Bad Science: Quacks, Hacks, and Big Pharma Flacks

by Ben Goldacre

studies funded by a pharmaceutical company were found to be four times more likely to give results that were favorable to the company than were independent studies.

If you are smiling in recognition at this paragraph, then you are a very bad person.

Publication bias is common, and in some fields it is more rife than in others.

This requires, only briefly, that you pay attention.

Sometimes, when they get positive results, instead of just publishing them once, they publish them several times, in different places, in different forms, so that it looks as if there were lots of different positive trials.

dangerous effects from drugs can be either deliberately downplayed or, worse than that, simply not published.

almost all these problems—the suppression of negative results, data dredging, hiding unhelpful data, and more—could largely be solved with one very simple intervention that would cost almost nothing: a clinical trials register, public, open, and properly enforced.

The problems of publication bias, duplicate publication, and hidden data on side effects, which all cause unnecessary death and suffering, would be eradicated overnight, in one fell swoop.

It’s worth noting that drug adverts aimed directly at the public are legally allowed only in the United States and New Zealand, as pretty much everywhere else in the developed world has banned them, for the simple reason that they work.

From our example above, with high cholesterol, you could have a 50 percent increase in risk (the “relative risk increase”), or a 2 percent increase in risk (the “absolute risk increase”), or, let me ram it home, the easy one, the informative one, an extra two heart attacks for every hundred men, the natural frequency.

I want to know whom 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 (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:

Anyone who is going to trade in numbers, and use them, and think with them, and persuade with them, let alone lock people up with them, also has a responsibility to understand them.

In February 1998 a group of researchers and doctors led by a surgeon called Andrew Wakefield from the Royal Free Hospital in London published a research paper in The Lancet that by now stands as one of the most misunderstood and misreported papers in the history of academia.

it is badly written and has no clear statement of its hypothesis, or indeed of its conclusions

The paper described twelve children who had bowel problems and behavioral problems (mostly autism) and mentioned that the parents or doctors of eight of these children believed that their children’s problems had started within a few days of their being given the MMR vaccine.

they include allegations of multiple conflicts of interest, undeclared sources of bias in the recruitment of subjects for the paper, undisclosed negative findings, and problems with the ethical clearance for the tests.

various intrusive clinical investigations, such as lumbar punctures and colonoscopies, were carried out on the children, not to determine their own treatment but rather for research purposes; furthermore, these tests were conducted without ethics committee approval.

one of the children being investigated as part of an extension of the MMR research project was seriously harmed during colonoscopy and was rushed to intensive care at Great Ormond Street Hospital after his bowel had been punctured in twelve places. He suffered multiple organ failure, including kidney and liver problems, and neurological injuries, and received $740,000 in compensation.

When your parents were young, they could fix their own car and understand the science behind most of the everyday technology they encountered, but this is no longer the case.

No difference was found between vaccinated and unvaccinated children in the rates of autism or autistic spectrum disorders and no association between development of autism and age at vaccination.

the risks from measles, though small, are real and quantifiable.

Though mumps is rarely fatal, it’s an unpleasant disease with unpleasant complications (including meningitis, pancreatitis, and sterility).

Congenital rubella syndrome has become increasingly rare since the introduction of MMR but causes profound disabilities, including deafness, autism, blindness, and mental handicap, resulting from damage to the fetus during early pregnancy.

In 1901, males born in the U.K. could expect to live to forty-five, and females to forty-nine.

For a book about accuracy in data, this is flagrantly false: the mean life expectancy was dragged down by outliers of early death.