.gif)
Bad Science (book)
Encyclopedia
Bad Science is a book by Ben Goldacre
, criticising mainstream media reporting on health and science issues. Published by Fourth Estate in September 2008, the book contains extended and revised versions of many of his Guardian
columns. It has been positively reviewed by the British Medical Journal and the Daily Telegraph and has reached the Top 10 bestseller list for Amazon Books. Although almost all reviews have been positive, some points have been criticised, and the forum on his website has a section devoted to corrections. It was shortlisted for the 2009 Samuel Johnson Prize
.
, a programme of specific physical exercises that its commercial promoters claim can create new pathways in the brain. The uncritical adoption of this programme by sections of the British school system is derided.
is used to prompt a discussion of the nature of scientific evidence, with reference to the placebo
effect, regression to the mean, and the importance of blind testing and randomisation
in the design of fair clinical trials. Having concluded that homeopathic pills have been shown to work no better than placebo pills, the author suggests homeopathy may still have psychological benefits which could be the subject of further study.
and prognosis
with no other treatment helps recovery, but ethical and time constraints usually prevent doctors from giving this reassurance. Exploiting the placebo
effect is presented as possibly justifiable if used in conjunction with effective conventional treatments. The author links its use by alternative medicine practitioners with the diversion of patients away from effective treatments and the undermining of public health campaigns on AIDS
and malaria
.
are accused of misusing science and mystifying diet to bamboozle the public. Misrepresentations of the results of legitimate scientific research to lend bogus authority to nutritionist theories, while ignoring alternative explanations are cited in evidence. The use of weak circumstantial associations between diet and health found in observational studies as if they proved nutritionist claims is criticised. The unjustified over-interpretation of surrogate outcomes
in animal (or tissue culture
) experiments as proving human health benefits is explored. The cherry picking of published research to support a favoured view is contrasted with the systematic review
designed to minimise such bias. The supposed benefits of antioxidants are questioned with studies showing they may be ineffective or even harmful in some cases. The methods used by the food supplement industry to manufacture doubt about any critical scientific reports are likened to those previously used by the tobacco
and asbestos
industries.
and her scientific claims are dissected. Statements exemplifying her scientific knowledge include that the consumption of dark-leaved vegetables like spinach "will really oxygenate your blood" as they are high in chlorophyll, and that "each sprouting seed is packed with the nutritional energy needed to create a fully-grown, healthy plant". She is described masquerading as a genuine medical doctor on her TV reality/health shows. Her publications are compared with a Melanesian cargo cult
; superficially correct but lacking any scientific substance. Her belief in the special nutritional value of plant enzymes (which are broken down in the gut like any other proteins) is ridiculed. The general problems involved in establishing any firm links between diet and health are examined.
capsules make children smarter is examined. The book probes the methodological weaknesses of the widely publicised "Durham trial" where the pills were given to children to improve their school performance and behaviour, but without any control groups and wide open to a range of confounding factors
. The failure to publish any results and backtracking on earlier claims by the education authorities is slated. The media's preference for simple science stories and role in promoting dubious health products is highlighted. Parallels are drawn between the Equazen company behind the Durham fish oil trials and the Efamol
company's promotion of evening primrose oil.
success in presenting nutritionism as a scientific discipline in the media, and forging links with some British universities is also noted. The book judges that his success is based on misinterpreting and cherry-picking favourable results from the medical literature, in order to market his vitamin pills. His promotion of vitamin
C in preference to AZT
as a treatment for AIDS
, vitamin E to prevent heart attacks, and vitamin A to treat autism
are all condemned as lacking in sound evidential support. His reliance on the work of discredited fellow nutritionist Dr. R.K. Chandra
is likewise slated. The Universities of Luton and Teesside are criticised for their past associations with Holford and the ION.
produced by researchers not publishing negative results is illustrated with funnel plot
s. Examples are made of the SSRI antidepressants and Vioxx drugs. Reform of trials registers to prevent abuses is proposed. The ethics of drug advertising and manipulation of patient advocacy groups are questioned.
are revealed to be the product of PR companies using biddable academics to add weight to their marketing campaigns. Among other examples, the speculation by Dr. Oliver Curry (a political theorist at the LSE
) that the human race will evolve into two separate races, presented as a science story across the British media, is exposed as a PR stunt for a men's TV channel. The relative scarcity of sensational medical breakthroughs since a golden age of discovery between 1935 and 1975, is seen as motivating the production of dumbed-down stories which trumpet unpublished research and ill-founded speculation. An inability to evaluate the soundness of scientific evidence is seen to give undeserved prominence to marginal figures with fringe views.
es, which, Goldacre argues, explain some of the appeal of alternative medicine ideas. Biases mentioned include confirmation bias
, the availability heuristic
, illusory superiority
and the clustering illusion
(the misperception of random data). It also discusses Solomon Asch
's classic study of social conformity
.
and Lucia de Berk
, in which the author says poor understanding and presentation of statistics played an important part in their criminal trials.
Goldacre notes how the Daily Mirror once managed to combine "three all-time classic bogus science stories" into one editorial: the Arpad Pusztai affair
of GM crops, Andrew Wakefield
and the MMR vaccine controversy
and Chris Malyszewicz and the MRSA hoax. On the other hand journalists were very poor in uncovering or reporting on the thalidomide
tragedy - only covering well the ultimate political issue of compensation.
. The post dated 9 April 2009 states: This is the “missing chapter” about vitamin pill salesman Matthias Rath. Sadly I was unable to write about him at the time that book was initially published, as he was suing my ass in the High Court.
The full chapter has been made universally available under a Creative Commons
license with the title The Doctor Will Sue You Now. Additionally, this full chapter is included as chapter 10 in the New Paperback Edition.
In this chapter the author explains its origin, its reasons for being excluded and describes his personal reasons and tribulations in the said legal resolution. Being his personal point of view it contains an account of his anger at being gagged due to legal/financial restrictions, his support by the Guardian (whom he writes for) and his now encyclopedic knowledge of the subject in question.
Ben Goldacre
Ben Michael Goldacre born 1974 is a British science writer, doctor and psychiatrist. He is the author of The Guardian newspaper's weekly Bad Science column and a book of the same title, published by Fourth Estate in September 2008....
, criticising mainstream media reporting on health and science issues. Published by Fourth Estate in September 2008, the book contains extended and revised versions of many of his Guardian
The Guardian
The Guardian, formerly known as The Manchester Guardian , is a British national daily newspaper in the Berliner format...
columns. It has been positively reviewed by the British Medical Journal and the Daily Telegraph and has reached the Top 10 bestseller list for Amazon Books. Although almost all reviews have been positive, some points have been criticised, and the forum on his website has a section devoted to corrections. It was shortlisted for the 2009 Samuel Johnson Prize
Samuel Johnson Prize
The Samuel Johnson Prize for Non-Fiction is one of the most prestigious prizes for non-fiction writing. It was founded in 1999 following the demise of the NCR Book Award and based on an anonymous donation. The prize is named after Samuel Johnson...
.
Introduction
A brief introduction (by Goldacre) touching on subjects covered by subsequent chapters. It bemoans the widespread lack of understanding of evidence-based science.Chapter 1: Matter
Detoxification methods (the Aqua Detox, ear candles etc.) that can easily be shown to be bogus by simple experiments. Discusses the "detox phenomenon." Touches on purification rituals.Chapter 2: Brain Gym
The claims for Brain GymBrain Gym
The Brain Gym program is based on the concept that learning challenges can be overcome by carrying out certain movements, the use of which will create pathways in the brain...
, a programme of specific physical exercises that its commercial promoters claim can create new pathways in the brain. The uncritical adoption of this programme by sections of the British school system is derided.
Chapter 3: The Progenium XY Complex
On cosmetics, and the misleading and pseudoscientific claims by their manufacturers.Chapter 4: Homeopathy
HomeopathyHomeopathy
Homeopathy is a form of alternative medicine in which practitioners claim to treat patients using highly diluted preparations that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient...
is used to prompt a discussion of the nature of scientific evidence, with reference to the placebo
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...
effect, regression to the mean, and the importance of blind testing and randomisation
Random sample
In statistics, a sample is a subject chosen from a population for investigation; a random sample is one chosen by a method involving an unpredictable component...
in the design of fair clinical trials. Having concluded that homeopathic pills have been shown to work no better than placebo pills, the author suggests homeopathy may still have psychological benefits which could be the subject of further study.
Chapter 5: The Placebo Effect
Examples of the power of the mind over pain, anxiety and depression are presented with studies showing how higher prices, fancy packaging, theatrical procedures and a confident attitude in the doctor all contribute to the relief of symptoms. In patients with no specific diagnosed condition, even a fake diagnosisDiagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
and prognosis
Prognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...
with no other treatment helps recovery, but ethical and time constraints usually prevent doctors from giving this reassurance. Exploiting the placebo
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...
effect is presented as possibly justifiable if used in conjunction with effective conventional treatments. The author links its use by alternative medicine practitioners with the diversion of patients away from effective treatments and the undermining of public health campaigns on AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
and malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
.
Chapter 6: The Nonsense du Jour
NutritionistsNutritionism
Nutritionism is a paradigm that assumes that it is the scientifically identified nutrients in foods that determine the value of individual food stuffs in the diet. In other words, it is the idea that the nutritional value of a food is the sum of all its individual nutrients, vitamins, and other...
are accused of misusing science and mystifying diet to bamboozle the public. Misrepresentations of the results of legitimate scientific research to lend bogus authority to nutritionist theories, while ignoring alternative explanations are cited in evidence. The use of weak circumstantial associations between diet and health found in observational studies as if they proved nutritionist claims is criticised. The unjustified over-interpretation of surrogate outcomes
Surrogate endpoint
In clinical trials, a surrogate endpoint is a measure of effect of a certain treatment that may correlate with a real clinical endpoint but doesn't necessarily have a guaranteed relationship...
in animal (or tissue culture
Tissue culture
Tissue culture is the growth of tissues or cells separate from the organism. This is typically facilitated via use of a liquid, semi-solid, or solid growth medium, such as broth or agar...
) experiments as proving human health benefits is explored. The cherry picking of published research to support a favoured view is contrasted with the systematic review
Systematic review
A systematic review is a literature review focused on a research question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question. Systematic reviews of high-quality randomized controlled trials are crucial to evidence-based medicine...
designed to minimise such bias. The supposed benefits of antioxidants are questioned with studies showing they may be ineffective or even harmful in some cases. The methods used by the food supplement industry to manufacture doubt about any critical scientific reports are likened to those previously used by the tobacco
Tobacco
Tobacco is an agricultural product processed from the leaves of plants in the genus Nicotiana. It can be consumed, used as a pesticide and, in the form of nicotine tartrate, used in some medicines...
and asbestos
Asbestos
Asbestos is a set of six naturally occurring silicate minerals used commercially for their desirable physical properties. They all have in common their eponymous, asbestiform habit: long, thin fibrous crystals...
industries.
Chapter 7: Dr Gillian McKeith PhD
The Scottish TV diet guru and self-styled "doctor" Gillian McKeithGillian McKeith
Gillian McKeith is a Scottish nutritionist, television presenter, and writer. She is the former host in the UK of Channel 4's You Are What You Eat and Granada Television's Dr Gillian McKeith's Feel Fab Forever, and as of 2010 presents Eat Yourself Sexy on the W Network in Canada...
and her scientific claims are dissected. Statements exemplifying her scientific knowledge include that the consumption of dark-leaved vegetables like spinach "will really oxygenate your blood" as they are high in chlorophyll, and that "each sprouting seed is packed with the nutritional energy needed to create a fully-grown, healthy plant". She is described masquerading as a genuine medical doctor on her TV reality/health shows. Her publications are compared with a Melanesian cargo cult
Cargo cult
A cargo cult is a religious practice that has appeared in many traditional pre-industrial tribal societies in the wake of interaction with technologically advanced cultures. The cults focus on obtaining the material wealth of the advanced culture through magic and religious rituals and practices...
; superficially correct but lacking any scientific substance. Her belief in the special nutritional value of plant enzymes (which are broken down in the gut like any other proteins) is ridiculed. The general problems involved in establishing any firm links between diet and health are examined.
Chapter 8: 'Pill Solves Complex Social Problem'
The claim that fish oilFish oil
Fish oil is oil derived from the tissues of oily fish. Fish oils contain the omega-3 fatty acids eicosapentaenoic acid , and docosahexaenoic acid , precursors of certain eicosanoids that are known to reduce inflammation throughout the body, and are thought to have many health benefits.Fish do not...
capsules make children smarter is examined. The book probes the methodological weaknesses of the widely publicised "Durham trial" where the pills were given to children to improve their school performance and behaviour, but without any control groups and wide open to a range of confounding factors
Confounding
In statistics, a confounding variable is an extraneous variable in a statistical model that correlates with both the dependent variable and the independent variable...
. The failure to publish any results and backtracking on earlier claims by the education authorities is slated. The media's preference for simple science stories and role in promoting dubious health products is highlighted. Parallels are drawn between the Equazen company behind the Durham fish oil trials and the Efamol
David Horrobin
David Frederick Horrobin was an entrepreneur, medical researcher, author and editor. He is best known as the founder of the biotechnology company Scotia Holdings and as a promoter of evening primrose oil as a medical treatment, Horrobin was founder and editor of the journals Medical Hypotheses and...
company's promotion of evening primrose oil.
Chapter 9: Professor Patrick Holford
The influence of the best-selling author, media commentator, businessman and founder of the Institute for Optimum Nutrition (which has trained most of the UK's "nutrition therapists") is acknowledged. Holford'sPatrick Holford
Patrick Holford is a British nutritionist/nutritional therapist and author. He appears regularly on television and radio in the UK and abroad. He has 34 books in print in 24 languages...
success in presenting nutritionism as a scientific discipline in the media, and forging links with some British universities is also noted. The book judges that his success is based on misinterpreting and cherry-picking favourable results from the medical literature, in order to market his vitamin pills. His promotion of vitamin
Vitamin
A vitamin is an organic compound required as a nutrient in tiny amounts by an organism. In other words, an organic chemical compound is called a vitamin when it cannot be synthesized in sufficient quantities by an organism, and must be obtained from the diet. Thus, the term is conditional both on...
C in preference to AZT
Zidovudine
Zidovudine or azidothymidine is a nucleoside analog reverse-transcriptase inhibitor , a type of antiretroviral drug used for the treatment of HIV/AIDS. It is an analog of thymidine....
as a treatment for AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
, vitamin E to prevent heart attacks, and vitamin A to treat autism
Autism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...
are all condemned as lacking in sound evidential support. His reliance on the work of discredited fellow nutritionist Dr. R.K. Chandra
Ranjit Chandra
Ranjit Kumar Chandra, OC is a professional in the field of nutrition and immunology who has been accused of committing scientific fraud by the British Medical Journal...
is likewise slated. The Universities of Luton and Teesside are criticised for their past associations with Holford and the ION.
Chapter 10: Is Mainstream Medicine Evil?
The book remarks on the relatively low percentage of conventional medical activity (50 to 80%) which could be called "evidence-based". The efforts of the medical profession to weed out bad treatments are seen to be hampered by the withholding or distortion of evidence by drug companies. The science and economics of drug development are outlined, with criticism of the lack of independence of industrial research and the neglect of Third World diseases. Some underhand tricks used by drug companies to engineer positive trial results for their products are explored. The publication biasPublication bias
Publication bias is the tendency of researchers, editors, and pharmaceutical companies to handle the reporting of experimental results that are positive differently from results that are negative or inconclusive, leading to bias in the overall published literature...
produced by researchers not publishing negative results is illustrated with funnel plot
Funnel plot
A funnel plot is a useful graph designed to check the existence of publication bias in systematic reviews and meta-analyses. It assumes that the largest studies will be near the average, and small studies will be spread on both sides of the average...
s. Examples are made of the SSRI antidepressants and Vioxx drugs. Reform of trials registers to prevent abuses is proposed. The ethics of drug advertising and manipulation of patient advocacy groups are questioned.
Chapter 11: How the Media Promote the Public Misunderstanding of Science
The misrepresentation of science and scientists in the media is attributed to the preponderance of humanities graduates in journalism. The dumbing-down of science to produce easily assimilated wacky, breakthrough or scare stories is criticised. Wacky "formula stories" like those for "the perfect boiled egg" or "most depressing day of the year"Blue Monday (date)
Blue Monday is a name given to a date stated, as part of a publicity campaign by Sky Travel, to be the most depressing day of the year.This date was published in a press release under the name of Cliff Arnall, at the time a tutor at the Centre for Lifelong Learning, a Further Education centre...
are revealed to be the product of PR companies using biddable academics to add weight to their marketing campaigns. Among other examples, the speculation by Dr. Oliver Curry (a political theorist at the LSE
London School of Economics
The London School of Economics and Political Science is a public research university specialised in the social sciences located in London, United Kingdom, and a constituent college of the federal University of London...
) that the human race will evolve into two separate races, presented as a science story across the British media, is exposed as a PR stunt for a men's TV channel. The relative scarcity of sensational medical breakthroughs since a golden age of discovery between 1935 and 1975, is seen as motivating the production of dumbed-down stories which trumpet unpublished research and ill-founded speculation. An inability to evaluate the soundness of scientific evidence is seen to give undeserved prominence to marginal figures with fringe views.
Chapter 12: Why Clever People Believe Stupid Things
This chapter is a brief introduction to the research on cognitive biasCognitive bias
A cognitive bias is a pattern of deviation in judgment that occurs in particular situations. Implicit in the concept of a "pattern of deviation" is a standard of comparison; this may be the judgment of people outside those particular situations, or may be a set of independently verifiable...
es, which, Goldacre argues, explain some of the appeal of alternative medicine ideas. Biases mentioned include confirmation bias
Confirmation bias
Confirmation bias is a tendency for people to favor information that confirms their preconceptions or hypotheses regardless of whether the information is true.David Perkins, a geneticist, coined the term "myside bias" referring to a preference for "my" side of an issue...
, the availability heuristic
Availability heuristic
The availability heuristic is a phenomenon in which people predict the frequency of an event, or a proportion within a population, based on how easily an example can be brought to mind....
, illusory superiority
Illusory superiority
Illusory superiority is a cognitive bias that causes people to overestimate their positive qualities and abilities and to underestimate their negative qualities, relative to others. This is evident in a variety of areas including intelligence, performance on tasks or tests, and the possession of...
and the clustering illusion
Clustering illusion
The clustering illusion refers to the tendency erroneously to perceive small samples from random distributions to have significant "streaks" or "clusters", caused by a human tendency to underpredict the amount of variability likely to appear in a small sample of random or semi-random data due to...
(the misperception of random data). It also discusses Solomon Asch
Solomon Asch
Solomon Eliot Asch , also known as Shlaym, was an American Gestalt psychologist and pioneer in social psychology.-Early life and education:...
's classic study of social conformity
Asch conformity experiments
The Asch conformity experiments were a series of studies published in the 1950s that demonstrated the power of conformity in groups. These are also known as the Asch Paradigm.-Introduction:...
.
Chapter 13: Bad Stats
This chapter covers the cases of Sally ClarkSally Clark
Sally Clark was a British solicitor who became the victim of an infamous miscarriage of justice when she was wrongly convicted of the murder of two of her sons in 1999...
and Lucia de Berk
Lucia de Berk
Lucia de Berk, often called Lucia de B. or Lucy de B is a Dutch licenced paediatric nurse, who was subject to a miscarriage of justice. She was sentenced to life imprisonment in 2003 for four murders and three attempted murders of patients in her care...
, in which the author says poor understanding and presentation of statistics played an important part in their criminal trials.
Chapter 14: Health Scares
In this chapter, the author claims that the press selectively used a "laboratory" that gave positive MRSA results where other pathology labs found none. Creating an "expert" from Chris Malyszewicz who worked from a garden shed.Goldacre notes how the Daily Mirror once managed to combine "three all-time classic bogus science stories" into one editorial: the Arpad Pusztai affair
Pusztai affair
The Pusztai affair is a controversy that began in 1998 after protein scientist Arpad Pusztai went public with research he was conducting with genetically modified potatoes. In a short interview he reported that rats fed potatoes engineered to express a plant lectin had stunted growth and a...
of GM crops, Andrew Wakefield
Andrew Wakefield
Andrew Wakefield is a British former surgeon and medical researcher, known as an advocate for the discredited claim that there is a link between the measles, mumps and rubella vaccine, autism and bowel disease, and for his fraudulent 1998 research paper in support of that claim.Four years after...
and the MMR vaccine controversy
MMR vaccine controversy
The MMR vaccine controversy was a case of scientific misconduct which triggered a health scare. It followed the publication in 1998 of a paper in the medical journal The Lancet which presented apparent evidence that autism spectrum disorders could be caused by the MMR vaccine, an immunization...
and Chris Malyszewicz and the MRSA hoax. On the other hand journalists were very poor in uncovering or reporting on the thalidomide
Thalidomide
Thalidomide was introduced as a sedative drug in the late 1950s that was typically used to cure morning sickness. In 1961, it was withdrawn due to teratogenicity and neuropathy. There is now a growing clinical interest in thalidomide, and it is introduced as an immunomodulatory agent used...
tragedy - only covering well the ultimate political issue of compensation.
Index
The hardback and first paperback editions did not include an index. Several indexes were prepared by bloggers, including one prepared by Oliblog. The latest paperback issue includes a full index.Previously unpublished chapter: The Doctor Will Sue You Now
Further to the release of this book a resolution of the legal status of one of the chapters has come about since Goldacre won a libel case filed against him by Matthias RathMatthias Rath
Matthias Rath is a doctor, businessman, and vitamin entrepreneur. He earned his MD degree in Germany. Rath claims that a program of nutritional supplements , including formulations that he sells, can treat or cure diabetes, cardiovascular disease, cancer, and HIV/AIDS...
. The post dated 9 April 2009 states: This is the “missing chapter” about vitamin pill salesman Matthias Rath. Sadly I was unable to write about him at the time that book was initially published, as he was suing my ass in the High Court.
The full chapter has been made universally available under a Creative Commons
Creative Commons
Creative Commons is a non-profit organization headquartered in Mountain View, California, United States devoted to expanding the range of creative works available for others to build upon legally and to share. The organization has released several copyright-licenses known as Creative Commons...
license with the title The Doctor Will Sue You Now. Additionally, this full chapter is included as chapter 10 in the New Paperback Edition.
In this chapter the author explains its origin, its reasons for being excluded and describes his personal reasons and tribulations in the said legal resolution. Being his personal point of view it contains an account of his anger at being gagged due to legal/financial restrictions, his support by the Guardian (whom he writes for) and his now encyclopedic knowledge of the subject in question.