Download Lectures on Biostatistics (1971).
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Download review of Lectures on Biostatistics (THES, 1973).

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There have been some really excellent books about quackery this year.  This isn’t one of them, because

Nice dedication uh?

it is about a lot more than quackery  It is about the scientific method in general. and in particular about how often it is misunderstood by journalists.  Abuse of evidence by the pharmaceutical industry is treated just as harshly as abuse of evidence by homeopaths and you get the low-down on both.

Buy it here.

“More importantly, you will also see how a health myth can be created, fostered and maintained by the alternative medicine industry using all the same tricks on you, the public, which big pharma uses on doctors. This is about something much bigger than homeopathy.” (p.28)

Sir Iain Chalmers, a founder of the Cochrane Collaboration , co-author of the best lay text on evidence says: “Bad Science introduces the basic scientific principles to help everyone become a more effective bullshit detector”.  And there is no more invaluable skill than being a bullshit detector.

Chalmers says also “Ben Goldacre has succeeded where the ‘public engagement in science’ organisations have so signally failed.” That is exactly right. ‘Public engagement’ has rapidly become bureaucratised, and at its worst, is no better than a branch of the university’s marketing department.  This sort of public engagement corrupts as much as it enlightens. Goldacre enlightens, and he also makes you laugh.

In the introduction, Goldacre says

“You cannot reason people out of positions that they didn’t reason themselves into.” (p xii)

It’s a nice point, but the rest of the book makes a magnificent attempt to do just that.

There is quite a lot about medicine, of course, that’s his job, after all.  But it isn’t all quackery by a long chalk  Quackery is merely a good hook to hang the arguments on about how you distinguish what’s true from what isn’t.  That’s partly because quacks make every mistake known to mankind (sometimes through ignorance, sometimes just to boost  sales), and partly just because it is a topic that interests people, and with which they are bombarded every day   I  feel exactly the same.  If I were to talk about the statistics of single ion channels, nobody would read it (big mistake -it’s fascinating), but if one can use the case of honey versus cough medicine to explain the analysis of variance, there is a chance that someone might find it interesting.

As much as anything, Goldacre’s book is about C.P. Snow’s two cultures.  The chapters on the distortion and trivialisation of science in the media are just terrific.

“My basic hypothesis is this: the people who run the media are humanities graduates with little understanding of science, who wear their ignorance as a badge of honour.  Secretly, deep down, perhaps they resent the fact that they have denied themselves access to the most significant  developments in the history of Western thought from the past two hundred years.” Chapter 11, p. 207

“.. . . here is the information I would like from a newspaper to help me make decisions about my health, when reporting on a risk: I want to know who you’re talking about (e.g. men in their fifties): I want to know what the baseline risk is (e.g. four men out of a hundred  will have a heart attack over ten years);  and I want to know what the increase in risk is , as a natural frequency [not as relative risk] (two extra men out of that hundred will have a heart attack over ten years). I also want to know exactly what’s causing that increase in risk -an occasional headache pill or a daily tub full of pain-relieving medication for arthritis.  Then I will consider reading your newspapers again, instead of blogs which are written by people who understand research , and which link reliably back to the original academic paper, so that I can double check their précis when I wish. ” (p. 242)

I detect some ambiguity in references to things that aren’t true. Sometimes there is magnanimity.   At other times he is a grade one kick-ass ninja. For example

I can very happily view posh cosmetics -and other forms of quackery -as a special,  self-administered, voluntary tax on people who don’t understand science properly (p. 26)

Of course nobody wants to ban cosmetics, or even homeopathy.  But a lot of bad consequences flow from  being over-tolerant of lies if you take it too far (he doesn’t).  The lying dilemma and the training dilemma are among them. Some unthinking doctors will refer troublesome patients to a reflexologist.  That gets the worried-well out of their surgery but neglects the inevitable consequence that Human Resources box-ticking zombies will then insist on having  courses that teach the big toe is connected to the kidney (or whatever) so that reflexologists can have an official qualification in mystical mumbo-jumbo.

Is there anything missing from the book?  Well inevitably.  There are plenty of villains among the peddlers of nutri-bollocks, and in the media.   But there isn’t much about the people who seem to me to be in some ways even worse.  What about the black-suited men and women in the Ministry of Health and in some vice-chancellors’ chairs who betray their institutions and betray the public through some unfathomable
mixture of political correctness, scientific ignorance and greed?   What about the ludicrous behaviour of quangos like Skills for Health? You have to wait right to the end of the book to hear about universities. But when it comes, it is well worth the wait.

“I’m not surprised that there are people with odd ideas about medicine, or that they sell those ideas. But I am spectacularly, supremely, incandescently unimpressed when a a university starts to offer BSc science courses in them.” (p. 317)

It’s almost worth buying Ben Goldacre’s book for that sentence alone.

This book is a romp through the folly, greed and above all the ignorance of much in our society.  It’s deeply educational.  And it makes you laugh.  What more could you want?

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14 Responses to Ben Goldacre’s Bad Science. “Let me tell you how bad things have become”

  • An index.

  • Yes, now you mention it, a more complete index, and references to all the original papers that are mentioned, would certainly be welcome, at least by nerds like me. Perhaps all the original papers in full could be put on the web and picked up by readers of the print version. That’s for the next edition I hope

  • Yes, Ben an index. I just wanted to quote you on something, and am forced to read the whole goddam tome again.

  • Must go and buy myself a copy.. had been toying with the idea of procuring a free one by saying I was going to review it, but His Ben-ness obviously deserves some reward (other than geek approbation) for all his efforts.

    Talking of doctors referring to practitioners of quack therapies, one less than PC view of this – though possibly quite a common view – was pithily summarised by a GP I know thus:

    “I’ve found imaginary therapies work surprisingly well for imaginary illnesses”

  • “My basic hypothesis is this: the people who run the media are humanities graduates with little understanding of science, who wear their ignorance as a badge of honour. Secretly, deep down, perhaps they resent the fact that they have denied themselves access to the most significant developments in the history of Western thought from the past two hundred years.”

    Or indeed the past two thousand years.

  • Tush, DavidTheAstronomer. The study of history, its scientific developments, and the good and bad uses to which those developments are put are the realm of the humanities graduate as much as the scienties.

    The study of literature, with its speculative portrayals of visits to the moon, to the bottom of the sea, to other planets and other times, in general its ability to give imagination a concrete reality, teach the student that ideas can aid scientific discovery just as much as the other way round.

    The study of philosophy may teach us why certain scientific ideas are pursued rather than others in certain ages; what perceptions and sensibilities hold sway over those ages’ minds.

    For the proper humanities student, science is as much a part of their studies as the history of ideas, false and true.

    And the humanities student or journalist may sometimes be able to bridge a gap between the general, relatively uninformed public, and the trained scientist. They are not without worth.

    It is when they falsely represent the science either for spurious thrills or through ignorance that they must be condemned, not just because they traduce science, but because they also traduce the proper study of the humanities.

  • Almost finished my copy. Highly enjoyable – and accessible: my 12 year old daughter has been attempting to steal it. Surely a book like this could be put onto the secondary school curriculum – an abridged version in PSHE lessons? (Dream on…)

    But – Mojo & LCN have beaten me to it. An index would be lovely: it kind of detracts from the force of one’s argument (in my case about the chlorine in the detox footbath not being evidence of nasty toxins being purged from the body) if one has to flitter wildly through the book, in the heat of the argument, to find the relevant passage. I’m now using those coloured tab things – sad, I know.

    About the “two cultures”: is this culturally specific to the UK? I was educated outside the UK, in a system where one had to take maths and a science subject in the final school leaving examination, even if one intended to study the humanities (as I did) at higher level. While I remember people saying that they disliked maths or science, I don’t recall, at least from my contemporaries, the ‘badge of honour’ mentality I have encountered sometimes here.

  • cracking book, reviewed it in part already with the rest to follow this weekend hopefully (mainly out of a feeling of obligation as i blagged a review copy from t’publishers – don’t feel bad about it Dr. Aust, you can always buy Ben a as pint they cost about as much in London…) – [url=http://teekblog.blogspot.com/2008/09/book-review-bad-science-by-ben-goldacre.html] it’s here for those who are interested.[/url]

    DC – a nice precis of the book I have to say, good point about C.P Snow’s two cultures too.

    highly recommended, and as for it being taught in schools – we can only hope Claire!!

  • I think Claire’s idea is an excellent one (that a book like this could be put onto the secondary school curriculum). I don’t recall getting handy hints in science lessons about how to spot dodgy claims and I definitely don’t remember being taught how to avoid fooling myself. [Feynman referred to this gap in his Caltech lecture: “But this long history of learning how not to fool ourselves—of having utter scientific integrity—is, I’m sorry to say, something that we haven’t specifically included in any particular course that I know of. We just hope you’ve caught on by osmosis”]

    I think some of the characters in Ben’s book make bullshit claims that are difficult to spot not necessarily because the science is particularly hard to understand, but because not everyone really gets that quoting a single small study (say, to support an argument that substance x is ‘good for you’) is, essentially, misrepresenting the evidence. This book is really handy for people who don’t yet have the skills to defend themselves against the tactics of those who present dodgy marketing dressed up as academia. It’s wickedly funny in places, too. I particularly like the line in the chapter on Brain Gym about kids massaging their carotid arteries needing the sharp scissors only mummy is allowed to use.

  • @ Dr Aust, I have heard similar pragmatic views from relatives and aquaintances who are medics and of course one can understand where they are coming from. But I share David’s misgivings and also wonder if such a course of action risks damaging patient-doctor communication and trust in the long term (I think this links into the ‘ethical placebo’ debate). And, as this reported discussion suggests, the illnesses are, sometimes, not imaginary.

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