HIV/AIDS Skepticism

Pointing to evidence that HIV is not the necessary and sufficient cause of AIDS

Recognizing REAL pseudo-science — Details, distinctions, and pundit Ben Goldacre

Posted by Henry Bauer on 2011/12/26

Quite some time ago I had occasion to lambaste columnist Ben Goldacre, MD, for his culpably uninformed comments about Christine Maggiore; see “Scientifically illiterate science pundit: Ben Goldacre”. I put his book, Bad Science, on my reading list but at low priority in the expectation that it would be an unpleasant chore necessary as a prelude to writing a critical review. Finally got around to reading the book, and find that I need to urge others to read it, in particular for its sound discussions of how the media’s coverage of science is generally misleading; how misleading too is the way in which statistics are disseminated by drug companies and the media; and how the drug companies are not to be trusted. And there are various interesting tidbits of information:
   →   Goldacre is spot on about the mess that the media make of covering scientific matters, and how disastrous is the ignorance of those in power (Chapter 11: How the media promote the public misunderstanding of science). He cites a dictionable* word, churnalism, credited to journalist Nick Davies and referring to the uncritical rehashing of press releases as news.
   →   Chapter 12, “Bad Stats”, is generally sound and informative about how statistics can be misused and misrepresented, though the presentation is not very well organized. I don’t agree, for example, that “natural frequencies” are the only sensible way to communicate risk, though I agree that they should always be included. I would also have liked prime emphasis on correlation never proving causation and high probability never equaling certainty.
   →   The book acknowledges that serious flaws in clinical trials are quite common (pp. 44-5).
   →   The drug companies are properly given short shrift, e.g. p. 184 ff.
   →   Specific details show how clinical trials can be deliberately biased to favor drug approval, and other flaws in the process (pp. 189-206).
   →   The detailed debunking of British charlatans, though directly pertinent only for British readers, are well worth reading because similar situations with similar characteristics are present on this side of the Atlantic.
   →    There are interesting tidbits of information about early German research into smoking and lung cancer (footnote, p. 218) and data indicating that episodes of fear of vaccination have been regional.

On the negative side:
   →   Goldacre appears to believe that mainstream medicine is evidence-based (pp. x, 316), when most of it isn’t. Later he cites anecdotal evidence that 50-80% of treatment decisions are evidence-based, but only 13% of the treatments themselves are evidence-based with another 21% are “likely to be beneficial” (p. 182). In other words, doctors who properly rely on the evidence available to them from drug companies and official agencies are, about half the time, relying on unsound evidence.
Throughout, the book insinuates that mainstream medicine can be trusted even when admitting that it often cannot be, e.g. at p. 99 when referring to the Cochrane Collaboration.
In this vein, Goldacre misleads about John Ioannidis’s work (p. 219), implying that it reveals the unreliability of brand new studies. But Ioannidis has actually shown that widely and long accepted mainstream treatments are based on flawed early trials presented by drug companies.
   →   Goldacre is far too blithely dismissive of the harm done to “a very small number of people” by any medical intervention or “any human activity” (p. 298). “Whenever we take a child to be vaccinated”, Dr. Goldacre writes, “we’re aware that we are striking a balance between benefit and harm, as with any medical intervention” (p. 313). Nonsense. Statisticians and researchers may understand this, but most of the rest of us trust the advice our doctors give us — particularly when we have no choice but to sign the “informed consent” forms if we want to be treated. We just hope that our trust is warranted, we don’t balance benefits against risks. Goldacre may not understand this because he doesn’t deal with patients.
   →   A pervasive strand of Goldacre’s bravado is denigration of “humanities graduates” by contrast to scientists, among whom he seems, wrongly, to include doctors; see “Doctors aren’t scientists, and medicine isn’t science”.
   →   The book implies that glucosamine can do nothing against arthritis (p. 155). A judicious evidence-based assessment says otherwise **.
   →   Goldacre is quite wrong about HIV/AIDS (p. 88) when even common sense ought to have warned him: if Botswana really has a 48% prevalence of what’s supposedly a fatal disease, the country ought to have been depopulated long ago. Antiretrovirals are described as life-saving (p. 184), but they are the opposite.
   →    Goldacre denigrates Linus Pauling for cherry-picking (p. 98) — the Pauling who is widely regarded as the greatest chemist of the 20th century, the founder of molecular biology, winner of two Nobel Prizes, who urged the importance of dietary anti-oxidants (and was maligned for doing so) long before it became the conventional wisdom. This is only one example of Goldacre’s outsized ego, hubris, self-confidence, and inability to see himself as others see him. The book’s style may turn some people off for this reason; Goldacre is just too full of himself.

On several points, I’m not sure how sound the coverage is:
   →   Goldacre parrots the mainstream condemnation of Andrew Wakefield who warned that multiple vaccinations might be a cause of autism. I’ve read only enough about this affair to conclude that legitimate questions remain. Goldacre notes the irony that there is a definite correlation between maternal rubella infection while pregnant and autism in the later-born child; but surely this makes plausible Wakefield’s belief that exposure to rubella vaccine at an early age might act similarly? In some babies at least?
Since most or all vaccines harm a few individuals, surely it is always worth keeping a mind open and studying possible reasons for that, looking for characteristics that might identify people particularly likely to react badly to a specific vaccine.
   →   David Horrobin is described as marketing by dubious means remedies that turned out to be ineffective (p. 157 ff.). The details Goldacre presents seem sound, though he admits that Horrobin may not have been guilty of actual deceit. This picture does not jibe with the David Horrobin who founded Medical Hypotheses and published sensible articles about peer review and the like, as well as the fascinating book, The Madness of Adam and Eve (Bantam 2001).

Bad Science and the many columns Goldacre has written illustrate two absolute truths:
1. There are no general principles or guidelines that can serve as short cuts for deciding whether any given controversial claim is worth attending to. There is no sound way to pronounce something “good science” or “bad science” without digging comprehensively into the evidence and the arguments pro and con; see Science or Pseudoscience: Magnetic Healing, Psychic Phenomena, and Other Heterodoxies.
2. Any given individual or book can be sound on some general matters and on some specific instances and yet quite wrong about other instances and generalities. The degree to which Goldacre is sound on any given point correlates with the amount of detail with which he is familiar.

Quite generally, compendia of “pseudo-science” are likely to be wrong about some of the topics, because the compilers of such lists simply haven’t had the time to look in sufficient detail at all the topics they cover. Recent examples include science journalist Specter’s Denialism (2009), which is uninformed and wrong about HIV/AIDS among others. A much better book is physicist Friedlander’s At the Fringes of Science (1995), but it remains uninformed and wrong about UFOs and cold fusion, for instance. Shermer’s Why People Believe Weird Things: Pseudoscience, Superstition, and Other Confusions of Our Time, too, is good about some topics and biased on others. Various older compendia and debunkings of supposed pseudo-science are cited in Science or Pseudoscience: Magnetic Healing, Psychic Phenomena, and Other Heterodoxies. The mid-20th century classic in this genre is Martin Gardner’s Fads and Fallacies in the Name of Science (1952/57). It is detailed and instructive about some outlandish claims but fails to let the reader know that chiropractic and osteopathy have overcome their cranky birth in one person’s hunch and developed into pragmatically useful healing techniques, superior to mainstream medicine in handling lower-back pain, for example.
All compendia have one thing in common: the authorial claims to base judgments on general principles or assessment of specific evidence are rationalizations; what is labeled as sound is what happens — for whatever reason — to strike the author as sound, and anything the author finds unbelievable — for whatever reason — is labeled pseudo-science. Readers have this choice: accept the author’s personal opinions, or dig into the evidence for themselves and arrive at an informed opinion.

Caveat lector.

* “dictionable”: worthy of being in a dictionary but not yet included. Another worthy is “tritto”, to describe repetition beyond “ditto”.

** Donal O’Mathuna & Walt Larimore, Alternative Medicine — The Christian Handbook, Zondervan 2001. Although several early chapters are addressed specifically to Christians, the assessments of specific claimed remedies are entirely empirical and evidence-based.

17 Responses to “Recognizing REAL pseudo-science — Details, distinctions, and pundit Ben Goldacre”

  1. Dave Smith said

    Well done Henry. Though I have not read the author who is the main topic of this article, the level of balance you display in this critique does you good service. It’s all too easy for us to be outright dismissive of others and their works due to the general message they contain without ourselves indulging in this type of critical thinking and balanced review.

    And if ANY word should be in dictionaries but is not, “churnalism” deserves to be at the top of the list. It seems that true investigative journalism has been replaced with sensationalist journalism and that many in this internet age who masquerade as journalists are adept at no more than digital cut and paste.

    Cheers, Dave.

  2. Paul Vahur said

    It appears that dictionable itself is dictionable word. At least it’s not in the 2007 Collins print version and doesn’t come up on google search🙂

    • Henry Bauer said

      Paul Vahur:
      Yes, “dictionable” is itself a dictionable word. I believe it was coined by my friend, Jack Good, a polymath who was a world-renowned statistician and interested in and fascinating about many topics, language, psychic phenomena, much else.

  3. This is a meaty and interesting posting. Thanks again Henry.

    Intriguing autism report: one expert tested hundreds of his patients and discovered that 80 percent of them had elevated nagalase levels.

    Such high levels of nagalase occur when you have cancer (otherwise macrophage activating factor makes macrophages eat up or kill the cancer cells, I believe), or are pregnant (since the fetus must protect itself from activated macrophages which would notice these are not mama’s cells), or viral infection (since activated macrophages consume or kill virus infected cells).

    This could (possibly) indicate that autism is a result of an uncured viral infection. So maybe GcMAF or MAF 314 would help autistics revert to normals. Likely this would be worth a test, especially if MAF 314 yogurt becomes easily available.

    Typo: “Any give individual” is missing an ‘n’.

    “on any given point correlates with” although “correlation is not …”.

    “handling lower-back pain” has a low cost, low risk fix said to work 19 times out of 20 is using shock absorbing innersoles. Goes along with discoveries of below normal shock absorption in the skeleton among those with low back pain. Perhaps there is more evidence now, but solutions that are cheap and don’t require prescriptions tend not to be emphasized by people who earn money from sick people. This is especially true for generic cancer cures with no patented drug to assure monopoly profits.

    • Henry Bauer said

      Richard Karpinski:
      Thank you!
      My “on any given point correlates” isn’t intended as the proof, it’s a generalization of what I’d seen in his writing. I had commented favorably on his detailed debunking of charlatans, and unfavorably on his misinformed piece about Maggiore.

  4. mo79uk said

    Oddly enough I started reading Bad Science just recently too (been lingering on my Kindle for months). What I’ve read so far, I agree, is by and large sound — it seems like it’s a little by a different author to the one who blogs on and writes for the Guardian.
    I’ve already read the chapter on AIDS prior, the most glaring criticism of that — as with most HIV-believing books — is that it doesn’t tackle the science at all. Goldacre actually made that chapter available for free if anyone would like to read it:

    I, myself, am supportive of Goldacre’s view on MMR. To me, if MMR is the cause of autism, finding out why it doesn’t cause MMR in others is the interesting part. In the UK, MMR has been around since 1987, but autism has been rising since 1980.

    • Henry Bauer said

      I don’t understand “finding out why it doesn’t cause MMR in others”. That might just be because they don’t have the specific characteristic that predisposes to autism from MMR, IF THERE IS ONE. So surely the cases to study are the autism ones? Not easy, of course, because one is then looking for all sorts of variables after the event and it might not be possible to identify everything that happened within a few weeks (say) before the vaccination.

      • mo79uk said

        I’m just wondering if a possible characteristic is something that can be modulated. Maybe it’s about what autistic children should have received rather than what they seemingly shouldn’t have.

      • Henry Bauer said

        As with “HIV” and “AIDS”, we just don’t know enough…

      • Possibly autistic children need some activated macrophages to kill or consume the virus infected cells and thus eliminate the virus which would eliminate the problem. Then, again, possibly not. At least the proposition is susceptible to testing with GcMAF or MAF 314.

      • mo79uk said

        GcMAF probably isn’t a far out idea. Wakefield did find that a lot of autistic children presented gut disorders alongside and I don’t think that observation should be ignored.

  5. SkepticalGuy said

    Good post.

    I especially appreciate your inclusion of science philosophy in your approach to this topic.
    Personally, I became acquainted with the area of science philosophy through my lifelong interest in the paranormal, and particularly, ufological studies; subjects you mention in this article. I applaud you for that, even though some of your detractors have brought up Nessie and the like in order to discredit you. Such is the burden of being open-minded and honest.

    Henry wrote:
    ” → A pervasive strand of Goldacre’s bravado is denigration of “humanities graduates” by contrast to scientists, among whom he seems, wrongly, to include doctors;
    … → Goldacre denigrates Linus Pauling for cherry-picking (p. 98) … This is only one example of Goldacre’s outsized ego, hubris, self-confidence, and inability to see himself as others see him. The book’s style may turn some people off for this reason; Goldacre is just too full of himself.”

    I assume these two points are complimentary of each other i.e. he counts himself in a special category, perhaps above reproach in some manner? I know you’ve mentioned him previously, but the allegations of ego etc. weren’t completely laid out here I don’t think. You’ve obviously read the book!

    As for hubris and ego, maybe it’s something that I’ve been calling for some time “Going over one’s stethoscope”? I’ve seen a number of anecdotes of where a patient dares to exhibit (often justifiably so) knowledge about their specific condition that the doctor does not possess or that challenges their indoctrination, and they often react negatively to someone “going over their stethoscope”, sometimes ending that particular doctor-patient relationship altogether.

    This is evident in areas other than medicine: HIV/AIDS (not just the clinical part), climate change alarmism, evolution, and other controversial topics, national politics included. There is a very visible exhibition of ego, hubris, even arrogance, on the part of one who considers themselves a part of the consensus or Orthodoxy, and hence, unassailable in their statements. I’m sometimes surprised at how some of these persons, with their pretense to scientific right-thinking, will occasionally make obviously biased errors in their arguments, particularly when they start making personal accusations.

    “Credentialism” I think is the proper word. Like the question I believe was posed to Dr. Gallo. “What do you think about Dr. Duesberg’s theories on AIDS?”
    “Oh, him? Duesberg isn’t an AIDS scientist!”

    What constitutes an AIDS scientist? Seriously. If Dr. Seth Kalichman can be an AIDS scientist, why is Dr. Peter Duesberg, or Dr. Henry Bauer, or anyone on the other side, not applicable for that title?

    • Henry Bauer said

      I like “going over one’s stethoscope” for transgressing credentialism. My gross generalization has been that experts who are really confident in their knowledge and understanding will handle evidence-based arguments from lay people as well as other experts in good humor and with substantive responses; the ones who can’t handle it are actually insecure in their purported expertise. Of course there are other factors involved too, personality for instance.
      The HIV/AIDS vigilantes often accuse us of cherry-picking, but as you point out, they certainly cherry-pick when it comes to who is properly credentialed!

      • SkepticalGuy said

        HA! “going over one’s stethoscope” just popped into my head one time, when thinking of some of the heated encounters I’ve read about people with their doctors. Some people have to be the authority figure.

        My gross generalization has been that experts who are really confident in their knowledge and understanding will handle evidence-based arguments from lay people as well as other experts in good humor and with substantive responses; the ones who can’t handle it are actually insecure in their purported expertise.

        No doubt. I didn’t get around to commenting on what Mr. Smith said in the first comment here, but that is something I have noticed. It is something odd in the level of hostility from some of the “experts” in certain fields. People who forgo any semblance of cordial dialogue and delve straight into ad hominems raise instant red flags with me, personally. I’m sure you’re very familiar with the acid tongue of J. Todd DeShong. Ick! Perfect example of such a person.

        In regards to what you said about cherry-picking, and something I said above:
        “I’m sometimes surprised at how some of these persons, with their pretense to scientific right-thinking, will occasionally make obviously biased errors in their arguments..”

        One example, was a guy on a forum that openly declared that there was no evidence of extraterrestrials or what have you behind UFO’s at all. I don’t know about your view on what constitutes evidence, but I felt like posting as many dictionary definitions of the word ‘evidence’ as possible, to contrast with the word ‘proof’. I declined to. I felt, knowing how this person presents themselves, that they *should* know better.
        Another time, a guy accused me outright of recommending that someone claiming an implant of some sort should seek medical advice from an abduction researcher who was not a doctor. This was blatantly false, or at least a great misunderstanding of what I had written earlier. It came across as a desperate lashing out.
        In both cases, these people were the staunch “defenders of science” and right thinking, both very antagonistic towards anything out of the ordinary or challenging of the orthodoxy, and supposedly very factual and thorough AKA scientific. So, it was a bit puzzling to see both of those careless examples from them.

        Then again, the cherry-picking also extends to double standards.

      • Henry Bauer said

        There are very few people who even try to be pragmatic and evidence-based — and those of us who try don’t always succeed. 😉
        On blogs, there are very VERY few who are there to discuss as opposed to rant.

  6. mo79uk said

    A quote that Goldacre posted on his secondary blog: If only he’d realise that dismissing HIV scepticism makes him slightly two-faced.

    • Henry Bauer said

      Many thanks indeed for this link. The editorial by Krumholz, to which Goldacre refers, is simply first rate.
      The universal problem is that even if our recognition of generalities is sound — truth emerges from conflicting views properly argued — we cannot always be aware that our own pet opinions might not be entirely evidence-based.
      No one can dig into the evidence on every topic where opinions differ.
      The new problem is that so much that is officially promulgated nowadays, in science and medicine, represents only a majority view and not an evidence-based consensus. Examples and suggested explanations are in my forthcoming book — I hope within a couple of months — Dogmatism in Science and Medicine: How Dominant Theories Monopolize Research and Stifle the Search for Truth (McFarland, Fall/Winter 2012)

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