evidence, he argues, has become a public health issue.

Much of the MRSA scare was a circus. MMR was a debacle. Cases of mumps were almost unheard of before the media bandwagon got started, but by 2005, there was an epidemic. The moral is clear: when the well of information is contaminated, people get ill.

Hence the present work Bad Science (2008), a crash course in interpretation of medical data, coupled with crunching take-downs of some of Goldacre’s long-standing irritants – especially the nutritionists Gillian McKeith and Patrick Holford. We start at the shallow end, so to speak, with a detox foot-bath that uses ‘an ionising unit’ to ‘adjust the bio-energetic field’ of water. One sticks one’s feet in a trough and a murky fluid forms around them – toxins, one supposes. The trained professional can then read these to determine the state of one’s innards. Except that the same brown stuff forms whether your feet are there or not. The ‘toxins’ are rust. Welcome to what Goldacre calls ‘the theatre of goo’, and to the indispensability of control experiments.

This same basic trick, of fudging or concealing the relevant comparison, is endemic to medical charlatanry from the lowliest herbalist to the mightiest pharmaceutical conglomerate. There are other wheezes: cherry-pick the studies that make your favoured treatment look like the Philosopher’s Stone and ignore the wider analysis that suggests it’s a dud. Or carry out a trial yourself, and wait until the results are in before you decide what your treatment was meant to do. The odds are that something will have gone better than average. There are still deeper games one can play. In conducting your research, what should you say about test subjects who drop out? How should you frame follow-up interviews? How should you screen against placebo effects? This last topic is particularly tricky, as Goldacre explains. The effect can occur even when patients know they are being given a placebo. It can overpower the physiological action of a treatment, so that drugs end up doing the opposite of what one would expect. In one famous experiment, nauseous patients were cured by a dose of the emetic ipecac, administered under false pretences. Even the unspoken beliefs of doctors seem to exert an influence.

As Goldacre notes, there’s an irony here for all those alternative treatments that work by exploiting the placebo effect. When homeopaths spin their fables about the healing power of water’s ‘molecular memory’, they’re venturing a mechanical explanation for their results, a sort of naive reductionism. But how much more mysterious and fascinating is it that the mere ritual of medical assistance should itself be efficacious? The notion of a magic pill seems to touch something deep within our collective psyches. Likewise the idea of a plucky maverick, braving the censure of the corrupt establishment. Most of us aren’t good at reading graphs, or knowing what data would be needed to support a given conclusion. Instead we cleave to fairy-tales. This ought to make you cross. At the height of the MRSA hysteria, microbiologists from University College Hospital wrote to a newspaper to express doubts about the tests it was quoting. The results came from a single lab (a plucky outsider) and described a rare strain of the bacteria usually only found in Australia. Since the lab had previously done some work for the Australian press, it seemed probable that samples had been cross-contaminated, a common enough occurrence. After several letters, the newspaper wrote back. ‘We believe in the accuracy and integrity of our articles,’ it said. ‘We believe the test media used…were sufficient to detect the presence of pathogenic type MRSA.’ What you are seeing here, in Goldacre’s words, is ‘a tabloid journalist telling a department of world-class microbiologists that they are mistaken about microbiology”. And the upshot? Sick people were afraid to go to hospital.

This super book works as an introduction to the scientific method and is hugely entertaining at the same time.

Originally published in 2008.

382 pages in Harper Perennial paperback edition