03 November 2010

Exasperation

Having delivered my ANZSOG seminar paper on 'Identity Theatre: Rhetoric & Reality in Contemporary National Identity Schemes' I'm playing catch-up with reading, including Ronald Desiatnik's Without Prejudice Privilege in Australia (LexisNexis Butterworths 2010), Culture Crisis: Anthropology and Polotics in Aboriginal Australia (Sydney: UNSW Press 2010) edited by Jon Altman & Melinda Hinkson and John Willinsky's The Access Principle: The Case for Open Access to Research and Scholarship (Cambridge: MIT Press 2006).

The features a brief review of 'Wrapped in Data and Diplomas, It's Still Snake Oil' by Katherine Bouton in the NY Times offers a brief review of Bad Science: Quacks, Hacks, and Big Pharma Flacks (Faber 2010) by Ben Goldacre.

Bouton comments that -
Ben Goldacre is exasperated. He’s not exactly angry — that would be much less fun to read — except in certain circumstances. He is irked, vexed, bugged, ticked off at the sometimes inadvertent (because of stupidity) but more often deliberate deceptions perpetrated in the name of science. And he wants you, the reader, to share his feelings.
Let's just say I do.

Bouton goes on to explain that Goldacre's -
initial targets are benign. Health spas and beauty salons offer detox footbaths for $30 and up, or you can buy your own machine online for $149.99. You put your feet in salt water through which an electrical charge runs. The water turns brown, the result of electrolysis, and you’re supposedly detoxed. Dr. Goldacre describes how one could produce the same effect with a Barbie doll, two nails, salt, warm water and a car battery charger, thus apparently detoxing Barbie. The method is dangerous, however, because of the chance of getting a nasty shock, and he wisely warns readers not to try his experiment themselves.
Goldacre reportedly offers more than just spirited debunking of nonsense -
The appearance of “scienciness”: the diagrams and graphs, the experiments (where exactly was that study published?) that prove their efficacy are all superficially plausible, with enough of a “hassle barrier” to deter a closer look. Dr. Goldacre ... shows us why that closer look is necessary and how to do it.

You'll get a good grounding in the importance of evidence-based medicine (the dearth of which is a “gaping” hole in our culture). You'll learn how to weigh the results of competing trials using a funnel plot, the value of meta-analysis and the Cochrane Collaboration. He points out common methodological flaws: failure to blind the researchers to what is being tested and who is in a control group, misunderstanding randomization, ignoring the natural process of regression to the mean, the bias toward positive results in publication. "Studies show" is not good enough, he writes: "The plural of 'anecdote' is not data".
Indeed. I doubt that Dr Goldacre is a fan of Grof and Laszlo.

Bouton comments that -
Goldacre has his favorite nemeses, one of the most prominent being the popular British TV nutritionist Gillian McKeith, whose books and diet supplements are wildly successful. According to her Web site, “Gillian McKeith earned a Doctorate (PhD) in Holistic Nutrition from the American Holistic College of Nutrition, which is now known as the Clayton College of Natural Health.” (The college closed in July of this year.) Clayton was not accredited, and offered a correspondence course to get a Ph.D that cost $6,400. She is also a "certified professional member" of the American Association of Nutritional Consultants, where, Dr. Goldacre writes, he managed to get certification for Hettie, his dead cat, for $60. Ms. McKeith has agreed not to call herself 'Dr.' anymore.
Perhaps my dead moggie - Ervin of World Futures would presumably describe her as "no longer living in the familiar form in this world but ... alive nonetheless" - a certification. So very useful in this universe and other parts of the metaverse.

As I've commented elsewhere, nonsense can be dangerous.
Sometimes bad science is downright harmful, and in the chapter titled 'The Doctor Will Sue You Now', the usually affable Dr. Goldacre is indeed angry, and rightly so. The chapter did not appear in the original British edition of the book because the doctor in question, Dr. Matthias Rath, a vitamin pill entrepreneur, was suing The Guardian and Dr. Goldacre personally on a libel complaint. He dropped the case (after the Guardian had amassed $770,000 in legal expenses) paying $365,000 in court costs. Dr. Rath, formerly head of cardiovascular research at the Linus Pauling Institute in Menlo Park, Calif., and founder of the nonprofit Dr. Rath Research Institute, is, according to his Web site, "the founder of Cellular Medicine, the groundbreaking new health concept that identifies nutritional deficiencies at the cellular level as the root cause of many chronic diseases".

Dr. Rath’s ads in Britain for his high-dose vitamins have claimed that “90 percent of patients receiving chemotherapy for cancer die with months of starting treatment” and suggested that three million lives could be saved if people stopped being treated with “poisonous compounds.” He took his campaign to South Africa, where AIDS was killing 300,000 people a year, and in newspaper ads proclaimed that “the answer to the AIDS epidemic is here.” The ads asked, "Why should South Africans continue to be poisoned with AZT? There is a natural answer to AIDS". That answer was multivitamin supplements, which he said "cut the risk of developing AIDS in half."

"Tragically," as Dr. Goldacre writes, Dr. Rath found a willing ear in Thabo Mbeki. Despite condemnation by the United Nations, the Harvard School of Public Health and numerous South African health organizations, Dr. Rath’s influence was pervasive. Various studies have estimated that had the South African government used antiretroviral drugs for prevention and treatment, more than 300,000 unnecessary deaths could have been prevented.

You don’t have to buy the book to read the whole sorry story, which is readily available online. Dr. Goldacre believes in the widest possible dissemination of information. But if you do buy the book, you'll find it illustrated with lucid charts and graphs, footnoted (I’d have liked more of these), indexed and far more serious than it looks. Depending on your point of view, you’ll find it downright snarky or wittily readable.
Christine Corcos meanwhile points to a follow-up to the Charna Johnson case in Arizona (weird, but alas no weirder than claims in World Futures) and highlights Christopher Buccafusco's 43 page 'Spiritualism and Wills in the Age of Contract' [PDF]. As I've indicated elsewhere in this blog, Australian courts don't respect the authority of statements supposedly delivered from the dead (or undead) via a medium and, irrespective of pious expressions by exponents of akashic holism, are unlikely to do so in the near future.