Today, 25 September, is the first anniversary of the needless death of Stefan Grimm. This post is intended as a memorial.
He should be remembered, in the hope that some good can come from his death.
On 1 December 2014, I published the last email from Stefan Grimm, under the title “Publish and perish at Imperial College London: the death of Stefan Grimm“. Since then it’s been viewed 196,000 times. The day after it was posted, the server failed under the load.
Since than, I posted two follow-up pieces. On December 23, 2014 “Some experiences of life at Imperial College London. An external inquiry is needed after the death of Stefan Grimm“. Of course there was no external inquiry.
And on April 9, 2015, after the coroner’s report, and after Imperial’s internal inquiry, "The death of Stefan Grimm was “needless”. And Imperial has done nothing to prevent it happening again".
The tragedy featured in the introduction of the HEFCE report on the use of metrics.
“The tragic case of Stefan Grimm, whose suicide in September 2014 led Imperial College to launch a review of its use of performance metrics, is a jolting reminder that what’s at stake in these debates is more than just the design of effective management systems.”
“Metrics hold real power: they are constitutive of values, identities and livelihoods ”
I had made no attempt to contact Grimm’s family, because I had no wish to intrude on their grief. But in July 2015, I received, out of the blue, a hand-written letter from Stefan Grimm’s mother. She is now 80 and living in Munich. I was told that his father, Dieter Grimm, had died of cancer when he was only 59. I also learned that Stefan Grimm was distantly related to Wilhelm Grimm, one of the Gebrüder Grimm.
The letter was very moving indeed. It said "Most of the infos about what happened in London, we got from you, what you wrote in the internet".
I responded as sympathetically as I could, and got a reply which included several of Stefan’s drawings, and then more from his sister. The drawings were done while he was young. They show amazing talent, but by the age of 25 he was too busy with science to expoit his artistic talents.
With his mother’s permission, I reproduce ten of his drawings here, as a memorial to a man who whose needless death was attributable to the very worst of the UK university system. He was killed by mindless and cruel "performance management", imposed by Imperial College London. The initial reaction of Imperial gave little hint of an improvement. I hope that their review of the metrics used to assess people will be a bit more sensible,
His real memorial lies in his published work, which continues to be cited regularly after his death.
His drawings are a reminder that there is more to human beings than getting grants. And that there is more to human beings than science.
Click the picture for an album of ten of his drawings. In the album there are also pictures of two books that were written for children by Stefan’s father, Dieter Grimm.
Dated Christmas eve,1979 (age 16)
Well well. It seems that Imperial are having an "HR Showcase: Supporting our people" on 15 October. And the introduction is being given by none other than Professor Martin Wilkins, the very person whose letter to Grimm must bear some responsibility for his death. I’ll be interested to hear whether he shows any contrition. I doubt whether any employees will dare to ask pointed questions at this meeting, but let’s hope they do.
Since writing about anti-scientific degrees in Nature (March 2007), much has been revealed about the nonsense that is taught on these degrees. New Year’s day seems like a good time to assess how far we’ve got, five years on.
At the beginning of 2007 UCAS (the universities central admission service) offered 45 different BSc degrees in quackery, at 16 universities.
Now there are only 24 such degrees.
If you exclude chiropractic and osteopathy, which all run at private colleges, with some sort of "validation" from a university, there are now only 18 BSc/MSc courses being offered in eight universities.
Degrees in homeopathy, naturopathy and "nutritional therapy", reflexology and aromatherapy have vanished altogether from UCAS.
In the race to provide BScs in anti-science, Middlesex University has now overhauled the long-standing leader, Westminster, by a short head.
Michael Driscoll, vice-chancellor of Middlesex
Let’s see what’s gone.
The University of Central Lancashire (UCLAN) was the first to see sense. In August 2008 they announced closure of their “BSc” degree in homeopathy. On September 2008 they announced an internal review of their courses in homeopathy. herbalism and acupuncture. The report of this review closed down all of them in July 2009. I first asked for their teaching materials in July 2006. I finally got them in December 2010, after winning an appeal to the Information Commissioner, and then winning an appeal against that decision at an Information tribunal . By the time I got them, the course had been closed for over two years. That is just as well, because it turned out that UCLAN’s students were being taught dangerous nonsense. No wonder they tried so hard to conceal it.
Salford University was the next to go. They shut down their courses in complementary medicine, homeopathy and acupuncture. In January 2009 they announced " they are no longer considered “a sound academic fit” ". Shortly afterwards. a letter appeared in The Times from three heavyweights (plus me) congratulating the vice-chancellor on his decision.
University of Westminster
For many years, Westminster was the biggest supplier of BSc degrees in quackery. At the beginning of 2007 they offered 14 different BSc degrees in homeopathy, naturopathy, nutritional therapy, "complementary therapies", (western) herbal medicine and traditional Chinese medicine with acupuncture. Some of their courses were so bizarre that some of the students and even staff sent me slides which taught things like "amethysts emit high Yin energy". Like UCLAN, Westminster also held an internal review. Unlike UCLAN it came to the absurd conclusion that all would be well if they injected more science into the courses. The incompetence of the review meant that those who wrote it hadn’t noticed that if you try to put science into homeopathy or naturopathy, the whole subject vanishes in a puff of smoke. Nevertheless Westminster closed down entry to BSc homeopathy in March 2009 (though the subject remained as part of other courses).
Three years after the Nature article, all five BSc homeopathy degrees had shut their doors.
During 2011, Westminster shut down Naturopathy, Nutritional therapy, Therapeutic bodywork and Complementary Medicine. See, for example,
More dangerous nonsense from the University of Westminster: when will Professor Geoffrey Petts do something about it?
Professor Geoffrey Petts of the University of Westminster says they “are not teaching pseudo-science”. The facts show this is not true
University of Westminster shuts down naturopathy, nutritional therapy, but keeps Acupuncture and Herbal Medicine
Now Westminster has only four courses in two subjects. They still teach some dangerous and untrue things, but I suspect the writing is on the wall for these too.
I have seen a document, dated 11 April 2011, which states
“The following courses have been identified as ‘at risk’ (School definition) and will be discussed at the APRG and University Review Group2, due to poor recruitment and high cost of delivery:
Integrated Health Scheme: BSc Complementary Medicine, Naturopathy; BSc Chinese Medicine; BSc Nutritional Therapy; BSc Herbal Medicine”
All but Chinese medicine and Herbal medicine have already gone. Almost there.
University of Wales
Since my first post in 2008 about the validation scam operated by the University of Wales, and some good investigations by BBC Wales TV, the outcome was the most spectacular so far. The entire institution collapsed. They no longer "validate" external degrees at dodgy business colleges, loony religious colleges or magic medicine colleges.
Another worthless validation: the University of Wales and nutritional therapy (October 2008) This is a ‘degree’ in nutrtional therapy. It is even more hilarious than usual, but it passed the validation anyway.
Scandal of the University of Wales and the Quality Assurance Agency (November 2010). This post followed the BBC Wales TV programme. At last the QAA began to notice, yet further confirmation of its utter ineptitude.
The University of Wales disgraced (but its vice chancellor is promoted) (October, 2011) The eventual collapse of the university was well-deserved. But it is very weird that the people who were responsible for it have still got their jobs. In fact the vice-chancellor, Marc Clement, was promoted despite his mendacious claim to be unaware of what was going on.
It remains to be seen how many of the many quack courses that were validated by the University of Wales will be taken on by other universities. The McTimoney College of Chiropractic is owned by BPP University (so much for their quality control, as explained in Private Eye). but still claims to be validated by Wales until 2017.
Some of the more minor players
Edinburgh Napier University. After an FOI request (rejected), Napier closed their herbal medicine degree in 2010.
Hot and cold herbal nonsense from Napier University Edinburgh: another course shuts. (June 2010)
As expected, the Scottish Information Commissioner agreed with that for England and Wales and ordered material to be sent. Edinburgh Napier University teaches reflexology, aromatherapy and therapeutic touch. Scottish Information Commissioner says you should know. Some of the horrors so discovered appeared in Yet more dangerous nonsense inflicted on students by Edinburgh Napier University. The embarrassment seems to have worked. Their remaining degrees in aromatherapy and reflexology have now vanished from UCAS too. All that remains is a couple of part time “Certificates of Credit” for aromatherapy and reflexology
Anglia Ruskin Univerity Not only have BSc degrees gone in aromatherapy and reflexology, but their midwifery degree now states "We are unable to accept qualifications in aromatherapy, massage and reflexology."
University of Derby Reflexology and aromatherapy have gone, though doubtless Spa management therapies have much nonsense left
University of Greenwich. BSc in Complementary Therapies (Nutritional Health) and BSc in Complementary Therapies (Nutritional Health) have been shut. The BSc Acupuncture is listed on their web site but it is under review, and is not listed in UCAS for 2012. (Acupuncture is run at International College of Oriental medicine, validated by Greenwich.). Only osteopathy (MOst) is still running, and that is a validation of an external course run at The European School of Osteopathy, in Maidstone
Thames Valley University was renamed the University of West London in 2010. The nonsense that was run there (e.g. Nutritional Fairy Tales from Thames Valley University) seems to have vanished. Their previous alt med guru, Nicola Robinson, appears now to be at London South Bank University (ranked 116 out of the 116 UK universities)
Chiropractic Surprisingly, given the total discreditation of chiropractic in the wake of the Simon Singh affair, and the internecine warfare that followed it, none of the chiropractic courses have shut yet. Some are clearly in trouble, so watch this space.
Osteopathy has also had no course closures since 2007. Like chiropractic it also suffers from internecine warfare. The General Osteopathic Council refuses to disown the utter nonsense of "craniosacral" osteopathy. But the more sensible practitioners do so and are roughly as effective as physiotherapists (though there are real doubts about how effective that is).
Excluding chiropractic and osteopathy, this is all that’s left. It now consists almost entirely of Chinese medicine and a bit of herbal.
Glyndwr university (Known as North East Wales Institute until 2008) Ranked 104 out of 116 UK universities
BSc Acupuncture (B341) BSc
BSc Complementary Therapies for Healthcare (B343)
Cardiff Metropolitan University (UWIC) (Known as University of Wales Institute Cardiff (UWIC) until Nov 2011.) The vice-chancellor of Cardiff Metropolitan, Antony Chapman, is in the QAA’s board of directors, so perhaps it isn’t surprising that the QAA has done nothing.
BSc Complementary Therapies (3 years) (B390)
BSc Complementary Therapies (4 yrs inc Foundation) (B300)
University of Lincoln
Acupuncture (B343) 3FT Hon BSc
Herbal Medicine (B342) 3FT Hon BSc
University of East London Ranked 113 out of 116 UK universities
Acupuncture (B343) 3FT Hon BSc
London South Bank University Ranked 116 out of 116 UK universities
Acupuncture (B343) 4FT Deg MCM
The Manchester Metropolitan University Ranked 93 out of 116 UK universities
Acupuncture (B343) 3FT Hon BSc
Acupuncture (B348) 3FT Hon BSc
Ayurvedic Medicine (A900) 4FT Oth MCM
Herbal Medicine (B347) 3FT Hon BSc
Traditional Chinese Medicine (BT31) 4FT Hon BSc
University of Westminster
Chinese Medicine: Acupuncture (B343) 3FT Hon BSc
Chinese Medicine: Acupuncture with Foundation (B341) 4FT/5FT Hon BSc/MSci
Herbal Medicine (B342) 3FT Hon BSc
Herbal Medicine with Foundation Year (B340) 4FT/5FT Hon BSc/MSci
It seems that acupuncture hangs on in universities that are right at the bottom of the rankings.
Manchester Metropolitan gets the booby prize for actually starting a new course, just as all around are closing theirs. Dr Peter Banister, who was on the committee that approved the course (but now retired), has told me ” I am sceptical in the current economic climate whether it will prove to be successful”. Let’s hope he’s right.
But well done Westminster. Your position as the leader in antiscientific degrees has now been claimed by Middlesex University. Their "degrees" in Ayurveda mark out Middlesex University as the new King of Woo.
Over to you, Professor Driscoll. As vice-chancellor of Middlesex University, the buck stops with you.
Both still teach Chinese and herbal medicine, which are potentially dangerous. There is not a single product from either that has marketing authorisation from the MHRA, though the MHRA has betrayed its trust by allowing misleading labelling of herbal medicines without requiring any evidence whatsoever that they work, see, for example
Why degrees in Chinese medicine are a danger to patients
More quackedemia. Dangerous Chinese medicine taught at Middlesex University
Why does the MHRA refuse to label herbal products honestly? Kent Woods and Richard Woodfield tell me
In contrast to the large reduction in the number of BSc and MSc degrees, there has actually been an increase in two year foundation degrees and HND courses in complementary medicine, at places right near the bottom of the academic heap. The subject is sinking to the bottom. With luck it will vanish entirely from universities before too long.
Although all of the degrees in magic medicine are from post-1992 universities, the subject has crept into more prestigious universities. Of these, the University of Southampton is perhaps the worst, because of the presence of George Lewith, and his defender, Stephen Holgate. Others have staunch defenders of quackery, including the University of Warwick, University of Edinburgh and St Batholomew’s.
Why have all these courses closed?
One reason is certainly the embarrassment caused by exposure of what’s taught on the courses. Professors Petts (Westminster) and Driscoll (Middlesex) must be aware that googling their names produces references to this and other skeptical blogs on the front page. Thanks to some plain brown emails, and, after a three year battle, the Freedom of Information Act, it has been possible to show here the nonsense that has been foisted on students by some universities. Not only is this a burden on the taxpayer, but, more importantly, some of it is a danger to patients.
When a course closes, it is often said that it is because of falling student numbers (though UCLAN and Salford did not use that excuse). Insofar as that is true, the credit must go to the whole of the skeptical movement that has grown so remarkably in the last few years. Ben Goldacre’s "ragged band of bloggers" have produced a real change in universities and in society as a whole.
The people who should have done the job have either been passive or an active hindrance. The list is long. Vice-chancellors and Universities UK (UUK), the Quality Assurance Agency (QAA), the Hiigher Education Funding Council England (HEFCE), Skills for Health, the Medicines and Health Regulatory Authority ( MHRA) , the Health Professions Council (HPC), the Department of Health, the Prince of Wales and his reincarnated propaganda organisation, the "College of Medicine", the King’s Fund, the Universities and Colleges Union (UCU), OfQual, Edexcel, National Occupational Standards and Qualifications and the Curriculum Authority (QCA).
Whatever happened to that "bonfire of the quangos"?
2 January 2012 The McTimoney College of Chiropractic (owned by BPP University) claims that its “validation” by the University of Wales will continue until 2017. This contradicts the statement from UoW. Watch this space.
3 January 2012. Thanks to Neil O’Connell for drawing my attention to a paper in Pain. The paper is particularly interesting because it comes from the Southampton group which has previously been sympathetic to acupuncture. Its authors include George Lewith. It shows, yet again that there is no detectable difference between real and sham acupuncture treatment. It also shows that the empathy of the practitioner has little effect: in fact the stern authoritarian practitioner may have been more effective.
Patients receiving acupuncture demonstrated clinically important improvements from baseline (i.e., a 29.5% reduction in pain), but despite this, acupuncture has no specific efficacy over placebo for this group of patients. The clinical effect of acupuncture treatment and associated controls is not related to the use of an acupuncture needle, nor mediated by empathy, but is practitioner related and may be linked to the perceived authority of the practitioner.”
Sadly. the trial didn’t include a no-treatment group, so it is impossible to say how much of the improvement is regression to the mean and how much is a placebo effect. The authors admit that it could be mostly the former.
Surely now the misplaced confidence in acupuncture shown by some medical and university people must be in tatters.
In yet another sign that even acupuncture advovates are beginning to notice that it doesn’t work, a recent article Paradoxes in Acupuncture Research: Strategies for Moving Forward, shows some fascinating squirming.
3 January 2012. The Daily Telegraph has carried a piece about closure of university courses, written by Michael Hanlon. On 31 January they carried a much longer piece.
3 January 2012. It is a great pity that some physiotherapists seem to have fallen hook, line and sinker for the myths of acupuncture. Physiotherapists are, by and large, the respectable face of manipulative therapy. Their evidence base is certainly not all one would wish, but at least they are free of the outrageous mumbo humbo of chiropractors. Well, most of them are, but not the Acupuncture Association of Chartered Physiotherapists (AACP), or, still worse, The Association of Chartered Physiotherapists in Energy Medicine, a group that is truly away with the fairies. These organisations are bringing a very respectable job into disrepute. And the Health Professions Council, which is meant to be their regulator, has, like most regulators, done nothing whatsoever to stop it.
5 January 2012. Times Higher Education gives a history of the demise of the University of Wales, Boom or Bust. It’s a useful timeline, but like so many journalists, it’s unwilling to admit that bloggers were on to the problem long before the BBC, never mind the QAA.
There was also a leader on the same topic, Perils of the export business. It again fails to take the QAA to task for its failures.
Interviews for Deutsche Welle and Middle East Broadcasting Center TV.
17 January 2012 Another question answered. I just learned that the ludicrous course in Nutritional Therapy, previously validated by the University of Wales (and a contributor to its downfall), is now being validated by, yes, you guessed, Middlesex University. Professor Driscoll seems determined to lead his univerity to the bottom of the academic heap. His new partnership with the Northern college of Acupuncture is just one of a long list of validations that almost rivals that of the late University of Wales. The course has, of course, an enthusiastic testimonial, from a student. It starts
I work full time as a team leader for a pension company but I am also a kinesiologist and work in my spare time doing kinesiology, reiki and Indian head massage.
Evidently she’s a believer in the barmiest and totally disproved forms of magic medicine. And Middlesex University will give her a Master of Science degree. I have to say I find it worrying that she’s a team leader for a pension company. Does she also believe in the value of worthless derivatives. I wonder?
18 January 2012. the story has gone international, with an interview that I did for Deutsche Welle, UK universities drop alternative medicine degree programs. I’m quoted as saying “They’re dishonest, they teach things that aren’t true, and things that are dangerous to patients in some cases”. That seems fair enough.
There is also an interesting item from July 2010 about pressure to drop payment for homeopathy by German health insurance
31 January 2012
The Daily Telegraph carried a prominent 1200 word account (the title wasn’t mine). The published version was edited slightly.
I was asked recently to write a reply to an article about "research managers" for the magazine Research Fortnight. This is a magazine that carries news of research and has a very useful list of potential research funding agencies.
The article to which I was asked to respond originally had the title “Researchers and Research Managers, a match made in heaven?“, before the subeditors got hold of it. It was written by Simon Kerridge, who is secretary of the Association for Research Managers and Administrators The printed version of his article can be downloaded here, and the printed version of my response here. My response, as submitted, is below with live links.
This invitation came at a strangely appropriate time, just at the moment that every university is having serious budget cuts, Well, here is a chance to make a good start on cutting out non-jobs..
Researchers and Research Managers: an imminent divorce?
David Colquhoun, UCL.
The web site of the Association of Research Managers and Administrators says it has 1600 individual members , but every scientist I have met is baffled about why they have suddenly sprung into existence. The web site says “Our mission is to facilitate excellence in research by identifying and establishing best practice in research management and administration”. I had to read that several times in an attempt to extract a meaning from the mangled bureaucratic prose. “Our mission is to promote excellence in research”. How can non-scientists with no experience of research possibly “promote excellence in research”? They can’t, and that’s pretty obvious when you read the second half of the sentence. They propose to improve science by promoting research management, i.e. themselves.
Kerridge’s article didn’t help much either. He seems to think that research managers are there to make that scientists fulfil “overall strategic aims of the University”. In other words they are there to make sure that scientists obey the orders of non-scientists (or elderly ex-scientists) who claim to know what the future holds. I can think of no better way to ruin the scientific reputation of a university and to stifle creativity.
We all appreciate good support. We used to have a very helpful person in the department (not a ‘manager’) who could advise on some of the financial intricacies, but now it is run by a ‘manager’ it has been centralised, depersonalised and it is far less efficient.
The fact of the matter seems to be that “research managers” are just one more layer of hangers-on that have been inflicted on the academic enterprise during the time new labour was in power. They are certainly not alone. We have now have “research facilitators” and offshoots of HR running nonsense courses in things like Brain Gym . All of these people claim they are there to support research. They do no such thing. They merely generate more paper work and more distraction from the job in hand. Take a simple example. At a time when there was a redundancy committee in existence to decide which academics should be fired in my own faculty, the HR department advertised two jobs (on near professorial salaries) for people trained in neurolinguistic programming (that is a well-known sort of pseudo-scientific psychobabble, but it’s big business ).
A quick look at what research managers actually do (in two research-intensive universities) shows that mostly they send emails that list funding agencies, and to forward emails you already had from someone else. Almost all of it can be found more conveniently by a couple of minutes with Google. Although they claim to reduce administrative work for scientists, it is usually quicker to do it yourself than to try to explain things to people who don’t understand the science. They don’t save work, they make it.
One might well ask how it is that so much money has come to be spent on pseudo-jobs like “research managers”. I can only guess that it is part of the ever-expanding tide of administrative junk that encumbers the work of people who are trying to do good creative science. It also arises from the misapprehension, widespread among vice-chancellors, that you can get creative science by top down management of research by people who know little about it.
I’m reminded of the words of the “unrepentant capitalist”, Luke Johnson  (he was talking about HR but the words apply equally here).
“HR is like many parts of modern businesses: a simple expense, and a burden on the backs of the productive workers”,
“They don’t sell or produce: they consume. They are the amorphous support services”.
“I have radically downsized HR in several companies I have run, and business has gone all the better for it.”
The dangers are illustrated by the report  of a paper by the professor of higher education management at Royal Holloway (yes, we already have a chair in this non-subject). It seems that “Research "can no longer be left to the whims and fortunes of individual academics" “. It must be left to people who don’t do research or understand it. It’s hard to imagine any greater corruption of the academic enterprise.
Oddly enough, the dire financial situation brought about by incompetent and greedy bankers provides an opportunity for universities to shed the myriad hangers-on that have accreted round the business of research. Savings will have to be made, and it’s obvious that they shouldn’t start with the people who do the teaching and research on which the reputation of the university depends. With luck, it may not be too late to choke off the this new phenomenon before it chokes us. If you want research, spend money on people who do it, not those who talk about it.
 Association of Research Managers and Administrators http://www.arma.ac.uk/about/
 When HR gets hold of academe, quackery and gobbledegook run riot. Times Higher Education 10 April 2008, http://www.timeshighereducation.co.uk/story.asp?sectioncode=26&storycode=401385 and expanded version at http://www.dcscience.net/?p=226
 What universities can do without. http://ucllifesciences.wordpress.com/2010/04/25/what-universities-can-do-without/
 Luke Johnson The Truth About the HR Department, Financial Times, Jnauary 30 2008 http://www.ft.com/cms/s/0/9e10714c-ced7-11dc-877a-000077b07658.html and http://www.dcscience.net/?p=226
 Managers must be qualified to herd the academic cats. Times Higher Education 20 May 2010 http://www.timeshighereducation.co.uk/story.asp?sectioncode=26&storycode=411643
I had never intended to write about climate. It is too far from the things I know about. But recent events have unleashed a Palin-esque torrent of comments from people who clearly know even less about it than I do. In any case, it provides a good context to think about trust in science,
My interest in it, apart from little matters like the future of the planet, lies in the reputation of science and scientists.
I have been going on for years now about the lack of trust in science, and the extent to which it is a self-inflicted problem. The latest reactions to the developments at the University of East Anglia and the IPCC may show the nature of the problem with dreadful clarity,
Many of us came into science because, apart from the sheer beauty of nature, it seemed like one of the few honest ways of earning a living. Most scientists that I know still think like that, but recent
events invite some reexamination of honesty in science.
How dishonest is science?
The first thing to say is that I have never come across anything in my own field that would qualify as fraud, or even dishonest. I did once have a visit from a rather distressed postdoc (not in my area of work) who felt pressurised by her boss into putting an interpretation on her work that she did not agree with. In the end, the bit of work in question was left out of the paper. That could be held to be dishonest, in that the omission wasn’t mentioned, but it could also be held that the omitted result was too ambiguous to contribute much to the paper. It was just short of the point where I’d have felt compelled to do something about it. But only just. That is about the worst thing I’ve encountered in a lifetime.
There is, of course, an enormous difference between being wrong and being dishonest. Any research that is worth doing has an outcome that can’t be predicted before the work is done. At best, one can hope for an approximation to the truth. Mistakes in observations, analysis or interpretation will sometimmes mean the announced result is completely wrong, with no trace of dishonesty being involved. But when that happens, others soon fiind the mistake. It is that self-correcting characteristic of science that keeps it honest in the long run.
Of course there have been occasional cases of outright fraud, simple
falsification or fabrication of data. How often it occurs is not really known. There is a recent analysis in PLoS One, about verified cases of misconduct in the USA suggested that 1 in 100,000 scientists per year are to blame, but other ways of counting give larger numbers. For example, if asked around 2 in 100 scientists claim to be aware of misconduct by someone else., The numbers aren’t huge but they are much bigger than they should be.
It isn’t perhaps surprising that the Fanelli study found misconduct was most frequent in “medical (including clinical and pharmacological) research studies”, which are often funded by the pharmaceutical industry, Basic biomedical research and other subjects were better, though sadly that could be only because they are less often offered money.
What gives rise to dishonesty?
It seems obvious that one motive is money, as suggested by the worst rates of misconduct being found in the clinical pharmacological studies, It is well known that studies funded by industry are more likely to produce results that favour the product than those funded in other ways.
The other reason is presumably the human desire to win fame, promotion and to get grants.
It is no excuse, but it is perhaps a reason for misconduct that the pressure to publish and produce results is now enormous in academia. Even in good universities people are judged by the numbers (rather than the quality) of papers they produce and by what journal they happen to be published in. Contrary to public perception, even quite senior people have no guarantee that they can’t be fired, and life for postdoctoral fellows, who do a large fraction of experimental research, is harsh to the point of cruelty. They exist on a series of short term contracts, they work exceedigly hard and have poor prospects of getting a secure job. In conditions like that, the only surprising thing is that there is so little dishonesty.
The pressure to publish in particular journals is particularly invidious because it is known that the number of citations that a paper gets (itself a fallible measure of quality) is independent of the journal in which it appears. Bibliometrists are the curse of our age. (See, for example Challenging the tyranny of impact factors, 2003; and How to get good science, 2007 or its web version; and Peter Lawrence’s article, The mismeasurement of science)
The enormous competitive pressure under which academics work is imposed by vice-chancellors, research councils and other senior people who should know better, It is a self-inflicted wound.
In other words, the authorities provide a strong incentive to do poor, over-hurried and occasionally dishonest science. Perhaps the surprising thing in the circumstances is that there is so little outright fabrication. The very measures that have the aim of improving science actually have just the opposite effect. That is what happens when science is run by people who don’t do it.
For an idea of what life is like in science now, try Peter Lawrence’s Real Lives and White Lies in the Funding of Scientific Research. Or, for someone at the other end of their career, Jennifer Rohn’s account on Nature blogs.
Given the high degree of insecurity for young researchers, compounded by well-intentioned but vacuous “training” from daft Robert’s’ "training courses", or the dismaly ineffective Concordat, the only surprise is that so many people remain honest and devoted to good science. Nothing raises the ire of hard-pressed scientists more than the constant emails form HR trying to force people to go to gobbledygook courses on "wellbeing". Times Higher Education recently did a piece on "Get happy", The comments are worth reading.
So what about climate change?
Out of thousands of pages in the IPCC reports, a single mistake was found, On page 493 of the IPCC’s second 1000-page Working Group report on “Impacts, Adaptation and Vulnerability” (WGII) it was said that Himalayan glaciers were “very likely” to disappear by 2035. Glaciers are melting but that date can’t be justified. This single mistake has been blown out of all proportion. Furthermore it is important to notice that the mistake was found by scientists, not by ‘sceptics’. It is a good example of the self-correcting nature of science. Nevertheless this single mistake has provoked something close to hysteria among those who want to deny that something needs to be done.
On the other hand, the hacked emails from the University of East Anglia (UEA) look bad. It simply isn’t possible at the moment to say whether they are as bad as they seem at first sight, We just don’t know whether anything of importance was concealed, but we should know.
One thing can be said with certainty, and that is that the reaction to their revelation by Dr Phil Jones, and by the vice-chancellor of the University of East Anglia, was nothing short of disastrous. Fred Pearce put it very well in Climate emails cannot destroy proof that humans are warming the planet
Most unforgivably of all, UEA refused to comply with requests under the Freedom of Information Act, and there is some reason to think that relevant material was deleted. The deputy information commissioner, Graham Smith, said: in a statement that
“The emails which are now public reveal that Mr Holland’s requests under the Freedom of Information Act were not dealt with as they should have been under the legislation. Section 77 of the Freedom of Information Act makes it an offence for public authorities to act so as to prevent intentionally the disclosure of requested information.”.
That seems to me to be a matter that requires the resignation of the vice-chancellor. On this matter, I think George Monbiot is spot on in his article “Climate change email scandal shames the university and requires resignations“.
There was a big feature about academic freedom in Times Higher Education recently. One of the problems was what happens to someone who brings their own university into disrepute. But when that term is used, it is always used about junior partners in the organisation (you know, professors and the like). It should apply equally to heads of communications and vice-chancellors who bring their own university into disrepute, whether the disrepute is brought about by failing to comply with the Freedom of Information Act, or by promoting courses in junk medicine.
In general, conspiracy theories are wrong. I’m not sure how much of the distortion of climate data results from surreptitious funding of opposition to doing anything by the fossil fuel industry. The Royal Society is an organisation that is not usually prone to conspiritorialist views. That means one must take it seriously the fact that in 2006, the Royal Society wrote to ExxonnMobil to ask them to stop funding climate denialist organisations. This is a bit like the way Big Pharma has been caught funding “user groups” that endorse their products. Some newspapers like to stir up controversies about things that aren’t very controversial. For example there is a good analysis of a recent Sunday Times piece here.
Of course it is often alleged that "quackbusters" are funded by Big Pharma, though in fact the amounts of money involved are far too small for Big Pharma to bother. Climate deniers too like to suggest that there is some sort of conspiracy, arranged between hundreds of labs in the world to conceal the fact that there is no such thing as warming. I guess that shows only that deniers know little about how science works. it is an exceedingly competitive business, and getting hundreds of labs to say the same thing would be like trying to herd cats.
If there is a problem, it is the other way round. Labs are in such intense competition with each other, that it lcan lead to undesirable levels of secrecy.
Blogs in which researches have a direct dialogue with the public are a big help. As always in the blogosphere, the problem is to find the reliable sources. Two excellent sites, in which scientists (not journalists or lobbyists) talk directly with the public are realclimate.org and Andrew Russell’s blog. The post on RealClimate, IPCC errors: facts and spin, is especially worth reading.
Total openness is the only cure
All the raw data and all emails have to be disclosed openly. Everything should be put on the web as soon as possible. By appearing to go to ground, UEA has made enormous problems for itself and for the rest of the world. Some people object to total openness on the grounds that the other side tells lies. In the case of climate change (and in the case of junk medicine too) that is undoubtedly true. The opponents are ruthlessly dishonest about facts. The only way to counter that is by being ruthlessly and visibly honest about what you know, and why.
The UK’s Meteorological Office has, to its great credit, put raw data on line. That policy has already paid off, because a science blogger found a mistake in the way that some Australian data had been incorporated into forecasts. The Met Office thanked him and corrected the mistake. In fact the error makes no substantial difference to the warming trend, but the principle is just great. The more people who can check analyses and eliminate slip-ups the better.
Putting raw data on the web is an idea that has been gathering force for a while, in all areas of work, not just climate change. In my own are (stochastic properties of single ion channel molecules) our analysis programs have always been available on the web, free to anyone who wants them, despite the large amount of work that has gone into them. And we run a course. almost free, on the theory that underlies our analyses. Within the last couple of months we have been discussion ways of making public all our raw data (in any case, we would always have sent it to anyone who asked). Digitised single channel records are big files (around 100 Mb) and it is only recently that the web has been able to deal with such large amounts of raw data. There are also problems of how to format data so other people can read it, The way we are all heading is clear, and the fact that some people in climate science appeared to be hiding raw data is a disgrace.
Public relations is not the cure
It is not uncommon to read that science needs better PR. That is precisely what is not needed. PR exists to put only one side of the story. That makes it an essentially dishonest occupation. Its aims are the very opposite of those of science. The public aren’t stupid: often they recognise when they are getting half the story.
It is particularly unfortunate that many universities have developed departments with names like "corporate communications". Externally they are seen as giving information about science, and indeed some of the things they do are successful public engagement in science. Only too often, though, it is made clear internally that an important aim of these departments is to improve the image of the university.
But you have to choose. You can engage the public in science or you can be a PR image-builder. You can’t be both.
The matter came to a head in 2008 when, according to a report in Times Higher Education, the University of Nottingham issued a memo that defined public engagement as: “The range of activities of which the primary functions are to raise awareness of the university’s capabilities, expertise and profile to those not already engaged with the institution”.
The mainstream media and political blogs
The biggest problem of all with climate change is that it has become more about politics than about facts. It has become an essential credential for any conservative to deny that climate is changing. It is part of their public image, and most conservatives neither know nor care about evidence. Like Sarah Palin, they just know. In the USA especially, the argument is not really about climate at all. It is really about discrediting Barack Obama -a sort of swift-boat treatment that uses whatever lies are needed.
Just as with the great MMR fiasco and the promotion of its false link to autism, reports in newspapers and blogs must bear much of the blame for failing to inform readers of the actual underlying facts and, just as important, the uncertainties. Of course some papers have done a pretty good job, particularly the Guardian and the Independent in the UK, and the New York Times.. The political blogs, by and large, haven’t. The Huffington Post has made little effort (and publishes some appalling nonsense about medicine too).
The problem with political blogs and tabloid newspapers is that they are much more interested in sensation and circulation than they are in giving accurate news and information. Take, for example, the Guido Fawkes blog. To be fair, the blog itself says "The primary motivation for the creation of the blog was purely to make mischief at the expense of politicians and for the author’s own self-gratification. Its writer", so you know not to expect much, Paul Staines, was at the Westminster Skeptics event, Does Political Blogging Make a Difference? He makes no pretence of taking the news seriously, which, I guess, is why I don’t read his blog. After the talks I asked why his blog did little about climate change. His answer was "where are your sandals?". On the way home I tweeted, from a very overcrowded train (most trains from Euston being cancelled that night),
"On way home from #sitp political blogging. Learned that Guido serious about nothing but Guido. Narcissist not journalist."
At least one other person there agreed (thanks, Dave Cole).
It was good to hear Sunny Hundall of Liberal Conspiracy (the only one I read), but I found myself agreeing mostly with the chair, Nick Cohen. It would be a tragedy if the great national and local papers were to vanish. Guido Fawkes and Huffington Post are not remotely like proper newspapers.
Specialist blogs like this one are fine if you are interested in the topics we write about, but we don’t begin to supplant proper newspapers. Bloggers can and do occasionally get good stories. Those that are written by scientists can analyse more critically than most journalists have either the knowledge or the time to do. Bur they don’t come close to supplanting the detailed reporting in good newspapers of local events, what happens in law courts or in parliament. That’s why it is vital to buy newspapers, not just read them free on the web.
James Hayton, who is in nanoscience has posted his thoughts obout trust in science on his blog. I discovered this via Twitter (@James_Hayton). He also posted a beautiful clip from the Ascent of Man, in which Jacob Bronowski speaks, from Auschwitz, of the consequences of irrational dogma. I’m old enough to remember Bronowski on a 1950s radio programme, the Brains Trust, though James Hayton clearly isn’t. Now I enjoy equally his daughter, Lisa Jardine‘s talks about science and history.
1 March 2010. Phil Jones, and the vice-chancellor of the University of East Anglia, appeared before a parliamentary committee. I found their responses to questions very disappointing. The evidence submitted by the Institute of Physics was strongly worded, but spot on.
“The CRU e-mails as published on the internet provide prima facie evidence of determined and co-ordinated refusals to comply with honourable scientific traditions and freedom of information law. The principle that scientists should be willing to expose their ideas and results to independent testing and replication by others, which requires the open exchange of data, procedures and materials, is vital.”
7 March 2010. Thanks to some kind remarks from Michael Kenward (see first comment). I sought wider coverage of this item in the mainstream media. Consequently, on Thursday 4 March, a much shortened version of this article appeared on the Guardian environment site. That piece has accumulated so far, 230 comments. The discussion of it has spread to the two blogs that I recommended, Andy Russell’s blog and RealClimate.org, though it has been diverted onto the side-issue of the letter from the Institute of Physics. The seemingly innocent idea that total openness would increase trust has, to my real astonishment, resulted in hysterical accusations that I’m a crypto-denialist. The constant politically-motivated attacks on climate science seem to have induced a paranoid siege mentality in some of them. There is a real danger that such people will harm their own cause, and that would be tragic.
We have listed many reasons hear why you should never trust Boots. Here are the previous ones.
Can you trust Boots?
Don’t Trust Boots
Boots reaches new level of dishonesty with CoQ10 promotion
This post is about a "functional food". That is about something a bit more serious than homeopathy, though I’ll return to that standing joke in the follow-up, because of Boots’ latest shocking admission..
Alternative medicine advocates love to blame Big Pharma for every criticism of magic medicine. In contrast, people like me, Ben Goldacre and a host of others have often pointed out that the differences seem to get ever smaller between the huge Alternative industry (about $60 billion per year), and the even huger regular pharmaceutical industry (around $600 billion per year),
Boots are as good an example as any. While representing themselves as ethical pharmacists, they seem to have no compunction at all in highly deceptive advertising of medicines and supplements which are utterly useless rip-offs.
The easiest way to make money is to sell something that is alleged to cure a common, but ill-defined problem, that has a lot of spontaneous variability.. Like stress, for example.
The Times carried a piece Is Boots’s new Lactium pill the solution to stress?. Needless to say the question wasn’t answered. It was more like an infomercial than serious journalism. Here is what Boots say.
What does it do?
This product contains Lactium, a unique ingredient which is proven to help with the stresses of every day life, helping you through a stressful day. Also contains B vitamins, magnesium and vitamin C, which help to support a healthy immune system and energy levels.
Why is it different?
This one a day supplement contains the patented ingredient Lactium. All Boots vitamins and suppliers are checked to ensure they meet our high quality and safety standards.
So what is this "unique ingredient", Lactium? It is a produced by digestion of cow’s milk with trypsin. It was patented in 1995 by the French company, Ingredia, It is now distributed in the USA and Canada by Pharmachem. which describes itself as “a leader in the nutraceutical industry.” Drink a glass of milk and your digestive system will make it for you. Free. Boots charge you £4.99 for only seven capsules.
What’s the evidence?
The search doesn’t start well. A search of the medical literature with Pubmed for "lactium" produces no results at all. Search for "casein hydrolysate" gives quite a lot, but "casein hydrolysate AND stress" gives only seven, of which only one looks at effects in man, Messaoudi M, Lefranc-Millot C, Desor D, Demagny B, Bourdon L. Eur J Nutr. 2005.
There is a list of nineteen "studies" on the Pharmachem web site That is where Boots sent me when I asked about evidence, so let’s take a look.
Of the nineteen studies, most are just advertising slide shows or unpublished stuff. Two appear to be duplicated. There are only two proper published papers worth looking at, and one of these is in
rats not man. The human paper first.
Paper 1 Effects of a Bovine Alpha S1-Casein Tryptic Hydrolysate (CTH) on Sleep Disorder in Japanese General Population, Zara de Saint-Hilaire, Michaël Messaoudi, Didier Desor and Toshinori Kobayashi [reprint here] The authors come from France, Switzerland and Japan.
This paper was published in The Open Sleep Journal, 2009, 2, 26-32, one of 200 or so open access journals published by Bentham Science Publishers.
It has to be one of the worst clinical trials that I’ve encountered. It was conducted on 32 subjects, healthy Japanese men and women aged 25-40 and had reported sleeping disorders. It was double blind and placebo controlled, so apart from the fact that only 12 of the 32 subjects were in the control group, what went wrong?
The results were assessed as subjective sleep quality using the Japanese Pittsburg Sleep Quality Index (PSQI-J). This gave a total .score and seven component scores: sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction.
In the results section we read, for total PSQI score
"As shown in Table 2, the Mann-Whitney U-test did not show significant differences between CTH [casein tryptic hydrolysate] and Placebo groups in PSQI-J total scores at D0 (U=85; NS), D14 (U=86.5; NS), D28 (U=98.5; NS) and D35 (U=99.5; NS)."
Then we read exactly similar statements for the seven component scores. For example,. for Sleep Quality
As shown in Table 3, the Mann-Whitney U-test did not show significant differences between the sleep quality scores of CTH and Placebo groups at D0 (U=110.5; NS), D14 (U=108.5; NS), D28 (U=110; NS) and D35 (U=108.5; NS).
The discussion states
"The comparisons between the two groups with the test of Mann-Whitney did not show significant differences, probably because of the control product’s placebo effect. Despite everything, the paired comparisons with the test of Wilcoxon show interesting effects of CTH on sleep disorders of the treated subjects. "
Aha, so those pesky controls are to blame! But despite this negative result the abstract of the paper says
"CTH significantly improves the PSQI total score of the treated subjects. It particularly improves the sleep quality after two weeks of treatment, decreases the sleep latency and the daytime dysfunction after four weeks of treatment.
Given the antistress properties of CTH, it seems possible to relate the detected improvement of sleep aspects to a reduction of stress following its’ chronic administration."
So there seems to be a direct contradiction between the actual results and the announced outcome of the trial. How could this happen? The way that the results are presented make it hard to
tell. As far as I can tell, the answer is that, having failed to find evidence of real differences between CTH and placebo, the authors gave up on the placebo control and looked simply at the change
from the day 0 basleine values within the CTH group and, separately, within the placebo group. Some of these differences did pass statistical significance but if you analyse it
that way. there is no point in having a control group at all.
How on earth did such a poor paper get published in a peer-reviewed journal? One answer is that there are now so many peer-reviewed journals, that just about any paper, however poor, can get published
in some journal that describes itself as ‘peer-reviewed’. At the lower end of the status hierarchy, the system is simply broken.
Bentham Science Publishers are the publishers of the The Open Sleep Journal. (pity they saw fit to hijack the name of UCL’s spiritual founder, Jeremy Bentham). They publish 92 online and print journals, 200 plus open access journals, and related print/online book series. This publsher has a less than perfect reputation. There can be no scientist of any age or reputation who hasn’t had dozens of emails begging them to become editors of one or other of their journals or to write something for them. They have been described as a "pyramid scheme” for open access. It seems that every Tom, Dick and Harry has been asked. They have been described under the heading Black sheep among Open Access Journals and Publishers. More background can be found at Open Access News..
Most telling of all, a spoof paper was sent to a Bentham journal, The Open Information Science Journal. . There is a good account of the episode the New Scientist, under the title “CRAP paper accepted by journal”. It was the initiative if a graduate student at Cornell University. After getting emails from Bentham, he said “”It really painted a picture of vanity publishing”. The spoof paper was computer-generated rubbish, but it was accepted anyway, without comment. Not only did it appear that is was never reviewed but the editors even failed to notice that the authors said the paper came from the "Center for Research in Applied Phrenology", or CRAP. .The publication fee was $800, to be sent to a PO Box in the United Arab Emirates. Having made the point, the authors withdrew the paper.
Paper 5 in the list of nineteen stidies is also worth a look. It’s about rats not humans but it is in a respectable journal The FASEB Journal Express Article doi:10.1096/fj.00-0685fje (Published online June 8, 2001) [reprint here].
Characterization of α-casozepine, a tryptic peptide from bovine αs1-casein with benzodiazepine-like activity. Laurent Miclo et al.
This paper provides the basis for the claim that digested milk has an action like the benzodiazepine class of drugs, which includes diazepam (Valium). The milk hydrolysate, lactium was tested in rats and found to have some activity in tests that are alleged to measure effects on anxiety (I haven’t looked closely at the data, since the claims relate to humans).. The milk protein, bovine αS1 casein contains 214 amino acids. One of the many products of its digestion is a 10-amino-acid fragment (residues 91 -100) known as α-casozepine and this is the only product that was found to have an affinity for the γ-amino-butyric acid (GABA) type A receptors, which is where benzodiazepines are thought to act. There are a few snags with this idea.
- The affinity of α-casozepine peptide had 10,000-fold lower affinity for the benzodiazepine site of the GABAA than did diazepam, whereas allegedly the peptide was 10-fold more potent than diazepam in one of the rat tests.
- The is no statement anywhere of how much of the α-casozepine peptide is present in the stuff sold my Boots, or whether it can be absorbed
- And if digested milk did act like diazepam, it should clearly be callled a drug not a food.
What’s the conclusion about lactium?
Here is what I make of it.
Does it relieve stress? The evidence that it works any better than drinking a glass of milk is negligible. Tha advertising is grossly misleading and the price is extortionate.
Corruption of science. There is a more interesting aspect than that though. The case of lactium isn’t quite like the regular sort of alternative medicine scam. It isn’t inherently absurd, like homeopathy. The science isn’t the sort of ridiculous pseudo-scientific ramblings of magic medicine advocates who pretend it is all quantum theory The papers cited here are real papers, using real instruments and published in real journals,
What is interesting about that is that they show very clearly the corruption of real science that occurs at its fringes, This is science in the service of the dairy industry and in the service of the vast supplements industry. These are people who want to sell you a supplement for everything.
Medical claims are made for supplements, yet loopholes in the law are exploited to maintain that they are foods not drugs. The law and the companies that exploit it are deeply dishonest. That’s bad enough. but the real tragedy is when science itself is corrupted in the service of sales.
Big Pharma and the alternative industry. Nowhere is the slose alliance between Big Pharma and the alternative medicine industry more obvious than in the supplement and nutriceutical markets. Often the same companies run both. Their aim is to sell you thinks that you don’t need, for conditions that you may well not have, and to lighten your wallet in the process. Don’t believe for a moment that the dark-suited executives give a bugger about your health. You are a market to be exploited.
If you doubt that, look from time to time at one of the nutraceutical industry web sites, like nutraingredients.com. They even have a bit to say about lactium. They are particularly amusing at the moment because the European Food Safety Authority (EFSA) has had the temerity to demand that when health claims are made for foods, there is actually some small element of truth in the claims. The level of righteous indignation caused in the young food industry executives at the thought that they might have to tell the truth is everywhere to see. For example, try Life in a European health claims wasteland. Or, more relevant to Lactium, Opportunity remains in dairy bioactives despite departures. Here’s
a quotation from that one.
“Tage Affertsholt, managing partner at 3A Business Consulting, told NutraIngredients.com that the feedback from industry is that the very restrictive approach to health claims adopted by the European Food Safety Authority (EFSA) will hamper growth potential.”
“Affertsholt said: “Some companies are giving up and leaving the game to concentrate on more traditional dairy ingredients.”
Science and government policy
It may not have escaped your notice that the sort of low grade, corrupted, fringe science described here, is precisely the sort that is being encouraged by government policies. You are expected to get lots of publications, so never mind the details, just churn ’em out; The hundreds of new journals that have been created will allow you to get as meny peer-reviwed publications as you want without too much fuss, and you can very easily put an editorship of one of them on your CV when you fill in that bit about indicators of esteem. The box tickers in HR will never know that it’s a mickey mouse journal.
Boots own up to selling crap
Although this post was nothing to do with joke subjects like homeopathy, it isn’t possible to write about Boots without mentioning the performance of their professional standards director, Paul Bennett, when he appeared before the Parliamentary Select Committee for Science and Technology.. This committee was holding an “evidence check” session on homeopathy (it’s nothing short of surreal that this should be happening in 2009, uh?). The video can be seen here, and an uncorrected transcript. It is quite fun in places. You can also read the written evidence that was submitted.
Even the Daily Mail didn’t misss this one. Fioana Macrae wrote Boots boss admits they sell homeopathic remedies ‘because they’re popular, not because they work’
“It could go down as a Boot in Mouth moment.
Yesterday, the company that boasts shelf upon shelf of arnica, St John’s wort, flower remedies and calendula cream admitted that homeopathy doesn’t necessarily work.
But it does sell. Which according to Paul Bennett, the man from Boots, is why the pharmacy chain stocks such products in the first place.
Mr Bennett, professional standards director for Boots, told a committee of MPs that there was no medical evidence that homeopathic pills and potions work.
‘There is certainly a consumer demand for these products,’ he said. ‘I have no evidence to suggest they are efficacious.
‘It is about consumer choice for us and a large number of our customers believe they are efficacious.’
His declaration recalls Gerald Ratner’s infamous admission in 1991 that one of the gifts sold by his chain of jewellers was ‘total crap’.”
The Times noticed too, with Boots ‘labels homeopathy as effective despite lack of evidence‘.
Now you know that you can’t trust Boots. You heard it from the mouth of their professional standards director.
A commentary on the meeting by a clinical scientist summed up Bennett’s contribution thus
"Paul Bennett from Boots had to admit that there was no evidence, but regaled the committee with the mealy-mouthed flannel about customer choice that we have come to expect from his amoral employer."
The third session of the Scitech evidence check can be seen here, and the uncorrected transcript is here. It is, in a grim way, pure comedy gold, More of that later.
Being interested in science communication, I was pleased when the BMJ asked me to review Unscientific America , by Chris Monney and Sheril Kirshenbaum.
The BMJ provides a link that allows you access to the whole review. They have made very few changes from the submitted version, which is reproduced below (with live links in the text. [Download pdf of print version]
I very soon discovered that the book had already caused ructions in the USA, as a result of its advocacy of appeasement of religious groups. In particular there was all out war with P.Z.Myers, whose very popular blog, Pharyngula. documented the battle in detail).
It is an American book through and through, and in the USA the biggest threat to reason comes from the far-right religious fundamentalists who preach young-earth creationism. It is said that 46% of US citizens believe that the earth is less than 10,000 years old. The same far-right religious groups also preach that carrying guns is good, that Iraq was responsible for 9/11, that climate change is a socialist conspiracy and that health care for everyone is a communist plot. And they never hesitate to lie in the promotion of their ‘religious’ views. The US situation is totally different from that in Europe, where religion is all but dead, and young earth creationism is the preserve of a few cranky used-car dealers (and possibly Tony Blair?)
Review of the Week
Trust me, I’m a scientist
David Colquhoun, professor of pharmacology, University College London
Unscientific America sounds like a fascinating topic, not least because the book is a follow-up from Mooney’s The Republican War on Science. It is written entirely from a US perspective (the USA sequenced the genome and invented the internet, apparently unaided). It’s reported that 46 percent of Americans believe that the earth is less than 10,000 years old. That’s certainly cause for alarm and Mooney & Kirshenbaum are certainly alarmed. They think that the public needs to be educated in science. They identify the obvious problems, evolution, climate change and quackery and ask what can be done. The problem is that they propose no good solutions, and some bad ones. Their aims are worthy but sometimes the book reads like an over-long and somewhat condescending whine about why science and scientists are not sufficiently appreciated.
I simply don’t think that it’s true that the public are not interested in science, nor that they can’t understand it at a level that is sufficient to be useful. It’s true that they have been let down badly by some sections of the media. Think particularly of the “great MMR hoax”1. The disastrous fall in vaccination is more attributable to talk show presenters and air-headed celebrities than to lack of interest from the public. People are systematically deceived by anti-vaxers, climate change denialists, vitamin pill salesmen and a horde of crackpot alternative therapists.
There is one problem that Mooney & Kirshenbaum don’t talk about at all, yet it seems to me to be one of the biggest problems in science communication. It isn’t lack of interest by the public, nor even lack of understanding, but lack of trust. The tendency of real science to indulge in hyperbolic self-promotion is one reason for the lack of trust. Sometimes this descends into outright dishonesty2,3. That is a tendency that is promoted by government and funding agencies by their insistence on imposing silly performance measures. The public is quite sensible enough to take with a pinch of salt the almost daily announcements of “cancer cures” that emanate from university press offices.
On the face of it, one should be encouraged that ‘public engagement in science’ is the mode du jour. It isn’t quite that simple though. Only too often, universities regard public engagement as a branch of their own PR machine4. They even instruct you about what tone of voice to use when talking publicly.
One reason why scientists need to talk to people outside the lab is precisely to counteract this tide of nonsense from PR people, who are paid to deceive. The problem for academics is usually time. We already do three jobs, teaching, research and coping with HR bollocks. How can we find time for a fourth job? That’s not easy, especially for the best researchers (those that do research themselves, not just lead a team). Mooney & Kirshenbaum suggest that the solution is to create a “cadre of communication and outreach experts”. I don’t think this would work. They would, by and large, be outsiders, writing uncritical paeans, dictated by big name scientists. A new cadre of PR hangers-on does not sound like a great idea. A better, and very much cheaper, solution would be to provide a course in free blogging software and we’ll do it ourselves.
The two chapters that I looked forward to reading, on religion and on “The bloggers cannot save us”, proved deeply disappointing. The authors are firmly in the camp of what Richard Dawkins called the “Neville Chamberlain school of evolutionists&rdquo.; They maintain “if the goal is to create an America more friendly to science and reason, the combativeness of the New Atheists is strongly counterproductive”. They are particularly critical of P.Z. Myers5, the University of Minnesota developmental biologist who is splendidly clear in his views. Of the communion wafer, he famously said “It’s a frackin’ cracker”. But he, and Dawkins, are right. When it comes to young earth creationists we have a war on our hands, and nowhere more than in the USA. What’s more it’s a winnable war. Mooney & Kirshenbaum are all for appeasement, but appeasement won’t work. It might please the more moderate wings of the church, but they already believe in evolution and are regarded by fundamentalists as being just as big an enemy as Myers and Dawkins. And, one must ask, who has done best at getting a wide public readership? P.Z Myers’ blog, Pharyngula, has up to two million page views a month. Dawkins’ book The God Delusion has sold three million copies. In comparison the bland and often rather condescending corporate science web sites get tiny numbers of hits.
In Europe in general, and the UK in particular, young earth creationists are not the major problem that they are in the USA, despite being supported by Tony Blair6. Perhaps the nearest analogy in Europe is the threat to reason from various sorts of crackpot medicine. The appeasers are widespread. The Royal Colleges and the Department of Health are at the forefront of the Neville Chamberlain approach. But appeasement hasn’t worked there either. What has worked is the revelation that university courses are teaching that “amethysts emit high yin energy”7. Or, in a lecture on herbal approaches for patients with cancer, “Legally, you cannot claim to cure cancer. This is not a problem because: ‘we treat people, not diseases’ “8. This is shocking stuff but it has not been unearthed by the corporate media, but by bloggers.
I think Mooney and Kirshenbaum have it all wrong. They favour corporate communications, which are written by people outside science and which easily become mere PR machines for individuals and institutions. Such blogs are rarely popular and at their worst they threaten the honesty of science. More and more individual scientists have found that they can write their own blog. It costs next to nothing and you can say what you think. A few clicks and the world can read what you have to say. Forget corporate communications. Just do it yourself. It’s fun. And think of the money you’d save for doing science if the PR people were just fired.
(1) Goldacre, B. The media’s MMR hoax. 2008 http://www.badscience.net/2008/08/the-medias-mmr-hoax/
(2) PLoS One. Ghostwriting documents now fully available on PLoS Medicine website. 21-8-2009 http://speakingofmedicine.plos.org/2009/08/21/ghostwriting-documents-now-fully-available-on-plos-medicine-website/
(3) Colquhoun, D. Universities Inc. in the UK. The Corporate Corruption of Higher Education: part 2. 6-12-2007 http://www.dcscience.net/?p=193
(4) Corbyn, Z. Nottingham raises eyebrows over definition of ‘public engagement’. 21-8-2008 http://www.timeshighereducation.co.uk/story.asp?sectioncode=26&storycode=403234
(5) Myers, P. Z. Pharyngula. 2009 http://scienceblogs.com/pharyngula/
(6) Pyke, N. Revealed: Blair’s link to schools that take the Creation literally (Independent 13 June 2004). 13-7-2004 http://www.independent.co.uk/news/uk/politics/revealed-blairs-link-to-schools-that-take-the-creation-literally-732032.html
(7) Colquhoun, D. Westminster University BSc: "amethysts emit high yin energy". 23-4-2008 http://www.dcscience.net/?p=227
(8) Colquhoun, D. Herbal approaches for patients with cancer. 10-8-2009 http://www.dcscience.net/?p=2043
P.Z. Myers has posted about thie book review, on Pharyngula, as Is this book dead yet? There are a lot more comments there than here, though few of them address the question of science communications..
Butterflies and Wheels is generating a lot of hits
Sense about Science have just produced a rather good pamphlet that exposes, yet again. the meaningless marketing slogan “detox”. You can download the pamphlet from their web site.
The pamphlet goes through the claims of eleven products. Needless to say, the claims are either meaningless, or simply untrue.
- Garnier Clean Detox Anti-Dullness Foaming Gel
“Detoxifies by cleansing the skin’s surface”
- MG Detox Shampoo Trevor Sorbie
“Deep cleansing and clarifying shampoo”
- Boots Detox Body Brush
“Ritualistic body brushing helps expel toxins through the skin”
- Innocent Natural Detox Smoothie
“Helps neutralise nasty free radicals which can cause damage to your body’s cells”
- Vitabiotics Detoxil 15 day support
“Helps the body cleanse itself of toxins and pollutants caused by the excesses of a busy life”
- V-Water Detox
“Cleanse your system and whisk away the polluting nasties”
- 4321 Shape Up and Detox
“To drain off water and toxins” and “purify the body”
- Boots Detox 5 Day Plan
Works “in harmony with your body to flush away toxins”
- Farmacia Spa Therapy Detox range
To “rid your body of these damaging toxins”
- Crystal Spring Detox patches
“I’m the easy way to detox, just put me on one foot at night and take me off in the morning”
- Fushi Holistic and Health Solutions Total Detox Patch
“it acts as a toxin sink and absorbs impurities through your feet”
One nice thing about the pamphlet is that each item is written by a young scientist (including my close neighbour, Daniella Muallem). They are all people at an early stage in their career, but they care enough to spend time dissecting the rubbish spread by companies in order to part you from your money.
Garnier, it’s true, is a cosmetics company, so one expects nothing but lies You won’t be disappointed on that score.
That least ethical of pharmaceutical companies, Boots, appears twice The Boots Detox Body Brush is reviewed by a young chemist, Tom Wells. It turns out (there’s a surprise) to be nothing more than an ordinary stiff brush. It seems that Boots’ definition of “detox”, for this purpose, is “removing dead skin cells” A totally shameless con, in other words.
The Boots Detox 5 day plan consists if 5 phials of apple or strawberry flavoured goo containing two vitamins and one mineral, mixed with glycerol. In this case the young investigator, Evelyn Harvey, elicited a quite remarkable response from Boots.
Well, have you tested the effects of that diet, with or without the detox product? Does the ‘goo’ stuff [the drink which forms part of the plan] add anything extra?
Well, it’s meant to kick start it.
But has is been tested like that?
Ok, I’m thinking I’ll just try a healthy diet for a week, a bit more exercise, and not bother with buying the detox.
Yes, that sounds like a better idea, to be honest I’d never do this myself.
The media coverage
The Radio 4 Today programme interviewed Ben Goldacre and the managing director of yet another product “Detox in a box” (following their usual policy of equal time for the Flat Earth Society). Listen to the mp3. When Ben Goldacre asked the MD for evidence for the claim made on the web site of Detox in a box, that their diet could remove cadmium from the body, it was denied explicitly that any such claim had been made.
But by 10.02 the site had already changed
So no apology for the mistake. Just a sneaky removal of a few words.
That seems to be the only change though. All the rest of the nutribollocks is still there. For example
There isn’t the slightest reason to believe that it will “improve our immune function”.
There isn’t the slightest reason to think that scavenging free radicals would do you any good, even if it happened.
There isn’t the slightest reason to think it will strengthen body’s fight against cancer cells (that looks like a breach of the Cancer Act to me).
“Cleansing mucous” doesn’t mean much, but whatever it is there isn’t any reason to think its true.
“Purify our blood”. Total meaningless bollocks. The words mean nothing at all. I’ve been here before.
Ben Goldacre’s own account is here “The barefaced cheek of these characters will never cease to amaze and delight me.”
The BBC web site does a good job too.
The Guardian gives an excellent account (James Randerson).
The Daily Mail writes “Detox diets to kick-start the New Year are a ‘total waste of money’ “.
Medical News Today write “Debunking The Detox Myth“.
The Daily Telegraph disgraces itself by not only failing to carry a decent account of the item, but it does run an article on “Detox holidays: New year, new you“. Mega-expensive holidays for the mega-stupid (not to mention the capital letter after the colon).
The Daily Mash provides a bit of cognate fun with “BRITAIN SIGNS UP FOR VORDERMAN’S 28-DAY PISS-DRINK DETOX“. That alludes to “Carol Vorderman’s 28-Day Detox Diet”. A woman who got an enormous salary for playing a parlour game on TV, and has done some good for maths education, is reduced to promoting nonsense for yet more money.
As Clive James pointed out, it’s a but like watching George Clooney advertising coffee for, of all unethical companies, Nestlé. They really look very silly.
Evening Standard 6th January. Nick Cohen writes “Give up detox – it’s bad for your health”
“Giving up on detox should not be painful, however. On the contrary, it should e a life-enhancing pleasure.”
The Times. rather later (January 18th) had a lovely one, “Detox
Debunked“, by the inimitable Ben Goldacre, His account of /detox; as a quasi-religious ‘cleansing ritual’, is spot on.
We know all about the sixteen or so universities that run “BSc” degrees in hokum. They are all “post-1992” universities, which used to be polytechnics. That is one reason why it saddens me to see them destroying their own attempts to achieve parity with older universities by running courses that I would regard as plain dishonest.
Older universities do not run degree courses in such nonsense. Academics (insofar as they still have any influence) certainly would not put up with it if they tried. But nevertheless you can find quackery in some of the most respected universities, and it gets there not via academics but (guess what) via Human Resources. It creeps in through two routes. One is the “training courses” that research staff now have to do (the “Roberts agenda”). The other route is through occupational health services.
Quackery in training courses
It isn’t easy to find out what happens elsewhere, but I was certainly surprised to find out that UCL’s own HR department was offering a course that promised to teach you the “core principles” of Brain Gym and Neurolinguistic Programming, both totally discredited bits of psycho-babble, more appropriate to the lifestyle section of a downmarket.women’s magazine than a university. I gather that HR’s reaction after I brought this to light was not to ask what was wrong with it, but just to get angry.
In a spirit of collegiality I offered to run a transferable skills course myself. I even offered to do it for nothing (rather than the rumoured £700 per day charged by the life style consultants). I proposed a course in ‘How to read critically’ (subtitle ‘How to detect bullshit’). This seems to me to be the ultimate transferable skill. Bullshit occurs in every walk of life. My proposal was moderately worded and perfectly serious.
Guess what? Despite several reminders, I have never had any response to my suggestion. Well, I suppose that HR people now regard themselves as senior to mere professors and there is really no need to reply to their
Quackery in occupational health. Leicester sets a good example
If you work at a university, why not search the university’s web site for “complementary medicice” or complementary therapies”. If it is a real university, you won’t find any degrees in homeopathy, or in amethysts
that emit high yin energy. But some quite surprising places are found to be recommending magic medicine through their Occupational Health service, which usually seems to be part of HR. In fact at one time even UCL was doing it, but no soon had somebody sent me the link than it disappeared. As a matter of historical record, you can see it here (it had all the usual junk, as well as harmless stuff like yoga and pilates).
While looking for something else I stumbled recently some other cases. One was at the University of Leicester, a very good university (and alma mater to the great David Attenborough who must have done more to point out the beauty of science than just about anyone). But we find on their staff wellbeing site, alongside some perfectly sensible stuff, a link to complementary therapies.
The list of ‘therapies’ includes not only the usual placebos, acupuncture, reiki, reflexology, but, even more exotically, a fraudulent Russian device called SCENAR therapy. They have a nice leaflet that explains all these things in words that run the whole gamut from meaningless gobbledygook to plain wrong. Here are some examples from the leaflet.
“In the feet, there are reflex areas corresponding to all the parts of the body and these areas are arranged in such a way as to form a map of the body in the feet”
Reflexology has been shown to be effective for:
- Back Pain
Well no, there are no such areas in your feet. That is sheer imagination. And reflexology has not “been shown to be effective” for any of those conditions. These claims for therapeutic efficacy are not only lies. They are also illegal.
Each hand position is held for a few minutes, and during this time healing energy will flow into you, balancing your energy system, releasing stress, soothing pain, and promoting your body’s natural ability to heal itself.”
This is sheer idiotic mumbo-jumbo. The “flow of healing energy” is totally imaginary. Such talk is offensive to anyone with half a brain. Insofar as they claim to heal anything, it is also illegal. The comes SCENAR.
“What is SCENAR?
SCENAR is an acronym for Self Controlled Energo- Neuro Adaptive Regulator. It is a reflex biofeedback device which when used by a qualified practitioner, can help to alleviate acute and chronic pain. It is licensed in the UK for pain relief but experience has shown that it is helpful in a wide variety of conditions.”
This is even more seriously nuts than the others. The term “licensed” means merely that it is electrically safe. It certainly does not mean that it works. Pubmed shows only three publications about the SCENAR device, all in Russian,
One sales site (apparently Russian) makes the following modest claim.
“A prime goal of the Russian Space Program was to provide space travelers with a portable medical device that would become their “universal medical assistant” in space. So from the beginning, the SCENAR was designed to replace an entire medical hospital, with all its staff, diagnostic and treatment facilities, even the pharmacy. A universal, non-invasive, portable regulator of body functions (among other things) was envisaged.”
The SCENAR device (right) looks like a TV remote control (perhaps it IS a TV remote control -we aren’t anywhere told in comprehensible terms what’s in the box. The Russian site sells also the rather baffling accessory on the right. The mind boggles.
Remote rectal-vaginal electrode for SCENAR
How does this rubbish get onto the web site of a good university?
I presume that it is just another sign of what happens when universities come to be run by non-academics. No doubt the occupational health people are well meaning and kind, but just scientifically illiterate. What about the HR person in charge of them? They are not known for scientific literacy either (which would not matter if they stuck to their job). But perhaps they just didn’t notice. There is only one way to find out. Ask. So I sent this letter.on 10th September.
I am a pharmacologist and I have a side interest in public understanding of science, alternative medicine.and medical fraud
I was quite surprised when Google led me unexpectedly to your complementary therapies page at http://www.le.ac.uk/staffwellbeing/complementary_therapy.html
There is, sad to say, a great deal of information on these pages that is simply not true. For example it has NOT been shown that reflexology has been shown to be effective in any of the conditions which you list, as far as I know
To take only one more example from this page, the SCENAR device is an even more extreme example. It is well known to be fraudulent. and has been investigated by the Washington State Attorney General.
This sort of thing is not what one would expect from a very respectable university, and it must be a great embarrassment to your excellent medical scientists.
Apart from the many scientific inaccuracies (which greatly impede the efforts of those of us who try to improve public understanding of science), you are, I hope, aware that there is a legal aspect.
Since May this year, new regulations have made it illegal to make claims for health benefits if evidence cannot be produced to show that the claims are justified. I would like to put it to you that many of the claims made on this page are not only immoral, but also illegal.
I wondered whether you , or your HR department, would like to make any comments
I got an immediate and very sympathetic response from the Director of HR and a week later, on17th September, he wrote
I have discussed the matter with my manager of Staff Counselling and Welfare and have agreed that it is probably safest that we remove the references to ‘complimentary’[sic] therapies from the site entirely.
Thank you for your helpful input and the recommendations for reading matter.”
So there is a lesson here. If you find this sort or stuff on your own institution’s web site, all that may be needed is a simple letter that points out what nonsense it is. Admittedly the HR man seemed rather more worried about whether the claims were illegal than whether they were true, but either way, it worked.
Only one little snag. As of 6 October the pages still have not been removed.
On the assumption that they eventually will be removed, I have kept copies of the Wellbeing page, of the Complementary Therapies page, and of the ‘explanatory leaflet’. They stand as part of a historical record that
shows, once again, what can happen when scientific matters get into the hands of HR. Fortunately Leicester University has an HR director who is willing to listen to advice.
Something seems to have gone seriously wrong. Despite the rapid response, virtually all the nonsense is still there on 13th October. It seems not to be so simple after all.
And despite several reminders, the advertisement for SCENAR ‘therapy’ is still on the University web site on December 14th. I know that no decision by HR can be made with fewer than 25 meetings and an awayday in Majorca, but this is getting ridiculous.
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.
“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?
We have often had cause to criticise Boots Alliance, the biggest retail pharmacist in the UK, because of its deeply unethical approach to junk medicine. Click here to read the shameful litany. The problem of Boots was raised recently also by Edzard Ernst at the Hay Literary Festival. He said
“The population at large trusts Boots more than any other pharmacy, but when you look behind the smokescreen, when it comes to alternative medicines, that trust is not justified.”
Ernst accused Boots of breaching ethical guidelines drawn up by the Royal Pharmaceutical Society of Great Britain, by failing to tell customers that its homeopathic medicines contain no active ingredients and are ineffective in clinical trials.
Another chain, Lloyds Pharmacy, are just as bad. Many smaller pharmacies are no more honest when it comes to selling medicines that are known to be ineffective.
Pharmacists are fond of referring to themselves as “professionals” who are regulated by a professional body, the Royal Pharmaceutical Society of Great Britain (RPSGB). It’s natural to ask where their regulatory body stands on the question of junk medicine. So I asked them, and this is what I found.
|17 April, 2008
I am writing an article about the role of pharmacists in giving advice about (a) alternative medicines and (b) nutritional supplements.
I can find no clear statements about these topics on the RPSGB web site.
Please can you give me a statement on the position of the Royal Pharmaceutical Society on these two topics.
In particular, have you offered guidance to pharmacists about how to deal with the conflict of interest that arises when they can make money by selling something that they know to have no good evidence for efficacy? This question has had some publicity recently in connection with Boots’ promotion of CCoQ10 to give you “energy”, and only yesterday when the bad effects of some nutritional supplements were in the news.
Here are some extracts from the first reply that I got from the RPSGB’s Legal and Ethical Advisory Service (emphasis is mine).
|28 April 2008
Pharmacists must comply with the Code of Ethics and its supporting documents. Principle 5 of the Code of Ethics requires pharmacists to develop their professional knowledge and competence whilst Principle 6 requires pharmacists to be honest and trustworthy.
The Code states:
5. DEVELOP YOUR PROFESSIONAL KNOWLEDGE AND COMPETENCE
At all stages of your professional working life you must ensure that your knowledge, skills and performance are of a high quality, up to date and relevant to your field of practice. You must:
5.1 Maintain and improve the quality of your work by keeping your knowledge and skills up to date, evidence-based and relevant to your role and responsibilities.
5.2 Apply your knowledge and skills appropriately to your professional responsibilities.
5.3 Recognise the limits of your professional competence; practise only in those areas in which you are competent to do so and refer to others where necessary.
5.4 Undertake and maintain up-to-date evidence of continuing professional development relevant to your field of practice.
6. BE HONEST AND TRUSTWORTHY
Patients, colleagues and the public at large place their trust in you as a pharmacy professional. You must behave in a way that justifies this trust and maintains the reputation of your profession. You must:
6.2 Ensure you do not abuse your professional position or exploit the vulnerability or lack of knowledge of others.
6.3 Avoid conflicts of interest and declare any personal or professional interests to those who may be affected. Do not ask for or accept gifts, inducements, hospitality or referrals that may affect, or be perceived to affect, your professional judgement.
6.4 Be accurate and impartial when teaching others and when providing or publishing information to ensure that you do not mislead others or make claims that cannot be justified.
And, on over-the counter prescribing
|In addition the “Professional Standards and Guidance for the Sale and Supply of Medicines” document which supports the Code of Ethics states:
“2. SUPPLY OF OVER THE COUNTER (OTC) MEDICINES
When purchasing medicines from pharmacies patients expect to be provided with high quality, relevant information in a manner they can easily understand. You must ensure that:
2.1 procedures for sales of OTC medicines enable intervention and professional advice to be given whenever this can assist the safe and effective use of medicines. Pharmacy medicines must not be accessible to the public by self-selection.
Evidence-based? Accurate and impartial? High quality information? Effective use?
These words don’t seem to accord with Boots’ mendacious advertisements for CoQ10 (which were condemned by the ASA).
Neither does it accord with the appalling advice that I got from a Boots pharmacist about Vitamin B for vitality.
Or their bad advice on childhood diarrhoea.
Or the unspeakable nonsense of the Boots (mis)-education web site.
Then we get to the nub. This is what I was told by the RPSGB about alternative medicine (the emphasis is mine).
|8. COMPLEMENTARY THERAPIES AND MEDICINES
You must ensure that you are competent in any area in which you offer advice on treatment or medicines. If you sell or supply homoeopathic or herbal medicines, or other complementary therapies, you must:
8.1 assist patients in making informed decisions by providing them with necessary and relevant information.
8.2 ensure any stock is obtained from a reputable source.
8.3 recommend a remedy only where you can be satisfied of its safety and quality, taking into account the Medicines and Healthcare products Regulatory Agency registration schemes for homoeopathic and herbal remedies.”
Therefore pharmacists are required to keep their knowledge and skills up to date and provide accurate and impartial information to ensure that you do not mislead others or make claims that cannot be justified.
It does seem very odd that “accurate and impartial information” about homeopathic pills does not include mentioning that they contain no trace of the ingredient on the label. and have been shown in clinical trials to be ineffective. These rather important bits of information are missing from both advertisements and from (in my experience) the advice given by pharmacists in the shop.
If you look carefully, though, the wording is a bit sneaky. Referring to over-the-counter medicines, the code refers to “safe and effective use of medicines”, but when it comes to alternative medicines, all mention of ‘effectiveness’ has mysteriously vanished.
So I wrote again to get clarification.
|29 April, 2008
Thanks for that information. I’d appreciate clarification of two matters in what you sent.
(1) Apropros of complementary and alternative medicine, the code says
8.3 recommend a remedy only where you can be satisfied of its safety and quality
I notice that this paragraph mentions safety and quality but does not mention efficacy. Does this mean that it is considered ethical to recommend a medicine when there is no evidence of its efficacy? Apparently it does. This gets to the heart of my question and I’d appreciate a clear answer.
This enquiry was followed by a long silence. Despite several reminders by email and by telephone nothing happened until eventually got a phone call over a month later (May 3) from David Pruce, Director of Practice & Quality Improvement, Royal Pharmaceutical Society of Great Britain. The question may be simple, but the RPSGB evidently it hard, or more likely embarrassing, to answer.
When I asked Pruce why para 8.3 does not mention effectiveness, his reply, after some circumlocution, was as follows.
Pruce: “You must assist patients in making informed decisions by providing necessary and relevant information . . . we would apply this to any medicine, the pharmacist needs to help the patient assess the risks and benefits.”
DC: “and would that include saying it doesn’t work better than placebo?”
Pruce “if there is good evidence to show that itmay, but it depends on what the evidence is, what the level of evidence is, and the pharmacist’s assessment of the evidence”
DC “What’s your assessment of the evidence?”
Pruce, “I don’t think my personal assessment is relevant. I wouldn’t want to be drawn on my personal assessment”. “If a pharmacist is selling homeopathic medicines they have to assist the patient in making informed decisions”
“I don’t think we specifically talk about the efficacy of any other medicine” [DC: not true, see para 2.1, above]
“We would expect pharmacists to be making sure that what they are providing to a patient is safe and efficacious”
DC “So why doesn’t it mention efficacious in para 8.3”
Pruce “What we are trying to do with the Code of Ethics is not go down to the nth degree of detail ” . . . “there are large areas of medicine where there is an absence of data”
DC “Yes, actually homeopathy isn’t one of them. It used to be.”
Pruce. “uh, that’s again a debatable point”
DC I don’t think it’s debatable at all, if you’ve read the literature
Pruce. “well many people would debate that point” “This [homeopathy] is a controversial area where opinions are divided on it”
DC “Not informed opinions”
Pruce “Well . . . there are also a large number of people that do believe in it. We haven’t come out with a categorical statement either way.”
I came away from this deeply unsatisfactory conversation with a strong impression that the RPSGB’s Director of Practice & Quality Improvement was either not familiar with the evidence, or had been told not to say anything about it, in the absence of any official statement about alternative medicine.
I do hope that the RPSGB does not really believe that “there are also a large number of people that do believe in it” constitutes any sort of evidence.
It is high time that the RPSGB followed its own code of ethics and required, as it does for over-the-counter sales, that accurate advice should be given about “the safe and effective use of medicines”.
“The scientist on the High Street”
The RPS publishes a series of factsheets for their “Scientist in the High Street” campaign. One of these “factsheets” concerns homeopathy, [download pdf from the RPSGB]. Perhaps we can get an answer there?
Well not much. For the most part the “factsheet” just mouths the vacuous gobbledygook of homeopaths. It does recover a bit towards the end, when it says
“The methodologically “best” trials showed no effect greater than that of placebo”.
But there is no hint that this means pharmacists should not be selling homeopathic pills to sick people..
That is perhaps not surprising, because the Science Committee of the RPSGB copped out of their responsibility by getting the factsheet written by a Glasgow veterinary homeopath, Steven Kayne. You can judge his critical attitude by a paper (Isbell & Kayne, 1997) which asks whether the idea that shaking a solution increases its potency. The paper is a masterpiece of prevarication, it quotes only homeopaths and fails to come to the obvious conclusion. And it is the same Steven Kayne who wrote in Health and Homeopathy (2001)
“Homeopathy is not very good for treating bacterial infections directly, apart from cystitis that often responds to a number of medicines, including Berberis or Cantharis”.
So there is a bacterial infection that can be cured by pills that contain no medicine? Is this dangerous nonsense what the RPSGB really believes?
More unreliable advice
While waiting for the train to Cardiff on April 16th (to give a seminar at the Welsh School of Pharmacy), I amused myself by dropping into the Boots store on Paddington station.
|DC I’ve seen your advertisements for CoQ10. Can you tell me more? Will they really make me more energetic?
Boots: Yes they will, but you may have to take them for several weeks.
DC. Several weeks? Boots: yes the effect develops only slowly
Peers at the label and reads it out to me
DC I see. Can you tell me whether there have been any trials that show it works?
Boots. I don’t know. I’d have to ask. But there must be or they wouldn’t be allowed to sell it.
DC. Actually there are no trials, you know
Boots. Really? I didn’t think that was allowed. But people have told me that they feel better after taking it.
DC You are a pharmacist?
Sadly, this abysmal performance is only too typical in my experience, Try it yourself.
The malaria question
After it was revealed that pharmacists were recommending, or tolerating recommendations, of homeopathic treatment of malaria, the RPSGB did, at last. speak out. It was this episode that caused Quackometer to write his now famous piece on ‘The gentle art of homeopathic killing‘ (it shot to fame when the Society of Homeopaths tried to take legal action to ban it) Recommending pills that contain no medicine for the treatment or prevention or treatment of malaria is dangerous. If it is not criminal it ought to be [watch the Neals Yard video]. .
The RPSGB says it is investigating the role of pharmacists in the Newsnight sting (see the follow-up here). That was in July 2006, but they are stlll unwilling to say if any action will be taken. Anyone want to bet that it will be swept under the carpet?
The statement issued by the RPSGB, 5 months after the malaria sting is just about the only example that I can find of them speaking out against dangerous and fraudulent homeopathic practices. Even in this case, it is pretty mild and restricted narrowly to malaria prevention.
The RPSGB and the Quacktioner Royal
The RPSGB submitted a response to the ‘consultation’ held by the Prince’s Foundation for Integrated Health, about their Complementary Healthcare; a guide for patients.
|Response by the Royal Pharmaceutical Society of Great Britain
Dr John Clements, Science Secretary
“We believe that more emphasis should be given to the need for members of the public who are purchasing products (as opposed to services) to ask for advice about the product. Pharmacists are trained as experts on medicines and the public, when making purchases in pharmacies, would expect to seek advice from pharmacists”
So plenty of puffery for the role of pharmacists. But there is not a word of criticism about the many barmy treatments that are included in the “Guide for Patients”. Not just homeopathy and herbalism, but also Craniosacral therapy, Laying on of Hands, chiropractic, Reiki, Shiatsu –every form of barminess under the sun drew no comment from the RPS.
I can’t see how a response like this is consistent with the RPS’s own code of ethics.
A recent president of the RPSGB was a homeopath
|Christine Glover provides perhaps the most dramatic reason of all for thinking thst, despite all the fine words, the RPSGB cares little for evidence and truth The NHS Blogdoctor published “Letter from an angry pharmacist”.|
Mrs Glover was president of the RPSGB from 1999 to 2001, vice-president in 1997-98, and a member of the RPSGB Council until May 2005. She is not just a member, but a Fellow. (Oddly, her own web site says President from 1998 – 2001.)
So it is relevant to ask how the RPSGB’s own ex-president obeys their code of ethics. Here are some examples on how Ms Glover helps to assist the safe and effective use of medicines. . Much of her own web site seems to have vanished (I wonder why) so I’ll have to quote the “Letter from an angry pharmacist”., as revealed by NHS Blogdoctor,
“What has Christine got to offer?
- “We offer a wide range of Homeopathic remedies (over 3000 different remedies and potencies) as well as Bach flower remedies, Vitamins, Supplements, some herbal products and Essential Oils.”
- Jetlag Tablets highly recommended in ‘Wanderlust’ travel magazine. Suitable for all ages.
- Wind Remedy useful for wind particularly in babies. In can be supplied in powder form for very small babies. Granules or as liquid potency.
- Udder Care 100ml £80.00 One capful in sprayer filled with water. Two jets to be squirted on inner vulva twice daily for up to 4 days until clots reduced. Discard remainder. Same dose for high cell-counting cows detected.
Udder Care? Oh! I forgot to say, “Glover’s Integrated Healthcare” does cows as well as people. Dr Crippen would not suggest to a woman with sore breasts that she sprayed something on her inner vulva. But women are women and cows are cows and Dr Crippen is not an expert on bovine anatomy and physiology. But, were he a farmer, he would need some persuasion to spend £80.00 on 100 mls of a liquid to squirt on a cow’s vulva. Sorry, inner vulva.”
Nothing shows more clearly that the RPSGB will tolerate almost any quackery than the fact that they think Glover is an appropriate person to be president. Every item on the quotation above seems to me to be in flagrant breach of the RPSGB’s Code of Ethics. Just like the Society of Homeopaths, the code seems to be there merely for show, at least in the case of advice about junk medicine..
A greater role for pharmacists?
This problem has become more important now that the government proposes to give pharmacists a greater role in prescribing. Needless to say the RPSGB is gloating about their proposed new role. Other people are much less sure it is anything but a money–saving gimmick and crypto-privatisation.
I have known pharmacists who have a detailed knowledge of the actions of drugs, and I have met many more who haven’t. The main objection, though, is that pharmacists have a direct financial interest in their prescribing. Conflicts of interest are already rife in medicine, and we can’t afford them.
The Royal Pharmaceutical Society is desperately evasive about a matter that is central to their very existence, giving good advice to patients about which medicines work and which don’t. Pharmacists should be in the front line in education of the public, about medicines, the ‘scientist on the High Street’. Some of them are, but their professional organisation is letting them down badly.
Until such time as the RPSGB decides to take notice of evidence, and clears up some of the things described here, it is hard to see how they can earn the respect of pharmacists, or of anyone else.
Stavros Isaiadis’ blog, Burning Mind, has done a good piece on “More on Quack Medicine in High Street Shops“.
The Chemist and Druggist reports that the RPSGB is worried about the marketing of placebo pills (‘obecalp’ -geddit?). It does seem very odd that the RPSGB should condemn honest placebos, but be so very tolerant about dishonest placebos. You couldn’t make it up.
A complaint to the RPSGB is rejected
Just to see what happened, I made a complaint to thr RPSGB about branches of their own Code of Ethics at Boots in Hexham and in Evesham. Both of them supported Homeopathy Awareness Week These events had been publicised in those particularly unpleasent local ‘newspapers’ that carry paid advertising disguised as editorial material. In this case it was the Evesham Journal and the Hexham Courant.
Guess what? The RPSGB replied thus
“Your complaint has been reviewed bt Mrs Jill Williams and Mr David Slater who are both Regional Lead Inspectors. Having carried out a review they have concluded that support of homeopathic awareness week does not constitute a breach of the Society’s Code of Ethics or Professional Standards.”
In case you have forgotten, the Professional Standards say
2.1 procedures for sales of OTC medicines enable intervention and professional advice to be given whenever this can assist the safe and effective use of medicines.
The RPSGB has some very quaint ideas on how to interpret their own code of ethics
This is a fuller version, with links, of the comment piece published in Times Higher Education on 10 April 2008. Download newspaper version here.
If you still have any doubt about the problems of directed research, look at the trenchant editorial in Nature (3 April, 2008. Look also at the editorial in Science by Bruce Alberts. The UK’s establishment is busy pushing an agenda that is already fading in the USA.
Since this went to press, more sense about “Brain Gym” has appeared. First Jeremy Paxman had a good go on Newsnight. Skeptobot has posted links to the videos of the broadcast, which have now appeared on YouTube.
|Then, in the Education Guardian, Charlie Brooker started his article about “Brain Gym” thus
Dr Aust’s cogent comments are at “Brain Gym” loses its trousers.
The Times Higher’s subeditor removed my snappy title and substituted this.
So here it is.
“HR is like many parts of modern businesses: a simple expense, and a burden on the backs of the productive workers”, “They don’t sell or produce: they consume. They are the amorphous support services” .
So wrote Luke Johnson recently in the Financial Times. He went on, “Training advisers are employed to distract everyone from doing their job with pointless courses”. Luke Johnson is no woolly-minded professor. He is in the Times’ Power 100 list, he organised the acquisition of PizzaExpress before he turned 30 and he now runs Channel 4 TV.
Why is it that Human Resources (you know, the folks we used to call Personnel) have acquired such a bad public image? It is not only in universities that this has happened. It seems to be universal, and worldwide. Well here are a few reasons.
Like most groups of people, HR is intent on expanding its power and status. That is precisely why they changed their name from Personnel to HR. As Personnel Managers they were seen as a service, and even, heaven forbid, on the side of the employees. As Human Resources they become part of the senior management team, and see themselves not as providing a service, but as managing people. My concern is the effect that change is having on science, but it seems that the effects on pizza sales are not greatly different.
The problem with having HR people (or lawyers, or any other non-scientists) managing science is simple. They have no idea how it works. They seem to think that every activity
can be run as though it was Wal-Mart That idea is old-fashioned even in management circles. Good employers have hit on the bright idea that people work best when they are not constantly harassed and when they feel that they are assessed fairly. If the best people don’t feel that, they just leave at the first opportunity. That is why the culture of managerialism and audit. though rampant, will do harm in the end to any university that embraces it.
As it happens, there was a good example this week of the damage that can be inflicted on intellectual standards by the HR mentality. As a research assistant, I was sent the Human Resources Division Staff Development and Training booklet. Some of the courses they run are quite reasonable. Others amount to little more than the promotion of quackery. Here are three examples. We are offered a courses in “Self-hypnosis”, in “Innovations for Researchers” and in “Communication and Learning: Recent Theories and Methodologies”. What’s wrong with them?
“Self-hypnosis” seems to be nothing more than a pretentious word for relaxation. The person who is teaching researchers to innovate left science straight after his PhD and then did courses in “neurolinguistic programming” and life-coaching (the Carole Caplin of academia perhaps?). How that qualifies him to teach scientists to be innovative in research may not be obvious.
The third course teaches, among other things, the “core principles” of neurolinguistic programming, the Sedona method (“Your key to lasting happiness, success, peace and well-being”), and, wait for it, Brain Gym. This booklet arrived within a day or two of Ben
Goldacre’s spectacular demolition of Brain Gym “Nonsense dressed up as neuroscience”
“Brain Gym is a set of perfectly good fun exercise break ideas for kids, which costs a packet and comes attached to a bizarre and entirely bogus pseudoscientific explanatory framework”
“This ridiculousness comes at very great cost, paid for by you, the taxpayer, in thousands of state schools. It is peddled directly to your children by their credulous and apparently moronic teachers”
And now, it seems, peddled to your researchers by your credulous and
moronic HR department.
Neurolinguistic programming is an equally discredited form of psycho-babble, the dubious status of which was highlighted in a Beyerstein’s 1995 review, from Simon Fraser University.
“ Pop-psychology. The human potential movement and the fringe areas of psychotherapy also harbor a number of other scientifically questionable panaceas. Among these are Scientology, Neurolinguistic Programming, Re-birthing and Primal Scream Therapy which have never provided a scientifically acceptable rationale or evidence to support their therapeutic claims.”
The intellectual standards for many of the training courses that are inflicted on young researchers seem to be roughly on a par with the self-help pages of a downmarket women’s magazine. It is the Norman Vincent Peale approach to education. Uhuh, sorry, not education, but training. Michael O’Donnell defined Education as “Elitist activity. Cost ineffective. Unpopular with Grey Suits . Now largely replaced by Training .”
In the UK most good universities have stayed fairly free of quackery (the exceptions being the sixteen post-1992 universities that give BSc degrees in things like homeopathy). But now it is creeping in though the back door of credulous HR departments. Admittedly UCL Hospitals Trust recently advertised for spiritual healers, but that is the NHS not a university. The job specification form for spiritual healers was, it’s true, a pretty good example of the HR box-ticking mentality. You are in as long as you could tick the box to say that you have a “Full National Federation of Spiritual Healer certificate. or a full Reiki Master qualification, and two years post certificate experience”. To the HR mentality, it doesn’t matter a damn if you have a certificate in balderdash, as long as you have the piece of paper. How would they know the difference?
A lot of the pressure for this sort of nonsense comes, sadly, from a government that is obsessed with measuring the unmeasurable. Again, real management people have already worked this out. The management editor of the Guardian, said
“What happens when bad measures drive out good is strikingly described in an article in the current Economic Journal. Investigating the effects of competition in the NHS, Carol Propper and her colleagues made an extraordinary discovery. Under competition, hospitals improved their patient waiting times. At the same time, the death-rate e emergency heart-attack admissions substantially increased.”
Two new government initiatives provide beautiful examples of the HR mentality in action, They are Skills for Health, and the recently-created Complementary and Natural Healthcare Council.(already dubbed OfQuack).
The purpose of the Natural Healthcare Council .seems to be to implement a box-ticking exercise that will have the effect of giving a government stamp of approval to treatments that don’t work. Polly Toynbee summed it up when she wrote about “ Quackery
and superstition – available soon on the NHS “ . The advertisement for its CEO has already appeared, It says that main function of the new body will be to enhance public protection and confidence in the use of complementary therapists. Shouldn’t it be decreasing confidence in quacks, not increasing it? But, disgracefully, they will pay no attention at all to whether the treatments work. And the advertisement refers you to
the Prince of Wales’ Foundation for Integrated Health for more information (hang on, aren’t we supposed to have a constitutional monarchy?).
Skills for Health, or rather that unofficial branch of government, the Prince of Wales’ Foundation, had been busy making ‘competences’ for distant healing, with a helpful bulletted list.
“This workforce competence is applicable to:
- healing in the presence of the client
- distant healing in contact with the client
- distant healing not in contact with the client”
And they have done the same for homeopathy and its kindred delusions. The one thing they never consider is whether they are writing ‘competences’ in talking gobbledygook. When I phoned them to try to find out who was writing this stuff (they wouldn’t say), I made a passing joke about writing competences in talking to trees. The answer came back, in all seriousness,
“You’d have to talk to LANTRA, the land-based organisation for that”,
“LANTRA which is the sector council for the land-based industries uh, sector, not with us sorry . . . areas such as horticulture etc.”.
Anyone for competences in sense of humour studies?
The “unrepentant capitalist” Luke Johnson, in the FT, said
“I have radically downsized HR in several companies I have run, and business has gone all the better for it.”
Now there’s a thought.
The provost’s newletter for 24th June 2008 could just be a delayed reaction to this piece? For no obvious reason, it starts thus.
“(1) what’s management about?
Human resources often gets a bad name in universities, because as academics we seem to sense instinctively that management isn’t for us. We are autonomous lone scholars who work hours well beyond those expected, inspired more by intellectual curiosity than by objectives and targets. Yet a world-class institution like UCL obviously requires high quality management, a theme that I reflect on whenever I chair the Human Resources Policy Committee, or speak at one of the regular meetings to welcome new staff to UCL. The competition is tough, and resources are scarce, so they need to be efficiently used. The drive for better management isn’t simply a preoccupation of some distant UCL bureaucracy, but an important responsibility for all of us. UCL is a single institution, not a series of fiefdoms; each of us contributes to the academic mission and good management permeates everything we do. I despair at times when quite unnecessary functional breakdowns are brought to my attention, sometimes even leading to proceedings in the Employment Tribunal, when it is clear that early and professional management could have stopped the rot from setting in years before. UCL has long been a leader in providing all newly appointed heads of department with special training in management, and the results have been impressive. There is, to say the least, a close correlation between high performing departments and the quality of their academic leadership. At its best, the ethos of UCL lies in working hard but also in working smart; in understanding that UCL is a world-class institution and not the place for a comfortable existence free from stretch and challenge; yet also a good place for highly-motivated people who are also smart about getting the work-life balance right.”
I don’t know quite what to make of this. Is it really a defence of the Brain Gym mentality?
Of course everyone wants good management. That’s obvious, and we really don’t need a condescending lecture about it. The interesting question is whether we are getting it.
There is nothing one can really object to in this lecture, apart from the stunning post hoc ergo propter hoc fallacy implicit in “UCL has long been a leader in providing all newly appointed heads of department with special training in management, and the results have been impressive.”. That’s worthy of a nutritional therapist.
Before I started writing this response at 08.25 I had already got an email from a talented and hard-working senior postdoc. “Let’s start our beautiful working day with this charging thought of the week:”.
He was obviously rather insulted at the suggestion that it was necessary to lecture academics with words like ” not the place for a comfortable existence free from stretch and challenge; yet also a good place for highly-motivated people who are also smart about getting the work-life balance right.”. I suppose nobody had thought of that until HR wrote it down in a “competence”?
To provoke this sort of reaction in our most talented young scientists could, arguably, be regarded as unfortunate.
I don’t blame the postdoc for feeling a bit insulted by this little homily.
So do I.
Now back to science.
This is an old joke which can be found in many places on the web, with minor variations. I came across it in an article by Gustav Born in 2002 (BIF Futura, 17, 78 – 86) and reproduce what he said. It has never been more relevant, so it’s well worth repeating. The title of the article was British medical education and research in the new century.
“The other deleterious development in UK research is increased bureaucratic control. Bureaucracy is notoriously bad for all creative activities. The story is told of a company chairman who was given a ticket to a concert in which Schubert’s Unfinished Symphony was to be played. Unable to go himself, he passed the ticket on to his colleague, the director in charge of administration and personnel. The next day the chairman asked, ‘Did you enjoy the concert?’ His colleague replied, ‘My report will be on your desk this afternoon’. This puzzled the chairman, who later received the following:
Report on attendance at a musical concert dated 14 November 1989. Item 3.
Schubert’s Unfinished Symphony.
- The attendance of the orchestra conductor is unnecessary for public performance. The orchestra has obviously practiced and has the prior authorization from the conductor to play the symphony at a predetermined level of quality. Considerable money could be saved by merely having the conductor critique the performance during a retrospective peer-review meeting.
- For considerable periods, the four oboe players had nothing to do. Their numbers should be reduced, and their work spread over the whole orchestra, thus eliminating the peaks and valleys of activity.
- All twelve violins were playing identical notes with identical motions. This was unnecessary duplication. If a larger volume is required, this could be obtained through electronic amplification which has reached very high levels of reproductive quality.
- Much effort was expended in playing sixteenth notes, or semi-quavers. This seems to me an excessive refinement, as listeners are unable to distinguish such rapid playing. It is recommended that all notes be rounded up to the nearest semi-quaver. If this were done, it would be possible to use trainees and lower-grade operatives more extensively.
- No useful purpose would appear to be served by repeating with horns the same passage that has already been handled by the strings. If all such redundant passages were eliminated, as determined by a utilization committee, the concert could have been reduced from two hours to twenty minutes with great savings in salaries and overhead.
- In fact, if Schubert had attended to these matters on a cost containment basis, he probably would have been able to finish his symphony.
In research, as in music, blind bureaucracy has the effect of destroying imaginative creativity. If that is truly valued, it must remain free from bureaucratic excesses. And indeed, the great strength of British science has always been the ability of curiosity-driven individuals to follow up original ideas, and the support that these individuals receive from organizations such as the MRC and the Wellcome Trust. This has given research workers the possibility to twist and turn in following up intuitions and ideas in other fields as well as their own. This freedom has been significantly eroded by job insecurity in universities and in commercial enterprises.”
Later in the article, Born talks about innovation in the pharmaceutical industry
“This ‘urge to merge’, which is affecting the pharmaceutical industry worldwide, is almost always claimed to be justified by the need for a larger research budget to sustain innovation. The actual evidence indicates that such mergers hide -for a while failure of innovation. An almost universal response to this problem has been to ‘streamline’ and ‘commercialize’ the process of research, with ultimate control vested in accountants rather than in pharmaceutically informed scientists. This has meant that the industry’s research and development programmes are being driven by technical novelties, notably computer- aided drug design, combinatorial chemistry, high-throughput screening and genomics. All these techniques are very cost-intensive and, what is worse, are superseding individual scientists with profound appreciation of disease mechanisms and knowledge of biochemical and pharmacological mechanisms. It is they whose ability to ask the crucial, often seemingly simple questions, that have led to blockbuster drugs. Outstanding British examples are James Black’s discovery of the gastric acid secretion inhibitors, and Hans Kosterlitz’s question whether the brain might perhaps contain some analgesic chemical like that in -of all things the poppy plant.”
“The fact is that drug discovery, like all discoveries, is more an individual than a team achievement, at least at the beginning. With a few notable exceptions, the trouble with the industry is summarized by a group research director at one of the leading pharmaceutical companies:
“Creative individuals are being driven out of the industry and being replaced by functionaries wbo parrot strategic maxims. Research is being driven by lawyers, financial experts, salesmen and market strategists who are completely unable to develop new ideas. It is doubtful whether there are any senior executives who understand the problem” (Drews, J., 1999 In quest of tomorrow’s medicine, Springer-Verlag, New York).
“Partly as a result of mismanagement and partly as a result of a search for solutions which takes no account of disease mechanisms and biomedical complexity, substantial parts of the pharmaceutical industry are failing to innovate at a rate which is needed for their health and for the health of the general public. Research management needs to be rethought with a much greater emphasis on creative individuals with a broad knowledge of biology and medicine, a lower emphasis on market research, and a greater openness to the information to be gained from clinical studies (Horrobin, D.F., 2000, Innovation in the pharmaceutical industry. J. R. Soc. Med. 93, 341 – 345. ).”
For more on keeping univeristies honest, see the excellent new blog, The storm breaking upon the university.
Boots the Chemists have proved themselves dishonest before, over their promotion of homeopathy and of B Vitamins “for vitality”
In a press release dated 12 March 2008, they have hit a new low in ethical standards
|Boots help boost the nation’s energy levels in just one week
“Health and beauty expert Boots has launched an exclusive energising vitamin supplement that helps boost depleted energy levels and maintain vitality. It is the first time that this exclusive form of CoQ10 has been made available on the high street.”
” . . .supplementation can help to supply higher levels of CoQ10 than are available in the diet. Boots Energy Super Strength CoQ10 containing natural Kaneka CoQ10 is a way of boosting energy levels that can help people who lack energy to see results in a week”
Last year there was an equally misleading press release about CoQ10 from Solgar/Boots Herbal. That one was headed “Need More Energy – Solgar’s Nutri Nano™ Uses Nanotechnology to Deliver Unprecedented Bioavailability of CoQ10”. Not only is the word ‘energy’ misused but notice that the trendy term ‘nanotechnology’ is worked in for extra sciencey effect. It turns out that all this means is that the preparation contains micelles. So nothing new there either. Micelles have been known for almost 100 years.
In contrast, the Boots online store is noticeably more restrained. Could that be because the Advertising Standards People can’t touch press releases, just as they can’t control what Boots Expert Team tell you face to face in the shop?
Boots PR contact is given as: Carrie Eames, PR Manager, Boots The Chemists, D90W WG14, Thane Road, Nottingham NG90 1BS. I’m not sure how Ms Eames sleeps at night. Perhaps you should write to her and let her know what you think.
You might point out to her Boots (anti) Social Corporate (ir)Responsibility Page. It says
|“So it’s part of our heritage to treat our customers fairly and act with integrity in everything we do, rather than seizing on the quickest and easiest way to turn a profit.”|
CoQ10 and “energy”
Coenzyme Q10 (also known as ubiquinone) is a relatively small molecule. It cooperates with cytochrome enzymes (big proteins) to synthesize a molecule called ATP. This is a chemical form of energy that can be used to do work, such as making a muscle fibre contract.
The word “energy ” here is used in the sense that a physicist would use it. It is measured in joules or in calories. The meaning of the word ‘energy‘ is described nicely in the Wikipedia entry. For example, when an electric current passes through a resistor (like a kettle) the electrical energy is converted to heat energy, and the energy used is potential difference (volts) X current (amps) X time. In other words energy is power (in watts) times time. So another unit for energy is kilowatt-hours (one kilowatt-hour is about 3.6 megajoules).
Energy in this sense has nothing whatsoever to do with the everyday use of ‘energy’ to indicate your vitality, or how lively you feel.
Furthermore there is not the slightest empirical reason to think that CoQ10 makes you feel more lively. None. The press release cites a sciencey-sounding reference (Ernster L, Dallner G. Biochemical, physiological and medical aspects of ubiquinone function. Biochim Biophys Acta. 1995 May 24;1271(1):195-204.). But this paper is just a review of the biochemistry, nothing whatsoever to do with feeling good.
CoQ10 and the supplement business
There is nothing new in this big push by Boots. CoQ10 has been a staple of supplement business for a long time now. All sorts of medical claims have been made for it. Everything from migraine, to Parkinson’s disease to cancer has been raised as possible benefits of the magic drug, oops, I mean ‘supplement’. This is quite improper of course, since it is being sold as a food not as a medicine, but it is standard practice among supplement hucksters, and so far they have been allowed to get away with it.
What’s interesting though is that until Boots PR machine swung into action, one thing that hadn’t been claimed much is that it made you feel more lively. That’s one they just invented.
CoQ10 and the press
It’s standard technique to get free advertising by hoping that journalists will dash off an article on the basis of a press release, with the hope that they will be in too much hurry to check the spin. Too often it works.
The Daily Mail has big coverage of the press release, under the title “Can a 60p pill from the chemist really add years to your life?“. This was written by Anna Hodgekiss and it’s not bad. It starts with a nice note of scepticism
“Forget vitamins C, E or even B12. The real wonder supplement is Coenzyme Q10 or CoQ10. That’s what Boots would have you believe, anyway. ”
“So should we all be taking this supplement?
Not according to David Colquhoun, professor of pharmacology at University College London, who says Boots’ claims are “deliberately misleading customers”.
“Yes, CoQ10 helps the body convert glucose into energy, but it’s not the psychological get-up-and-go energy you feel day to day.
“The type of energy it does produce powers our muscles and cells – physical energy. They have confused the two here to promote a product that I’m not convinced would make any difference to how you actually feel at all.”
The article goes on
Among the other sceptics is Scott Marsden, a senior dietician at The London Clinic.
“There haven’t been enough trials to warrant us all taking CoQ10,” he says.
“It sounds boring, but if you are healthy and eating a balanced diet, you will get all the nutrients you need and shouldn’t have to take supplements.
“Not only could you be spending money unnecessarily, you could also be putting your health at risk. Buy some wholesome food instead.” “
Dr Clare Gerada, vice chairman of the Royal College of General Practitioners, is more forthright.
“While there is some evidence to suggest CoQ10 supplements may help patients with heart failure or severe respiratory disorders, more work is needed,” she says.
“This is just another example of normal health being medicalised, and it’s an issue that worries me.
“The human body is an amazing machine, and we have never been in better health. The fact that more people are living well into their 80s and 90s is proof.
“People need to stop looking for a wonder pill in their quest to live for ever.”
But guess who comes out fighting for Boots? None other than my old friend Dr Ann Walker. Little wonder then that my Nutriprofile result recommended a co Q10 supplement, because she is involved in that too.
Ann Walker’s colleague on the Nutriprofile project, Dr Sarah Brewer comments on CoQ10 on the Healthspan site, thus.
“As CoQ10 is vital for energy production in muscle cells, lack of CoQ10 is linked with lack of energy, physical fatigues, muscle aches and pains . . .”
It seems that she also can’t distinguish between energy in joules and energy as vitality,
Female First and Marie Claire also carry a story “Boots Sell ‘Life Extending’ Pill”
“A new pill that claims to add years to our lives is due to hit shelves in Boots stores this week but scientists say the drug is misleading.”
“Despite these claims Professor David Colquhoun told Marie Clare that he believes the drug is ‘deliberately misleading customers’: “Yes, CoQ10 helps the body convert glucose into energy, but it’s not the psychological get-up-and-go energy you feel day to day,” he said.”
(Funny, I never consciously spoke to Marie Claire but the quotation is OK.)
The Times, in contrast, carries an appalling column by their Dr Thomas Stuttaford, “A natural solution to tiredness“. There isn’t even a question mark in the title, and the content is totally uncritical. Private Eye has nicknamed the author ‘Dr Thomas Utterfraud’. How very cruel.
See also, excellent articles on CoQ10 by Ben Goldacre in the Guardian, and at badscience.net, and at Holfordwatch and Dr Aust’s Spleen
Aha Boots have repeated their mendacious claims in newspaper advertisements
This appeared in the Guardian on 18 March, and I’m told it was in the Mail too.
The small print says
“The new Boots Energy supplement contains Kaneka Q10 to help boost your energy levels throughout the day”
Here is what I just sent to the Advertising Standard Authority, or email email@example.com . Why not have a go yourself?
|“The words “boost your energy levels” and “still lacking energy” constitute a (presumably deliberate) confusion beteen ‘energy’ measured in joules and the everyday use of the word ‘energy’ to mean vitality. The former usage would be justified in viewof the role of Coenzyme Q10 in ATP production. There is neither theoretical justification nor any empirical evidence that CoQ10 helps your vitality or ‘energy’ in the latter sense.”|
A full size graphic to attach to your complaint can be downloaded here.
We are all interested in the relationship between our health and what we eat. What a pity that so little is known about it.
The problem, of course, is that it almost impossible to do randomised experiments, and quite impossible in most cases to make the experiments blind. Without randomisation there is no way to be sure about causality, and causality is all that matters. All you can do is measure “associations” and that sort of information is simply unreliable.
For example, if you simply observe that people who eat a lot of dark green vegetables are healthier than those who don’t, there is no reliable way to tell whether their health is caused by eating the vegetables. It is just as likely that, for example, rich people are healthier because the are rich, not because they eat more vegetables. The answer, though usually not known, is the only thing that matters for offering advice. The crucial problem is that, in the latter case, it will do no good at all to bully a poor person to eat more vegetables: their health will not improve because their bad health was caused by poverty, not by lack of vegetables.
It is precisely this difficulty that results in the constantly conflicting advice that we are given about diet. I can’t think of any single thing that does more harm to real science than the fact that one week we are told that red wine is bad and the next week we are told that red wine is good. No doubt both statements were based on a naive observational studies, the significance of which is vastly exaggerated by its authors (and often by their university’s media department too).
The first job of a scientist is to be able to say “I don’t know”. Under pressure from the government’s audit culture, and the HR apparatchiks who embrace it so eagerly, all that is forgotten only too easily. he lack of certain answers about diet leaves a vacuum into which not only naive scientists are sucked, but also it is a gift for hucksters who are eager to sell you expensive ‘supplements’, whether or not you need them. As always, it is a case of caveat emptor.
The questions are important to us all, so when sciencepunk pointed out to me a chance to check my own diet, I went for it. I try to keep pretty close to the current guidelines. Unreliable though they may be, they are the best we’ve got. So I went to the Nutriprofile site, and filled in the questionnaire, quite honestly (apart from saying I was 37 -I wish).
I eat plenty of fruit and oily fish every week so I though I’d do quite well. No such luck. I ended up being told I was deficient in iron and selenium, and at “risk of deficiency” in vitamin B5 (pantothenic acid), folate, vitamins D, E, K, magnesium, copper and potassium.
Uhuh, I must really be ill and I’d never realised it.
At the bottom of this analysis of all my deficiencies comes the sales pitch, “your personalised supplement recommendations”.”Strongly recommended” for me is Gold Standard A-Z Multivitamins (just click on the “buy now” button). I’m also “recommended” to buy Omega 3 1000mg capsules.
And then I’m invited to consider a whole list of other supplements
“The following products have been given a 1 star rating. This usually means they have been recommended to meet a specific issue raised by your NutriProfile. You should consider these supplements where you feel they could help if the issue is particularly important to you”
Here is the list.
- Selenium + A,C,E,
- Echinacea (“may help you maintain a healthy immune system”).
- OptiFive (antioxidant supplement)
- Co-enzyme Q10 (“may help you maintain energy levels” -look out for a forthcoming post on this scam)
- Memo Plus (“may help you maintain brain health and cognitive function”),
- Panax Ginseng (“may help you to maintain energy levels”
- Psyllium Husks
- Vitamin D
- Ginkgo Biloba
As always, there are lots of fantasies about “strengthening the immune system”. And the great antioxidant myth is exploited to the full.
Puzzled by this result, I got my wife to do the questionnaire, and also a particularly healthy and diet conscious colleague.
My wife was recommended to buy Omega 3 1000mg, Osteo Plus Bone health supplement (despite telling them that she already took calcium) and 50 Plus Multivitamins (“may help you address any deficiency in essential vitamins and minerals and may also help you maintain a healthy immune system and maintain energy levels. “). And then it may not.
My spectacularly healthy and diet conscious colleague got a strongly recommended (maximum 5 stars like me) for Gold Standard A-Z Multivitamins and for Omega 3 1000mg, as well as “recommended” for plant sterols, garlic and Opti-Omega 3.
Either I’m a lot unhealthier than I thought, or Nutriprofile is a sales scam.
Is there anyone at all who does NOT need supplements?
By this stage I was getting suspicious so I sent the link to a professional dietitian, Catherine Collins of St George’s Hospital London. Unlike the people running the site, she has no financial interest in selling you pills. I asked her to fill in the questionnaire as a hypothetical person who had an ideal diet, based on current nutritional knowledge . Surely such a paragon of dietetic virtue would not need to buy pills too?
Don’t you believe it. At least she didn’t get any 5 star “strongly recommended”, but she did get “Recommended for you” Opti-Omega 3 (3.5 stars) and Gold Standard A-Z Multivitamins (3 stars). Plus, of course the whole list of “you may like to consider”, same as everyone seems to get.
So I asked Collins how it came about that everyone seems to end up being recommended to buy pills after going through all the questions. Here is what she said.
“Apparently my ratio of omega3:6 is unbalanced. not if you ate the amount of oily fish i’d put in, and used ‘vegetable’ oil which is mono-rich rapeseed. I think they’ve used the sunflower analysis to generate this distortion.
I disagree with absolute amounts of omega-3 per day. The amount I recorded meant I would easily exceed a daily intake of 500 mg of the important omega-3 fats, EPA and DHA
Low Vitamin B6 and folate – totally incorrect recommendation based on my entries
Potassium – the survey indicated concern that diet provided 200mg per day less potassium than recommended. This was incorrect, the flaw I assume being due to inability of the questionnaire to handle portion sizes. Should I have been worried even if this had been accurate? Of course not. Potassium is widespread across food groups, the most concentrated being fruit and vegetables. It is an essential nutrient, but its requirements are relative to sodium (‘salt’) intake.
Their omega-3 fat recommendation is double the FSA/ SACN suggestion of 450mg/d – they actually quote this in their supporting information but then say ‘experts say we need double’ [their experts are below]. This is highly misleading. We need a combination of omega-3 fats in our diet for health – not only the ‘fishy’ EPA and DHA, but also the readily available ALA, found in vegetable (rapeseed) oil
Omega 3:6 ratio -completely wrong based on the foods entered. Demonstrates a major flaws in the assumptions made about type and amount of foods in the diet.
Water recommendations. Totally inaccurate information based on the myth expounded by the health food industry and its workers that caffeine is a diuretic. This been extensively researched and proven to be not true ( Grandjeans excellent work). The only way in which a caffeinated beverage is ‘diuretic’ to someone who takes caffeinated drinks regularly is in the volume of drink consumed.
“”This appears an elaborate pill-pushing exercise. Superficially reassuring in promoting the recognised FSA (Food Standards Agency] line – but then giving undue – and unjustifiable – support to the anecdotal ‘experts recommend’ to create what will be a powerful sell”
The comment about water intake stems from this bit of Collins’ Nutriprofile:
“Caffeinated drinks, fizzy drinks and alcohol do not count because, whilst they contain water, they are mild diuretics, ie. they boost urine output and therefore should only form a small part of your total fluid intake.”
This myth (aka nutribollocks) is quite contrary to what the real research (going back to 1928) says, Check “Laying the caffeine myth to rest” for the real story..
I’m told that Healthspan are now sending out the paper questionnaire in newspapers. Presumably this is to ensure that the poor, the elderly etc and others who that aren’t computer literate don’t miss their buying opportunity. How considerate of them.
Nutriprofile’s expert team
Who is the expert team behind Nutriprofile? Here they are.
What do the real experts say about supplements?
The story you get is quite different when you ask somebody who is not trying to sell you something
The Food Standards Agency says
“Most people should be able to get all the nutrients they need by eating a varied and balanced diet. But if you choose to take supplements, it’s important to know that taking too much or taking them for too long can cause harmful effects.”
Harvard Men’s Health Watch says
“Harvard Men’s Health Watch suggests that the average man give up the multivitamin, at least until scientists solve the puzzle of folic acid and cancer.”
“If you eat a balanced diet that includes food from all the major groups, there should be no need to take vitamin supplements. The food you eat will provide you with all the vitamins and minerals you need. “
I guess we should not be surprised at the direct contradiction between this advice and that of the Nutriprofile questionnaire. After all, Nutriprofile was developed by a company, Healthspan, that is devoted to selling “supplements” with all the dubious claims and customer testimonials associated with the alternative health industry.
But this is what always happens when big business controls science.
Oddly enough, Ann Walker’s experience seems to be much the same as ours. In an interview on the Healthspan site we read this.
Q: Which nutritional supplements do you choose to take?
A: I regularly take a multivitamin, vitamins C and E, fish oil, and a calcium and magnesium combination. I also take vitamin D during the winter and some herbs as and when they are needed.
Even if I have improved my diet, each time I complete the NutriProfile questionnaire my requirement for a multivitamin, calcium and magnesium, and a fish oil supplement are always thrown up.
Didn’t it occur to her to wonder why?
The sales pitch was followed up on 27 March the email arrived from Healthspan “Healthspan are offering you £5 to spend towards your recommended supplements”. One can’t say whether this offer goes to people who were not recommended supplements, because so far no such person has been found.
This afternoon I went to the Coliseum to see a revival of Jonathan Miller’s 1986 production of the Mikado. It was beautifully staged. The well-known patter song of Ko-Ko, the Lord High Executioner of Japan, begged for a version that deals with anti-science (original here). The serious post will come later. Meanwhile here’s some late night rhyming.
As some day it may happen that a victim must be found,
I’ve got a little list — I’ve got a little list
Of society offenders who might well be underground,
And who never would be missed — who never would be missed!
There’s the pestilential bureaucrats who want to send you on a course —
The HR folks who treat you not as human but as mere resource
Skills specialists who think that education just means training
And all ex-scientists who used to work, but now are only feigning
They’d none of ’em be missed — they’d none of ’em be missed!
He’s got ’em on the list — he’s got ’em on the list;
And they’ll none of ’em be missed — they’ll none of ’em be missed.
And that deluded nuisance, whom no one understands
The homeopathist – I’ve got her on the list!
All Reiki folks, pill hucksters and layers on of hands
They’d none of ’em be missed — they’d none of ’em be missed.
And herbalists and Princes who like to talk to trees
Those phony nutritionists who’ll treat you for large fees
And that singular anomaly, the acupuncturist —
I don’t think they’d be missed — I’m sure they’d not be missed!
You may put ’em on the list — you may put ’em on the list;
And they’ll none of ’em be missed — they’ll none of ’em be missed!
There’s the vision statement writer, and others of that sort
And the crystal therapist — I’ve got him on the list!
And the people who think long words are a substitute for thought
They never would be missed — they never would be missed!
Then those whose knight starvation makes them crave the honours list
So all below must suffer in case their chance is missed
And those who think that science can be judged by its citations
And so kill creativity by funding only applications
But it really doesn’t matter whom you put upon the list,
For they’d none of ’em be missed — they’d none of ’em be missed!
You may put ’em on the list — you may put ’em on the list;
And they’ll none of ’em be missed — they’ll none of ’em be missed!
I replaced two lines after my pedantic sister pointed out their imperfect rhyme and scansion. Personally I’m with Charles Babbage.
Here is letter that Babbage is said to have written to Tennyson after reading “The vision of sin”.
In your otherwise beautiful poem there is a verse that reads:
“Every moment dies a man
Every moment one is born”
It must be manifest that, were this true, the population of the world would be at a standstill. In truth the rate of birth is slightly in excess of that of death. I would suggest that in the next edition of your poem you have it read:
“Every moment dies a man
Every moment 1 1/16 is born”
Strictly speaking this is not correct. The actual figure is a decimal so long that I cannot get it in the line, but I believe that 1 1/16 will be sufficiently accurate for poetry.
I am etc,
(The Mathematical Gazette, 1927, p270)