I don’t think that MedHyp’s dubious reputation is known outside of the medical scholars. I remember a well-respected and very senior chemistry professor at a large American research university gloating about a graduate student publishing something in this journal. He thought that the quick response and lack of changes meant that the idea was absolutely perfect and predicted great things for the student’s career.

Is there any particular reason that you couldn’t add the fairly basic level of fact-checking that a daily newspaper does to MedHyp? That is, if you see some _fact_ being wildly misrepresented, you call the author and say, “There seems to be an error here, and I hope you can fix it and re-sumbit,” instead of saying “Eh, it’s wrong, but who cares what lies are in it, as long as I sell papers?”

I’ve gotten simple facts wrong before (e.g., by overlooking a single word in a paragraph), and I’ve always appreciated people pointing it out to me. Surely this would be better than having the entire world ridicule the author, the journal, and yourself.

Only the first part should be archived in a frozen, article-type form. These could well be published first and peer reviewed only later, as is the current practice in some fields of science (see http://arxiv.org/).

The second part, interpretations, should be dealt with in open workspaces designed for mass collaboration. There are methods to effectively organise these discussions to achieve convergence. To give one example, see pragma-dialectics in Wikipedia. These methods are still under-utilised (this blog is a typical example).

As an example, let’s look at the current discussion raised by Peter Duesberg and David Rasnick. If their interpretations are on shaky grounds, they could have easily been shot down in an open workspace, without any need of editorial decisions. In an open workspace, anyone could publish their statements (idea promoted by Bruce G Charlton) and all statements incoherent with facts would be invalidated (idea promoted by Ben Goldacre) by peers. There is no need to remove invalid statements, because they are shown to be invalid. On the contrary, it prevents from repeating invalid statements.

A paradigm shift to open scientific workspaces has at least two major problems. It is not clear how scientists could get merit from participating in mass collaboration instead of writing articles. In addition, this might cause problems to the business logic of scientific journals.

We have drafted a procedure description for a journal that is based on the ideas briefly described above: Opasnet Journal (http://en.opasnet.org/w/Opasnet_Journal).

Mikko Pohjola
Jouni Tuomisto
environmental health scientists
THL, Finland

When Jeanette Winterson advocates Homeopathic remedies for AIDS in Africa etc it is tantamount to saying “These people do not deserve real tested treatment for their illness”. That’s only a few steps from ideas advocated by American Celebs that one’s life is wholly predicated on their thought patterns.

I am going to have a good read of this (probably while sitting through this boring conference I’m being sent to today).

I think AIDS denialism is illegal in NZ where I live at the moment. There was a major campaign about the science of AIDS after a young girl Eve van Grafhorst died in the 90’s. I should check it out.

Peer review has its pitfalls (particularly in the exposure of most scientific fraud, where journals do a piss-poor job except in headline cases). That is not to say that MH does a good job, or serves a wortyhwhile purpose, but it could do.

After all they publish anything written in (reasonably comprehensible) English and it would seem an ideal forum for a robust response.

I would personally favour the existence of many more journals like MH, but with some gatekeeping (over factual content as opposed to interpretation).

Journals have totally useless correspondence sections, which is a problem.

Not by me, I felt bad for taking a dig at disgruntled humanities grads before and I think you make a good point about the encroachment of anti-science thinking. I just noticed that the latest attempt at propaganda for AIDS denial, a seemingly well-funded “documentary” entitled House of Numbers, lists as an Executive Producer Martin Penny, who I think is also a major educational benefactor in the UK (he’s CEO of Good Hair Day). Penny is also cited as supporting an upcoming AIDS denial conference in the US in November:

http://ra2009.org/index.php?option=com_content&view=article&id=52&Itemid=57

According to the internet archive, Penny’s name was added to the list of people “who doubt the HIV-AIDS theory” between June 29 and July 2 of 2007:

http://web.archive.org/web/20070629184931/http://www.rethinkingaids.com/quotes/rethinkers.htm
http://web.archive.org/web/20070702055910/http://www.rethinkingaids.com/quotes/rethinkers.htm

Bizarre.

I was shocked last year to hear of AIDS denialist tropes being passed around a dinner table with a very well known British-American businesswoman last year, herself well acquainted with scientific knowledge and her husband being a major educational benefactor.

I think for some people they have multiple and conflicting worldviews and it only seems to bother me/us. Even bringing up peer review makes people yawn. Anti-science thinking has encroached in many other ways, sbversively ‘management’ theory is one that prports to be scientific in a way bt is certainly not.

Most people that earn a decent wage and live in the nice areas of this city, seem to have a major affectation for alternative medicine. So many doctors are no utilising ‘integrative’ many more than when I left a few years ago.

I’m tired and rambling and am going to get flamed for this probably.

The AIDS denialist groups desperately seek to get their pseudoscience and anti-science views into any journal whatsoever that has some form of credibility, and being listed on PubMed does provide a journal with perceptional credibility. The lay public indeed rarely reads the journals, and members of the public probably don’t have the general knowledge to tell the difference between Med Hyp and Nature or the NEJM. The AIDS denialists ruthlessly exploit that lack of knowledge. They do so by posting “their” papers on websites, and by referring to them as examples of how “their” work has passed peer review (sic), so MUST be quality science. They do this to confuse the public, and the tactic works, at least to an extent. Readers of the denialist web sites who lack a scientific background cannot and do not discriminate between what’s in the denialist papers, and what’s in the vast body of scientific literature on HIV/AIDS. Med Hyp itself might well not “pretend to be something that it is not”, but for sure the AIDS denialists pretend that it’s a quality, peer-reviewed journal. And by doing so they fool, and harm, the lay public.

I don’t follow the vaccine-autism websites, but I think the same scenario likely applies there: “If it’s in Med Hyp, it must be right, right?”.

The way to stop these abuses of the scientific literature is to ensure that only sound, solid science with a rational basis is published in peer-reviewed, PubMed-listed journals. There are websites dedicated to the advancement of crazy ideas that are contrary to the best interests of public health. Their existence is a great shame, but there’s nothing that scientists can do about that. What we can do is insist on high standards for the scientific literature. Med Hyp has not met those standards, and in not doing so it has betrayed our profession.

Ben Goldacre does not have the right to decide what is and what isn’t acceptable to theorise. If ever he has the effect of stagnating debate and restricting new ideas, then he has become the enemy of science. He may write what he wishes, but should not encourage a campaign to shut down a journal. Science is not an opinion, nor a
consensus. When a journalist writes “scientists believe” he is usually being lazy and misleading. Science is simply a method for finding things out. One of the things required for good science to thrive is a world in which people can come up with new ideas and try
them out. At any given moment, the scientific mainstream is in a particular state. The only way this can change is if people are allowed to spread new ideas. Without new unaccepted ideas, science halts. If an idea is published in a journal, and that same journal publishes several other ideas that are bad, then the first idea is
scientifically no worse by association with those other bad ones. An idea is either good or not good, and the person who came up with it is an irrelevance, as is its proximity in a journal to other ideas.

Dr Goldacre runs a website which in some ways resembles MH. He is its one editor. He writes what he pleases to write. I agree with much of what he writes. I disagree with much of what he writes. It would not occur to me to mount a campaign to ban his site because I disagreed with one of the items on it. I do not see in Dr Goldacre’s writing any plainly-expressed call for an end to MH, but he is now a man of influence, and may even spark a witch-hunt when he did not mean to. If Dr Goldacre finds a bad idea in MH, he should attack the idea because it is bad. Peer review is flawed, as he admits in his article. If everything has to be peer reviewed to be accepted as “science” then one of the main flaws of peer review (that ideas not in keeping with the current fashion become suppressed) becomes massively magnified. A partial remedy for this is to have outlets that are not
peer-reviewed for new scientific ideas. So long as those outlets are clearly labelled as what they are, this is fine.

Duesberg P et al. The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition. J Biosci. 2003 Jun; 28(4): 383–412.

e.g. “Even the professional journals and the science writers of the public media comply with the interests of government- funded majorities because they depend on their monthly scientific breakthroughs, the lucrative advertisements from their companies, and the opinion of their subscribers.”

The paper also complains about how other journals refused to publish it. But this paper actually goes one better than the Medical Hypotheses paper and doesn’t just misrepresent a study on the benefits of antiretroviral therapy, it flat-out misquotes it.

The authors – Peter Duesberg, Claus Koehnlein & David Rasnick – change a sentence from this paper:

Declining Morbidity and Mortality among Patients with Advanced Human Immunodeficiency Virus Infection
http://content.nejm.org/cgi/content/full/338/13/853

that reads: “Patients with a diagnosis of cytomegalovirus retinitis or M. avium complex disease before study entry or during the first 30 days of follow-up and patients with active P. carinii pneumonia at the beginning of follow-up were excluded from the analyses of the incidence of that opportunistic infection.”

To: “Patients with a diagnosis of cytomegalovirus retinitis or M. aviarum complex disease before study entry or during the first 30 days of follow-up and patients with active P. carinii pneumonia at the beginning of follow-up were excluded.”
http://www.virusmyth.com/aids/hiv/pddrchemical.pdf – page 399

In order to pretend that the people with AIDS described in the Palella paper weren’t sick before starting antiretroviral therapy, because Duesberg’s theory says antiretrovirals cause AIDS. The paper actually shows that mortality was highest in people who received no treatment, and lowest in people on combinations including a protease inhibitor.

I can see the arguments for maintaining an alternative to the peer-reviewed journal model as you state is your desire. There is a danger of the development of a scientific orthodoxy with no place for the dissenting view even if it has good supporting evidence.
But, if you wish to take this path, you have a responsibility to ensure that that dissenting view is well-reasoned and presented. In publishing a paper which seriously distorts other important articles on the subject, you bring problems on your own head.
You state that the paper in question was accepted according to the criteria for evaluation used by Medical Hypotheses. I can only conclude from this that those criteria do not include a need for claims made about the existing body of knowledge to be accurate. If so, then I think that you can hardly complain if moves are made to remove your journal from citation indexes.
You appear to regard yourself as the guardian of something precious: If so, I can only suggest that you are taking poor care of it.
Oh, yes, and the fact that Karl Popper was once on the editorial board cuts little ice with me when he died several years before you took over editorial duties.

if there is anywhere where i have said i dont like humanities graduates, rather than humanities graduates who grandly profess expertise in areas they demonstrably haven’t bothered to get familiar with, then do please let me know, so that i can correct it. but i don’t think i’ve said anywhere that i just don’t like humanities graduates.

“there’s a more than a few grumpy humanities graduates like me lurking on this site.”

Yeah I’m a pretty grumpy old humanities graduate who’s been lurking for three years and more, but haven’t dared say a word since the humanities-graduate bashing started — particularly after I seemed to have been subject to a humanities-graduate purge when I stopped getting Bad Science emails and I couldn’t get them reinstated.

All seemingly unconcerned as to whether their comments are on topic or not.

To get back to the subject of the post, there is a trail of misrepresentation associated with the Lancet treatment response paper. The first example I saw was Neville Hodgkinson, who wrote an article for The Business entitled “Anti-retro drugs fail to increase HIV patients’ lifespan”http://www.helpforhiv.com/antiretro.pdf

Around the same time, Bookslut published an interview with Celia Farber, who offers the same misrepresentation in nauseatingly self-serving terms:

http://www.bookslut.com/features/2006_09_009885.php

“Of course [ACT UP and other activist groups] meant well! Of course they wanted to save their loved ones and brothers! Of course they didn’t know! But it was a disaster and we have to face it. The really weird thing about this whole thing is if you got on the phone with one of them, they would say people like me are responsible for mass deaths for planting the notion that HIV does not cause AIDS — which we discussed at the beginning — and for scaring people away from antiretrovirals. All I can say is only data speaks.

[Farber begins to read from an Aug. 5 Lancet article, “HIV treatment response and prognosis in Europe and North America in the first decade of highly active antiretroviral therapy: a collaborative analysis” (it looks at 20,000 patients in Europe and North America on cocktail therapy, also known as HAART therapy). “Virological response after starting HAART improved over calendar years, but such improvements has not translated into a decrease in mortality since 1996” (the year these drugs were launched).]

AIDS is immune deficiency. AIDS is immune collapse. There are many roads that lead to Rome; there are many roads that lead to immune collapse. What we were saying about AZT in the early years is that, for god’s sake, this is a chemotherapeutic agent — an old cancer drug from the ’60s that was shelved as too toxic for human use. Chemotherapy obliterates the immune system. AIDS is a disease described as obliteration of the immune system caused by a virus. Protease inhibitors are a different kettle of fish. While they also greatly undermine the immune system they also weren’t total killers like AZT. They didn’t just mass destroy the cells; they brought some benefit as well. They’re broad-spectrum microbials. They did clear up infections and they absolutely did bring people back from the precipice of death. But what I just told you about is a ten-year perspective study. And when they looked over those ten years the utopian dream did not pan out. Their HIV levels are going down, whoop-dee-doo, but they are not living longer. It’s a very strange position to be in. Those of us on the skeptical side have never been more right but we have never been more hated.”

Farber then later repeats the misrepresentation in an article for a magazine called Alive:

http://www.alive.com/6146a15a2.php?subject_bread_cramb=328

“After a period of intense marketing of antiretrovirals (drugs that purport to attack the HIV retrovirus), the drugs are no longer universally seen as lifesaving. A paper published in 2006 in The Lancet reported the results of a large study that tracked 22,000 HIV-positive people between 1995 and 2003. It found that the drug therapy they received, known as HAART (highly active antiretroviral therapy) did not “translate into a decrease in mortality.””

Peter Duesberg has the paper on his website under the heading “Articles Documenting HIV is Passenger Virus”

http://www.duesberg.com/articles/index.html
http://www.duesberg.com/articles/2006,%20Lancet,%20HIV%20treatment%20resp..pdf

But he doesn’t include the supplemental table from the paper with 2 year follow up, perhaps because that table shows that the number of AIDS events plummets in the second year of antiretroviral therapy (in flat contradiction to Duesberg’s claim that the drugs somehow cause AIDS).

When Christine Maggiore launched an “updated” version of her book “What If Everything You Knew About AIDS Was Wrong?” shortly before she died she included the same misrepresentation:

http://www.aliveandwell.org/cgi-bin/show_news.cgi?date=090107

“The largest study of HAART (highly active antiretroviral therapy) contradicts popular claims that HAART extends life. Tracking 22,000 previously treatment-free HIV positives that began medications between 1995 and 2003, authors discovered, “Viral response improved but such improvement has not translated into a decrease in mortality.””

If you google the quote “has not translated into a decrease in mortality.” you can find many more examples of people repeating the false claims of AIDS denialists regarding what the paper shows.

I presently have a strange double life as a humanties lecturer at an FE college and a scientific researcher, so I span both sides of the aisle.

Science literacy and science education are two overlapping, but distinct things. Acceptance of scientific evidence and the scientific method don’t have to go hand in had with a career in it.
The dismissal of all non-scientific subjects seems to be part of a strange one-upmanship mentality that implies osme sort of scientific hierachy we should all be subservient to. “I’m more scientific than you, my PhD trumps your MSc, I’m a physicist therefore ‘better’ than a psychologist”. The logical conclusion of which is that we should defer all cultural efforts to a handful of physicists with PhDs and that we in the sciences should all be very, very smug.

The suggestion seems to be that A. All humanities graduates are scientifically illiterate B. All humanities graduates have been tainted by the horrible virus of postmodernism and therefore unable to understand what evidence is, and C. That there is never any real need for humanities graduates.

I did an English degree in a strongly ‘postmodern’ department and my experience was very different to the stereotype you invoke. We were encouraged to be critical and reflective of the ideas presented. I honestly don’t know anyone ‘brainwashed’ by their undergraduate experiences, though plenty were challenged. Plenty of my fellow students called bullshit on it and wrote essays about how it was airy-fairy nonsense that lacked evidence. They still got high marks and were rewarded for their ability to think and write clearly. Postmodernism has had its time and has been dwindling in popularity in most academic departments since the end of Clinton’s presidency.

Believe it or not, my ‘postmodern’ academic experience led me directly down the path to science, my MSc and then research. Had I not been exposed to those ideas I don’t think I would have found myself drawn towards empirical methods.
Without my humanities degree I wouldn’t be able to do my job, nor would I have some of the richness in my cultural life. My degree taught me good ’scientific’ virtues like independence of thought and critical thinking.

Whisper it.. but there are plenty of rational, empirically-minded arts and humanities graduates out there. Quite a few of them are probably lurking on this site. Your choice of subject doesn’t automatically determine your attitudes towards science or evidence-based thinking.

There’s an important and meaningful debate to be had about science education in this country. (For instance I agree some sort of compulsory science component in undergraduate degrees would do wonders for public levels of scientific literacy and I can only lament the Government’s failure to fully implement the findings the Tomlinson report) I just don’t think that scientific content is the sole value by which we can determine which subjects are with value and which are without.

Anyway, grumble over.

Ben, I’d love you to clarify your position on all this, clearly there’s a more than a few grumpy humanities graduates like me lurking on this site.

AIDS denialists thrive on the internet. They post their drivel on non-reviewed Blogs and web-sites. That’s the nature of the beast. But underpinning these postings is material that has appeared in professional journals, and listed on PubMed. Although most scientists (but sadly not all) know rubbish when they see it, that’s not the case with lay people. Members of the public all too often lack the knowledge to judge the merits of a paper, or indeed a journal, and they make the assumption that if a paper is in a PubMed-listed journal “it must be right”. The assume that AIDS denialism is based on publications of equal professional stature to the ones from real scientists that appear in “proper journals”. As noted above, the public doesn’t realize that the Med Hyp editor is the sole arbiter of the quality of what appears in that journal. The public deserves better than that. And scientists might fight to protect the public from such low standards.

This latest scandal is not an isolated one. In the past, Med Hyp has published papers on the alleged and utterly spurious link between vaccines and autism. Those articles also damage the public, by again providing a sham veneer of “credibility” to the pseudoscience that lies behind the vaccine-autism link. And again, real people are harmed by such nonsense.

It harms nobody if Med Hyp publishes papers on the Loch Ness Monster or the length of lines on palms. That’s all silly rubbish that makes the scientific and medical professions look foolish, but at least nobody dies as a result of reading it. But when it comes to AIDS denialism and the vaccine-autism allegations, lines are crossed because people ARE harmed. As scientists, we CANNOT live in Ivory Towers and natter away about our “rights” to publish anything and everything we want, whatever the consequences. Those rights are actually privileges, ones that are, in effect, granted to us by the public who fund what we do. We should respect that and act accordingly.

For example in today’s (15 Sep) Daily Express, an item on the E. coli farm outbreak refers throughout to the “E. Coli virus” … does that give you any confidence on anything else written there ?

From the Thomson JCR for 2008, the self-cites, and self-cites to years used in the impact factor calculation are:

Medical Hypotheses: 9% (386/4109); 13% (164/1229)

Journal of Theoretical Biology (used as a comparator by BGC in the Grauniad, for some reason): 6% (852/12876); 12% (241/1988)

and, for further comparison:

British Medical Journal: 2% (1981/68464); 5% (336/6606)
Nature: 0% (4029/443967); 1% (1027/56676)
Science: 0% (3454/409290); 1% (979/49771)
PNAS: 2% (10195/416018); 3% (2415/63787)
New England Journal of Medicine: 0% (2034/205750); 1% (520/32311)
Journal of Bacteriology: 13% (7670/58715); 17% (1243/7253)
Microbiology (SGM): 4% (444/9783); 5% (128/2168)

J. Theor. Biol. and J. Bact. are perfectly fine journals, so I don’t see anything too unusual about the self-cite rate for Medical Hypotheses. I wonder if the proportion of self-cites is a poor indicator of quality, but rather inversely associated with the breadth of journal coverage and/or the corresponding size of the community?