September 25, 2008
Ben Goldacre: Bad Science
Ben Goldacre has become Richard Dawkins’ understudy, now that Dawkins is too busy arguing with fundamentalists to write about science any more. In his weekly Guardian column, Bad Science, Goldacre – a full-time NHS doctor – skewers cant and half-truths in the painful joints where science meets journalism and advertising. He also has a website, which he named Bad Science to avoid confusion. Now he’s written a book. I can’t remember the name.
What impresses about Goldacre in his Guardian column is his even-handed dedication to the rational, and his refusal to toe the obvious lines. He’s as keen to denounce hysterical anti-GM crop protests as he is to criticise Monsanto. He points out that anyone worried about the health effects of radiation from mobile phones should live as close as possible to a phone mast.
If this last seems counterintuitive, then such upturning of expectations is exactly what Goldacre wants us to be aware of when reading of ‘sciencey’ claims in the media and advertising. His central aim is to arm the layman reader with enough knowledge of how science reporting works to enable us to spot the dodgy stuff for ourselves. I’m not saying he doesn’t trust us or his own powers of saturation coverage, but he does seem to be keeping up the column and website until we all get on message.
He has a whole bran tub full of examples for us. Brain Gym may sound familiar: it’s sold as a way of “enhancing learning skills.” Goldacre writes:
When you strip away the nonsense, it advocates regular breaks, intermittent light exercise, and drinking plenty of water. This is all entirely sensible.
However “most people know what constitutes a healthy diet already. If you want to make money out of it, you have to make space for yourself in the market: and to do this, you must overcomplicate it, attach your own dubious stamp.” Brian Gym’s dubious stamp is to recommend various exercises such as rubbing the “brain buttons” – effectively attempting to massage the carotid arteries through the ribcage.
Similarly, there is the legendary Gillian McKeith, TV nutritionist (Goldacre reminds us that ‘nutritionist’ is not a protected term and a title which can be claimed by anyone, unlike ‘dietitian’): he considers her “a joke … a menace to the public understanding of science”. She has been written about so widely that Goldacre hardly needs to devote a whole chapter to her, but he does remind us of her most striking suggestions, such as that “skid-mark stools” are “a sign of dampness inside the body – a very common condition in Britain.” The human body is about 65% water, and her thoughts on those which do not have dampness inside them, are not recorded.
To some extent all this seems like taking a sledgehammer to crack a nut. And Goldacre is the new Dawkins for another reason: he’s preaching to the converted. At the beginning of the Gillian McKeith chapter, he expresses the expectation that “since you’ve bought this book you may already be harbouring some suspicions” about McKeith. But he has broader themes to explore, and where Bad Science is most valuable is in the tutorial – by bad example – Goldacre gives us on how clinical trials and studies are carried out. We learn about sampling, controls, peer review, and all the other elements which enable scientists to determine whether a particular study is worth the hyperbole attached to it in the papers. There is much too on the excesses of the pharmaceutical industry, though there’s a reason for their desperation these days: “The golden age of medicine has creaked to a halt” and most drug companies these days are reduced to making “me-too” copies of existing drugs, or diagnosing new illnesses (“Social Anxiety Disorder”) for existing medication.
This leads to the meat of the book, though there’s a fair amount of wading to do to get there (Goldacre doesn’t seem to be a natural writer, at least not at book length, and all the examples and hobby horses can get a little much, in a way they don’t in a weekly column. He also has an unfortunate weakness for silly jokes). Goldacre is exercised about the media portrayal of science, or rather its obsession with misrepresenting health science (“The Daily Mail in particular has become engaged in a bizarre ongoing ontological project, diligently sifting through all the inanimate objects of the universe in order to categorise them as a cause of – or cure for – cancer”). For instance:
In 2007 the British Medical Journal published a large, well-conducted, randomised controlled trial, performed at lots of different locations, run by publicly funded scientists, that delivered a strikingly positive result: it showed that one treatment could significantly improve children’s antisocial behaviour. The treatment was entirely safe, and the study was even accompanied by a very compelling cost-effectiveness analysis.
Did this story get reported as front-page news in the Daily Mail, natural home of miracle cures (and sinister hidden scares)? Was it followed up on the health pages, with an accompanying photo feature, describing one child’s miraculous recovery, and an interview with an attractive happy mother with whom we could all identify?
No. This story was unanimously ignored by the entire British news media, despite their preoccupation with antisocial behaviour, school performance and miracle cures, for one very simple reason: the research was not about a pill. It was about a cheap, practical parenting programme.
There is also coverage of MRSA ‘superbug’ scares, leading to the alarming revelation that the microbiology clinic to which all the UK newspapers turned for their samples to prove the presence of MRSA in hospitals, was in fact a man operating out of his garden shed. This is just a premable to the main course of what Goldacre calls “the media’s MMR hoax” where a tiny ‘study’ of twelve children in 1998 led to a nine-year campaign in the British media against the measles/mumps/rubella triple vaccine for children on the grounds that it was believed to cause autism. Goldacre takes 40 pages over this, explaining that there was never any evidence for the link, but also that the news reporting of the story exemplified all the media’s worst excesses in science reporting. “Less than a third of broadsheet reports referred to the overwhelming evidence that MMR is safe, and only 11 per cent mentioned that it is regarded as safe in the ninety other countries in which it is used.”
To some extent, much of Bad Science could be summed up in two phrases. “A fool and his money are soon parted,” and “That which can be asserted without evidence, can be dismissed without evidence.” But it is when this becomes a matter of life and death – as in the MMR scare, which has coincided with a drop in take-up for the vaccine and the first death from measles since 1992 – that Goldacre’s commitment to the truth becomes vital. A much more striking and horrifying example of this is missing from the book; that of Matthias Rath, whom Goldacre accused of contributing to deaths of Aids victims in Africa by promoting his vitamin treatments and denouncing traditional antiretroviral drugs. Rath sued The Guardian for libel, but dropped his action last week. This was too late for publication of the book earlier this month, but expect an appendix in the next edition; and a big party round Goldacre’s way. Everyone’s invited; except Gillian McKeith.