Bad Science (Goldacre book)

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Bad Science
Book badscience cover.jpg
First edition cover
Author Ben Goldacre
CountryUnited Kingdom
LanguageEnglish
Subject Pseudoscience
GenreNon-fiction
Publisher Fourth Estate
Publication date
September 2008
Media typePrint (Paperback)
Pages338
ISBN 978-0-00-724019-7
OCLC 259713114
500 22
LC Class Q172.5.E77 G65 2008

Bad Science is a book written by Ben Goldacre which criticises certain physicians and the media for a lack of critical thinking and misunderstanding of evidence and statistics which is detrimental to the public understanding of science. [1] In Bad Science, Goldacre explains basic scientific principles to demonstrate the importance of robust research methods, experimental design, and analysis to make informed judgements and conclusions of evidence-based medicine. Bad Science is described as an engaging and inspirational book, written in simple language and occasional humour, to effectively explain academic concepts to the reader. [2]

Contents

Bad Science was originally published in the UK by Fourth Estate in September 2008 and later editions have since been published through HarperCollins Publishers. [3] [4] The book has generally been well-received with positive reviews by the British Medical Journal and the Daily Telegraph. [5] [6] Bad Science reached the Top 10 bestseller list for Amazon Books and was shortlisted for the BBC Samuel Johnson Prize for Non-Fiction 2009. [7]

Synopsis

Each chapter deals with a specific aspect of bad science, often to illustrate a wider point. For example, the chapter on homeopathy becomes the point where he explains the placebo effect, regression to the mean (that is, the natural cycle of the disease), placebo-controlled trials (including the need for randomisation and double blinding), meta-analyses like the Cochrane Collaboration and publication bias.

Introduction

Goldacre begins by highlighting that the substandard understanding of statistics and evidence-based medicine within our society leads to the misrepresentation of science within the media. [8] Ultimately, constant bombardment from the media and advertising is detrimental and misleading public understanding of science. Throughout this book, Goldacre aims to provide knowledge of bad science practices to help readers differentiate the truth from the lies and form their own judgement of science.  

Chapter 1: "Matter"

Goldacre recognised that the scientific knowledge of marketers and journalists is often rudimentary, relying on basic notions and ideas from GCSE-level science. [9] Consequently, through basic reasoning errors, they have the power to misinterpret evidence and mislead public understanding. Throughout this chapter, Goldacre debunks pseudoscientific claims within the alternative medicine phenomenon of detoxification, using simple science experiments to demonstrate the basic principles of experimental design and analysis. With three examples Goldacre shows that theatre is a common feature of detox products and that detox itself has no scientific meaning but instead is a marketing innovation based on cultural rituals. [10]

Chapter 2: "Brain Gym"

Goldacre slams Brain Gym as transparent pseudoscientific nonsense. [11] At the time the book was written, Brain Gym was promoted by local education authorities and practised in hundreds of schools across the country. [12] Goldacre explains how the use of quackery- decorating simple explanations with scientific terminology- can convince non-specialists that a series of complex exercises can ‘enhance the experience of whole brain learning’. [13] As such, children were systematically fed pseudoscience. [14]

Chapter 3: The Progenium XY Complex

The cosmetic industry yields high profit from elegantly communicated pseudoscience. [15] Often targeted at young women, Goldacre explains that cosmetic advertisement portrays science as incomprehensible rather than a balance between evidence and theory. [16] He suggests that marketing teams incorporate convincing molecular language to suggest that particular ingredients within cosmetic products can improve skin appearance. In fact, such ‘magical’ ingredients are present at negligible concentrations as they often cause side effects. It is also difficult to alter skin appearance with cosmetic intervention as homeostatic feedback systems tightly regulate biology.

Chapter 4: "Homeopathy"

Homeopathy, an alternative medicine based on the theory that ‘like cures like’ and that very high dilutions strengthen the treatment. While Goldacre suggests "conceptual holes" in the theory, his main issue is that it ultimately does not work. He explains how evidence-based medicine works and how homeopathy has not met these standards.

Chapter 5: "The Placebo Effect"

The placebo effect. Already introduced in the previous chapter, Goldacre discusses it in further detail. He notes factors that can enhance the placebo effect, such as higher prices, fancy packaging, theatrical procedures and a confident attitude in the doctor. He also discusses the ethical issues of the placebo. He concludes the placebo effect is possibly justifiable if used in conjunction with effective conventional treatments, but it does not justify alternative medicine.

Chapter 6: "The Nonsense du Jour"

Nutritionism, which Goldacre does not consider to be proper science but has been accepted as so by the media. He says nutritionists often misrepresent legitimate scientific research, make claims based on weak observations, over-interpreted surrogate outcomes in animal and tissue culture experiments and cherry picked published research.

Chapter 7: "Dr Gillian McKeith PhD"

Gillian McKeith, a nutritionist who presented You Are What You Eat on Channel 4. Though presented as a medical doctor, her degree was neither medical nor accredited. Goldacre noted factual errors in her claims, such as those on chlorophyll. He compares her writings and advice to a Melanesian cargo cult; it looked scientific but lacked the substance. Goldacre argues that micro-regulating a person's diet has little effect on their health, and it is more important to try to lead a generally healthy lifestyle. He also argues that general health of the population correlates with affluence better than anything else.

Chapter 8: "Pill Solves Complex Social Problem"

The claim that fish oil capsules make children smarter, especially the "Durham trial" that promoted these. Goldacre notes these trials lacked control groups and were wide open to a range of confounding factors. He notes how the education authorities failed to publish any results and backtracked on earlier claims. He discusses the media's preference for simple science stories and role in promoting dubious health products. 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"

Patrick Holford, a best-selling author, media commentator, businessman and founder of the Institute for Optimum Nutrition (which has trained most of the UK's "nutrition therapists"). Goldacre notes how Holford helped present nutritionism as a scientific discipline to the media, and forged links with some British universities. He says Holford is promoting unproven claims about vitamin pills by misinterpreting and cherry picking favourable results from medical literature.

Chapter 10: " The Doctor Will Sue You Now"

Matthias Rath, a vitamin salesman. This chapter was not present in the original edition, as Rath was suing Goldacre at the time for libel. [17] After Goldacre won, it has been included in later editions [18] and Goldacre has made it freely available online. [19] In this chapter, he discusses how Rath travelled to Africa to promote vitamin pills as treatments for HIV/AIDS, and how these ideas were met with sympathy by the government of Thabo Mbeki in South Africa.

Chapter 11: "Is Mainstream Medicine Evil?"

Mainstream medicine. Goldacre notes that a surprisingly low proportion of conventional medical activity (50 to 80%) is truly "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. He explains the science and economics of drug development, 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 12: "How the Media Promote the Public Misunderstanding of Science"

The role of media in misrepresenting science. Goldacre blames this on the preponderance of humanities graduates in journalism, and the media for wacky, breakthrough or scare stories. This includes stories about formulas for "the perfect boiled egg" or "most depressing day of the year" and a speculation that the human race will evolve into two separate races. These were publicity stunts for companies. Goldacre blames the lack of sensational medical breakthroughs since a golden age of discovery between 1935 and 1975, with medicine making only gradual improvements since.

Chapter 13: "Why Clever People Believe Stupid Things"

Cognitive biases. In a chapter titled "Why Clever People Believe Stupid Things", Goldacre explains 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 14: "Bad Stats"

The cases of Sally Clark and Lucia de Berk. Goldacre says poor understanding and presentation of statistics played an important part in their criminal trials.

Chapter 15: "Health Scares"

The MRSA hoax. Goldacre accuses the press of selectively choosing to use a "laboratory" that kept giving positive MRSA results when other pathology labs were producing none. The laboratory was a garden shed, run by Chris Malyszewicz, who was treated by the press as an "expert" but had no relevant qualifications. Goldacre believes the press were far more to blame for the misinformation than Malyszewicz. Goldacre argues that journalists have been poor at uncovering medical scandals. For example, it was doctors and not journalists who discovered the thalidomide tragedy; only covering well the political issue of compensation.

Chapter 16: "The Media's MMR Hoax"

Andrew Wakefield and the MMR vaccine controversy. Goldacre argues that while Wakefield's paper began the hoax about MMR causing autism, the greatest blame for the misinformation lies with the media, who should have realised that Wakefield's paper provided no evidence of a link.

Index

The hardback and first paperback editions did not include an index. Several indexes were prepared by bloggers, including one prepared by Oliblog. [20] The latest paperback issue includes a full index.

See also

Related Research Articles

Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability or evidence of effectiveness. Unlike modern medicine, which employs the scientific method to test plausible therapies by way of responsible and ethical clinical trials, producing repeatable evidence of either effect or of no effect, alternative therapies reside outside of medical science and do not originate from using the scientific method, but instead rely on testimonials, anecdotes, religion, tradition, superstition, belief in supernatural "energies", pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources. Frequently used terms for relevant practices are New Age medicine, pseudo-medicine, unorthodox medicine, holistic medicine, fringe medicine, and unconventional medicine, with little distinction from quackery.

<span class="mw-page-title-main">Homeopathy</span> Pseudoscientific system of alternative medicine

Homeopathy or homoeopathy is a pseudoscientific system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths or homeopathic physicians, believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called similia similibus curentur, or "like cures like". Homeopathic preparations are termed remedies and are made using homeopathic dilution. In this process, the selected substance is repeatedly diluted until the final product is chemically indistinguishable from the diluent. Often not even a single molecule of the original substance can be expected to remain in the product. Between each dilution homeopaths may hit and/or shake the product, claiming this makes the diluent "remember" the original substance after its removal. Practitioners claim that such preparations, upon oral intake, can treat or cure disease.

Magnetic therapy is a pseudoscientific alternative medicine practice involving the weak static magnetic field produced by a permanent magnet which is placed on the body. It is similar to the alternative medicine practice of electromagnetic therapy, which uses a magnetic field generated by an electrically powered device. Magnet therapy products may include wristbands, jewelry, blankets, and wraps that have magnets incorporated into them.

<span class="mw-page-title-main">Placebo</span> Substance or treatment of no therapeutic value

A placebo can be roughly defined as a sham medical treatment. Common placebos include inert tablets, inert injections, sham surgery, and other procedures.

<span class="mw-page-title-main">Quackery</span> Promotion of fraudulent or ignorant medical practices

Quackery, often synonymous with health fraud, is the promotion of fraudulent or ignorant medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, qualification or credentials they do not possess; a charlatan or snake oil salesman". The term quack is a clipped form of the archaic term quacksalver, from Dutch: kwakzalver a "hawker of salve". In the Middle Ages the term quack meant "shouting". The quacksalvers sold their wares at markets by shouting to gain attention.

In a blind or blinded experiment, information which may influence the participants of the experiment is withheld until after the experiment is complete. Good blinding can reduce or eliminate experimental biases that arise from a participants' expectations, observer's effect on the participants, observer bias, confirmation bias, and other sources. A blind can be imposed on any participant of an experiment, including subjects, researchers, technicians, data analysts, and evaluators. In some cases, while blinding would be useful, it is impossible or unethical. For example, it is not possible to blind a patient to their treatment in a physical therapy intervention. A good clinical protocol ensures that blinding is as effective as possible within ethical and practical constraints.

<span class="mw-page-title-main">Gillian McKeith</span> Scottish television presenter and writer

Gillian McKeith is a Scottish television personality and writer. She is known for her promotion of various pseudoscientific ideas about health and nutrition. She is the former host of Channel 4's You Are What You Eat (2004–2006), Granada Television's Dr Gillian McKeith's Feel Fab Forever (2009–2010), and W Network's Eat Yourself Sexy (2010). In 2008, McKeith regularly appeared on the E4 health show Supersize vs Superskinny, and in 2010, she was a contestant on the tenth series of the ITV show I'm a Celebrity...Get Me Out of Here!

Matthias Rath is a doctor, businessman, and vitamin salesman. He earned his medical degree in Germany. Rath claims that a program of nutritional supplements, including formulations that he sells, can treat or cure diabetes, cardiovascular disease, cancer, and HIV/AIDS. These claims are not supported by any reliable medical research. Rath runs the Dr. Rath Health Foundation, has been closely associated with Health Now, Inc., and founded the Dr. Rath Research Institute.

<span class="mw-page-title-main">Ben Goldacre</span> British physician, academic and science writer (born 1974)

Ben Michael Goldacre is a British physician, academic and science writer. He is the first Bennett Professor of Evidence-Based Medicine and director of the Bennett Institute for Applied Data Science at the University of Oxford. He is a founder of the AllTrials campaign and OpenTrials to require open science practices in clinical trials.

Patrick Holford is a British author and entrepreneur who endorses a range of controversial vitamin tablets. As an advocate of alternative nutrition and diet methods, he appears regularly on television and radio in the UK and abroad. He has 36 books in print in 29 languages. His business career promotes a wide variety of alternative medical approaches such as orthomolecular medicine, many of which are considered pseudoscientific by mainstream science and medicine.

<i>Mad in America</i> 2002 book by Robert Whitaker

Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill is a 2002 book by medical journalist Robert Whitaker, in which the author examines and questions the efficacy, safety, and ethics of past and present psychiatric interventions for severe mental illnesses, particularly antipsychotics. The book is organized as a historical timeline of treatment development in the United States.

<span class="mw-page-title-main">Energy medicine</span> Pseudo-scientific alternative medicine

Energy medicine is a branch of alternative medicine based on a pseudo-scientific belief that healers can channel "healing energy" into a patient and effect positive results. The field is defined by shared beliefs and practices relating to mysticism and esotericism in the wider alternative medicine sphere rather than any sort of unified terminology, leading to terms such as energy healing or vibrational medicine being used as synonymous or alternative names. In most cases there is no empirically measurable energy involved: the term refers instead to so-called subtle energy. Practitioners may classify the practice as hands-on, hands-off, and distant where the patient and healer are in different locations. Many schools of energy healing exist using many names: for example, biofield energy healing, spiritual healing, contact healing, distant healing, therapeutic touch, Reiki or Qigong.

<span class="mw-page-title-main">Sense about Science</span> British non-profit organisation

Sense about Science is a United Kingdom charitable organization that promotes the public understanding of science. Sense about Science was founded in 2002 by Lord Taverne, Bridget Ogilvie and others to promote respect for scientific evidence and good science. It was established as a charitable trust in 2003, with 14 trustees, an advisory council and a small office staff. Tracey Brown has been the director since 2002.

Peter Christian Gøtzsche is a Danish physician, medical researcher, and former leader of the Nordic Cochrane Center at Rigshospitalet in Copenhagen, Denmark. He is a co-founder of the Cochrane Collaboration and has written numerous reviews for the organization. His membership in Cochrane was terminated by its Governing Board of Trustees on 25 September 2018. During the COVID-19 pandemic, Gøtzsche was criticised for spreading disinformation about COVID-19 vaccines.

<span class="mw-page-title-main">Peter Fisher (physician)</span> British doctor

Peter Antony Goodwin Fisher, FRCP was an English physician who served as physician to Queen Elizabeth II for 17 years.

<i>Trick or Treatment?</i> 2008 book by Singh and Ernst

Trick or Treatment? Alternative Medicine on Trial is a 2008 book by Simon Singh and Edzard Ernst. The book evaluates the scientific evidence for alternative medicines such as acupuncture, homeopathy, herbal medicine, and chiropractic, and briefly covers 36 other treatments. It finds that the scientific evidence for these alternative treatments is generally lacking. The authors concluded that homeopathy is merely a placebo.

<i>Bad Pharma</i> 2012 book critical of the pharmaceutical industry

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients is a book by the British physician and academic Ben Goldacre about the pharmaceutical industry, its relationship with the medical profession, and the extent to which it controls academic research into its own products. It was published in the UK in September 2012 by the Fourth Estate imprint of HarperCollins, and in the United States in February 2013 by Faber and Faber.

<span class="mw-page-title-main">AllTrials</span>

AllTrials is a project advocating that clinical research adopt the principles of open research. The project summarizes itself as "All trials registered, all results reported": that is, all clinical trials should be listed in a clinical trials registry, and their results should always be shared as open data.

<span class="mw-page-title-main">Detoxification foot baths</span> Pseudoscientific alternative medicine

Detoxification foot baths, also known as foot detox, ionic cleansing, ionic foot bath and aqua/water detox are pseudoscientific alternative medical devices marketed as being able to remove toxins from the human body. They work by providing an electric current to an electrode array immersed in a salt water solution. When switched on, the electrodes rapidly rust in a chemical process called electrolysis which quickly turns the water brown. This reaction happens regardless of whether or not a person's feet are immersed in the water and no toxins from the human body have ever been detected in the water after use.

The infinitesimally low concentration of homeopathic preparations, which often lack even a single molecule of the diluted substance, has been the basis of questions about the effects of the preparations since the 19th century. Modern advocates of homeopathy have proposed a concept of "water memory", according to which water "remembers" the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to exist, in terms of any detectable effect, biological or otherwise.

References

  1. Goldacre, Ben (2009). Bad science (Fourth Estate paperback ed.). London. ISBN   978-0-00-728487-0. OCLC   428679822.{{cite book}}: CS1 maint: location missing publisher (link)
  2. "Bad Science". University College Oxford. Retrieved 2023-01-30.
  3. Goldacre, Ben (September 2008). Bad Science. London: Fourth Estate. ISBN   978-0007240197. OCLC   259713114.
  4. "Bad Science". HarperCollins Publishers UK. Retrieved 2023-01-30.
  5. Richard Smith (October 2008). "Becoming Ben – Smith 337". BMJ. 337. bmj.com: a1856. doi:10.1136/bmj.a1856. S2CID   220115523 . Retrieved 2011-08-15.
  6. "Review: Bad Science by Ben Goldacre". www.telegraph.co.uk. 27 September 2008.
  7. "Book awards: Samuel Johnson Prize for Non-fiction shortlist | LibraryThing". LibraryThing.com. Retrieved 2023-01-30.
  8. Goldacre, Ben (2009). Bad science (4th ed.). London. pp. ix. ISBN   978-0-00-728487-0. OCLC   428679822.{{cite book}}: CS1 maint: location missing publisher (link)
  9. Goldacre, Ben (2009). Bad science (4th ed.). London. p. 1. ISBN   978-0-00-728487-0. OCLC   428679822.{{cite book}}: CS1 maint: location missing publisher (link)
  10. Goldacre, Ben (2009). Bad science (4th ed.). London. p. 12. ISBN   978-0-00-728487-0. OCLC   428679822.{{cite book}}: CS1 maint: location missing publisher (link)
  11. Goldacre, Ben (2009). Bad science (4th ed.). London. p. 15. ISBN   978-0-00-728487-0. OCLC   428679822.{{cite book}}: CS1 maint: location missing publisher (link)
  12. "Experts dismiss educational claims of Brain Gym programme". the Guardian. 2008-04-03. Retrieved 2023-01-30.
  13. Goldacre, Ben (2009). Bad science (4th ed.). London. p. 13. ISBN   978-0-00-728487-0. OCLC   428679822.{{cite book}}: CS1 maint: location missing publisher (link)
  14. Spaulding, Lucinda S.; Mostert, Mark P.; Beam, Andrea P. (2010-01-19). "Is Brain Gym® an Effective Educational Intervention?". Exceptionality. 18 (1): 18–30. doi:10.1080/09362830903462508. ISSN   0936-2835. S2CID   143272201.
  15. Ringrow, Helen (2014-12-31). "Peptides, proteins and peeling active ingredients: exploring 'scientific' language in English and French cosmetics advertising". Études de stylistique anglaise (7): 183–210. doi: 10.4000/esa.1322 . ISSN   2116-1747.
  16. Goldacre, Ben (2009). Bad science (4th ed.). London. p. 27. ISBN   978-0-00-728487-0. OCLC   428679822.{{cite book}}: CS1 maint: location missing publisher (link)
  17. "BadScience.net". Ben Goldacre. Archived from the original on 12 April 2009. Retrieved 2009-04-13.
  18. Goldacre, Ben (2009). Bad Science, Paperback. UK: Harper Perennial. ISBN   978-0007284870.
  19. "The-Doctor-Will-Sue-You-Now.pdf" (PDF). Ben Goldacre. Archived (PDF) from the original on 19 April 2009. Retrieved 2009-04-13.
  20. "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.