Bad Science: Quacks, Hacks, and Big Pharma Flacks

Bad Science: Quacks, Hacks, and Big Pharma Flacks



The Pequod Review:

Based purely on the cover (which is not always a bad way to judge a book), Ben Goldacre's Bad Science would appear to be yet another pop science book that takes aim at easy targets — quack doctors, innumerate journalists, and pseudoscientific thinking more generally. But the book has an unexpected amount of intelligence and wit, which makes it stand out in a crowded field.

At its core, Bad Science is a defense of the scientific method. Goldacre begins by showing why we do scientific and medical studies, and how they need to be structured in order to be useful. From there, he proceeds to show how these studies are often incorrectly designed or interpreted (sometimes intentionally so) by nutritionists, medical experts, pharmaceutical companies and the news media in order to back up arguments that are not supported by the evidence. Goldacre highlights a number of real world examples of pseudoscience to prove his point — the health benefits of vitamins, the effectiveness of alternative medical treatments, and various child-rearing fads — all of which are persuasively shown to prove much less than their proponents claim.

Here is how he introduces his chapter on nutrition:

Food has become, without question, a national obsession. The Daily Mail in particular has become engaged in a bizarre ongoing ontological project, diligently sifting through all the inanimate objects of the universe in order to categorise them as a cause of — or cure for — cancer. At the core of this whole project are a small number of repeated canards, basic misunderstandings of evidence which recur with phenomenal frequency.

Although many of these crimes are also committed by journalists, we will be reviewing them later. For the moment we will focus on ‘nutritionists’, members of a newly invented profession who must create a commercial space to justify their own existence. In order to do this, they must mystify and overcomplicate diet, and foster your dependence upon them. Their profession is based on a set of very simple mistakes in how we interpret scientific literature: they extrapolate wildly from ‘laboratory bench data’ to make claims about humans; they extrapolate from ‘observational data’ to make ‘intervention claims’; they ‘cherry-pick’; and, lastly, they quote published scientific research evidence which seems, as far as one can tell, not to exist. 

It’s worth going through these misrepresentations of evidence, mainly because they are fascinating illustrations of how people can get things wrong, but also because the aim of this book is that you should be future-proofed against new variants of bullshit. There are also two things we should be very clear on. Firstly, I’m picking out individual examples as props, but these are characteristic of the genre; I could have used many more. Nobody is being bullied, and none of them should be imagined to stand out from the nutritionist crowd, although I’m sure some of the people covered here won’t be able to understand how they’ve done anything wrong. 

Secondly, I am not deriding simple, sensible, healthy eating advice. A straightforwardly healthy diet, along with many other aspects of lifestyle (many of which are probably more important, not that you’d know it from reading the papers) is very important. But the media nutritionists speak beyond the evidence: often it is about selling pills; sometimes it is about selling dietary fads, or new diagnoses, or fostering dependence; but it is always driven by their desire to  create a market for themselves, in which they are the expert, whereas you are merely bamboozled and ignorant. 

Prepare to switch roles. 

Goldacre then proceeds to comprehensively back it up, with clear examples of poorly-designed studies and misleading news reports. It's a review that is not only entertaining — with witty put-downs of the hucksters and charlatans who peddle nonsense — but highly practical, as Goldacre teaches readers how to dissect scientific studies and become more informed consumers of news.

Later he shows how skin care companies market their products using misleading claims:

Classically, cosmetics companies will take highly theoretical, textbookish information about the way that cells work — the components at a molecular level, or the behavior of cells in a glass dish — and then pretend it's the same as the ultimate issue of whether something makes you look nice. "This molecular component," they say, with a flourish, "is crucial for collagen formation." And that will be perfectly true (along with many other amino acids which are used by your body to assemble protein in joints, skin, and everywhere else), but there is no reason to believe that anyone is deficient in it, or that smearing it on your face will make any difference to your appearance. In general, you don't absorb things very well through your skin, because its purpose is to be relatively impermeable. When you sit in a bath of baked beans for charity you do not get fat, nor do you start farting.

Toward the end of the book, Goldacre covers the MMR vaccine controversy — the claim that childhood vaccines for measles, mumps and rubella can lead to autism — and shows how it has been driven by cherry-picked studies, fraudulent "experts," and inaccurate news coverage. It's one of the most powerful parts of the book given its importance to broader public health, and it helps Goldacre show the potentially tragic consequences of living our lives without basic numeracy skills. Highly recommended.