Wednesday, April 3, 2013

Bad Science: Quacks, Hacks, and Big Pharma Flacks

I started reading Ben Goldacre's columns in The Guardian a few weeks before he suspended it to write his second book.  I decided to look for his first book, and promptly forgot until I saw the last few minutes of a talk Goldacre gave promoting Bad Pharma.  Since I'm still on the Book Diet, I took Bad Science out of the library, which was probably a wise decision.  I really enjoyed this book, but I'm also unlikely to read it again.

Goldacre is an Oxford-educated doctor, so his writing focuses on health-related topics.  He has an engaging style, and after a few pedantic (and by his own admission condescending) background chapters, he alternates between exposing "treatments" with no scientific support and more nuanced articles which explain how fairly simple statistical principles and concepts like confirmation bias lead us to believe lies wrapped up in technobabble.

Some of Goldacre's targets, like homeopathy, Brain Gym (a set of breathing and self-massage exercises that allegedly improves brain function - who falls for this?), and 'scientific' makeup get off fairly lightly.  They're mostly harmless, usually damaging only the consumer's checking account.  He's much harsher on targets whom he believes have done real harm.  Vitamin pusher Matthais Rath claimed that HIV does not cause AIDS and, by encouraging South Africans to give up antiretroviral drugs in favor of his supplements, probably caused tens of thousands of deaths and hundreds of thousands of excess transmissions.  This truly horrifying chapter did not appear in the original edition of Bad Science because Rath sued Goldacre and The Guardian; in a just world, the survivors of those who died after exchanging HIV drugs for useless pills would sue him for wrongful death.  He rightfully faults Andrew Wakefield for the MMR scare which returned deadly but preventable diseases to endemic status in the United Kingdom, but he also blames the gullible and lazy science press and the Blairs for fanning the "controversy."

Nutritionists seem to fall between the two poles.  I don't see how they're as harmful to their 'patients' as charlatans like Rath and Wakefield, but he treats them much more harshly than homeopaths and cosmetics companies.  I think he's offended by the abuse of science - most of his examples feature Gillian McKeath, host of You Are What You Eat.  McKeath took something sensible (and not particularly marketable) - eat smaller portions, focus on greens and grains, and get some exercise - and wrapped it in pseudo-scientific explanations that would leave a scientifically-inclinded high school student giggling uncontrollably.  Instead of saying that darker greens have high levels of phytochemicals, she says they "oxygenate the blood" because they "have so much chlorophyll."  Seriously?  As Goldacre points out, you have no light in your large intestine, and even if you did, you have no gills with which to absorb oxygen.  McKeath and her ilk are just making it up and they don't care that they are.  That deeply offends Goldacre.

As I said above, I enjoyed Bad Science, but he didn't cover anything new to me.  I've got a science degree and have spent the past decade doing document review for large pharmaceutical litigations.  Bad Science was confirmation bias - it told me what I already knew, and gave me a chance to shake my head at the gullibility of my species.  I'll read his new book and his columns, but I won't regret returning this volume to the library.

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