Supplementary benefits

August 11th, 2005 by Ben Goldacre in alternative medicine, bad science, herbal remedies, scare stories, times | 16 Comments »

Ben Goldacre
Thursday August 11, 2005
The Guardian

· OK, it’s me and Susan Clarke from the Sunday Times, on the floor, mano a mano. This week someone is asking for Read the rest of this entry »

Risky Business

June 20th, 2005 by Ben Goldacre in mirror, scare stories, statistics, telegraph, times | 20 Comments »

Comment
Risky business

Health-scare stories often arise because their authors simply don’t understand numbers

Ben Goldacre
Monday June 20, 2005
The Guardian

Competence always looks better from a distance, but I have a confession to make: I’m a doctor, and I just don’t understand most of the stories on health risks in the news. I don’t mean I can’t understand the fuss. I mean I literally can’t understand what Read the rest of this entry »

Risk of infection

May 26th, 2005 by Ben Goldacre in bad science, dangers, express, independent, mail, mirror, MMR, telegraph, times | 1 Comment »

Ben Goldacre
Thursday May 26, 2005
The Guardian

· I’d like to open with a sanctimonious moment. I don’t expect anyone else in the world to follow suit, but from now on, if I refer to published academic research, I’ll be giving the full reference, at the foot of the column if there’s space, or at least on the web version. Why this is not standard media practice has always mystified me. “Science communicators” do read original papers and critically appraise them before writing about them, don’t they?

· Anyway, we’ll come back to testicles later. Meanwhile, there are two outbreaks of polio in Yemen and Indonesia. The strain of poliovirus originated – pay attention – in the Kano province in northern Nigeria. What, you may ask, has this got to do with your gonads – or indeed those of the man you love? Well, a couple of years ago Kano was the focal point of a Nigerian Muslim boycott of polio vaccination. Imams claimed that the vaccine was dangerous, poisoned, contaminated and part of a US plot to spread Aids or infertility in the Islamic world. Five Nigerian states boycotted it. Because, as any trendy MMR-dodging north London middle class humanities graduate couple with children would agree, just because vaccination has almost eradicated polio – a debilitating disease which as recently as 1988 was endemic in 125 countries – does not mean it is necessarily a good thing.

· This brings us back to testicles. Because, sadly, the natural world does not quite share my sense of retributive justice, nor does the paramyxovirus that causes mumps. If it were infecting only the innocent unvaccinated offspring of humanities graduates with no understanding of risk, I’d pretend to be sad on their behalf. But no. There were 8,104 cases of mumps confirmed in the UK last year, up from a combined total of 3,907 for all the previous five years, chart fans.

· But mumps cases last year were predominantly in young adults, because young adults as a herd have the lowest immunity. And one in five young men who get mumps can expect orchitis, a new joy for fans of infected and inflamed testicles. If your balls hurt and you’re infertile, you might wish to thank, for their peculiar interpretation and eulogising on the dangers of MMR: Andrew Wakefield, Nigella Lawson, Libby Purves, Suzanne Moore, Lynda Lee-Potter, The Daily Mail, Leo Blair’s tight-lipped parents, and, let’s be fair, every single national newspaper.

BMJ 2005 May 14;330: 1119-20

More Than Molecules

May 5th, 2005 by Ben Goldacre in alternative medicine, times, very basic science | 2 Comments »

Bad style

Talk about bad science

Ben Goldacre
Thursday May 5, 2005
The Guardian

· In light of the ever present danger that I am tragically killed in a revenge attack, or indeed a sexual experiment that goes horribly wrong, I thought I ought to explain how to write a Bad Science column. First, decide who you’re going to bang on about. This week it had to be Susan Clark, of course. This means buying the Sunday Times. Turn to the Style section, that’s where the science is. Ignore the article about “oxygen plasma potion”. Just leave it. Also ignore the slightly hysterical article about Read the rest of this entry »

Beware alt.therapy

April 28th, 2005 by Ben Goldacre in alternative medicine, bad science, fish oil, nutritionists, times, very basic science | 2 Comments »

Ben Goldacre
Thursday April 28, 2005
The Guardian

· Sometimes I have elaborate and grotesque fantasies about alternative therapists, like the reliably foolish Susan Clark from the Sunday Times’ “What’s the alternative?” column. This week she was lecturing us on Omega-3 oils, in the pseudoscientific, jargon-laden, authoritarian rhetoric typical of the alternative therapies. They like to preserve the mystery, I suppose, though I’d count myself lucky to sneak half as much unexplained terminology onto one science page as the average alternative therapist gets away with – and I’d be using it correctly – but we’re getting carried away. Back to my fantasy.

· I imagine Susan Clark reading about herself once again in Bad Science, and try to picture her response. Does she need to check with a friend whether I’m right and she’s wrong? Do they have a secret giggle at her too? Do I spoil the surprise for her, if I point out what she gets wrong each time? Should I leave it to her to find out, like a kind of GCSE project? Does she ever believe she’s wrong? Or does she believe that we are two intellectual titans, who disagree on a complex issue of advanced science, where it is hard to be absolutely certain who is right and who is wrong?

· Look, it was nothing so big. She just said: “Fatty acids are composed of carbon molecules linked with hydrogen and oxygen atoms.” I mean, maybe it’s a slip that just happened to get past the scientifically literate Clark and all the Sunday Times’s scientifically literate subeditors, maybe she does know the difference between a molecule and an atom (Key Stage 4 science on the national curriculum, incidentally, I just checked, and you do it aged about 14). Maybe I should be ashamed of my pedantry. But as far as I’m concerned, if her sentence doesn’t leap out of the page at you, then you need a new engagement ring and some lead in your pencil; but maybe she’s never heard of graphite, or diamond, or fullerene (the cool, ball-shaped carbon molecule).

· No, hang on, she says the carbon molecules in fatty acids are “linked with hydrogen and oxygen atoms”. Perhaps this isn’t a slip of the tongue, or a misplaced word. Perhaps this is a systematic misunderstanding of the actual subject she’s banging on about like some expert. Maybe the sentence doesn’t even make sense if you swap “atom” for “molecule”; does she mean the carbon is joined together by oxygen and hydrogen? Why even try to write about it, if you don’t understand it? Oh, and we’re back to the first paragraph.

Hypothetical questions

February 17th, 2005 by Ben Goldacre in bad science, references, times | 2 Comments »

Ben Goldacre
Thursday February 17, 2005
The Guardian

· OK, look, I know I’m picky, so forgive me for what I’m about to do, because it’s probably not very fair. Nigel Hawkes, the health editor of the Times, wrote an article two weeks ago about how having younger siblings can reduce your risk of developing multiple sclerosis. “The ‘hygiene hypothesis’ is that increasing cleanliness and absence of disease has led to the rise of several autoimmune diseases, including asthma, arthritis and now MS,” he says, which is quite true. There is that hypothesis, and it has been around for about 40 years. “This new study lends support to the idea,” he said, referring to the paper, in the Journal of the American Medical Association, which his article was about.

· He described the findings of the paper very well (I’m not being patronising, I’m being honest, he did). The researchers found that “if, by the age of six, children had one younger sibling, their risk of MS was reduced by 30%; if they had two, risk was reduced by 67%.” It is a pretty interesting finding. And there is more: “In addition, the greater the exposure to younger siblings, the later the onset of the disease [MS]. But there was no benefit in having older brothers and sisters, or if the age gap was greater than six years.”

· That is what they found, says the Times. It is what they found. So here’s my problem. This is what the Times also said: “MS is an autoimmune disease caused by the immune system turning against its host and destroying the myelin sheath that surrounds nerve fibres.” True. But then: “This is more likely to happen if a child at a key stage of development is not exposed to infections from younger siblings, says the study.” Well, I don’t know about that. The data from the study certainly could support that hypothesis. The authors of the study may have a strong suspicion that the hygiene hypothesis is indeed the most parsimonious explanation for their data. But the experiment did not say that the immune system is more likely to turn against its host and destroy the myelin sheath if a child at a key stage of development is not exposed to “infections” from younger siblings. It just said it is more likely to if a child at a key stage of development is not exposed to younger siblings. To my mind, the Times confused hypothesis and data. And the fact that this small difference annoys me so much is proof that I am, in fact, the pickiest man in the world.

Please send your bad science to bad.science@guardian.co.uk

Atomic tomatoes are not the only fruit

December 16th, 2004 by Ben Goldacre in africa, alternative medicine, bad science, celebs, channel 4, channel five, cosmetics, dna, express, gillian mckeith, herbal remedies, independent, letters, mail, MMR, nutritionists, oxygen, penises, PhDs, doctors, and qualifications, quantum physics, references, space, statistics, telegraph, times, very basic science, water | 9 Comments »

This article is a rough transcript of the most excellent Bad Science Awards 2004 that were held in the Asylum Club on Rathbone St W1, a tiny basement club with a fire safety license for 150. We were expecting 20 people but to general astonishment there were queues down the street, and an unruly crowd who were drunkenly, loudly, and at one point quite violently baying for Gillian McKeith’s blood. Also performing were the excellently frightening and dangerous Disinformation presents “National Grid”, performance terrorism with victorian electrical equipment and rubber gloves, featuring Mark Pilkington of Strange Attractor and Guardian Far Out fame.

Thursday December 16, 2004
The Guardian

Ben Goldacre on the gongs nobody wants to win…

Andrew Wakefield prize for preposterous extrapolation from a single unconvincing piece of scientific data

With its place at the kernel of Bad Science reporting in the news media, this was bound to be a hotly contested category. Were there any Read the rest of this entry »

Mixing medicines

November 11th, 2004 by Ben Goldacre in bad science, dangers, death, herbal remedies, times | 3 Comments »

Ben Goldacre
Thursday November 11, 2004
The Guardian

· Ah, Susan Clark of the Sunday Times (What’s the Alternative?), how I love her. This time she’s giving advice about which natural substances are safe to take with warfarin. First, she bemoans the dearth of research on the subject. Then she ignores the useful stuff in what we do know. “As a simple guideline, patients who are taking warfarin should avoid any natural remedies that have an action on the cardiovascular system.” I have no idea where that idea came from: but warfarin is famous for being interfered with by other drugs. St John’s Wort, for example, is a very popular drug – herb, collection of drugs in a plant, whatever – that reduces the plasma concentration of warfarin, along with phenytoin and rifampicin: that’s not because they’re active on the cardiovascular system, that’s probably because they interfere with liver enzymes, which means it makes them work harder. Those enzymes also break down warfarin, so if they’re working harder, they break down the warfarin more too, so there’s less of it around in your blood, and you’re more likely to have another nasty clot and die. Likewise, ginseng reduces the plasma levels of warfarin, so they shouldn’t be mixed either. And lots of others.

· So: stand by for the kind of nerdy, and usefully boring science story you’ll see in a paper when I am prime minister of the world government. In a recent study, 2,600 patients on warfarin were sent a questionnaire on what alternative therapies they took: 1,360 responded (believe me, that’s a high response rate) and a whole 19.2% of those responders were, it turned out, taking one or more complementary therapies. Ninety-two per cent of them hadn’t thought to mention this to their doctor. Only 28.3% of all respondents had even thought that herbal medicines could interfere with prescription drugs. Because hardly anybody’s telling them. And, the patients who were taking the complementary therapies – the ones you’d hope would be aware of the risks – were even less likely to think they might interfere with prescription drugs (at a statistical significance of P<0.001, which means there’s a one in 1,000 possibility of that finding occurring by chance).

· Now, doctors have a responsibility to ask about alternative therapies. Patients have a responsibility to themselves to volunteer the information. And the PR arm of the alternative therapy industry, the ones who write articles in national newspapers, have a responsibility to know their onions, and share their knowledge.

Cranial osteopathy

September 23rd, 2004 by Ben Goldacre in bad science, gillian mckeith, nutritionists, PhDs, doctors, and qualifications, times | 51 Comments »

Ben Goldacre
Thursday September 23, 2004
The Guardian

· “Cranial osteopathy – aligning the plates of the skull.” Sounds great. Maybe I can use it to treat my hangovers. The Times certainly likes it, and it even got Dr Toby Murcott to tell us how it works in a box, alongside a case study, called “What’s the evidence?” Toby says: “Can cranial osteopathy treat the brain? Cranial osteopathy is a gentle technique – practitioners claim to feel a subtle pulse in the fluid surrounding the brain. There is some research to suggest that these pulses are related to slow, regular changes in blood pressure in the brain. This has yet to gain wide acceptance and it’s not clear how working with these might lead to health improvements.” Here’s what you need to know.

· First, cranial osteopaths don’t even think the pulses are blood pressure; their theories revolve around the “inherent rhythmic motility” of the brain and spinal cord, mixed with breath and cardiac cycles, causing rhythmic fluctuation of the brain and surrounding fluid, which they think they can feel through the bones of your skull, and fix up with a bit of wiggling. They write long articles about actin and myosin (the things in muscle cells that make them move) being present in brain cells; unfortunately, they always forget to mention that brain cells lack the dense arrays of those filaments which are necessary to generate any significant movement.

· But are there real “cranial pulses” to be felt, however they may be generated? It’s easy to find out: ask a couple of cranial osteopaths to write down the frequency of the pulses on the same person’s skull, and then see if they give the same answer. There have been five papers published doing just this, and in none of them did the osteopaths give similar answers. Which suggests to me that (a) this is not a reliable biological phenomenon, and (b) perhaps these cranial osteopaths are, er, imagining it. So: the discipline is based on a misunderstanding, they can’t measure what they claim to measure and work with, and there’s no evidence to say it works.

· When I see a box labelled “What’s the evidence?” next to a health article by a Dr Toby Murcott, call me naive, but I assume he’s a medical doctor, rather than a science journalist with a PhD. And by now, regular readers must be wondering how I’m going to crowbar Gillian McKeith into this column. Well, what do you know, Dr Toby Murcott was the “science adviser” on You Are What You Eat, the TV show that told us we should eat more dark leaves, because the chlorophyll would oxygenate our blood. Bravo.

The following appeared two weeks later:

Don’t knock it

Thursday October 7, 2004
The Guardian

I don’t care what Ben Goldacre says (Bad science, September 23), after having severe sleeping problems for almost two years due to stress I was referred to an osteopath by my GP. I haven’t needed sleeping pills since (three months now). Bad science? Perhaps, but it worked for me.
E McDonald
Antwerp, Belgium

It’s all in the title

September 16th, 2004 by Ben Goldacre in bad science, dangers, herbal remedies, nutritionists, PhDs, doctors, and qualifications, times | 2 Comments »

Ben Goldacre
Thursday September 16, 2004
The Guardian

· It’s hard to know who to trust these days, what with pseudoscientists pretending to have all kinds of qualifications and quoting authorities all over the shop. Susan Clark’s consistently entertaining “What’s The Alternative?” column in the Sunday Times recommends artemisinin this week, as an alternative herbal malaria prophylaxis for someone travelling to Asia. “The Global Fund to Fight Aids, Tuberculosis and Malaria is funding the shift to artemisinin-based combination therapies in 26 countries,” she says. Sounds good. I’ll do you a favour, and spare you the rant about how chloroquine costs 20 cents per treatment while fashionable ideas like artemisinin cost $2.40, and stick to more important facts. Like: artemisinin is a treatment for malaria, not a preventive measure, because its half-life is too short, and the excellent and sensible Global Fund does not recommend it as a prophylaxis, nor does it endorse anything, as it is just a funding body. Perhaps Susan Clark can’t tell the difference. Here’s hoping her readers are a bit more cautious.

· So who do you trust? What about a “consultant podiatric surgeon”? Sounds a bit like “consultant orthopaedic surgeon”, doesn’t it? Or “consultant vascular surgeon”? Except a consultant podiatric surgeon is just a chiropodist who has decided to charge a bit more. Nice move, but it’s hard to prove that the public have been misled here. Sorry, I mean to say they have “misunderstood” the innocent phonetic coincidence between “consultant orthopaedic surgeon” and “consultant podiatric surgeon”. So the British Orthopaedic Trainees Association has surveyed 262 members of the public, and what do you know: 95% thought that consultant podiatric surgeons had qualified as doctors, while only 9.5% thought chiropodists were doctors. Ker-ching. Mind you, 97.3% thought consultant orthopaedic surgeons had been to medical school, and even a few junior doctors got the answers wrong. In a world full of “Dr Gillian McKeith PhDs”, until the government starts protecting professional titles, and regulating all the people who have popped up to make money out of our obsession with health, I can’t start to think about the financial gain for these wily characters because (holds head sanctimoniously aloft), there are actually rather serious issues about what goes through the heads of people who think they’re giving informed consent to treatment by self-appointed professionals.