September 25, 2008

Ben Goldacre: Bad Science

Posted in Goldacre Ben at 8:00 am by John Self

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.

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15 Comments »

  1. KevinfromCanada said,

    One of the characteristics of excellent book reviewers is that they produce a review which gives you a lot of information and also lets you conclude that there is no reason to read the book in question. I fully appreciate all of the information in this review and it tells me everything I want to know about Bad Science, which I will certainly be quoting at appropriate events. My apologies to the author and publisher for a decision not to invest in buying the book.

  2. Oh damn this sounds like a book I would like to read. I try to avoid Monsanto products as there was a lengthy article on them in Vanity Fair recently. As a sociologist, my first question is always ‘how was the study designed?’ I know you can design studies to produce completely opposite results if you are unscrupulous.

    Thanks for the review and the link to the site. I read a lot of science but I don’t review it as it seems (at least in the U.S.) people are not interested or do not understand it.

  3. KevinfromCanada said,

    Ummmm, I don’t mean to be cranky Candy, but I am not at all sure that Vanity Fair is a better source of science informantion than Monsanto. If you look at their ad pages, Vanity Fair is even more a prisoner of the commercial world than Monsanto is. And I don’t think they know much about science, but I am an arts guy anyway.

  4. The Vanity Fair article was about Monsanto’s practice of trying to force farmers to use their genetically modified seeds. It was not about science. I have been reading Vanity Fair for over thirty years and they have a pretty good track record for facts – not perfect – but pretty good.

  5. Also Vanity Fair does not write about science – not in the years I have been reading it. I do, however, read Scientific American, Discover and various other scientific periodicals as well as many, many books.

  6. John Self said,

    Well Kevin and Candy, Bad Science is worth reading, but I think it lacks a couple of elements for a really good popular science book. These are a strong narrative thread, so it seems like a book rather than a collection of pieces on the same subject (though there are some strong ‘stories’ in it like the MRSA and MMR chapters, and ideas from earlier chapters are reprised later), and also a good prose style. There’s nothing wrong with Goldacre’s writing, but it’s never gripping the way (say) Malcolm Gladwell can be, or stylish as in this extract from Richard Dawkins’ Unweaving the Rainbow, which attempts to put the extent of life on earth into some kind of comprehensible perspective: and succeeds.

    Fling your arms wide in an expansive gesture to span all of evolution from its origin at your left fingertip to today at your right fingertip. All across your midline to well past your right shoulder, life consists of nothing but bacteria.

    Many–celled, invertebrate life flowers somewhere around your right elbow. The dinosaurs originate in the middle of your right palm, and go extinct around your last finger joint. The whole history of Homo sapiens and our predecessor Homo erectus is contained in the thickness of one nail clipping. As for recorded history; as for the Sumerians, the Babylonians, the Jewish patriarchs, the dynasties of Pharaohs, the legions of Rome, the Christian Fathers, the Laws of the Medes and Persians which never change; as for Troy and the Greeks, Helen and Achilles and Agamemnon dead; as for Napoleon and Hitler, the Beatles and Bill Clinton, they and everyone that knew them are blown away in the dust of one light stroke of a nail file.

  7. With science books I don’t need a narrative thread. I just want the info and I tend to skip over unnecessary words and phrases. That is the only way to plow through the amount of reading matter I have. I still think I would like to read it but with the current financial crisis I am having to call a halt to most book buying for the present. One reason I am glad I have so many books as yet unread.

  8. Beth said,

    Bravo, Mr. Self! Ten years on from the ”study” published in The Lancet linking the MMR vaccine to autism, it seems almost every day new quackery is born to mislead desperate parents and to hoist immunizations up the whipping post for fresh lashing. Enough! I’d also recommend Dr. Paul Offit’s new book, Autism’s False Prophets, for a readable exposé of the bad science that continues to hurt children by exposing them to preventable disease.

  9. I now have all but one of the Booker short list books. The one I don’t have will undoubtedly be the winner. I think I will start with The Clothes On Their Backs.

    Next year I am going back to my old habits and just wait for the winner.

  10. Mrinal Bose said,

    John, I’ve not read Ben Goldacre, but being a doctor myself, have interest in and experience of reading medical columns by doctors. Most of them are awful, laboured, and crappy. The only exception I’ve found so far is Theodore Dalrymple who writes for the Spectator. His columns are witty and full of humour. Often he digs deep into socio-economic conditions to write about any disease/patient and its treatment. Theodore is pen name. His real name is Anthony Daniels.

    • Louise said,

      A psychiatrist who calls his patients lunatics? That’s science? Pah! He has no idea what he is talking about: he was an NHS psychiatrist for a mere 14 years. I would challenge him to publicly confront the patients he has made such terrible accusations against. I’m quite capable of arranging this.

  11. John Self said,

    Thanks Mrinal. I’ve heard his name but don’t think I’ve read anything by him (or maybe I am thinking of the Anthony Daniels who played C-3PO in Star Wars!). ‘Dr Copperfield’ in the Times is amusing but glib.

    I thought this might also be a good place to post another of my favourite passages from a popular science book, this time from Armand Marie Leroi’s wonderful Mutants: On the Form, Varieties and Errors of the Human Body.

    Eighteen days after conception an embryo is just a white, oval disc about a millimetre long. It has no organs, just three tissue layers and a geometry. … Within the next ten days all this will have changed. The embryo will be recognisably an incipient human – or at least some sort of vertebrate, a dog, a chicken or perhaps a newt. It will have a head, a neck, a spinal column, a gut; it will have a heart.

    The first sign of all this future complexity comes on day 19 when a sheet of tissue, somewhat resembling the elongate leaf of a tulip, forms down the middle of the embryo. The leaf isn’t entirely flat: its edges show a tendency to furl to the middle, so that if you were to make a transverse section through the embryo you would see that it forms a shallow U. By the next day the U has become acute. Two more days and its vertices have met and touched in the middle of the embryo, rather as a moth folds its wings. And then the whole thing zips up, so that by day 23 the embryo has a hollow tube that runs most of its length, the nature of which is now clear: it is the beginning of the mighty tract of nerves that we know as the spinal column. At one end, you can even see the rudiments of a brain.

    Even as the nerve-cord is forming, the foundations of other organs are being laid. Two hitherto inconspicuous tubes, one on either side, then unite to make a single larger tube running the length of the embryo’s future abdomen, an abdominal tube that echoes the neural tube on its back. Within a few days this abdominal tube will begin to twist and then twist again to become a small machine of exquisite design. Though it still looks nothing like what it will become it already shows the qualities that led William Harvey to call it ‘the Foundation of Life, the Prince of All, the Sun of the Microcosm, on which all vegetation doth depend, from whence all Vigor and Strength doth flow.’ On day 21 it begins to beat.

  12. [...] Ben Goldacre: Bad Science By John Self 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 … Asylum – http://theasylum.wordpress.com [...]

    • Louise said,

      A psychiatrist who calls his patients lunatics? That’s science? Pah!

  13. John Self said,

    As suspected above, the paperback (or, since the original edition was also paperback, the ‘properback’) edition of Bad Science includes a chapter on Matthias Rath titled ‘The Doctor Will Sue You Now’. For anyone, like me, who has the old edition of the book without this chapter, it’s available free from Ben Goldacre’s website here.


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