Bad Science (32 page)

1
Be careful. One paper surveyed 122 ENT doctors and collected twenty-one cases of serious injury from burning wax falling onto the eardrum during ear candle treatment.

2
If you take one of these bags and squirt some water onto it, then pop a nice hot cup of tea on top of it and wait for ten minutes, you’ll see brown sludge forming. There are no toxins in porcelain.

3
Though it’s an American company, Brain Gym hasn’t quite caught on in the United States to the same degree that it has in the U.K. However, at least two American universities offer accreditation. You can get graduate credit for salary upgrade and recertification from the University of Colorado at Denver for Brain Gym and ADHD classes. For classes taught outside Colorado or adjoining states, you can get CEUs from Dominican University of California. Also Grand Valley State University.

4
At proper high doses, cinchona contains quinine, which can genuinely be used to treat malaria, although most malarial parasites are immune to it now.

5
For pedants, it’s a 30.89C dilution.

6
Physicians sometimes prescribe antibiotics to demanding patients in exasperation, even though they are ineffective in treating a viral cold, but much research suggests that this is counterproductive, even as a time-saver. In one study, prescribing antibiotics rather than giving advice on self-management for sore throat resulted in an increased overall workload through repeat attendance. It was calculated that if a doctor prescribed antibiotics for sore throat to one hundred fewer patients each year, thirty-three fewer would believe that antibiotics were effective, twenty-five fewer would intend to consult with the problem in the future, and ten fewer would come back within the next year. If you were an alternative therapist, or a drug salesman, you could turn those figures on their head and look at how to drum up more trade, not less.

7
Ernst has been awarded the first chair in complementary medicine at the University of Exeter.

8
So, Pinsent performed a double-blind, placebo-controlled study of fifty-nine people having oral surgery. The group receiving homeopathic arnica experienced significantly less pain than the group getting placebo. What you don’t tend to read in the arnica publicity material is that forty-one subjects dropped out of this study. That makes it a fairly rubbish study. It’s been shown that patients who drop out of studies are less likely to have taken their tablets properly, more likely to have had side effects, less likely to have got better, and so on. I am not skeptical about this study because it offends my prejudices but because of the high dropout rate. The missing patients might have been lost to followup because they are dead, for example. Ignoring dropouts tends to exaggerate the benefits of the treatment being tested, and a high dropout rate is always a warning sign.
The study by Gibson et al. did not mention randomization, nor did it deign to mention the dose of the homeopathic remedy, or the frequency with which it was given. It’s not easy to take studies very seriously when they are this thin.
There was a study by Campbell that had thirteen subjects in it (meaning a tiny handful of patients in both the homeopathy and the placebo groups). It found that homeopathy performed better than placebo (in this teeny-tiny sample of subjects), but didn’t check whether the results were statistically significant or merely chance findings.
Last, Savage et al. did a study with a mere ten patients, finding that homeopathy was better than placebo, but they too did no statistical analysis of their results.
These are the kinds of papers that homeopaths claim as evidence to support their case, evidence that they claim is deceitfully ignored by the medical profession. All these studies favored homeopathy. All deserve to be ignored, for the simple reason that each was not a fair test of homeopathy, simply on account of these methodological flaws.
I could go on, through a hundred homeopathy trials, but it’s painful enough already.

9
I agree: this is a bizarre and outrageous experimental finding, and if you have a good explanation for how it might have come about, the world would like to hear from you. Follow the reference, read the full paper online, and start a blog, or write a letter to the journal that published it.

10
I have deliberately expressed this risk in terms of the “relative risk increase,” as part of a dubious in joke with myself. You will learn about this starting.

11
Interestingly, Macfadden’s food product range was complemented by a more unusual invention of his own. The Peniscope was a popular suction device designed to enlarge the male organ that is still used by many today, in a modestly updated form. Since this may be your only opportunity to learn about the data on penis enlargement, it’s worth mentioning that there is in fact some evidence that stretching devices can increase penis size. Gillian McKeith’s Wild Pink and Horny Goat Weed sex supplement pills, however, sold for “maintaining erections, orgasmic pleasure, ejaculation…lubrication, satisfaction, and arousal,” could claim no such evidence for efficacy (and in 2007, after much complaining, these seedy and rather old-fashioned products were declared illegal by the Medicines and Healthcare Products Regulatory Agency, or MHRA). I mention this only because, rather charmingly, it means that Macfadden’s Peniscope may have a better evidence base for its claims than either his own food products or McKeith’s Horny Goat penis pills.

12
In this subject, like many medics of my generation, I am indebted to the classic textbook
How to Read a Paper
by Professor Trisha Greenhalgh at the University College London. It should be a bestseller.
Testing Treatments
by Imogen Evans, Hazel Thornton, and Iain Chalmers is also a work of great genius, appropriate for a lay audience and amazingly also free to download online from www.jameslindlibrary.org. For committed readers I recommend
Methodological Errors in Medical Research
by Bjorn Andersen. It’s extremely long. The subtitle is
An Incomplete Catalogue.

13
I’d be genuinely intrigued to know how long it takes to find someone who can tell you the difference between “median,” “mean,” and “mode,” from where you are sitting right now.

14
If it helps to make this feel a bit more plausible, bear in mind that you only need
any
two dates to coincide. With forty-seven people, the probability increases to 0.95; that’s nineteen times out of twenty! (Fifty-seven people and it’s 0.99; seventy people and it’s 0.999.) This is beyond your intuition; at first glance, it makes no sense at all.

15
The figures here are ballpark, from Gerd Gigerenzer’s excellent book
Reckoning with Risk
.

16
The magician and pseudoscience debunker James Randi used to wake up every morning and write on a card in his pocket: “I, James Randi, will die today,” followed by the date and his signature. Just in case, he has recently explained, he really did, by some completely unpredictable accident.

17
Many years later William McBride turned out to be guilty, in an unfortunate twist, of research fraud, falsifying data, and he was struck off the medical register in 1993. He was later reinstated.

18
Disdain for statistics in health care research wasn’t unusual at the time: Ignaz Semmelweis noticed in 1847 that patients were dying much more frequently on the obstetrics ward run by the medical students than on the one run by the midwifery students (this was in the days when students did all the legwork in hospitals). He was pretty sure that this was because the medical students were carrying something nasty from the corpses in the dissection room, so he instituted proper hand-washing practices with chlorinated lime and did some figures on the benefits. The death rates fell, but in an era of medicine that championed “theory” over real-world empirical evidence, he was basically ignored, until Louis Pasteur came along and confirmed the germ theory. Semmelweis died alone in an asylum. You’ve heard of Pasteur.

19
Here is Jack on cramp: “For years many people have suffered with cramp. By dowsing, I discovered that this is due to the fact that the body is not absorbing the element ‘scandium’ which is linked to and controls the absorption of magnesium phosphate.” And on general health complaints: “Based on my expertise in dowsing, I noted that many of my patients were suffering from severe deficiencies of carbon in their systems. The ease in which people these days suffer hairline fractures and broken bones is glaringly apparent to the eyes that are trained to see.”

20
Whether you buy the Department of Health phrase “MMR is safe” depends on what you decide you mean by “safe.” Is flying safe? Is your washing machine safe? What are you sitting on? Is that safe? You can obsess over the idea that philosophically nothing can ever be shown to be 100 percent safe, and many will, but you would be arguing about a fairly meaningless and uncommon definition of the word.

21
“The groups of investigators that either had access to original autism specimens or investigated them later for measles virus detection were invited to take part in the study but failed to respond. Similarly, it was not possible to obtain clinical specimens of autism cases from these investigators for independent investigations.”

22
In 2008, some journalists deigned—miraculously—to cover a PCR experiment with a negative finding. It was misreported as the definitive refutation of the entire MMR-autism hypothesis. This was a childish overstatement, and that doesn’t help anyone, either. I am not hard to please.

23
Not 11.7 percent, as claimed in the
Telegraph
and the
Daily Mail
in February and June 2006.