An NHS Doctor Analyzes Bad Scientific and Medical Reporting. The Results Will Astound You.

Book review: Bad Science, by Ben Goldacre (Amazon / Book Depository)

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… 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.

Guardian columnist and NHS doctor Ben Goldacre had had enough of the fad diets, homeopathy claims, alarmist medical “news”, cherry-picked and over-interpreted study results that make headlines. In Bad Science he not only shows how he easily obtained a nutritionist certification for his dead cat, but examines the impact of concepts like placebo effect and regression to the mean within bogus medical and supplement claims, body chemistry in relation to health and beauty claims, and so much more that’s relevant to the onslaught of poorly interpreted data we receive via media, marketing, and unqualified influencers.

I hope I can read and critically appraise medical academic literature—something common to all recent medical graduates—and I apply this pedestrian skill to the millionaire businesspeople who drive our culture’s understanding of science.

A big theme is “it’s a bit more complicated than that.” Goldacre reminds of this constantly, because one of the biggest problems is how journalists without medical backgrounds, lifestyle/wellness gurus, and marketers either over-interpret or cherry-pick data to make a story or sell products. There are kernels of truth or evidence, but it’s never as sweeping, generalized or easily applied as they indicate.

He explains how to recognize the hallmarks of bad or misinterpreted data and better understand how this relates to things like “miracle cures, MMR, the evils of big pharma, the likelihood of a given vegetable preventing cancer, the dumbing down of science reporting, dubious health scares, the merits of anecdotal evidence, the relationship between body and mind, the science of irrationality, the medicalization of everyday life, and more.”

For example, curcumin is often cited for its health-giving properties because there’s evidence of certain behaviors in lab tests. So a popular news story translates that to advising you to eat more curry, but: “put the theoretical claims in the context of your body. Very little of the curcumin you eat is absorbed. You have to eat a few grams of it to reach significant detectable serum levels, but to get a few grams of curcumin, you’d have to eat 100g of turmeric: and good luck with that. Between research and recipe, there’s a lot more to think about than the nutritionists might tell you.”

His style is effective, consisting of giving a straightforward explanation then breaking it down further with a more scientific analysis. This isn’t dense and was generally understandable even for my non-sciencey brain, but there were some I’ll need to reread. Which is fine — I’m endlessly thrilled this book exists and does so much mythbusting, and it’s so readable that it’s fun to revisit.

Sometimes even the more thorough explanations aren’t even all that scientific, which makes it all the more embarrassing that we accept flimsy claims from companies so readily without even the excuse of complicated science obfuscating the truth. Like here:

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… 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.

It’s having to say things like this that drives home how hard it must be being a doctor in a world that embraces pseudoscience. How are they not rolling their eyes out of their heads on the daily?

One of my favorite topics, also covered in The Angry Chef, is the debunking of the wellness movement’s biggest faceless villain, toxins, vanquished through various detox methods which are always unpleasant and often expensive. They’re also useless. As Goldacre explains, “That burgers and beer can have negative effects on your body is certainly true, for a number of reasons; but the notion that they leave a specific residue, which can be extruded by a specific process, a physiological system called detox, is a marketing invention.”

He also covers the concept of “regression to the mean,” a deceptively simple one behind many bogus health claims, also covered by the Angry Chef. It’s “basically another phrase for the phenomenon whereby, as alternative therapists like to say, all things have a natural cycle.” You start feeling better after you’ve been at your worst, essentially, which is also when you turn to a therapy that you later credit as having been the solution.

Two of his nemeses are author and nutritionist of dubious credentials Gillian McKeith and the Daily Mail, the latter of which he points out “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.” Which is hilarious but sadly true.

As informative as this was, sometimes the truth is really depressing. Like we learned here, this always just comes down to money, and if consumers can be confused enough that we don’t know what to believe, that equals profit. Here’s a bummer:

Whenever a piece of evidence is published suggesting that the $50-billion food supplement pill industry’s products are ineffective, or even harmful, an enormous marketing machine lumbers into life, producing spurious and groundless methodological criticisms of the published data in order to muddy the waters—not enough to be noteworthy in a meaningful academic discussion, but that is not their purpose.
This is a well-worn risk-management tactic from many industries, including those producing tobacco, asbestos, lead, vinyl chloride, chromium and more. It is called ‘manufacturing doubt’, and in 1969 one tobacco executive was stupid enough to commit it to paper in a memo: ‘Doubt is our product,’ he wrote, ‘since it is the best means of competing with the ‘body of fact’ that exists in the minds of the general public. It is also the means of establishing a controversy.

It’s also full of interesting factoids: did you know that Sylvester Graham, graham cracker inventor and the “first great advocate of vegetarianism and nutritionism as we would know it,” also believed that ketchup and mustard could cause insanity? In addition to the historical background underpinning ridiculous beliefs and pseudoscience claims, sometimes his conclusions are so simple as to be obvious, yet there are a lot of people who need to hear them. Like when he writes, “these are just stories, and the plural of anecdote is not data.” I might have actually squealed. That line just applies to so much.

This was originally published in 2008, and it’s unfortunate how little has changed in the meantime. If anything, some has gotten worse. All the more reason to disseminate this book widely. It ought to be taught in schools; in fact, it opens with an eyebrow-raising practice from UK schools that I can’t believe even happens.

But it closes on a hopeful note, encouraging other science and medical professionals to spread awareness and give critical appraisal similarly, emphasizing that “knowledge is beautiful, and because if only a hundred people share your passion, that is enough.” I appreciate his efforts so much. This is essential reading as basic due diligence for understanding the claims we’re presented with.

Bad Science: Quacks, Hacks, and Big Pharma Flacks
by Ben Goldacre
published 2008

Amazon / Book Depository

26 thoughts on “An NHS Doctor Analyzes Bad Scientific and Medical Reporting. The Results Will Astound You.

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  1. This is very timely: the other day a friend was telling me she ordered some crystals, including an extra strength necklace, to protect against radiation from computers etc. Another woman she knows carries an anti-radiation device with her all the time. Reminds me of that Netflix programme where a woman in the US moved to area where huge telescope and no mobile network as she was convinced all that was making her ill. I remember Gillian Keith, I think she lost the plot completely. I sort of realise the newspapers never report things which are complicated accurately, from the rare times they report on something I actually know about. It’s scary. Like the baked bean example!

    Liked by 1 person

    1. Ugh the crystals, what is with that? What did you even say? I’m usually speechless when someone tells me that stuff. I feel like I should start carrying around copies of this book to hand out to those who really need it. I feel bad for them because people turn to these alternative therapies and pseudosciencey practices because they’re feeling bad and either haven’t gotten better through conventional medicine or else distrust it for whatever reason. So there’s a lot of need and frustration, but it’s only compounded by these industries capitalizing on that. He makes the good point of why we think the supplement and alternative therapy markets are in it out of the goodness of their hearts when actually they’re massive moneymakers.

      What is Gillian McKeith’s deal?? She sounded just odious, he devotes an entire chapter to her crap here. Off to read the link you shared!

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  2. That was a few years ago but has come up again as they have just started latest show which includes Caitlyn Jenner; I never watch it, it’s not my cup of tea. They stick them in the jungle in Australia and make them do challenges involving creepy crawlies. It’s usually people whose careers are on the decline or D listers trying to get fame who sign up.

    Liked by 1 person

    1. They’re not my cup of tea either, the celebrity reality shows in the US are the same, just more sad and pitiful than anything! She just seems like quite the oddball, like another Gwyneth Paltrow making ridiculous claims but also claiming to be a doctor, which she’s clearly not but which makes people automatically trust her more. So dangerous.

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    1. Thank you! Wasn’t that hilarious. But also like, you’ll definitely remember the message in there. That’s what I loved about this book, he made the science accessible and memorable which is exactly what I needed. It was a really helpful and entertaining book, I can’t recommend it enough. Hope you like it!

      Liked by 1 person

  3. I read this when was first published and I remember finding it eye-opening! I didn’t read as much non-fiction back then as I do now so it was quite shocking to realise how easily we can be taken in by science/medical claims in the media. I have a friend who this time every year gets irate that I have a flu vaccination (she uses crystal therapy to protect herself from illness) but I have bad asthma and a spinal cord injury so flu is potentially really dangerous for me. You’ve made me want to re-read this book so I might look out for a copy.

    Liked by 1 person

    1. It definitely was eye-opening! Even after so much time has passed since its publication there was still a lot I learned from it, and elsewhere it was just good to better understand the science behind things I already knew. It’s definitely one to re-read, unfortunately this stuff hasn’t gone away and as I mentioned, some of it has just gotten worse. So disappointing.

      Ugh the crystals, why!! I don’t even know what to say about that. It’s also incredibly frustrating when people arrogantly assume that everyone has the same strong immune system or other physical advantages they do (the same reason I get annoyed with anti-vaxxers, you’re not just vaccinating your kid for their own good, but for everyone’s, including people who can’t fight these illnesses so easily, why do we even have to explain this). Good on you for getting the flu vaccine and reread this so you have the explanations in mind next time you need them 🙂

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  4. Oh, I can hardly WAIT to read this!!! I see a lot of use and benefit to some of the integrative things that are being done to compliment western medicine nowadays but I there are some things that are really far out there. I feel like this book would be a great way for me to consume the information being provided about each treatment.

    And can we just get the people selling the essential oils to calm down a bit?!?

    Liked by 1 person

    1. It is so, SO good!! There are definitely benefits to certain practices and additional/parallel therapies, but it’s important to understand whether or not there’s any proof that something works. Otherwise patients are just taking additional burdens on themselves thinking “won’t hurt, might help” and when it doesn’t it’s one more thing to feel frustrated about while still being sick, or else it’s a waste of money. But it’s also really hard for most laypeople to read and assess these kind of studies and data, it’s easier to just accept what we’re given as we’re given it. I’m so glad he debunks what he does here! It is just so valuable to read.

      And omg those oils!!! And they are SO expensive! He makes that point too, and it’s come up in a lot of the bad science books I’ve been reading – why do people think that alternative therapy and supplement companies aren’t in it for the money? Just so much nonsense! I can’t wait to hear what you think of it when you read it!!

      Liked by 1 person

      1. You know, I really never thought about the money aspect. People DO argue that natural stuff is so much better and then align it with all kinds of other positive moral elements but, also, seem mollified if it is expensive because “that must mean it works.” Oh man, it is so hard to argue with the convoluted logic!

        Liked by 1 person

      2. Isn’t it strange? There’s this weird idea that natural or alternative product companies/manufacturers have no hidden financial motive when actually it’s an absolutely massive business, especially considering that so many of the products can’t be proven to do much. You’re so right – really convoluted logic behind it all!

        Liked by 1 person

  5. I always debate about reading books about bad science reporting or medical frauds, because the topic fascinates me but also seems infuriating. This book seems like it might include some advice on recognizing bad science reporting though, which pushes me in the direction of picking it up, because I have some family members who could use advice for recognizing bad science reporting and sometimes I have a hard time describing why something is (to me) obviously fake.

    Liked by 1 person

    1. I know, it’s infuriating. I feel better being informed though, although I have a feeling you’re already in a better position because of your work and general knowledge. I think you’re probably more able to spot bad science when you see it.
      It was really helpful in giving keys for recognizing what’s lazy or incomplete analysis or cherry-picked data, I spot it constantly now! I found it all incredibly fascinating and I think you’d like it too, although it might not always be as mind-blowing for you since you have such a strong foundation here already!

      Liked by 1 person

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