Wednesday, 11 February 2009

Belief versus the scientific method

This is an unusual post: I’m highlighting a bit of real life, an actual issue, and it isn’t even about me.

The full story is on Ben Goldacre’s blog, Bad Science, but the essence is that a presenter on LBC radio recently hosted a phone-in show, in which she perpetuated the (now discredited) view that the MMR vaccine causes autism in children. What is actually true is that unvaccinated children risk catching measles, mumps and rubella, all of which are non-trivial diseases that have the potential to cause serious permanent damage, up to and including death.

Dr Goldacre points out that the print and broadcast media have a lot of influence, and shouldn’t be allowed to present discredited theories or plain falsehood as fact. I haven’t yet read his book (Lola II is reading it at the moment; dad finished it in one sitting from the sound of it) but I thoroughly applaud his rigorous approach to the scientific method. The debate about Darwin’s theories of evolution by natural selection rather than intelligent design is in the news quite a bit at the moment too, what with Darwin’s 200th birthday and it being 150 years since the publication of the classic book: “On the Origin of Species by Means of Natural Selection”.

I won’t encroach far upon the subject of religion, but I’m quite happy for everyone to believe what they want. My great friend Dave once argued very persuasively that the moon landings in the 1960’s were faked, and plenty of people like to consult a tarot reader and go to religious services (although I suspect they rarely do both). That’s fine by me, because they presumably benefit spiritually at nobody’s expense, and support employment, the economy and some glorious architecture while they’re at it. Of course I disapprove of crusades or fatwahs or killing people who don’t believe what you do.

People are welcome to believe in dowsing, chakras, detox diets, life after death, reiki, ghosts, the power of crystals, leprechauns, homeopathy, or any other nonsense. That’s fine as long as they don’t try to persuade anyone to substitute the nonsense for evidence-based treatment when they have a real biological illness.

In one of our modules this term, we all looked at various magazine articles with the intention of analysing readability. The article we looked at in my group was from Good Housekeeping magazine, about the incidence of cardiovascular disease in women. From memory (this happened a few weeks ago) it mentioned the potential for the danger signs being missed. Because women before the menopause are somewhat protected by the presence of oestrogen, GPs tend to misinterpret the symptoms because they don’t expect young women to have heart disease. It was obviously written in a style intended to appeal to the readership of Good Housekeeping, subtlely portraying women as martyrs, undervalued by society, prone to misfortune and discrimination, and powerless to control their own fortunes. The Bridget Jones scenario. How I hated that book. (The film wasn’t too bad.)

Instead of analysing readability, I started to wonder about the credibility of the article. It was unattributed, so I doubt that it was written by any health professional.

“We need an article about some aspect of women’s health,” says the editor. “Men are always being told about heart disease – what angle could there be for women?”

“We could say that women get heart disease too, but the symptoms are different,” says hack #1. “That means that GPs could easily misinterpret them as depression – we’d be able to have a cheap shot at the medical profession at the same time!”

“Well done,” says the editor. “Off you go. No need to do loads of fact checking; just get some plausible stuff off the Internet, and make it up if you run out of time. 500 words by Tuesday, please.”

I have no idea whether the article was 100% accurate or entirely fabricated, or somewhere in between. I was actually shocked to realise that everything in the article really could have been wholly invented. I’ve never been that suspicious of the printed word before, or of the noble trade of journalism.

Nobody wants to read highly scientific accounts of trials that show inconclusive or equivocal results, which is typical of the research that I’ve had to read so far. Scientific papers are really hard to read, and even harder to interpret and analyse critically, and rarely offer clarity to the reader. It’s obviously impossible to police everything in the media, but I’m on Ben Goldacre’s side: if we want the scientific truth we have to challenge opinionated falsehood, and sometimes we’ll have a fight on our hands. I’ll be fighting the good fight on his side, that’s for sure.

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