Clarice's Pieces: Be Scientific (Skeptical) about Scientific Research

David Suzuki said, "Education has failed in a very serious way to convey the most important lesson science can teach: skepticism."  His observation is proven right every single day.

I remember when I first learned that lesson at my mother's knee.  It was November 1959, and the first major food scare I can remember was set off by a report by the secretary of HEW, who, just before that Thanksgiving, warned that cranberries were "contaminated" with a weed-killer called aminotriazole.

Without paying much attention to the fine print of the reports about the chemical, consumers shunned cranberries, which remained heaped up at supermarkets even with drastic price cuts.

I had come home from college and was horrified to see my mother unloading the grocery bags, which contained several packages of cranberries.  I asked if she was unaware of the report.  She said she was not, but the cranberries had been gr own in the very same way for years, they were healthful and inexpensive, and no one had died from eating them before or would from eating them then.

And despite the panic, she was right.  The carcinogenic report the HEW secretary relied upon was that lab rodents eating huge doses of aminotriazole -- equivalent to eating fifteen thousand pounds of cranberries for several years -- developed cancer.  In other words, the danger was overblown, and we were right to ignore it.

In time, these preposterous food scares were a means for congressmen to get in the news by calling movie stars like Meryl Streep as expert witnesses on food safety, (largely leftist) "public interest" groups to raise money, and lazy reporters (especially those on the AP payroll) to file stories which were little more than handouts from such groups.  Activistcash.com documents this phenomenon better than anyone else, as this sample report on the Alar scare reveals.

Last year, the climate warming/climate change hysteria, which has caused limited resources to be diverted from energy production by proven means to the pockets of scamsters and into unreliable energy production operations, was proven to be a hoax of the same sort.

As my friend Charles Martin, the author of the two articles linked in the preceding paragraph, observes, the financial scam behind the climate scare and the manipulation of data to make the claim more plausible are not far different from the chicanery behind the utterly scandalous and fact-free Alar scare:

First, there were the true believers, like James Hansen, whose belief in the need to eliminate industrial civilization far predates the global warming explanation. (There is a side story to be told there as well. What do the true believers really believe? What do they advocate as ways to reduce humanity's environmental impact?) These true believers seem to be quite willing to ... adapt their scientific results to make sure that people on the outside are as frightened as possible.

There is another, larger group, who may or may not be true believers -- who can know what is in another man's heart? -- but who don't seem to worry too much about their own carbon impact, like Al Gore. (Oh, he buys indulgences from his own company, which is one little mercy -- he could conceivably instead say he would have built a bigger house with more carbon impact, and claimed a carbon credit.)  A fair number of these people, though, seem to be set up to make an immense pile of money off the carbon markets, and they all seem to have impeccable political connections.  This larger group makes sure that the true believers get big grants, and travel to conferences in Gstaad and Tahiti, and have well-financed platforms from which to speak.

It's that second group we most need to watch. In the old Soviet Union, these people -- the Communist Party members who received positions of power -- were called the nomenklatura. They weren't necessarily the true believers (in fact, a lot of the true Communists, like Beria and Trotsky, ended up dead or in Siberia), but they could mouth the slogans, pass on the Communist Party line, and play the system to get positions and power, dachas, and access to the "special" stores that always had sausage, green vegetables, and toilet paper.

And, of course, there is a third group: the rest of us. We are expected to pay the increased carbon offset costs quietly, cold in our darkened rooms, but warm in our hearts because we're saving the planet.

If you have not yet done so, I urge you read "Lies, Damned Lies. And Medical Science" in the Atlantic Monthly.  It documents the work of a Greek team of clinicians and Ph.D.s, including Professor John Ioannidis, who study whether medical-research studies can be trusted. According to the article these studies cannot be trusted.

But the horrific manipulation of research data to affect human behavior where the need to do so is unproven.  The consequences of such shifts are unfortunate; they are no longer limited to chemical scares, nutritional claims, and green energy and carbon credit promotion.  Such manipulation is now demonstrably infecting medical research, making it as unreliable as the hair-on-fire food and climate scares promoted by Fenton and a stable of nitwit movie stars and political snake oil salesmen.

He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. ... [H]e worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change -- or even to publicly admitting that there's a problem. [snip]

In poring over medical journals, he was struck by how many findings of all types were refuted by later findings. Of course, medical-science "never minds" are hardly secret. And they sometimes make headlines, as when in recent years large studies or growing consensuses of researchers concluded that mammograms, colonoscopies, and PSA tests are far less useful cancer-detection tools than we had been told; or when widely prescribed antidepressants such as Prozac, Zoloft, and Paxil were revealed to be no more effective than a placebo for most cases of depression; or when we learned that staying out of the sun entirely can actually increase cancer risks; or when we were told that the advice to drink lots of water during intense exercise was potentially fatal; or when, last April, we were informed that taking fish oil, exercising, and doing puzzles doesn't really help fend off Alzheimer's disease, as long claimed. Peer-reviewed studies have come to opposite conclusions on whether using cell phones can cause brain cancer, whether sleeping more than eight hours a night is healthful or dangerous, whether taking aspirin every day is more likely to save your life or cut it short, and whether routine angioplasty works better than pills to unclog heart arteries.

But beyond the headlines, Ioannidis was shocked at the range and reach of the reversals he was seeing in everyday medical research. "Randomized controlled trials," which compare how one group responds to a treatment against how an identical group fares without the treatment, had long been considered nearly unshakable evidence, but they, too, ended up being wrong some of the time. "I realized even our gold-standard research had a lot of problems," he says. Baffled, he started looking for the specific ways in which studies were going wrong. And before long he discovered that the range of errors being committed was astonishing: from what questions researchers posed, to how they set up the studies, to which patients they recruited for the studies, to which measurements they took, to how they analyzed the data, to how they presented their results, to how particular studies came to be published in medical journals.

This array suggested a bigger, underlying dysfunction, and Ioannidis thought he knew what it was. "The studies were biased," he says. "Sometimes they were overtly biased. Sometimes it was difficult to see the bias, but it was there." Researchers headed into their studies wanting certain results-and, lo and behold, they were getting them.

I thought this report, much of which deals with how scientists unconsciously or unintentionally allow bias to manipulate their findings, was shocking, though the part which dealt with how distorted findings often were career-enhancing, leading to funding and tenured positions especially if the theories involved were eye-catching, was not.  It was much like the nutritional claims and scares many of us often have developed a rational skepticism about.

Still, this week's story about the deliberate falsification of the research linking autism to childhood vaccines suggests to me that work like Ioannidis' deserves far more support to weed out both understandable error and such despicable charlatans as Dr. Andrew Wakefield, the man behind outright medical research fraud.

According to the British Medical Journal (footnotes not included):

"Science is at once the most questioning and ... sceptical of activities and also the most trusting," said Arnold Relman, former editor of the New England Journal of Medicine, in 1989.  "It is intensely sceptical about the possibility of error, but totally trusting about the possibility of fraud."1  Never has this been truer than of the 1998 Lancet paper that implied a link between the measles, mumps, and rubella (MMR) vaccine and a "new syndrome" of autism and bowel disease.

Authored by Andrew Wakefield and 12 others, the paper's scientific limitations were clear when it appeared in 1998.2 3  As the ensuing vaccine scare took off, critics quickly pointed out that the paper was a small case series with no controls, linked three common conditions, and relied on parental recall and beliefs.4  Over the following decade, epidemiological studies consistently found no evidence of a link between the MMR vaccine and autism.5 6 7 8 By the time the paper was finally retracted 12 years later,9 after forensic dissection at the General Medical Council's (GMC) longest ever fitness to practise hearing,10 few people could deny that it was fatally flawed both scientifically and ethically.  But it has taken the diligent scepticism of one man [Brian Deer], standing outside medicine and science, to show that the paper was in fact an elaborate fraud.

If you have not read the story, it appears that Dr Wakefield, who on insufficient evidence reported the link, had in fact been paid rather well to do this research by lawyers who intended to sue the pharmaceutical companies which produced the vaccines.  According to the British Medical Journal, which investigated Dr. Wakefield's research, he "misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study."  There were consequences:

The now-discredited paper panicked many parents and led to a sharp drop in the number of children getting the vaccine that prevents measles, mumps and rubella. Vaccination rates dropped sharply in Britain after its publication, falling as low as 80% by 2004. Measles cases have gone up sharply in the ensuing years.

In the United States, more cases of measles were reported in 2008 than in any other year since 1997, according to the Centers for Disease Control and Prevention. More than 90% of those infected had not been vaccinated or their vaccination status was unknown, the CDC reported.

"But perhaps as important as the scare's effect on infectious disease is the energy, emotion and money that have been diverted away from efforts to understand the real causes of autism and how to help children and families who live with it," the BMJ editorial states.

Wakefield has been unable to reproduce his results in the face of criticism, and other researchers have been unable to match them. Most of his co-authors withdrew their names from the study in 2004 after learning he had had been paid by a law firm that intended to sue vaccine manufacturers -- a serious conflict of interest he failed to disclose.

Wakefield's study, I must note, had as late as March of last year one prominent advocate: Robert Kennedy, Jr.  Perhaps he and Meryl Streep can find time in their busy careers to educate us further by co-authoring a scientific text.

Is it likely that Hollywood will latch onto this story with the sort of fervor it demonstrated for the now-certainly discredited "cancer cluster" which made Erin Brokovich and her employer wealthy?

I doubt it.  Don't you?

When villains like DDT and acid rain prove in fact not responsible for things like cancer and frogs' missing legs, those claims and the costs incurred as a result of them tend to drop from view.  It's hard to build up enmity for things like dragonfly nymphs and genes, after all.

As for my mother, who ignored the Great Cranberry Scare of 1959, she's 91, lives alone, manages all her own affairs, and ate cranberries again this Thanksgiving when she flew by herself from Florida to Los Angeles to spend the holiday with her family.
David Suzuki said, "Education has failed in a very serious way to convey the most important lesson science can teach: skepticism."  His observation is proven right every single day.

I remember when I first learned that lesson at my mother's knee.  It was November 1959, and the first major food scare I can remember was set off by a report by the secretary of HEW, who, just before that Thanksgiving, warned that cranberries were "contaminated" with a weed-killer called aminotriazole.

Without paying much attention to the fine print of the reports about the chemical, consumers shunned cranberries, which remained heaped up at supermarkets even with drastic price cuts.

I had come home from college and was horrified to see my mother unloading the grocery bags, which contained several packages of cranberries.  I asked if she was unaware of the report.  She said she was not, but the cranberries had been gr own in the very same way for years, they were healthful and inexpensive, and no one had died from eating them before or would from eating them then.

And despite the panic, she was right.  The carcinogenic report the HEW secretary relied upon was that lab rodents eating huge doses of aminotriazole -- equivalent to eating fifteen thousand pounds of cranberries for several years -- developed cancer.  In other words, the danger was overblown, and we were right to ignore it.

In time, these preposterous food scares were a means for congressmen to get in the news by calling movie stars like Meryl Streep as expert witnesses on food safety, (largely leftist) "public interest" groups to raise money, and lazy reporters (especially those on the AP payroll) to file stories which were little more than handouts from such groups.  Activistcash.com documents this phenomenon better than anyone else, as this sample report on the Alar scare reveals.

Last year, the climate warming/climate change hysteria, which has caused limited resources to be diverted from energy production by proven means to the pockets of scamsters and into unreliable energy production operations, was proven to be a hoax of the same sort.

As my friend Charles Martin, the author of the two articles linked in the preceding paragraph, observes, the financial scam behind the climate scare and the manipulation of data to make the claim more plausible are not far different from the chicanery behind the utterly scandalous and fact-free Alar scare:

First, there were the true believers, like James Hansen, whose belief in the need to eliminate industrial civilization far predates the global warming explanation. (There is a side story to be told there as well. What do the true believers really believe? What do they advocate as ways to reduce humanity's environmental impact?) These true believers seem to be quite willing to ... adapt their scientific results to make sure that people on the outside are as frightened as possible.

There is another, larger group, who may or may not be true believers -- who can know what is in another man's heart? -- but who don't seem to worry too much about their own carbon impact, like Al Gore. (Oh, he buys indulgences from his own company, which is one little mercy -- he could conceivably instead say he would have built a bigger house with more carbon impact, and claimed a carbon credit.)  A fair number of these people, though, seem to be set up to make an immense pile of money off the carbon markets, and they all seem to have impeccable political connections.  This larger group makes sure that the true believers get big grants, and travel to conferences in Gstaad and Tahiti, and have well-financed platforms from which to speak.

It's that second group we most need to watch. In the old Soviet Union, these people -- the Communist Party members who received positions of power -- were called the nomenklatura. They weren't necessarily the true believers (in fact, a lot of the true Communists, like Beria and Trotsky, ended up dead or in Siberia), but they could mouth the slogans, pass on the Communist Party line, and play the system to get positions and power, dachas, and access to the "special" stores that always had sausage, green vegetables, and toilet paper.

And, of course, there is a third group: the rest of us. We are expected to pay the increased carbon offset costs quietly, cold in our darkened rooms, but warm in our hearts because we're saving the planet.

If you have not yet done so, I urge you read "Lies, Damned Lies. And Medical Science" in the Atlantic Monthly.  It documents the work of a Greek team of clinicians and Ph.D.s, including Professor John Ioannidis, who study whether medical-research studies can be trusted. According to the article these studies cannot be trusted.

But the horrific manipulation of research data to affect human behavior where the need to do so is unproven.  The consequences of such shifts are unfortunate; they are no longer limited to chemical scares, nutritional claims, and green energy and carbon credit promotion.  Such manipulation is now demonstrably infecting medical research, making it as unreliable as the hair-on-fire food and climate scares promoted by Fenton and a stable of nitwit movie stars and political snake oil salesmen.

He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. ... [H]e worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change -- or even to publicly admitting that there's a problem. [snip]

In poring over medical journals, he was struck by how many findings of all types were refuted by later findings. Of course, medical-science "never minds" are hardly secret. And they sometimes make headlines, as when in recent years large studies or growing consensuses of researchers concluded that mammograms, colonoscopies, and PSA tests are far less useful cancer-detection tools than we had been told; or when widely prescribed antidepressants such as Prozac, Zoloft, and Paxil were revealed to be no more effective than a placebo for most cases of depression; or when we learned that staying out of the sun entirely can actually increase cancer risks; or when we were told that the advice to drink lots of water during intense exercise was potentially fatal; or when, last April, we were informed that taking fish oil, exercising, and doing puzzles doesn't really help fend off Alzheimer's disease, as long claimed. Peer-reviewed studies have come to opposite conclusions on whether using cell phones can cause brain cancer, whether sleeping more than eight hours a night is healthful or dangerous, whether taking aspirin every day is more likely to save your life or cut it short, and whether routine angioplasty works better than pills to unclog heart arteries.

But beyond the headlines, Ioannidis was shocked at the range and reach of the reversals he was seeing in everyday medical research. "Randomized controlled trials," which compare how one group responds to a treatment against how an identical group fares without the treatment, had long been considered nearly unshakable evidence, but they, too, ended up being wrong some of the time. "I realized even our gold-standard research had a lot of problems," he says. Baffled, he started looking for the specific ways in which studies were going wrong. And before long he discovered that the range of errors being committed was astonishing: from what questions researchers posed, to how they set up the studies, to which patients they recruited for the studies, to which measurements they took, to how they analyzed the data, to how they presented their results, to how particular studies came to be published in medical journals.

This array suggested a bigger, underlying dysfunction, and Ioannidis thought he knew what it was. "The studies were biased," he says. "Sometimes they were overtly biased. Sometimes it was difficult to see the bias, but it was there." Researchers headed into their studies wanting certain results-and, lo and behold, they were getting them.

I thought this report, much of which deals with how scientists unconsciously or unintentionally allow bias to manipulate their findings, was shocking, though the part which dealt with how distorted findings often were career-enhancing, leading to funding and tenured positions especially if the theories involved were eye-catching, was not.  It was much like the nutritional claims and scares many of us often have developed a rational skepticism about.

Still, this week's story about the deliberate falsification of the research linking autism to childhood vaccines suggests to me that work like Ioannidis' deserves far more support to weed out both understandable error and such despicable charlatans as Dr. Andrew Wakefield, the man behind outright medical research fraud.

According to the British Medical Journal (footnotes not included):

"Science is at once the most questioning and ... sceptical of activities and also the most trusting," said Arnold Relman, former editor of the New England Journal of Medicine, in 1989.  "It is intensely sceptical about the possibility of error, but totally trusting about the possibility of fraud."1  Never has this been truer than of the 1998 Lancet paper that implied a link between the measles, mumps, and rubella (MMR) vaccine and a "new syndrome" of autism and bowel disease.

Authored by Andrew Wakefield and 12 others, the paper's scientific limitations were clear when it appeared in 1998.2 3  As the ensuing vaccine scare took off, critics quickly pointed out that the paper was a small case series with no controls, linked three common conditions, and relied on parental recall and beliefs.4  Over the following decade, epidemiological studies consistently found no evidence of a link between the MMR vaccine and autism.5 6 7 8 By the time the paper was finally retracted 12 years later,9 after forensic dissection at the General Medical Council's (GMC) longest ever fitness to practise hearing,10 few people could deny that it was fatally flawed both scientifically and ethically.  But it has taken the diligent scepticism of one man [Brian Deer], standing outside medicine and science, to show that the paper was in fact an elaborate fraud.

If you have not read the story, it appears that Dr Wakefield, who on insufficient evidence reported the link, had in fact been paid rather well to do this research by lawyers who intended to sue the pharmaceutical companies which produced the vaccines.  According to the British Medical Journal, which investigated Dr. Wakefield's research, he "misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study."  There were consequences:

The now-discredited paper panicked many parents and led to a sharp drop in the number of children getting the vaccine that prevents measles, mumps and rubella. Vaccination rates dropped sharply in Britain after its publication, falling as low as 80% by 2004. Measles cases have gone up sharply in the ensuing years.

In the United States, more cases of measles were reported in 2008 than in any other year since 1997, according to the Centers for Disease Control and Prevention. More than 90% of those infected had not been vaccinated or their vaccination status was unknown, the CDC reported.

"But perhaps as important as the scare's effect on infectious disease is the energy, emotion and money that have been diverted away from efforts to understand the real causes of autism and how to help children and families who live with it," the BMJ editorial states.

Wakefield has been unable to reproduce his results in the face of criticism, and other researchers have been unable to match them. Most of his co-authors withdrew their names from the study in 2004 after learning he had had been paid by a law firm that intended to sue vaccine manufacturers -- a serious conflict of interest he failed to disclose.

Wakefield's study, I must note, had as late as March of last year one prominent advocate: Robert Kennedy, Jr.  Perhaps he and Meryl Streep can find time in their busy careers to educate us further by co-authoring a scientific text.

Is it likely that Hollywood will latch onto this story with the sort of fervor it demonstrated for the now-certainly discredited "cancer cluster" which made Erin Brokovich and her employer wealthy?

I doubt it.  Don't you?

When villains like DDT and acid rain prove in fact not responsible for things like cancer and frogs' missing legs, those claims and the costs incurred as a result of them tend to drop from view.  It's hard to build up enmity for things like dragonfly nymphs and genes, after all.

As for my mother, who ignored the Great Cranberry Scare of 1959, she's 91, lives alone, manages all her own affairs, and ate cranberries again this Thanksgiving when she flew by herself from Florida to Los Angeles to spend the holiday with her family.