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

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.

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* “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.

Scientifically illiterate science pundit: Ben Goldacre

My previous post, “Scientific illiteracy, the media, science pundits, governments, and HIV/AIDS” (15 January 2009),  had taken on a life of its own after starting out as a comment on Goldacre’s error-filled piece about Christine Maggiore. Now back to Goldacre.

Scientific literacy means to have learned the salient findings of history of science and related fields, for example, that a mainstream consensus is sometimes wrong, especially when it comes to novel matters. Scientific literates know that one cannot accept a mainstream consensus without further ado. Scientific literates know that if a mainstream consensus is challenged by competent people, one then needs to burrow fairly deeply into the actual evidence before reaching an eventual judgment about where the best case probably lies, with the mainstream or with the challengers.

Science pundits who talk about pseudo-science should know that the problem of defining pseudo-science has never been solved. They should know that philosophy of science concluded, after decades of intense effort, that there are no logical definitions or formal descriptions by which “real” science can be distinguished in principle from non-science, or false science, or pseudo-science. Those who label a subject “pseudo-science” should know that some topics so labeled later became accredited parts of mainstream science, while some matters long regarded as “scientific” were later relegated to the rubbish heap (see Science or Pseudoscience: Magnetic Healing, Psychic Phenomena, and Other Heterodoxies).

It requires detailed and comprehensive knowledge of each specific controversial claim to reach a reasonably informed estimate as to whether it’s likely to be lauded or dismissed in the scientific future. Scientifically literate pundits who do have such detailed knowledge, and who are also without vested self-interest pro or con, are unlikely to call something pseudo-science if distinguished scientists claim to discern some merit in it; at most they might spell out why it seems possible, or perhaps even likely, that these competent people have gone wrong this time. Above all, a genuinely informed science pundit will hesitate for a long time before making an assertion that presupposes 100% certainty — and 100% certainty is asserted when something is called pseudo-science.

Ben Goldacre carries the mantle of science pundit for a newspaper widely regarded as respectable and perhaps even generally reliable (Guardian, UK). I admit, though, that I hadn’t heard of him before his recent piece about Christine Maggiore appeared. It’s a shoddy, uninformed disgrace to journalism which exposes Goldacre as a scientific illiterate.

Goldacre transgresses what ought to be a sine qua non of science punditry and responsible journalism by feigning knowledge that he doesn’t possess. His ignorance about Maggiore is illustrated in the very first paragraph when he describes her as “lauded in the American media”. Perhaps he has never come across the Los Angeles Times, published in Christine’s home town, where she has been roundly maligned, indeed persecuted. All the information is readily available online,  including a complete file of the material about Maggiore and her daughter in the Los Angeles Times.

The second paragraph by Goldacre describes Maggiore as HIV-positive, when anyone who has even a passing acquaintance with her experience knows that she suffered a succession of positive, negative, and inconclusive tests, the very experience that led her to look into what’s actually known about HIV/AIDS. In the same paragraph, Goldacre asserts about breastfeeding that it “has been shown that this increases the risk of maternal transmission” — when the very opposite happens to be the case, to the considerable and ongoing consternation of mainstream researchers (“More HIV, less infection: the breastfeeding conundrum”, 21 November 2007).

About Maggiore’s daughter, Goldacre is sure enough right, that “The coroner attributed the death   to Aids” [sic, British usage], but he fails to mention that this coroner was long infamous for incompetence or corruption or both, that he made the “AIDS” diagnosis in a way that suggests it was only because he had come to know who the mother was, and that there is a still-pending law-suit against the coroner for disseminating his conclusion without proper evidential basis.

“Maggiore’s views on HIV were driven by the work of Peter Duesberg” is also untrue. Parroting the description of Duesberg as an “AIDS denier” illustrates how Goldacre simply repeats sound-bites unthinkingly: Duesberg has never denied that AIDS exists, in fact he has offered explanations for what brought it about. Nor has Duesberg done “very well with journalists”. Neville Hodgkinson did not learn from Duesberg, he discovered for himself in Africa that HIV/AIDS there is a colossal mistake; Hodgkinson was instructed by people like the Krynens, who had gone to Africa as conventional AIDS charity workers and then discovered at first hand that HIV/AIDS theory is wrong.

One can, I suppose, excuse a Pommie (Englishman) who calls Nature “probably the world’s most important academic journal”, but a scientifically literate pundit would not do so, recalling perhaps the words of Nobelist Paul Lauterbur that the history of science could be written in terms of paper rejected by Nature [“Nobel Prizes illustrate how research is done and evaluated”, 21 October 2008].

Goldacre is not alone, of course, in accepting results from a “demographic modelling study” as being so reliable as to be worth disseminating further; but, again, no self-respecting scientifically literate person should do so.

The peroration of Goldacre’s screed is, “Hundreds of thousands of lives, perhaps millions, have been lost because of a stupid idea, promoted by stupid people.”

No scientific literate would confuse being wrong on a matter of medical science with being stupid; by Goldacre’s criterion, he himself is stupid many times over. Nor would any thoughtful person label someone as stupid just because that person had an idea that might be called stupid; Goldacre’s clear implication is that he has never himself had an idea that might be called stupid, suggesting an infallibility nothing short of Pope-like or God-like.

I simply repeat Goldacre’s last two sentences, for they can be properly applied to the people who, in the face of all the evidence to the contrary, continue to insist on HIV/AIDS theory:
“To the best of my knowledge, not one has either apologised or clarified their stance. Just don’t let anyone tell you pseudoscience is harmless.”

Indeed, much harm has been done in the name of the pseudo-science of HIV/AIDS [“HIV/AIDS and parapsychology: science or pseudo-science?”, 30 December 2008].

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The only justification for disseminating what columnists, experts, pundits have to say is that the rest of us might learn something that we would be unlikely to know already. Goldacre merely repeats sound-bites, mis-information, and mis-interpretations that have made the rounds for a long time. He’s not doing his job.