The difference is that most studies actually cite the evidence and don’t just pull a bunch of “facts” out of their arseholes. It does matter where you are published (to a certain degree) because it means that your paper has at the very least been through peer review. Whilst not perfect, the peer review system would certainly rip this pathetic attempt at a meta review to shreds for the author’s continual insertion of personal bias, failing to cite sources, use of anecdotal evidence and generally poor reasoning skills.

Do you have any evidence to support these claims of a great conspiracy theory amongst journals? I highly doubt it. It’s besides the point, anyway as there are now plenty of independent, online publications to publish with that aren’t connected to the dreaded “BigPharma” boogie man.

Incidentally, I’m not biased towards corporate med. Why should I be? They don’t pay me anything.

“But that is a well-established elementary factoid of mercury toxicity and it is not critical to the hazard evidence anyway. Hanson has better things to get on with than spoon-feed the scientific infants here. Why waste everyone’s time with this pseudo-critique when you yourself have not bothered to check for evidence that he was wrong there?”

The point is, I shouldn’t have to. He should cite his sources so that I can go and read the original study and see if the conclusions they have drawn are reasonable. This is basic stuff.

“I trust you won’t expect the sun to rise next morning or bother to eat food again in the next few years, as these too are matters of mere unsubstantiated anecdotal evidence never confirmed by any proper published scientific study.”

Are you serious? Oh dear. I mean obviously the turning of the earth and the need for sustenance (two phenomena which have been shown through the scientific method, I should add) are on the same level as manufacturing “evidence” for a puerile attempt at a meta review. I think your analogy generator is broken.

“Only a seriously sloppy reader can conclude that all this can be dismissed as placebo.”

Except, that, I, um, didn’t. But that’s ok, maybe you can turn your irrelevant English test scores toward some reading comprehension instead of consistently insulting anyone who dares to disagree with you. What I did say was the the placebo effect cannot be dismissed in its entirety. The only way to show this would be to conduct a properly controlled trial and actually demonstrate the problems. Until then, you cannot dismiss it (well you can, but your reasoning would be flawed) which means your claims amount to very little.

“And since then a lifetime of benefits-dependency.
In this sort of context, your cheap casual presumptions are very offensive.”

Ah, so we finally get to the stick up your arse. Before you accuse someone else of being biased toward “BigPharma” (what a lark! How are those presumptions working out for you?), you should take a good look at your own rose-tinted glasses. Perhaps you really were affected by the mercury in you fillings. Who can say for sure? What we do know is that really, really wanting it to be true doesn’t make it so.

So I’ll reiterate what I was trying to say before (and which you seem to take as a personal insult for some reason…):

Your meta review was rubbish for good scientific reasons. Quite apart from the aforementioned use of anecdotes and other poor “evidence”, the biggest problem with the whole thing was the complete lack of controls. If you cannot control for variables, then you cannot draw solid conclusions and your data are meaningless. That’s it. You can whine about whatever you like. Insult me some more (as I’m sure you will). But that’s the rub and it’s what real scientists have to deal with every day. Do my data ACTUALLY support my conclusions or could there be some other explanation? These studies have not met this burden and so they have been loudly ignored by everyone. And so they should have.

Staphylococcus said: Firstly the author is a member of an advocacy group campaigning against amalgam fillings, which could lead to unintentional bias. A (quick) search of the scientific literature on PubMed revealed that this review has not been published in a peer-reviewed journal.

But so what? Most medical studies are authored by members of the (pseudo-)scientific corporate medical establishment and the peer-reviewed journals largely block the publication of anything that challenges their profit-making dogmas. So if we apply your reasoning on an equal basis then there’s no data left to discuss. Are you really an idiot? No, just severely, hopelessly baised in favour of corporate med, like most of Mr Goldacre’s uncritical acolytes (plus himself) I suggest.

Furthermore it matters not where it is published. The main function of the review is to draw together the results of 25 studies for the reader to judge for themself. He does add some sensible commentary which can be appreciated on its own merits if you are not already a corporatised bonehead.

The author also makes some interesting claims in the introductory section of the paper but fails to cite any of the literature in support of them. For example:
“There is no relation between symptom severity and levels of Hg in blood or urine. Individual sensitivity is more important.”

But that is a well-established elementary factoid of mercury toxicity and it is not critical to the hazard evidence anyway. Hanson has better things to get on with than spoon-feed the scientific infants here. Why waste everyone’s time with this pseudo-critique when you yourself have not bothered to check for evidence that he was wrong there?

“Our experience during 20 years has shown that dentists often cheat;
[………….]
The second quote is, in my opinion, somewhat disturbing as this is supposed to be a meta review and he is invoking unsubstantiated anecdotal evidence to explain the persistence of symptoms.

I trust you won’t expect the sun to rise next morning or bother to eat food again in the next few years, as these too are matters of mere unsubstantiated anecdotal evidence never confirmed by any proper published scientific study. Truly infantile reasoning there. I suggest participating in some randomised trials of parachute effectiveness: www.bmj.com/cgi/content/full/327/7429/1459

I wonder how you can so easily sweep aside the placebo effect from these studies as you did in you initial post.
From what I have read, I would suggest that this review has been ignored for good scientific reasons.
and PsyPro likewise said:
Virtually all of the alleged benefits can be dismissed as placebo effects, or, even more likely, illusory placebo effects [….] In fact, there is nothing in this highly selective group of studies worth referencing or commenting on. Sorry, Smart, but there is nothing here.
Dear outstanding geniuses, Hanson’s document itself discusses this matter quite adequately. It is pointed out that many patients came to the bothersome task of amalgam removal as the endpoint of a great many years of illness unhelped by any other interventions; and that improvements were maintained over many years after. Some such as Hesham el-Essawy have recovered from seriously non-placebic illnesses such as heart problems. Only a seriously sloppy reader can conclude that all this can be dismissed as placebo.
I myself have been mentally and physically trashed for 40 years since this curse was launched on me. Age 14, Exams FIRST in Maths, FIRST in Physics, FIRST in Chemistry, FIRST in Geography, third in French, fifth in Latin. Age 17, not even graded in any of the three A-levels enrolled to study.
And since then a lifetime of benefits-dependency.
In this sort of context, your cheap casual presumptions are very offensive.

Futhermore, and this is a key point in all this, the whole point was not the merits of the Hanson etc evidence, but the fact that all the pro-amalgam-quacks (including so-so-so-superior Mr Goldacre) consistently LIE these studies into non-existence. For instance in 72 pages of SCENIHR not the slightest mention of the many studies which just happen to challenge the safety of amalgam. These facts brook no discussion. Which is probably why Mr Goldacre has only commented here on other trivia in the meantime and seems content to rely on those half-baked responses to permit his continued silence on this serious challenge to his own outrageously offensive slurs about “scare stories” that “come round from time to time”. What a stinker of a rubber duck.

But you are assuming in this article that all papers are equal and this is not the case. As a reseacher you will come across papers that are rubbish. The methodology may be flawed, you may have discussed in person with the authors and know that their study had overlooked something crucial, then see their work published a year later with no improvement. What do you do? You have a couple of choices. Refer to the work and add a lengthy critique of why it is wrong: spend 500 words on something that is irrelevant and add 10 references to your reference list.

Or ignore it.

We have word maximum lengths and a restriction on the number of citations when publishing papers in journals. There are probably more important things for us to discuss than a rubbish paper. Many of the people in the field will know that the paper is rubbish anyway and eventually (hopefully) future studies will provide new evidence fr what we believe to be true. Its a kind of pragmatism and there are problems in doing this. Particularly if somebody with no critical understanding of the field uses network theory (which is indiscriminate) to make a judgment of data based based on citations.

“Us philosophers are way ahead of you. Philosophers of science have been talking about social networks influencing scientific research and consensus since Paul Feyerabend published his seminal “Against Method” in 1970… If scientists cast their net a little more widely, who knows, they may actually learn something.”

social scientists have been studying social networks and the diffusion of ideas since the 1940s, the classic papers on this are:

Ryan, B. and N. C. Gross (1943), “The Diffusion
of Hybrid Seed Corn in Two Iowa Communities.”
Rural Sociology, 8(1): 15-24.

and this one on the spread of medical innovations, which is very commonly cited:

Coleman, J. S., E. Katz and H. Menzel (1966),
Medical Innovation: A Diffusion Study,
Inidianapolis, The Bobbs-Merril Company, Inc.

if philosophers of science such as yourself were slightly less pompous, spent less time trying to take credit for other peoples ideas, and actually bothered to read the literature from the fields they claim to critique, they would look less like dicks.

It’s a shame that the only philosopher of science that scientists ever seem to have heard of is Karl Popper. His ‘falsification’ theory of scientific method provides a great ego-boost to science, but has not been highly regarded by philosophers for a very long time.

If scientists cast their net a little more widely, who knows, they may actually learn something.

Text really is a sucky communication medium.

I am also a scientist, and have no idea of any such club, but am at any rate not a “member” except in so far as Dr. Goldacre and I share a sceptical bent, and I appreciate the hard work he often puts into his attempts to debunk and question. At the same time, it would be great fun to catch the skeptics’ skeptic in some blindness or bias—indeed, I suspect Dr. Goldacre would appreciate and, indeed, highlight such lapses (as only proving his point that we are all susceptible to such blinders) and the irony. There is no conspiracy here.

I am a scientist and I’ll criticise whether it confers with Goldacre’s opinion or not.

Firstly, I will declare upfront, that I have no feelings on the subject of amalgam fillings one way or the other. I have a couple myself and have no issues with them, but if shown to be bad and a safer alternative presented, I see no reason not to discontinue their use.

As for the meta review you cited, I see several issues. Firstly the author is a member of an advocacy group campaigning against amalgam fillings, which could lead to unintentional bias. A (quick) search of the scientific literature on PubMed revealed that this review has not been published in a peer-reviewed journal.

The author also makes some interesting claims in the introductory section of the paper but fails to cite any of the literature in support of them. For example:

“There is no relation between symptom severity and levels of Hg in blood or urine. Individual sensitivity is more important.”

And:

“Our experience during 20 years has shown that dentists often cheat; all amalgam is not removed but only part of it and the rest is covered with composite plastics. The patients will often first become better but gradually the symptoms recur. Amalgam is regularly present beneath gold-crowns and – bridges and gold-amalgam contacts are often the worst causes of ill health. There are also brass screw posts with a thin and porous gold plating, often directly cemented into amalgam fillings. Such constructions often result in periapical inflammations.”

The second quote is, in my opinion, somewhat disturbing as this is supposed to be a meta review and he is invoking unsubstantiated anecdotal evidence to explain the persistence of symptoms.

Before I move on I must declare that I have not had time to read all the studies present. However, I wonder how you can so easily sweep aside the placebo effect from these studies as you did in you initial post. It’s obvious that no ethics committee on the planet would allow you to do a properly controlled trial with a placebo group that were told that their amalgam was to be removed and were given a sham act of removal without it actually taking place.

This leaves these studies wide open to recall bias, regression to the mean, the placebo effect of dramatic intervention, etc. Additionally the author of the meta review states himself that “The reason these patients visit the dentist is to have amalgam removed. A minority of patients remove amalgam to reduce the risk of future problems, for the unpleasant feeling of having a load of poison in the mouth, for aesthetic or environmental reasons.”

From what I have read, I would suggest that this review has been ignored for good scientific reasons.

Really? “exceptional benefits”? and “cannot be merely dismissed a placebo effects”? Virtually all of the alleged benefits can be dismissed as placebo effects, or, even more likely, illusory placebo effects (i.e., not even placebo benefits happened), and they are hardly exceptional. Virtually everyone of these studies consists of little more than testimonials following elective treatment. The few that have any kind of control group (which consists of no removal, but also no treatment of any kind—hardly a placebo control) showed almost the same collective effects. In fact, there is nothing in this highly selective group of studies worth referencing or commenting on. Sorry, Smart, but there is nothing here.

“however…”? However what? All that matters in your “reply” is that you happily declare that you wilfully ignore the 26 contrary evidence studies of 6000 patients even when they are pointed out to you. I can think of plenty of unflattering adjectives to follow up here with, but I don’t really think they should be necessary except in the case of the other True Believers of The Cult of The Great Ben for whom it appears there are no words that would make any difference anyway.

RAVNSKOV, U. (1994). QUOTATION BIAS IN REVIEWS OF THE DIET-HEART IDEA

J Clin Epidemiol Vol. 48, No. 5, 713-719, 1995 pp.

Even in adults and children ages 6 and above who have fifteen or more amalgam surfaces, mercury exposure due to dental amalgam fillings has been found to be far below the lowest levels associated with harm. Clinical studies in adults and children ages 6 and above have also found no link between dental amalgam fillings and health problems.

www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgam/default.htm

Now, I’m not a scientist and have not read the articles mentioned by Smart above, however I did take a look at the website provided, and it appears that the original sole function of the IAOMT was to fight against dental amalgam fillings, due to their supposed danger, which makes them a bit biased on this topic in my opinion.

The good news is that nobody is forced to get dental amalgam fillings (that I am aware of), as there are now several alternatives available, and I myself discussed the pros and cons of each with my dentist before getting a tooth filled.

The reason no government is recommending removal of fillings is because (1) it would be a huge task, (2) any such announcement would result in a huge panic, and (3) if removal is not done carefully enough it would cause more harm than good.