Bad Science (book)
First edition cover
|Media type||Print (Paperback)|
|LC Class||Q172.5.E77 G65 2008|
Bad Science is a book by Ben Goldacre, criticising mainstream media reporting on health and science issues. Published by Fourth Estate in September 2008, the book contains extended and revised versions of many of his Guardian columns. It has been positively reviewed by the British Medical Journal and the Daily Telegraph and has reached the Top 10 bestseller list for Amazon Books. It was shortlisted for the 2009 Samuel Johnson Prize.
- 1 Contents
- 1.1 Introduction
- 1.2 Chapter 1: Matter
- 1.3 Chapter 2: Brain Gym
- 1.4 Chapter 3: The Progenium XY Complex
- 1.5 Chapter 4: Homeopathy
- 1.6 Chapter 5: The Placebo Effect
- 1.7 Chapter 6: The Nonsense du Jour
- 1.8 Chapter 7: Dr Gillian McKeith PhD
- 1.9 Chapter 8: 'Pill Solves Complex Social Problem'
- 1.10 Chapter 9: Professor Patrick Holford
- 1.11 Chapter 10: Is Mainstream Medicine Evil?
- 1.12 Chapter 11: How the Media Promote the Public Misunderstanding of Science
- 1.13 Chapter 12: Why Clever People Believe Stupid Things
- 1.14 Chapter 13: Bad Stats
- 1.15 Chapter 14: Health Scares
- 1.16 Chapter 15: The Media's MMR Hoax
- 1.17 Index
- 1.18 Previously unpublished chapter: The Doctor Will Sue You Now
- 2 References
- 3 See also
A brief introduction (by Goldacre) touching on subjects covered by subsequent chapters. It bemoans the widespread lack of understanding of evidence-based science.
Chapter 1: Matter
Chapter 2: Brain Gym
The claims for Brain Gym, a programme of specific physical exercises that its commercial promoters claim can create new pathways in the brain. The uncritical adoption of this programme by sections of the British school system is derided.
Chapter 3: The Progenium XY Complex
On cosmetics, and the misleading and pseudoscientific claims by their manufacturers.
Chapter 4: Homeopathy
Homeopathy is used to prompt a discussion of the nature of scientific evidence, with reference to the placebo effect, regression to the mean, and the importance of blind testing and randomisation in the design of fair clinical trials. Having concluded that homeopathic pills have been shown to work no better than placebo pills, the author suggests homeopathy may still have psychological benefits which could be the subject of further study.
Chapter 5: The Placebo Effect
Examples of the power of the mind over pain, anxiety and depression are presented with studies showing how higher prices, fancy packaging, theatrical procedures and a confident attitude in the doctor all contribute to the relief of symptoms. In patients with no specific diagnosed condition, even a fake diagnosis and prognosis with no other treatment helps recovery, but ethical and time constraints usually prevent doctors from giving this reassurance. Exploiting the placebo effect is presented as possibly justifiable if used in conjunction with effective conventional treatments. The author links its use by alternative medicine practitioners with the diversion of patients away from effective treatments and the undermining of public health campaigns on AIDS and malaria.
Chapter 6: The Nonsense du Jour
Nutritionists are accused of misusing science and mystifying diet to bamboozle the public. Misrepresentations of the results of legitimate scientific research to lend bogus authority to nutritionist theories, while ignoring alternative explanations are cited in evidence. The use of weak circumstantial associations between diet and health found in observational studies as if they proved nutritionist claims is criticised. The unjustified over-interpretation of surrogate outcomes in animal (or tissue culture) experiments as proving human health benefits is explored. The cherry picking of published research to support a favoured view is contrasted with the systematic review designed to minimise such bias. The supposed benefits of antioxidants are questioned with studies showing they may be ineffective or even harmful in some cases. The methods used by the food supplement industry to manufacture doubt about any critical scientific reports are likened to those previously used by the tobacco and asbestos industries.
Chapter 7: Dr Gillian McKeith PhD
The Scottish TV diet guru and self-styled "doctor" Gillian McKeith and her scientific claims are dissected. Statements exemplifying her scientific knowledge include that the consumption of dark-leaved vegetables like spinach "will really oxygenate your blood" as they are high in chlorophyll, and that "each sprouting seed is packed with the nutritional energy needed to create a fully-grown, healthy plant". She is described masquerading as a genuine medical doctor on her TV reality/health shows. Her publications are compared with a Melanesian cargo cult; superficially correct but lacking any scientific substance. Her belief in the special nutritional value of plant enzymes (which are broken down in the gut like any other proteins) is ridiculed. The general problems involved in establishing any firm links between diet and health are examined.
Chapter 8: 'Pill Solves Complex Social Problem'
The claim that fish oil capsules make children smarter is examined. The book probes the methodological weaknesses of the widely publicised "Durham trial" where the pills were given to children to improve their school performance and behaviour, but without any control groups and wide open to a range of confounding factors. The failure to publish any results and backtracking on earlier claims by the education authorities is slated. The media's preference for simple science stories and role in promoting dubious health products is highlighted. Parallels are drawn between the Equazen company behind the Durham fish oil trials and the Efamol company's promotion of evening primrose oil.
Chapter 9: Professor Patrick Holford
The influence of the best-selling author, media commentator, businessman and founder of the Institute for Optimum Nutrition (which has trained most of the UK's "nutrition therapists") is acknowledged. Holford's success in presenting nutritionism as a scientific discipline in the media, and forging links with some British universities is also noted. The book judges that his success is based on misinterpreting and cherry-picking favourable results from the medical literature, in order to market his vitamin pills. His promotion of vitamin C in preference to AZT as a treatment for AIDS, vitamin E to prevent heart attacks, and vitamin A to treat autism are all condemned as lacking in sound evidential support. His reliance on the work of discredited fellow nutritionist Dr. R.K. Chandra is likewise slated. The Universities of Luton and Teesside are criticised for their past associations with Holford and the ION.
Chapter 10: Is Mainstream Medicine Evil?
The book remarks on the relatively low percentage of conventional medical activity (50 to 80%) which could be called "evidence-based". The efforts of the medical profession to weed out bad treatments are seen to be hampered by the withholding or distortion of evidence by drug companies. The science and economics of drug development are outlined, with criticism of the lack of independence of industrial research and the neglect of Third World diseases. Some underhand tricks used by drug companies to engineer positive trial results for their products are explored. The publication bias produced by researchers not publishing negative results is illustrated with funnel plots. Examples are made of the SSRI antidepressants and Vioxx drugs. Reform of trials registers to prevent abuses is proposed. The ethics of drug advertising and manipulation of patient advocacy groups are questioned.
Chapter 11: How the Media Promote the Public Misunderstanding of Science
The misrepresentation of science and scientists in the media is attributed to the preponderance of humanities graduates in journalism. The dumbing-down of science to produce easily assimilated wacky, breakthrough or scare stories is criticised. Wacky "formula stories" like those for "the perfect boiled egg" or "most depressing day of the year" are revealed to be the product of PR companies using biddable academics to add weight to their marketing campaigns. Among other examples, the speculation by Dr. Oliver Curry (a political theorist at the LSE) that the human race will evolve into two separate races, presented as a science story across the British media, is exposed as a PR stunt for a men's TV channel. The relative scarcity of sensational medical breakthroughs since a golden age of discovery between 1935 and 1975, is seen as motivating the production of dumbed-down stories which trumpet unpublished research and ill-founded speculation. An inability to evaluate the soundness of scientific evidence is seen to give undeserved prominence to marginal figures with fringe views.
Chapter 12: Why Clever People Believe Stupid Things
This chapter is a brief introduction to the research on cognitive biases, which, Goldacre argues, explain some of the appeal of alternative medicine ideas. Biases mentioned include confirmation bias, the availability heuristic, illusory superiority and the clustering illusion (the misperception of random data). It also discusses Solomon Asch's classic study of social conformity.
Chapter 13: Bad Stats
Chapter 14: Health Scares
In this chapter, the author claims that the press selectively used a "laboratory" that gave positive MRSA results where other pathology labs found none. Creating an "expert" from Chris Malyszewicz who worked from a garden shed.
Goldacre notes how the Daily Mirror once managed to combine "three all-time classic bogus science stories" into one editorial: the Arpad Pusztai affair of GM crops, Andrew Wakefield and the MMR vaccine controversy and Chris Malyszewicz and the MRSA hoax. On the other hand journalists were very poor in uncovering or reporting on the thalidomide tragedy - only covering well the ultimate political issue of compensation.
Chapter 15: The Media's MMR Hoax
The hardback and first paperback editions did not include an index. Several indexes were prepared by bloggers, including one prepared by Oliblog. The latest paperback issue includes a full index.
Previously unpublished chapter: The Doctor Will Sue You Now
Further to the release of this book a resolution of the legal status of one of the chapters has come about since Goldacre won a libel case filed against him by Matthias Rath. The post dated 9 April 2009 states: This is the “missing chapter” about vitamin pill salesman Matthias Rath. Sadly I was unable to write about him at the time that book was initially published, as he was suing my ass in the High Court.
The full chapter has been made universally available under a Creative Commons license with the title The Doctor Will Sue You Now. Additionally, this full chapter is included as chapter 10 in the New Paperback Edition.
In this chapter the author explains its origin, its reasons for being excluded and describes his personal reasons and tribulations in the said legal resolution. Being his personal point of view it contains an account of his anger at being gagged due to legal/financial restrictions, his support by the Guardian (whom he writes for) and his now encyclopedic knowledge of the subject in question.
- Goldacre, Ben (September 2008). Bad Science. London: Fourth Estate. ISBN 978-0-00-724019-7. OCLC 259713114.
- Richard Smith. "Becoming Ben - Smith 337". bmj.com. Retrieved 2011-08-15.
- "Ed Lake applauds a crusade against lazy and deceptive writing about science"
- NO WAY TO TREAT A DEDICATED DOCTOR The Sunday Mirror, 11 July 2004, Retrieved 13 December 2010
- Knightley, Phillip A battle won late The Independent, 25 August 1997, Retrieved 13 December 2010
- "Bad Science: the missing index « o_l_i_b_l_o_g". Oliolioli.wordpress.com. 2009-01-09. Archived from the original on 18 July 2011. Retrieved 2011-08-15.
- "BadScience.net". Ben Goldacre. Archived from the original on 12 April 2009. Retrieved 2009-04-13.
- "The-Doctor-Will-Sue-You-Now.pdf" (PDF). Ben Goldacre. Archived (PDF) from the original on 19 April 2009. Retrieved 2009-04-13.
- Goldacre, Ben (2009). Bad Science, Paperback. UK: Harper Perennial. ISBN 0-00-728487-X.