Bad Science by Ben Goldacre is a book about the threats to evidence based medicine and the problems with the media, alternative health, homeopathy, nutritionists and current practices in medicine. Goldacre writes a column in the Guardian and also has a blog at badscience.net.
The book is terrific. It points out how naturapathy and homeopathy works, i.e. by the placebo effect that is enhanced with appealing sounding nonsense. The book also looks at mental improvement nonsense, in particular the Brain Gym that has been paid for and offered to UK schools.
Goldacre is a doctor and knows what he is about. The book also points out that big pharma systematically distorts research findings and that a fair proportion of the medicine promoted by big pharma has been the result of the manipulation of clinical trials.
The book talks about the importance of the placebo effect and how it is a really important medical fact. We get better if people do something for us. If a man in a white coat listens to us and gives us a magic pill we have an even greater enhancement. Witchdoctors, witches and today’s purveyors of nonsense, homeopaths, do the same. The placebo effect is something we don’t understand and it’s something that troubles doctors. Doctors know that they can give people placebos it will help, but it is being dishonest to their patients, the question then comes as to whether they should or not.
Nutrionists get a serve, because they are often so dishonest. The basics of nutrition are simple, eat mainly fruit and vegetables, some meat if you choose, avoid too much sugar, fat and alcohol and vary you diet, don’t each too much and stay active. But this doesn’t sell very well. It’s hard to run a consultancy on common sense. Instead, nutritionalists make up nonsense, distort the results of scientific papers and sell supplments, which is far more profitable. Dr Gillian McKeith PhD, who holds no real degrees but makes large amounts of money conning people. Her practices are really quite amusing.
Goldacre takes further aim at the supplements industry and the media in a chapter on fish oil pills. A ‘trial’ was conducted with a great deal of media attention on how fish oil pills would improve student performance. The whole trial was, from beginning to end, nonsense. But the British press ate it up and promoted the whole debacle.
The book gives insight into how evidence based medicine runs, and often fails, good scientific trials. Goldacre also states that until the twentieth century doctors were not much good and may even have harmed people. He describes a golden age of medicine from about 1935 and 1975. Interestingly he points out that really good process for evidence based medicine came in at the end of that time and that many of the trials run in the 1950s and even 1960s were not of a high standard and that adverse findings were suppressed. He talks about thalidomide and how there are now registeries set up to handle problems with reactions to medicines. He talks about how it is getting harder and harder to improve medicine and how this is a very serious issue for drug companies today, so serious in fact that there is a considerable suspicion that they are inventing lifestyle diseases and pushing over-medication as with ADHD.
Goldacre looks at just how awful the reporting of science is. He points out that science is usually reported as some study shows something with no reference to the data, the study, further reading and elucidation of what is being done. He’s right. Most of the media is so bad at reporting scientific findings it is cause for concern. He’s right.
He looks at why people believe silly things and looks at how we find spurious patterns in randomness, we’re biased toward positive evidence and biased towards finding things that confirm our beliefs. He looks at how poorly we statistics are used, looking at the ridiculous repeated claims of how marijuana is getting a higher THC content. Goldacre shows how statistics are misreported to show great changes when the real movement is often small.
There is a chapter on MRSA which was detected by one poor lab that was then magnified by the awful British tabloids to cause some consternation in the UK. The book has a chapter on the MMR vaccine scare in the UK, which is odd for foreign readers who did not experience the UK nonsense but interesting.
The book is hard to recommend strongly enough. It’s a fine book that makes its points well.