Without a doubt 'Bad Science' was the most thought-provoking book that I read in 2008, and I heartily recommend it to anyone who is interested in health, medicine, and how the media covers science. I'd also recommend it to anyone who isn't interested too - as they're probably most in need of the education the book provides in fundamental statistics, evidence-based medicine, and resistance to PR nonsense. In fact, I don't think it would be excessive to make this book the foundation for a secondary school curriculum in these areas.
However, the glaring absense of common-sense thinking in the media when it comes to science meant that reading 'Bad Science' left me feeling hopeless and slightly depressed. As Goldacre ably demonstrates, there's an army of homeopaths, nutritionists, PR firms, 'Big Pharma' drug companies, and ignorant journalists who actively distort and deliberately misinterpret science. They totally dominate the traditional media and smother any real news about the world of evidence-based research (especially medicine), instead using sensationalist and inaccurate science stories to sell whatever they're interested in: sugar pills, drugs, newspapers, beauty products, or whatever.
A point that the book rightly takes issue with is that the reliance on arbitrary 'authority figures' to sell us science undermines the fundamental principle that science is about evidence and testable hypotheses. As the Royal Society's motto goes, Nullius in Verba - on the word of no-one - means that it's not about who says what, it's what the evidence says. Even worse, these 'experts' often have no basis for their claims to authority - Goldacre's many examples include the (now deceased) Chris Malyszewicz, who - with a mail-order PhD from America and a back-garden shed 'laboratory' - was feted as the UK's leading MRSA expert and seems to have been single-handedly responsible for the majority of the positive test results of the 'filthy hospitals' scandal of 2005.
What's shocking is not that there are cranks or oddballs in the 'scientific community' (I use the term quite broadly!) but that the traditional media have been so keen to cynically exaggerate their expertise to create untruthful and sensationalist news stories.
The biggest story, of course, is the MMR hoax (lengthy excerpt here). As a (fairly ignorant) punter when it comes to MMR, the impression I received from the media was that there was some genuine possibility that MMR is linked to autism. This is completely false - there is no evidence for this at all. I feel duped by the newspapers I read which stirred up this story (and kept on stirring) despite the overwhelming evidence to the contrary. I was also surprised to read that the obsession with the MMR vaccine is confined to the UK - whilst in France and the US there is public outrage about other vaccines, equally unfounded, and equally hyped by the media.
The Gillian McKeith nonsense I've been aware of from reading Goldacre's blog. Ridiculous woman - see here for more info if you haven't come across the 'awful poo lady' before.
There were a number of other scientific studies I wasn't aware of before, and which perhaps form the basis for my feeling of hopelessness. I'll pick one example: the Kruger / Dunning paper of 1999 (available in full as a PDF here, and a fantastic read), which essentially demonstrated that people's inability to recognise their own incompetence leads to them holding an inflated and inaccurate assessment of their own levels of skill or expertise. From the summary of the paper's findings:
People tend to hold overly favorable views of their abilities in many social and intellectual domains. The authors suggest that this overestimation occurs, in part, because people who are unskilled in these domains suffer a dual burden: Not only do these people reach erroneous conclusions and make unfortunate choices, but their incompetence robs them of the metacognitive ability to realize it. Across 4 studies, the authors found that participants scoring in the bottom quartile on tests of humor, grammar, and logic grossly overestimated their test performance and ability. Although their test scores put them in the 12th percentile, they estimated themselves to be in the 62nd. Several analyses linked this miscalibration to deficits in metacognitive skill, or the capacity to distinguish accuracy from error. Paradoxically, improving the skills of participants, and thus increasing their metacognitive competence, helped them recognize the limitations of their abilities.
Additionally, the study found that non-expert people are equally bad at assessing expertise in others - the point which Goldacre makes when decrying the appalling ignorance and misunderstanding in the media when it comes to science. This doesn't bode well for improvement in the quality of science reporting any time soon.
Having re-read my article of a couple of years ago, I'm rather pleased to have come to some of the same conclusions as the book despite being unaware of the blog and column in the Guardian at the time. However there are a couple of areas where my opinion has now changed as a result of reading 'Bad Science'.
First, I gave the benefit of the doubt to the media. I portrayed them as merely gullible and ignorant, rather than actively promoting the public misunderstanding of science in order to sell newspapers. Whilst I have no doubt that journalists are often the dupes of PR companies, they are also complicit in deliberately cherry-picking statistics to find the minority (and often discredited) studies that misportray scientific opinion and artificially create controversy where it doesn't actually exist.
Second, and more seriously, I underplayed the role of evidence-based studies in telling us more about the world we live in. Recently graduated from a History and Philosophy of Science degree course, I think I was guilty of undue relativism in characterising science as a socially mediated activity, and erred too far in making out that science is similar to humanities subjects. This is something about which Goldacre is particularly adamant - it frustrates him that humanities graduates who work in the media expect that because opinion is formed in these areas by whoever argues loudest or hardest, and that they don't see why it shouldn't be the same in the sciences.
To go back to my point at the beginning of the post, I genuinely believe that everyone would benefit from reading this book, without exception. So if you're thinking that you'd like to be more aware of science and medicine in the media, read this book.
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Incidentally, this completes my first book review. One down, nine to go - I'm reading Homicide now - it's fantastic. I should have a review up in a couple of weeks.
