BEN GOLDACRE Bad Science

To whom it may concern

CONTENTS

Introduction

1 Matter

2 Brain Gym

3 The Progenium XY Complex

4 Homeopathy

5 The Placebo Effect

6 The Nonsense du Jour

7 Dr Gillian McKeith PhD

8 ‘Pill Solves Complex Social Problem’

9 Professor Patrick Holford

10 Is Mainstream Medicine Evil?

11 How the Media Promote the Public Misunderstanding of Science

12 Why Clever People Believe Stupid Things

13 Bad Stats

14 Health Scares

15 The Media’s MMR Hoax

And Another Thing

Further Reading and Acknowledgements

Notes

About the Author

Copyright

About the Publisher

INTRODUCTION

Let me tell you how bad things have become. Children are routinely being taught – by their own teachers, in thousands of British state schools – that if they wiggle their head up and down it will increase blood flow to the frontal lobes, thus improving concentration; that rubbing their fingers together in a special sciencey way will improve ‘energy flow’ through the body; that there is no water in processed food; and that holding water on their tongue will hydrate the brain directly through the roof of the mouth, all as part of a special exercise programme called ‘Brain Gym’. We will devote some time to these beliefs and, more importantly, the buffoons in our education system who endorse them.

But this book is not a collection of trivial absurdities. It follows a natural crescendo, from the foolishness of quacks, via the credence they are given in the mainstream media, through the tricks of the ?30 billion food supplements industry, the evils of the ?300 billion pharmaceuticals industry, the tragedy of science reporting, and on to cases where people have wound up in prison, derided, or dead, simply through the poor understanding of statistics and evidence that pervades our society.

At the time of C.P. Snow’s famous lecture on the ‘Two Cultures’ of science and the humanities half a century ago, arts graduates simply ignored us. Today, scientists and doctors find themselves outnumbered and outgunned by vast armies of individuals who feel entitled to pass judgement on matters of evidence – an admirable aspiration – without troubling themselves to obtain a basic understanding of the issues.

At school you were taught about chemicals in test tubes, equations to describe motion, and maybe something on photosynthesis – about which more later – but in all likelihood you were taught nothing about death, risk, statistics, and the science of what will kill or cure you. The hole in our culture is gaping: evidence-based medicine, the ultimate applied science, contains some of the cleverest ideas from the past two centuries, it has saved millions of lives, but there has never once been a single exhibit on the subject in London’s Science Museum.

This is not for a lack of interest. We are obsessed with health – half of all science stories in the media are medical – and are repeatedly bombarded with sciencey-sounding claims and stories. But as you will see, we get our information from the very people who have repeatedly demonstrated themselves to be incapable of reading, interpreting and bearing reliable witness to the scientific evidence.

Before we get started, let me map out the territory.

Firstly, we will look at what it means to do an experiment, to see the results with your own eyes, and judge whether they fit with a given theory, or whether an alternative is more compelling. You may find these early steps childish and patronising – the examples are certainly refreshingly absurd – but they have all been promoted credulously and with great authority in the mainstream media. We will look at the attraction of sciencey-sounding stories about our bodies, and the confusion they can cause.

Then we will move on to homeopathy, not because it’s important or dangerous – it’s not – but because it is the perfect model for teaching evidence-based medicine: homeopathy pills are, after all, empty little sugar pills which seem to work, and so they embody everything you need to know about ‘fair tests’ of a treatment, and how we can be misled into thinking that any intervention is more effective than it really is. You will learn all there is to know about how to do a trial properly, and how to spot a bad one. Hiding in the background is the placebo effect, probably the most fascinating and misunderstood aspect of human healing, which goes far beyond a mere sugar pill: it is counterintuitive, it is strange, it is the true story of mind–body healing, and it is far more interesting than any made-up nonsense about therapeutic quantum energy patterns. We will review the evidence on its power, and you will draw your own conclusions.

Then we move on to the bigger fish. Nutritionists are alternative therapists, but have somehow managed to brand themselves as men and women of science. Their errors are much more interesting than those of the homeopaths, because they have a grain of real science to them, and that makes them not only more interesting, but also more dangerous, because the real threat from cranks is not that their customers might die – there is the odd case, although it seems crass to harp on about them – but that they systematically undermine the public’s understanding of the very nature of evidence.

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