I bet you thought that I would love this book, and write all about how you must read it, and that it succinctly discusses every key issue pertaining to alternative medicine and pseudo-science, and that Ben Goldacre is a witty and entertaining writer.
You were right.
This book opens with a general introduction to a range of miscellaneous bad science, such as detox, ear candles, brain gyms and a look at the cosmetics industry, and then moves solidly into the ‘meat’ as Ben calls it, homeopathy. That chapter presents everything you need to know about the subject, completely and utterly demolishing any arguments for homeopathy along the way. However, Ben does agree that placebo effects are a large part of the appeal of homeopathy, and hence the following chapter presents a terrific summary of the effect in all its glory. In fact this chapter surprised me – the reach of the placebo effect is greater than I knew, reinforcing the need for tighter controls in clinical research.
The biggest surprise in the book is the spray given to the nutrition industry, and those calling themselves nutritionists, which Ben describes as ‘members of a newly invented profession who must create a commercial space to justify their own existence. In order to do this they must justify and over-complicate diet and foster your dependence on them’. While at first this seemed somewhat harsh, once he had elaborated a number of examples, I was convinced.
I also enjoyed the section on anti-oxidants, and how they are a giant marketing exercise. They represent an excellent example of ‘blindly following hunches’ garnered from laboratories. While starting out as a promising and plausible mechanism for prevention of disease, the sobering truth is that a review of literature (involving studies with a total of 230,000 participants) shows that taking antioxidant vitamin pills does not reduce deaths, but may actually increase them.
The next couple of chapters move into mainstream medicine and research, and specifically look at how bad science happens – all the flaws, both intentional and unintentional, that affect outcomes. This is brought home in the chapter entitled ‘Why clever people believe stupid things’ – which goes into the psychology of bias and misunderstanding, and is followed up by a chapter on the statistics involved. Again, have no fear – it is presented for the layman and is very straightforward to understand. For example, the discussion of the use of Bayesian probability instead of p values for testing hypotheses with low prior probability can be quite difficult to follow if you haven’t done stats since your uni days. This is quite an important issue, since the use of inappropriate statistical tests is one way that ludicrous research like homeopathy and pre-cognition in dogs can produce ‘promising’ results worthy of further research, when in fact results are just ‘noise’.
The book culminates in the final chapter on ‘The media’s MMR hoax’. Those of you who have followed the whole ‘MMR causes autism’ controversy (to be clear, there is no controversy – MMR DOES NOT cause autism), this presents a very tidy retrospective. But more importantly, it uses the MMR/autism issue as a case study to illustrate practically all of the points Ben has made throughout the book – bad research, bad motives, bad reporting, misleading data, and so on.
All in all, thoroughly entertaining and informative.
Accordingly, I now officially elevate Ben into the ranks of one of the great science communicators in the world. In fact, I’ll do another post soon on who I think the other great communicators are.