Seriously, what am I going to say to the IPPR?

July 19th, 2007 by Ben Goldacre in onanism | 41 Comments »

Just got back from a stats conference – how rock is my life – and I’m trying trying to decide what to say to the IPPR tomorrow? I know very little about politics with a capital P, or thinktanks, and I was rather hoping some of you might know better than me. It’s an informal chat thing, lunchtime, 20 minutes of talking from me, then questions.

www.ippr.org.uk/events/exchange/?id=2687

Bad Science
20 July 2007 -

The Institute for Public Policy Research (ippr) is delighted to be hosting an event with Ben Goldacre, Guardian columnist and author of Bad Science. At a time when science is used to prove everything and nothing, everyone has their own ‘bad science’ moments. From the useless pie-chart on the back of cereal packets to the use of the word ‘visibly’ in cosmetics ads, Ben will help people to quantify their instincts; that a lot of the so-called ‘science’ which appears in the media and in advertising is just wrong or misleading.

Ben Goldacre is an award winning writer, broadcaster, and medical doctor who has written the weekly Bad Science column in the Guardian since 2003. He appears regularly on Radio 4 and TV, and has written for the Guardian, Time Out, New Statesman, and the British Medical Journal as well as various book chapters. He has won numerous awards, including “Best Freelancer” at the Medical Journalists Awards 2006, the Healthwatch Award in 2006, and “Best Feature” at the British Science Writers Awards twice, in 2003 and 2005, and the Royal Statistical Society’s first Award for Statistical Excellence in Journalism. To find out more visit www.badscience.net

My first impulse – perhaps thinking too hard about what has a policy angle, and before I saw this puff on their site – was to talk about the ethics of bullshit. I’m a bit bored of quackery at the moment, but there are interesting issues around quackery regulation, and how to manage the risks and benefits of bullshit, like:

* Bending the rules for quacks when its politically expedient makes them think that’s how its done for everyone (I’m thinking of, say, MHRA and homeopathy, or UCLH formulary committee letting through homeopathy on the nod because of the RLHH)

* The placebo effect is ok but it’s in conflict with patient autonomy and informed consent and that needs to be openly discussed and managed

* Regulation for quacks is about professional self-aggrandisement, they get themselves caught up in “little-ender vs big-ender” professional squabbles, when all we really care about with regulation is stopping quacks from sexually and financially exploiting their patients (eg barefoot doctor allegations over shagging patients), and arguably missing medical diagnoses and treatments.

* Quackery at extremes is v harmful, outside a decadent context, eg South Africa nutritionism for AIDS

* As well as direct harm there is indirect harm from bullshit, such as undermining the pub understanding of sci and the nature of evidence

Plenty to talk about – and I am a bit tired – but maybe better to talk about Dont Dumb Me Down type “how the media promote the public misunderstanding of science” stuff. If I had really put some thought into it I could have knocked up something on using RCTs to examine social policy or something, but after unexpectedly staying up all night on Monday to do the BMJ piece I’m a bit knackered with no spare time.

Also I don’t really know what they’ll expect.

Any suggestions?


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41 Responses



  1. IanWac said,

    July 19, 2007 at 7:58 pm

    Ben,

    I wonder if it would be interesting to do a talk on “How you can tell when I’m lying to you…” Strikes me that this is what the blurb is asking for; looks a bit “Woe is me, those dastardly scientists are always pulling the wool over my eyes and I just can’t tell” OK, so good scientific understanding is the result of years of hard work, but what about 20 to 30 minutes of short cuts with the title above, then you can just go where the audience take you.

    Ian

  2. Kris Jones said,

    July 19, 2007 at 8:07 pm

    I have been to IPPR events on media regulation before. If those are anything to go by, the events tend to be relatively informal talks followed by round table discussion.

    20 minutes isn’t long so I’d have thought that talking about “how the media promote the public misunderstanding of science”, could easily use up the available time alone. Of course, it’s not just the media, but also the marketing of products and services that contribute, such as your kettle lead, fish oil and face cream examples. One might suspect that certain parts of the scientific community are complicit in promoting such misunderstandings.

    It’s best in a forum like the IPPR if one can not only outline the problem, but also point the way towards a solution. They might be interested to hear what could be done by the scientific community and the media to promote a better understanding.

    I have no scientific background myself. My career was focused on government policy-making. I have, however, always enjoyed your columns and I hope adding my tuppence worth here helps.

  3. Jut said,

    July 19, 2007 at 8:15 pm

    Hi Ben, I quite like the idea of “how the media promotes the public misunderstanding of science”.Maybe choosing to focus on the recent MMR scare or Wi-FI bullshit would be worth doing as these are two extreme examples, both within a very short time period

  4. woodbine said,

    July 19, 2007 at 8:16 pm

    In my experience the policy wonks and others who attend these sort of events are looking for “innovative thinkers” because they want to adapt their theories and popularise the thinker’s ideas as part of a policy that can cure social or government problems.

    This means that they’re often motivated by big ticket problems, crime, health, housing etc. They tend not to be motivated by the small ticket stuff, such as “will my accupuncturist try and poke me?”. I expect, they’ll be interested in regulatory stuff but they’ll also be interested in a hearing about how the acceptance of quakery has broad negative social consequences, in either a large context (AIDs in South Africa) or small a small context (UCLH committee’s undermining their standards). As long as you can do cause and effect I think they’ll like it.

    There’s one other aspect that might be of interest to them, which would appear more in the form of a question, but what do they do to verify the data that they often use as a basis for policy work?

    Good luck

  5. Stuu said,

    July 19, 2007 at 8:36 pm

    Just tells them that homeopathy causes autism, then ring the daily mail.

  6. Ben Goldacre said,

    July 19, 2007 at 8:49 pm

    but is cam a bit boring? i think the remote side effects of cam are whats interesting about it, like people being stupid about food, etc.

    maybe there is something more interesting to say about how the govt can engage with risk, and public perception of risk, etc? wrt electrosensitivity and mmr. but thats a massive issue, and also the electro stuff is something i’m working up into a massive 6000 word monster piece that i dont want to blow the lid on quite yet. also, again, very little that can be done ab out that kind of thing, unless you pass some kind of law to deal with the media being full of ignorant venal and exploitative humanities graduate tossers, which seems unlikely.

  7. Munin said,

    July 19, 2007 at 8:56 pm

    They might be interested in discussing the current de-facto regulation by bodies like the ASA & PCC.

    As I understand it, both these bodies can only respond to complaints, so the onus is on individuals to spot and raise issues. I quite like this approach in principal, though I think it would benefit from more public education, so people know that there’s a system and it relies on their input to work. However, it would be interesting to discuss the pros and cons of alternative approaches to regulation.

    Otherwise, if you’re really stuck, there’s always chicken.
    www.youtube.com/watch?v=yL_-1d9OSdk

  8. superburger said,

    July 19, 2007 at 9:10 pm

    CAM is ace topic. The gift that keeps on giving. Just ‘cos you think about it a lot doesn’t mean they do……

    I like the idea that we have situations where people and things outside mainstream science and medicine seek the credibility that comes with being regulated, but don’t want to have to be held to the same standards of evidence (if that makes sense.)

    OR Fish Oil bollocks.

    Dick jokes a must though.

  9. jimyojimbo said,

    July 19, 2007 at 9:19 pm

    Ben, Jut: “how the media promotes the public misunderstanding of science”

    Or how a lot of these stories seem to be reported by people obviously unskilled in rudimentary understandings of how to read scientific literature; press release science reporting, etc.

    It’s obvious that a (serious) media outlet wouldn’t have someone reporting, and especially giving opinion pieces, on say politics or economics who doesn’t have at least some knowledge of politics or economics.

    Does the media have a responsibility to utlise journalists trained in science reporting, as part of their remit to report accurately?

  10. j said,

    July 19, 2007 at 9:22 pm

    something about the ethics of bullshit research too, maybe?

    Wakefield’s research ‘ethics’ are topical at the moment, but there’s lots of examples of really, really bad CAM etc. research, where subjects are asked to let their bodies and their time be used for research that’s never going to generate any useful results.

  11. BrickWall said,

    July 19, 2007 at 9:23 pm

    OK maybe I’m old and cynical but the IPPR events I’ve been to (lunchtime talks like this rather than big projects stever refers to) have seemed to me to be mainly about which IPPR bod (never met one over 30, but maybe I’ve had unusual meetings) can ask the most “pertinent” question to get kudos with the boss. (God I really am a cynical git.) I think the ethics of bullshit is as good as anything especially in the light of stever’s experience – policy think tanks like to talk a lot about evidence until it becomes a little inconvenient for whatever idea they need to promote to be seen!

  12. zooloo said,

    July 19, 2007 at 9:25 pm

    CAM may be dull to the like that come here but is the general public aware?

    Would it be old news to the committee people?

    It’s a good place to start as there is so much supporting material and many supportive people

  13. le canard noir said,

    July 19, 2007 at 9:34 pm

    It might just be the frame of mind I am in right now (aggressively anti-homeopathy) but I am mulling over the ‘True cost of Homeopathy in the NHS’. It is not just the ~£10M of funding hospitals. What is the true cost of state-sponsored undermining of ebm? cost to the gp and the patient? And as you say, the new colonialism (the woo missionaries to Africa) of exporting quackery to people with no access to medicine and to those who exploit woo for post-colonial purposes. The cost is then uo there with worst international disasters.

  14. BarryNL said,

    July 19, 2007 at 10:09 pm

    I’d go from hammering home the point that the scientific method is the only way we actually have to reliably discover the true nature of the world we live in – and then make clear the threat to this presented by the abuse of science in the contemporary media and political world.

    After all, that’s the real core of what you say every week and what people need to realise to begin tackling the problem.

  15. superburger said,

    July 19, 2007 at 10:11 pm

    “why the learned science bodies (of which there are many)”

    yes, but their primary business is the peddling of journals. Not being learned and stuff.

  16. Shakeel said,

    July 19, 2007 at 10:29 pm

    I vote that you pull a Stephen Colbert at the Whitehouse Press Correspondant’s Dinner and spend your 20 minutes lampooning and accusing them of doing the things that they do that make life harder for types like you and I (ie, the scientifically literate) by allowing bullshit to be fed to the masses with nary a whisper, and often consent.

    Could be fun, and it’d definitely be a change of pace for you. I mean, seriously, how much do you want these guys to really like you? Part of me says that if they did like me, it’d mean I was a bad person.

  17. pv said,

    July 19, 2007 at 10:43 pm

    How about something on the culpability of quack medical practitioners. I know the subject has come up recently in the forum with regard to people who follow, say, their homeopathist’s advice and suffer as a consequence. Doctors who practice evidence based medicine can be struck off or sent to prison, or something in between, if they do the slightest thing wrong, whereas when a homeopathist or other quack behaves in a similar way, misdiagnoses or offers ineffective treatment with dire consequences for the patient… nothing happens and they carry right along, because then it becomes the fault of the patient. How can this be, particularly with regard to homeopathy which is sanctioned by the State through the NHS?
    Maybe something on that might be interesting.

  18. Stuu said,

    July 19, 2007 at 11:29 pm

    pv; homeopathy is generally regulated by flimsy boards that don’t actually have any power over whether or not people can practice.

    Are homeopaths on the NHS the same? I mean, does the NHS regulate them, or are they like hired help that are probably members of the royal soc. of homeopaths?

  19. SteveNaive said,

    July 19, 2007 at 11:31 pm

    CAM might be done to death here but £10m a year on NHS homeopathy is truly a disgrace.

    Here are a couple of quotes from an article on the IPPR website called ‘Extending Choice’ :

    “They [people] should have a choice of different evidence based treatments, including different kinds of talking therapies, different kinds of medication, exercise or leisure activities on prescription, complementary and alternative medicines, ‘watchful waiting’, or referrals to community and self-help support groups.”

    “They want to be treated by GPs who take a holistic approach, who are sympathetic and knowledgeable about complementary therapies and not just medication.”

    Good luck.

  20. le canard noir said,

    July 20, 2007 at 12:44 am

    bbc report here on IPPR, mental health and quackery…

    news.bbc.co.uk/2/hi/health/4376941.stm

  21. Dubby said,

    July 20, 2007 at 1:03 am

    Stuu (#7) has nailed it!
    Fight fire with fire. Once the scientifically illiterate editors give you exposure you have the platform to spread the word!

  22. pv said,

    July 20, 2007 at 1:13 am

    Stuu @23
    “homeopathy is generally regulated by flimsy boards that don’t actually have any power over whether or not people can practice”

    So there are no sanctions against malpractice. If someone dies through misdiagnosis or misdirection then it’s their own stupid fault.
    If it’s a regular GP, then the sky falls in on them and they are in deep shit.
    Homeopathists like to insist they deal in medicine. They can cure any number of life threatening ailments and diseases apparently. They would like, therefore, to think and for everyone else to believe they deal in matters of life and death. Yet they aren’t culpable if someone in their care dies or suffers severely as a result of malpractice.
    It shouldn’t matter if anyone with half a brain knows it’s complete nonsense. As long as the “patient” thinks homeopathy is medicine and the homeopathists and retailers are (fraudulently) selling it as such, then surely anyone practising this scam should be held legally liable for the consequences of their advice and practice.
    I suspect many homeopathists themselves believe it’s shit too, which is why they are against any legal type of regulation, or any regulation at all that would show them up to be the, albeit many of them deluded, frauds they are.
    Seems to me a fairly serious issue!

  23. PO8 said,

    July 20, 2007 at 5:52 am

    Seems to me somebody needs to fund a recognized-impartial center with real scientists and media specialists to take the role of informing journalists and the general public on the truth of “controversial” science and public policy topics. I’m thinking someplace with a hotline for the rare journalist who wants help understanding scientific facts and research, and a website that collects research reports and scientific interpretations for a variety of controversial topics together with unbiased critiques of media articles on those topics…

    Maybe a call to IPPR to take on this role would be worthwhile?

  24. kayman1uk said,

    July 20, 2007 at 8:43 am

    They’ve already announced what you’ll be talking about. I don’t think you can stray from this topic now it’s in London’s social calendar… “a lot of the so-called ’science’ which appears in the media and in advertising is just wrong or misleading”.

    CAM would obviously work here. Focussing on the case for permitting Doctors to ‘lie’ to make use of the placebo effect probably wouldn’t. 20 minutes isn’t long, so keep it tight.

    I’m sure you know the IPPR is extremely close to the labour party, and Gordon does love to regulate, so be careful they don’t just hear that the solution to quackery is bigger government. Hope it goes well.

  25. Camp Freddie said,

    July 20, 2007 at 10:00 am

    I’d go for a talk about rule-brending/breaking and regulation, since it’s a government thing.
    Bullet points 1, 3 and 4 in your original post.
    They need to generate ‘policy ideas’ from what you say.

    Public understanding is all about the media, and no government policy can change that (any government policy to influence the media would backfire).

    I think that you should end on the serious harm that quack science can do, otherwise there’s a danger of the policy wonks treating it as a puff speach (ho ho ho, look at the silly women believing the science on L’Oreal ads, will they never learn, ha ha ha).
    For example, a couple of weeks ago Patrick Holford appeared on Trevor McDonald Tonight promoting fish oil brain food, all the while he’s promoting dodgy vitamins to people dying of AIDS (suprised you didn’t comment on that, but I guess MMR has kept you busy!).
    If a real doctor/professor was caught making millions from lying to dying people, it’s be a Harold Shipman type scandal.

  26. Teek said,

    July 20, 2007 at 10:05 am

    what if the rapid (rabid, was that a typo or a joke?!) rebuttal unit wasn’t gubmint, but eg royal society, to give the air of independence?

  27. crgn said,

    July 20, 2007 at 11:01 am

    Possibly again a bit late, but the graph about the misrepresentation of THC of cannabis recently might be apposite today.

  28. Andrew Clegg said,

    July 20, 2007 at 11:10 am

    It’s probably way past the time when this would be useful, but the international development angle might be well received, and might also shock them out of the idea that CAM is harmless. Rath and Holford pushing vitamins to AIDS-infested Africa etc.

    Regarding the posts above about the cost to the NHS of homeopathy — Private Eye‘s “M.D.” (Phil Hammond I think?) reckons that on balance homeopathy etc. save the NHS money. The “we all know it’s made-up but it keeps the people with made-up illnesses away from our surgeries” angle. (That’s not verbatim but it’s close.)

    Of course I don’t know if that’s backed up by any actual evidence.

    Andrew.

  29. tjb said,

    July 20, 2007 at 12:11 pm

    I think a rapid rebuttal unit would face two difficulties. Firstly it would itself become a conduit for nonsensical ideas (much in the way that lots of lunatics reference their BMJ email responses). Secondly, no matter how rapid the rebuttals, unsubstantiated hypotheses and wild surmises can be generated faster, more easily and more cheaply.

  30. Grathuln said,

    July 20, 2007 at 12:55 pm

    The Government’s abuse of science might be more relevant to the Institute of Public Policy Research, if you’re looking for something other than CAM. That woolly “scientific” report that was heralded as “proving” there is no link between “alternate week rubbish collections and ill health”* for instance, or all the woo surrounding drug policy; cannabis “stronger strains” etc.

    *I gather this is being revisted, perhaps because despite the report containing a chart showing that the “number of councils who had received complaints” (spot the cunning use of statistics to tell true lies) had not increased since implementation of alternate week collections failed to cover up the fact there are a lot of very upset people.

    Of course this might be more controversial than having a pop at CAM.

    Good luck.

  31. altmedicine said,

    July 20, 2007 at 12:55 pm

    Hello Dr. Ben,

    I just have registered to your blog to say hi…I am new here…

    It’s always difficult to speak on politics…I hope you might have decided something.

  32. Dr Aust said,

    July 20, 2007 at 1:32 pm

    Ben wrote: “i really feel that the “rabid rebuttal” unit would fail, simply because the childish elements who write about eg mmr will simply mistrust anything the “gubmint” says on science”

    Agree it would have to not be the “gubmint”, Ben. Like teek I would like to see (e.g.) the Royal Society (which is the UK’s “national academy” of science) doing this. They have a Science in Society Committee, but I don’t know what it actually does.

    Also agree many people, esp. the woo-conspiracy-boosters, would simply ignore any such outlet. BUT… it would still be better to have an authoritative, independent “voice of the scientific mainstream” SOMEWHERE to complement the efforts of the bloggers.

    The only feasible alternative would be educating the broadcasters and journalists… but my overwhelming impression is that most don’t want to be better-informed, as that would impede their ability to make up the details to a pre-formed agenda.

  33. Wonko said,

    July 20, 2007 at 1:58 pm

    I am currently working on an EU funded project. One of the key conditions of grant is that we have to promote the EU (e.g., every document we produce has to have the EU logo on it) The political people will understand this as a valid approach to funding.

    At the moment, lots of academic institutions create scare stories as part of the pressure they put on policy makers for future funding. The resources for creating these scare stories must be coming from existing grants. Shift the terms of funding and you shift the way organisations behave. So why not propose that all UK Government science funding has to come with:

    1. A duty to adhere to a code of ethics on how the results are disseminated (eg, in the BMJ rather than the Daily Mail – at least in the first instance)

    2. A duty to actively raise public awareness of scientifc methods (eg, RCTs rather than asking a handful of people if they feel better).

    If this were done, then much of the media scaremongering could only occur at the risk not only of losing future funding, but also of having to repay previous grants.

  34. pv said,

    July 20, 2007 at 3:26 pm

    altmedicine said,

    July 20, 2007 at 12:55 pm

    “Hello Dr. Ben,

    I just have registered to your blog to say hi…I am new here…

    It’s always difficult to speak on politics…I hope you might have decided something.”

    But really easy to take advantage of the vulnerable and gullible, isn’t it.
    This is how to get traffic to your shite site so you can profit from Google too. Typical money grubbing sCAM fraudster.

  35. Kells said,

    July 20, 2007 at 3:52 pm

    Policy must be based on fact and not bullshit/ bad science.
    Take for instance the fact that the entire cabinet and opposition are happy to say they smoked dope whilst also reclassifying it to a higher grade. Its because dope in those days was so much weaker than todays ‘skunk’ (I hate hearing politicos using that word).
    This is simply not true- and is not based on any hard evidence and therefore public policy based on bullshit. PPBoB :)
    I vaguely remember being young and this kind of two faced preaching was entirely the wrong ‘policy’ that might have appealed to me.
    Facts are always better – if you take drugs there is a small chance that you will have a schizo(?) episode that could effect your entire life! Whats wrong with some truth?

  36. DrSteve said,

    July 20, 2007 at 5:00 pm

    What was the outcome of the talk – I was going to come but had to cry off!

    One thing that you could have talked about was ‘the nature and politics of evidence’. The ‘evidence’ that organisations like IPPR generate is sometimes exceptionally poor – more like informed opinion. Perhaps something on the ‘evidence heiracrhy would have been useful?

  37. JQH said,

    July 20, 2007 at 5:50 pm

    Ben, the peole who write the MMR crap will probably not believe anything the government says – agreed.

    But what about the people who read it? If it’s quickly rebutted by either the government or Learned Society or Respected Seat of Learning, said readers might realise they’re being fed crap by the journos.

  38. Ben Goldacre said,

    July 20, 2007 at 6:50 pm

    that was all incredibly helpful, in the event i dashed in late after dealing with a flood and some car crash getting in my way and spoke at an incomprehensibly high word rate about both the ethics of bullshit and media scares.

    the reasons why people believe in nonsense are incredibly interesting, what i find particularly fascinating is how out of date and unrealistic about people are about private funding of research. i mean i’m all for publicly funded research, but all these old fart businessmen from the quack industries talk as if they never were active participants in the business rush of the eighties. 90% of research is now funded by the private sector, universities have shared contracts with industry, if you don’t know that youre underinformed, and if you didnt fight it when it was happening 15-20 years ago then youre officially part of the problem. i totally dont see these jokers campaigning for higher taxes (as you can see i’m ranting about one particular discussion).

    /rant

    anyway more interestingly, it was as is famous for ippr full of very clever people between the ages of 3 and 9, and there is an mp3 some time, in fact ive got quite a few of those to post. we also chatted about the weird lack of randomised controlled trials in social policy, which i find really interesting (different culture), and people had some good examples of ones which ahd happened but which were duff (who randomises by last digit of telephone number? i mean really) which i hope they really will email me about.

  39. pv said,

    July 20, 2007 at 9:00 pm

    bootboy, I don’t think it’s loss of faith in established science per se. More that science and evidenced based medicine don’t provide the absolute answers required by the “clients”. And, of course, there are any number of unscrupulous or deluded individuals, be they religious, nutritionist, homeopathist or witch doctor, who are willing to fill the void and claim they have the definitive answer to everything…
    In short, people don’t understand the limitations of human knowledge so they become fodder for charlatans.
    It’s not a new problem, nor is it likely to go away any time soon.

  40. bootboy said,

    July 20, 2007 at 10:49 pm

    “bootboy, I don’t think it’s loss of faith in established science per se. More that science and evidenced based medicine don’t provide the absolute answers required by the “clients”.”

    Unfortunately, human nature is one parameter that we can’t adjust. ;-)

    However, I think it’s more than the age-old propensity to superstition.

    If you look at popular science literature and the attitudue towards science of the popular political movements 40 or 50 years, it was much more common for technology to be seen as a progressive force. We were all going to have jetpacks and robot-servants. Marxists practically based their entire belief system upon the emancipatory capability of technology – and their ideas had huge influence on the working class through trade unions, campaigns and so on. Certainly, there were large popular concerns, particularly about the atom bomb, but that was an eminently sensible concern. If you were a scientist, people took what you said seriously and many eminent scientists had international celebrity status.

    Nowadays, on the other hand, one can find the Socialist Workers Party leading the residents of a proletarian suburb of Dublin in a march against a mobile-phone mast: www.indymedia.ie/article/83473

    Contrast this with the fact that promising “electrification” was a key propaganda instrument for governments of Ireland in the early part of the twentieth century and one which helped to attach the proletariat to Fianna Fail till this day – in a country that was almost infinitely more superstitious than it is now.

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