Bacon Sandwich

I'm pretty busy writing up my work at the moment, hence the long break in posting this month. I'll try to fire out a few short but useful entries over the coming weeks rather than saving it all up for the monolithic posts I usually make.

Every week, some newspaper or another makes us frightened or happy by covering the latest risk data regarding "causes" or "cures" for cancer, stroke, heart disease and the like. Apparently they won't be happy until they've fully catalogued all Things at least once over, and preferably twice with flatly contradictory information. They present us with statements such as "Bacon Sandwiches raise cancer risk by 20%". That would probably put quite a few people off eating bacon sandwiches, but it's not a statistic you'll ever find in a peer-reviewed scientific paper. And there's a good reason for that. This sort of figure is what is called a "relative risk increase". It's calculated by taking the dividing the new risk (with bacon sanswiches) by the normal risk (sans sandwich) and multiplying by 100. We can see the weakness of that way of representing the numbers with an illustration such as this:

The risk of killing yourself with a revolver loaded with only a single bullet in a random chamber is 1 in 6. Put two bullets into two random chambers and the risk is 2 in 6 (or 1 in 3). These are absolute risks as opposed to relative risks. In percentages, the absolute risk is just over 16% with one bullet, but twice that (32%) with two bullets. Now let's do a Daily Mail on it and express this as a relative risk increase. That's a 16% increase over 16%. So by putting in the extra bullet you've just increased your risk of killing yourself when you pull the trigger by 100%. That last number is certainly the scariest, although we must admit that none of these numbers is particularly fun.

But here's where it gets interesting (stop rolling your eyes please). Imagine the risk of catching a fatal dose of the flu is 1 in 10,000,000 for each time you go to work on the train, but is 2 in 10,000,000 if you take the bus. These odds are very much lower than the absolute risks relating to the gun. In percentage terms they sound comfortingly low too (0.00001% increasing to 0.00002%). You're probably not going to base your public transport decision making on these numbers. However when we convert these numbers into a relative risk increase, we get... 100%. A headline that says "Buses Raise Flu Death Risk by 100%" is certainly going to either make you think twice about using the bus, or is going to make you think that those silly boffins are just spoofing (didn't they say buses were better for some reason last week?). You get exactly the same punch in a Daily Mail headline as the gun risk, and yet in reality they're not even vaguely similar.

This week a nice site caught my eye which puts all of that statistical wonder into a fun little web program that allows you to see the various ways in which scientific data can be made more scary. There's all sorts of ways to make a scare story out of a non story, and you can rest assured that most of the newspapers are quite prepared to use them.

Image from Wikipedia released under the terms of the GNU Free Documentation License.

Holy F**king Sh*t: Daily Mail debunks MMR autism link

This post may be unsuitable for minors or people upset by scenes of total doublethink.

Well, the day has finally come. The Daily Mail has finally joined the rest of the world in accepting that MMR is safe, and that the 1998 study by Andrew Wakefield has been "debunked" (even though the study never says that MMR causes autism, a press release did and it was debunked 10 years ago). Measles is on the rise again, and that's actually a big deal. Kids are getting sick, people have died and someone is going to hang. This isn't just Wakefield's fault of course. No, he should not be a scapegoat! There are others to blame. Us, apparently. In a remarkable display of doublethink, the Daily Mail points the finger at "middle-class MMR refuseniks". Parents who somehow bought the press-release pseudoscience presented by Wakefield (minus the et al). They must have picked it up off Reuters, the wiley middle-class (yet strangely uncritical and credulous) bastards.

Of course, the Mail don't mention the media frenzy that followed the "confirmation" of Wakefield's 1998 work (by, er.. Wakefield). The evidence-free total bullshitstorm that presented Wakefield's speculations directly to that middle-(and working-) class audience as if it were yet another scientific "breakthrough". The torrent of jargon filled trash that published everything that vaguely supported the hypothesis but ignored the dozens and dozens of studies debunking it, milking that story for every millilitre of newspaper sales it had. And how could they, since up until a month ago the Daily Mail were still doing it? Still implying that MMR was dangerous. But today they've hit the reset button. And I feel like I just fell through the looking glass. It's funny, in a totally horrifying kind of way. Well, let me just say, so that we can be clear. And you'll have to forgive me for my profanity because it just feels like that sort of moment.

THIS WAS YOUR FUCKING FAULT, YOU MORONS.

I mean, seriously. Read your own articles. People are going to hang for this, but the media are the ones judging who, so the list will doubtlessly be restricted to:

-A. J Wakefield
-The Middle Classes

I feel like I'm taking crazy pills.

Update 18:08: It's even crazier than I thought. A search for "MMR" on the Daily Mail reveals a similar article in 2008 blaming "mothers" for the oncoming measles epidemic. This article sits amongst yet more panic pieces calling MMR "controversial" and cagey coverage of the research that 'disproves MMR jab link to autism' (the quotes were in the headline as if incredulous). Clearly, the Mail spent 2008 being eased into a gentle but enormous u-turn.

MMR is safe. Tell your friends.

Bad Science writer Ben Goldacre recently reported on a stunningly ignorant radio broadcast by Jeni Barnett perpetuating the MMR vaccine scare. Ten years after a peer-reviewed paper didn't say there's a connection between MMR and autism but one of the authors told the media that it did, we're still going in circles. We can point fingers in all sorts of directions, including at ourselves, but the data has shown time and again that MMR is safe.

Ben posted the radio slot up to demonstrate that he was not cherrypicking the most stupid parts just to make Jeni look bad. But apparently this is legally not okay and so, because scientific debate has long ceased to matter in the MMR scare, the lawyers swooped in. Personally, I don't think any of us should allow fear to prevail when the cost is so great. The MMR scare is based on crap science and it's putting kids at risk. It has to stop.

Discuss it on Bad Science (there may even be some links to the radio programme): http://www.badscience.net/

On Jeni Barnett's blog: http://www.jenibarnett.com/2009/02/mmr_and_me.php

Update 16:52: Coincidentally, the BBC today announced that Measles cases rose yet again for the third year running. The cause is the reduction in MMR uptake and the result is going to be deaths. Not many deaths, but some.

Update 08 February 2009: And evidence has just emerged that the man behind the scare, Dr. Wakefield, falsified some of the original data showing a temporal association between MMR and autism. Far from there being even that correlation, it appears that some of the kids were showing documented autism characteristics prior to MMR vaccination and others displayed them much much later than was stated in Wakefield et al. (1998).

Things Happen After Event Shock

The Daily Mail have decided to have a go at MMR again as pointed out by Ben Goldacre at Bad Science. A child has fallen terribly ill "six months after MMR jab". Ten years after Andrew Wakefield speculated himself into the headlines by suggesting a link between MMR and autism (in a press-release mind, not in a research paper), this misguided rubbish is still being presented as "science news". Actually, most of the papers now seem to reject the link and are thus in the business of demonizing Wakefield himself, as if they had nothing to do with the scare. But the Daily Mail is apparently not quite ready to take even that ass-covering step. They cite the 1998 Wakefield paper (it was a press release that actually made the claims) and I have responded, though I wonder if it will be published.

Daily Mail, please read the 1998 paper by Wakefield et al. It does not suggest anything more than a temporal connection between the MMR vaccination and the onset of a symptom associated with autism (colitis) that's a long way from even suggesting a possible connection between MMR and autism. Wakefield decided to make that particular suggestion directly to the press, perhaps because the evidence did not support him and he knew it would not be published. More tellingly, ten of his his co-authors on the 1998 paper retracted their support for that claim.
So here we have another temporal association. Thing Y has happened after thing X. And so we must assume that X caused Y, right? Rubbish. I'd imagine a whole load of things happened before this poor kid fell ill.

At this point I ran out of words in the little submission box, so I'll conclude as I would have liked.

The child doubtlessly slept, ate breakfast and breathed constantly just prior to falling ill. So far as we can actually gather from the evidence here, almost anything could have "caused" this tragedy. The likeliest explanation though, is that it was nothing we could have predicted. You write that the child had previously suffered brain damage due to a Herpes Simplex infection at the age of two weeks. Anyone who has had coldsores will know that re-activation of that virus (it never leaves us) is not a predictable event and it has never been causally linked to events such as vaccination, as far as I'm aware.

To imply that MMR was responsible for this sad event is deeply irresponsible journalism and it will doubtlessly further the anti-vaccination movement and lead to more sick kids, and probably more deaths from measles- a disease that was nearly extinct in Europe before this totally unfounded scare.

Update 23 Jan 2009: Predictably enough, my comment has not appeared on the Daily Mail article. Nor have any at all, for that matter. Given that the Goldacre Evidence Army was alerted, that seems just a little suspect to me...

Fear and Vaccination in London

Author's note: After my successful foray into soapboxing with the LHC story, I decided to get back up on the box again to trumpet my current hypothesis. Science, the scientific method and scepticism are misunderstood by almost everyone and something has to be done. For more evidence of just how bad things are, check out the ongoing research into the dangers of dihydrogen monoxide. The research itself is satire (sorry to spoil the fun, but I certainly don't want people to think I don't get it). The reactions of the public are the really frighetning part. Anyway, on to the self-righteous ranting.

In 1998 a British-based surgeon, Dr. Andrew Wakefield published a research paper in which he and his team tentatively identified a bowel disorder associated with autism which he coined “autistic enterocolitis” and speculated (a very important word there) that this might be caused by vaccination with the MMR vaccine. Most people are roughly aware of what MMR is. The measles, mumps and rubella triple vaccine. It is a mixture of the three viruses, alive but weakened to the point that they’re not even able to infect infants. They do however cause the recipient’s immune system to generate lots of cells and antibodies that will basically squash the three viruses should they ever be seen again. The need for vaccination against these three diseases is an easy case to make. Measles in adults can cause brain damage. Mumps may cause infertility in males, especially kids. Rubella, if it infects the unborn through the mother, can cause a wide range of birth defects. These complications don’t occur often- but the viruses are so infectious that those rare cases would be a big deal in any highly populated country.

Cause and Effect

So MMR was suggested to have an influence on autistic intestinal inflammation, but there was more. According to Wakefield’s paper, there also appeared to be a connection between the time of administration of MMR to a child and emergence of autism, though that element of the study was retrospective. The paper itself did not rock the boat in the mainstream media, though the scientific community began criticising it immediately. The connection between MMR and autism was not clear, and the study group was small. Just twelve children, all selected because they had autism. At best, that sort of study would represent a starting point for some more solid research. To be meaningful and to make that connection really clear we’d need thousands of examples, and we’d to be able to compare our results with loads of non-autistic kids.

It wasn’t until Wakefield decided to jump outside of the peer-review system that things began to go bad. I discussed in a previous posting how science makes its way into the mainstream media. I even included a flow chart, which I’ll reproduce now. What Dr. Wakefield did was follow the path on the far right. Skipping all external controls and critique he instead decided to talk directly to the press. And what he had to say would cause a sensation. He called for a halt to administration of the MMR vaccine in favour of vaccinating for each of the three diseases separately over an extended time of several years. His stated reasoning was that he believed that MMR might be causing Autism. The initial response in the media was muted. The press release and an accompanying video released by Wakefield’s hospital drew some attention. Wakefield found himself defending his work in letters to the journal that had published his paper, Lancet. In 2000, Wakefield published more papers pushing his MMR hypothesis. Then in 2001, something snapped. Perhaps it was the publicity, the momentum built in the last couple of years. Perhaps Wakefield’s recent high-profile exit from his hospital position (a “mutual decision”) was noticed. Perhaps some of his new research papers pushed the right buttons. Whatever it was, the MMR and autism story hit the mainstream.

What Grows in Darkness

The newspapers went wild, particularly in the UK. By 2002, the stories in the press questioning the safety of MMR numbered in the thousands. Few dealt with the inconvenient peer-reviewed research papers that refuted Wakefield’s findings and the controversy dominated health reporting for several years. Here was a piece of news based on the (very carefully worded) concerns of a single surgeon. But somehow the line (in the Daily Mail at least) became “Scientists Fear MMR Link to Autism”. “One Scientist Cautiously and Inappropriately Suggests MMR Link to Autism” is not very catchy perhaps, but the fear mongering sentiment went further than headlines and permeated the reporting. As a direct result, MMR vaccination rates in the UK fell to 80% by 2003. In some urban areas of London, the rate was as low as 65%. When we learn a little about how vaccination works these, figures become even more alarming.

Vaccination is not 100% effective on a person-to-person basis, though it is usually above 99% effective. This is generally not an issue however, as vaccination also serves to protect the unvaccinated by eliminating the pool possible hosts for a given virus. Because your neighbours are all immune, your chances of even encountering the virus, let alone contracting it, are dramatically reduced. The virus is much less likely to be passed around by accident. This effect is called “herd immunity”. For the three viruses that MMR protects against, the threshold for good herd immunity is around 95% of the population. With the rate of uptake so low in 2005, the risk was rapidly increasing that herd immunity would collapse, resulting in large scale epidemics amongst the roughly 20% of unvaccinated children and the 1% for whom the vaccine had failed to take.

Predictably, the epidemics began around 2000, when the earliest signs of concern had begun to filter through to the public. Measles epidemics were reported in Ireland, Austria and Italy. Most significantly, measles incidences in the UK have increased steadily over the last eight years. Although the increase may appear minimal (from 56 cases per year in 1998 to an estimated 900 cases per year by 2006) the disease was declared “endemic” in the British population earlier this year. This means that the virus is now circulating freely in the population without need for re-infection from outside sources. So anyone without immunity is immediately at much greater risk. Herd immunity is degenerating. There is also evidence that travellers to and from Europe triggered minor outbreaks in the United States. Mumps is on the rise again also, primarily hitting age-groups who passed through infancy prior to the introduction of MMR. Some 70,000 cases were reported between 2004 and 2006. There were a handful of deaths as a result of the measles and mumps resurgences. Three deaths were reported in Ireland, one death in the UK and two cases of brain damage. Not many, but a reminder to us of times when these diseases were a true threat.

The degeneration of herd immunity is just the first step, there is another risk associated with allowing these viruses to become endemic. For every infected person there are literally billions of mumps, measles or rubella viruses in their system. The more viruses there are, the faster they reproduce. The faster they reproduce, the more often they mutate. With part of the population vaccinated and part not vaccinated, what we are doing is presenting the mutating viruses with an obstacle to overcome. The risk is growing that one of these three viruses may undergo the mutation required to evade MMR entirely.

In 2004, ten of Wakefield’s co-authors on the 1998 paper withdrew their support for the work. Since the first publication, at least twenty peer-reviewed research or review papers have discredited the MMR link to autism. Wakefield’s suggested new “autistic enterocolitis” has been dismissed by autism researchers as a common symptom of the condition. Ten years after the controversy began, MMR is not the only vaccine to fall victim to the resurgent paranoia and disillusionment with modern medicine, though this is a trend which predates the MMR scare. Some papers continue to lead a crusade against any proposals for new “multivalent” vaccines that, like MMR, would combine protection from several diseases.

Apportioning Blame

It was a need for a simple cause which ultimately brought the MMR crisis into being. But the fact is, there’s no known single cause for autism. And nor are the causes of the vaccination crisis as clear as they seem. It would be easy to point the finger at Dr. Wakefield. He’s certainly not free of blame. Wakefield’s 1998 study was prompted when he was approached by solicitors representing a group planning to sue MMR manufacturers for causing the autism. According to a Sunday Times report in 2006, Wakefield received money from that group to perform his 1998 study and it appears that some of the study participants were sourced by them too. It is also alleged that Wakefield’s hospital, who were quick to back his findings and arrange press contact, also received money in the form of legal aid. It seems clear from interviews at the time that Wakefield was aware of the fine balance of risks associated with his bold statement. He was aware that switching from the use of MMR to using three vaccines over a number of years very significantly increases a child’s risk of contracting one of the diseases in that time. Wakefield’s point was that the risk of autism outweighed both the fact that his results were unclear and the fact that his suggested course of action brought great risks. He should absolutely not have been going public with his poorly-conceived idea, yet his language in the press release and interviews was actually quite suitably cautious. The subtlety was lost on many news outlets. Rather than exhibit caution themselves, they perpetuated a fear-laden story that has done incalculable damage to public health in Europe. Many of these are the same papers that, years later, are now assassinating Wakefield’s character in light of professional misconduct charges. Ultimately we have to blame pretty much everybody; parents looking for simple answers, lawyers looking for litigation, a surgeon with a bias, a hospital looking for publicity, a media willing to spin anything to sell papers. Not to mention the confused reactions of most GPs and politicians (a blog in itself). And then there’s us. The scientists fought the good fight on the day, sure. But it could be argued that our aloofness from the public has created a culture in which science is only noticed when it is sensational; a culture in which the people have neither the education nor the inclination to view science with proper scepticism. It’s conceivable that just one of those groups had it in them to prevent this whole huge mess. Instead we are now facing continued vaccine paranoia and a dangerous resurgence of diseases we once had on the run.

Alternative Expectations

Scepticism is a balancing act. It’s not about a dismissive nature, any more than a credulous one. I like to think of myself as being a balanced, quite open-minded sceptic. Doubt, but don’t reject without evidence. Mind you, I get it wrong sometimes. Watching a fairly mindless piece of entertainment TV last week, I was introduced to the concept of light therapy, in particular for the treatment of depression as well as skin conditions. I could barely contain a snort of mockery as the wide-eyed presenter explained the serotonin-inducing and antibiotic wonders of various shades of intense light. Actually, I’m pretty sure I didn’t contain it at all. My automatic mistrust of the concept was hasty. After all, it is quite well established that sunlight may have all manner of influences on us, both emotional and physical. However, my scepticism led me to investigate further, which is never a bad thing. I visited Google Scholar to browse some of the peer-reviewed journals on light therapy. My aim; to find out if any evidence of the effectiveness of this therapy actually exists. Sure enough, there is some manner of science in there. Broadly, the studies performed to date have tended to be pretty inadequate in terms of sample size (rarely more than 20 patients) and time scale (weeks when we’d like years). So let’s say that the jury is still out, but that I look more favourably on the concept now than I did previously. I’m still a little dubious as to whether such treatments should already be available in clinics, when it appears as if a full-scale trial has yet to be conducted. It wouldn’t happen with a drug, after all. The wide-eyed presenter, perhaps familiar with the concept of “scepticism”, ensured us that the treatment was “scientifically proven”. Whatever that means.

So I figure that light therapy should not be dismissed. But it should certainly not be accepted on the basis of a TV personality’s assessment of what constitutes “scientific proof”. While light therapy may not be something that would conventionally be classed as “alternative medicine”, it did get me thinking about the topic. The very concept of alternative medicine is often offensive to many medics and scientists. It is a notion that thrives on the modern public’s disillusionment with science in general and the misguided concept that “another way” exists. The disillusionment is not entirely unjustified. And the philosophical rejection of reason shouldn’t prejudice our scientific judgement of the individual therapies classed under the blanket term of “alternative”. Just where did this sense of disillusionment with conventional medicine come from? I have some notions on that. Following the sudden revolution that began with the sanitation practices of the late 19th century, the western world witnessed an unprecedented improvement in public health. The work of scientists such as Koch and Pasteur did away with vague notions of the nature of disease. Ever hear of miasma theory? Nope, because it’s rubbish. Koch and Pasteur, giants of medicine, saw to it that the war upon germs could begin in earnest. Within a century the world’s greatest killers, smallpox, tuberculosis and polio, were either utterly destroyed or reduced to a shadow of their former threat. It was a true revolution. It was the end result of a paradigm shift in biology; the formulation of germ theory. But things have settled down now, we’re back to normal science. Cancer, once largely unheard of, is now the big killer. Many blame modern life, and the science that brought it, for putting things into their food and environment. The newspapers are obsessed with reporting on “things that cause cancer”, which apparently is almost everything. It’s easy to forget of course that 100 years ago very few people lived long enough to get cancer. Modern medicine’s perceived inability to “cure” cancer, heart disease and AIDS, has lead people to lose faith, even to become cynical about the means and even motives of doctors and the health industry. Of course, we scientists and doctors have not helped. Our curious culture of maintaining aloof superiority has fuelled the common man’s sense that science has become disconnected from humanity. In the absence of understandable contact from us, what has anybody to go on other than the caricatures of the media?

So, the “other way” becomes attractive. Dismissive scepticism, the worst kind of scepticism, now rules when dealing with doctors. Many have come to the assumption that alternative medicine forms part of what They Don’t Want You to Know, for reasons that are never entirely clear. A grand conspiracy. This attitude is no better than the average scientist’s blanket views on alternative therapy. It’s really just a matter of getting more information, and if we actually look for it, the beginnings of what we need to know are often already there in the journals. What should the average prospective patient look out for? The journals don’t make for an easy read, but I’ll try to summarise what makes for good testing.

In evidence-based medicine, efficacy and safety are tested using clinical studies. Because humans are so very unique and variable, the only way to be sure that a technique or drug is effective and safe is to go large. To use the biggest study groups possible. We also have to ensure that we study the effects over extended time periods. Both features are vital for the statistical analysis needed to make sense of all that human unpredictability. Most importantly of all we must use what scientists call “controls”. A control in a clinical study is essentially a group, as large and as similar as possible to the group receiving the test treatment, which is treated differently for the sake of comparison. To properly test acupuncture, for example, the bare minimum would be a study of several thousand patients with one group receiving conventional treatment, one receiving acupuncture and one receiving “sham” acupuncture in which the needles are applied but applied incorrectly. The last two groups must be “blinded”, which is to say that neither group should be aware of which is receiving real acupuncture.

A recent-ish study of acupuncture for back-pain followed this very template. They found that acupuncture beat conventional therapy for pain relief. But that isn’t the full story. Firstly, the volunteers consisted of patients for whom conventional therapy had failed. Secondly, they found that the sham acupuncture was just as effective as real acupuncture. This may be an indication of what is called the placebo effect. This is an apparent beneficial effect caused by a fake control treatment, be it the administration of a sugar pill or random pinpricks. Or perhaps there’s some peculiar value to being poked with needles in general. Put simply, it’s not clear what’s going on there. Acupuncture must remain in the realms of the untested for now and we should treat it as such. With doubt, but not with contempt.

On the flip side, we can ditch reiki and reflexology as they have been tested quite thoroughly and found to have no greater benefit than a massage. “Allergy tests” based upon applied kinesiology (the one where bottles of varies substances are held near your muscles) are pure and utter witchcraft in my view. There’s no connection between the results of these and the standard medical allergy test. Hell, some of those tests use sealed bottles, so quite how your body could ever react to the contents is a mystery. As for chiropractic... don’t get me started. Few studies have been able to demonstrate anything more than a placebo effect. Most damningly of all, as pointed out by Ben Goldacre, some chiropractors would rather block the process of scientific criticism of their field. The New Zealand Chiropractors Association has taken the highly suspicious step of attempting to sue a peer-reviewed journal. With your health on the line, is this the sort of carry-on you should accept from your doctor? (Author's Note 21 Aug 2008: The British Chiropractic Association are also sueing journalist Simon Singh for an allegedly libellous article on their faith. I mean, science.)You can be quite sure that no reputable scientist has ever sued in response to academic criticism. Proper studies such as I outlined above are hard to conduct on chiropractic spinal manipulation. This is primarily because the medics who usually run studies are not trained in the methods and chiropractors are reluctant to get involved. What information there is tends to be both limited and self-contradictory. This isn’t a nail in the coffin by any means, but it’s clear that the professionals could be doing more to make us trust them. The general folk and herbal medicine scene is a whole can of worms in its own right. It’s quite clear that some of it works, after all many modern drugs are derived from plant and fungal components. But it’s clear that we don’t know enough about the complex mixture of active ingredients in many such preparations to draw generalisations. Much like light therapy and acupuncture, it remains for me at the fringes of reason for the time being. Ultimately, the advice for navigating the maze that is alternative medicine is much the same as my advice regarding the reading of science in the mainstream media. Scepticism, but open scepticism. Demand evidence, statistics and hard facts. Mechanisms must be rooted in what we can observe. As for doctors, expect more from them too. Ask for explanations, don’t just accept prescriptions. Doctors are often impatient with patient questioning and take a dim view of patients coming to them with their own research from books or the internet. This needs to change. Try to open a dialogue, one that is respectful and yet still sceptical. Never forget that your doctor has some ten years of training and perhaps decades of practical experience. The relationship should ideally be a two-way communication.

As for “alternative medicine”, the term encompasses too wide a range of ideas and carries too much prejudice. To my mind there should be only two kinds of medicine. Tested and not. Only the successfully tested has a place in our lives. Much of what is now untested may one day be worthy of our trust, but right now our health and our lives are at stake. Nothing is more valuable, and nothing is more worthy of healthy scepticism.

It's Revolution, Baby

Science is usually portrayed and imagined as one of two clichés. The scientific establishment is a vast panel of crusty old sceptics, dismissive of innovative thinking and ever willing to attack upstarts. On the flip side of this, “revolutionary” science is so frequently fanfared to the front pages of newspapers that we could almost believe that scientists are as excitable and credulous as the tabloids appear to be. Everyone loves a David and Goliath story, so it is hardly surprising that every controversial finding is pounced upon. Miracle cures and perpetual motion machines are all the more exciting when it appears that they show up those stuffy old boffins. Strange how the rebels and their miracles most often vanish without further updates. With so many contradictory findings being touted each week, it’s easy to see why so many people become disillusioned with science. Going by the newspapers, I’m still not sure if my coffee addiction is going to give me a stroke or save me from a heart attack. In my previous blog (Science Says) I talked about why I think this happens, and why it’s not actually a reflection on proper science at all. True scientific revolution is another story and an exciting one. Maybe not “tabloid exciting” though.

The best explanation as to How Breakthroughs Happen goes like this. A couple of years ago I was fortunate enough to work with a rare kind of scientist. The man, who we shall simply call Oz, is to my mind one of an elite subset of scientists who dedicate their careers to answering a single, if profound question. Oz is also something of a philosophy buff and introduced me to the scientific philosophies of Thomas Kuhn, a man who had a lot to say on the matter of scientific revolutions. On the small scale, science is a cyclical process, as I outlined in First Assumptions. Hypothesise, test, refine, repeat. In time, hypothesis becomes theory or a new part of an existing theory. We can call the prevailing set of theories the “standing model” as they represent a human modelling of reality as we see it. Conferences and the peer review process serves as a rigorous test of the output of the scientific cycle. Scientists are a competitive, aggressive bunch. Attack, until only the truth remains. This constitutes what Kuhn called “normal science”. An overall model, the standing theory is in place, and scientists are filling in the blanks. It is tough work and worthy work. But, as the normal science phase drags on, discrepancies begin to arise.

When Isaac Newton published his theory of universal gravitation in 1687, it represented a fundamental change in the scientific understanding of the universe. It was a true piece of revolutionary science that dismissed theories as old as Aristotle. Once it was put forward and accepted by the community, normal science proceeded. Newton’s theory remained the standing model for over 200 years as the universe was measured and scrutinized using newer and better technologies. The cracks began to show. The movements of some of the planets didn’t fit the theory. The effects of gravity on light didn’t seem to either. And there was more. As always happens, a few contradictory measurements will tend to be dismissed as errors. But as they mount up, efforts will be made to explain them away within the context of the current model. This may well resolve the situation, but for Newton’s legacy this did not suffice. The physics community had entered what Kuhn called a “crisis phase”. The standing theory was clearly inaccurate, yet no theory existed to replace it. New hypotheses were put forward, amongst them the notion that the universe was filled with some manner of “aether”.

In 1905, almost unnoticed, a patent office clerk called Albert Einstein suggested a few things that might help explain how light worked. He demonstrated his ideas via some nice publications which were pretty much entirely dismissed as being a bit strange. A few years later, with a PhD under his belt, Einstein went the whole hog and published General Relativity, a new model that explained pretty much everything that was inconsistent in the Newtonian model and blew the aether out the window. The new thinking was so fundamentally different to Newton’s view of the universe that there was considerable resistance to his new model. As with all new science, revolutionary or otherwise, it had to face the purifying fire of skepticism, particularly from the aether heads. It wasn’t until 1919 that the experimental confirmations finally started to emerge. Einstein’s hypothesis prevailed and within a few years the scientific crisis was resolved. Kuhn called this sort of changeover a “paradigm shift”. The information, the observations, they’re still the same. The understanding has changed. Although the more recent notions of the aether-filled universe was now dismissed, Newton’s theories were not abolished. Instead they became merely a small part of a much bigger picture. Used for simple calculations where Einstein’s equations would be overkill. And so, the task of filling in the blanks in the new model began. Normal science was resumed.

Whilst scientists are often painted as inflexible types sticking to their established knowledge and rejecting change, the reality is that this resistance to change is as valuable as the change itself. It ensures that only the most robust hypotheses become theory. We stuffy boffins are always aware that one day the theories that we hold to may be superseded just as Newton was or may be overturned completely. Almost 100 years later, General Relativity, with additions, is still the accepted model. Yet at the extreme ends of physics the cracks are showing once again. It is perhaps ironic that it was Einstein’s ideas regarding the nature of light that would lead to the birth of Quantum Theory, a model which may one day lead to the next great paradigm shift in physics. For those interested, read up on the Large Hadron Collider. This year it may just prove or disprove a huge chunk of Quantum Theory. I have only a vague idea how, mind you. Physics is witchcraft in my books.

Normal science, crisis, paradigm shift, repeat. It’s a pattern that gave birth to giants of science such as Theory of Evolution and the Galilean model, or such field-specific shifts as the discovery of adaptive immunity. Don’t worry, I’ll probably write about those ones some day. My point is that paradigm shifts may change an entire arm of science, such as Biology, or just a small corner of that arm. Dr. Oz is, to my mind, on his way to heralding a paradigm shift in Biology. He’s in one of those small corners of the field, but the implications of his work speak for themselves. He’s convinced me, at least. The information hasn’t changed, but the way I understand it will never be the same. Let the crisis begin.

Science Says: Popular Science “Will Give You Cancer”

"Digressions, objections, delight in mockery, carefree mistrust are signs of health; everything unconditional belongs in pathology." -Nietzsche

How often do we pick up a newspaper to find that science has yet again warned us of the dangers of something we all like doing? Power lines cause cancer. Coffee causes strokes. Wait no, it protects against heart attacks. So does wine. But it causes liver disease. Several weeks later, it’ll be something else. Fear it. What passes for science news in the mainstream media, be it highbrow or tabloid is often understandably simplified. Maybe it is too simplified, but what is perhaps of more concern is just where this science is coming from, and whether the editors of our beloved media outlets have sufficient knowledge of the workings of science to make good calls on what is likely to represent real findings.

Take the recent (ish) example cited by Ben Goldacre in his column, Bad Science. It all started when the British newspaper the Sunday Express ran with a headline that said:

Suicides “Linked to Mobile Phone Masts”

This front page article revisited the recent epidemic of suicides in Britain, citing the opinion of a certain doctor “who sits on a government advisory committee on mobile radiation” and who has apparently discovered a link between mobile phone deflector masts and depression. The opinion was presented as a revolutionary scientific finding and doubtlessly caused many people great concern. Ever sceptical, Bad Science found out that said scientist is not part of a government advisory committee but of an independent group which interacts with the British department of health via a mediation group. They’re quite far removed from the government and have no official standing. They further found that said scientist had not published his findings via the conventional route and that the data was not readily available. To a scientist, this sort of evasiveness sets off major alarm bells. And they were justified in this case. It emerged that the same scientist has previously made the claim that AIDS is not caused by the HIV virus but by electromagnetic radiation. In scientific circles, this is roughly equivalent to holocaust denial. Not very coincidentally, this claim looks very much like the claims he is now making regarding depression in the Sunday Express. This smacks of an agenda, and an agenda was indeed found. The “scientist” has numerous books available to buy online regarding the dangers of electromagnetic radiation and the healing power of magnets. Magnet healing kits may also be purchased from him, albeit with no explicit (or legally-binding) claims of having any sort of healing power at all. To put it bluntly, The Sunday Express have given their front page to the science world’s version of Delboy.

There’s far more to the story but Ben Goldacre explains in much greater depth and with greater eloquence than I could. His website comes highly recommended.

What should the non-scientist reader believe these days? To my mind, the best way for the average Joe to approach mainstream science reporting (and all popular science in print or on TV) is with scepticism and basic knowledge of how scientific findings are published and validated. So let’s look at that process. Please? I’ve even provided a flow chart as a visual aid! See, the mainstream press is represented by a small explosion which I hope makes the flow chart exciting.

So, scientific research is conducted all over the place. It is done to varying standards and with varying bias or agenda. For a recap on how proper research is conducted check out my previous posting, First Assumptions. This research is submitted to science journals. These are like ultra specialist magazines, and they mostly will only publish raw science, fresh from the lab. Scientists don’t get paid for this. It’s a privilege to be accepted. In order for that to happen, the work has to pass through “peer review”. This means that the work is assessed by an independent group of scientists in the appropriate field. Every figure, graph and photo is scrutinised. Every turn of phrase dismantled. It’s rather like sending your work to a whole group of Simon Cowells. A lot of research gets rejected out of hand or must be brought up to scratch. Mean things are said, feelings are hurt. The best stuff, the most solid stuff, gets into the journals. Unless you are a scientist or an extreme enthusiast, don’t even think of trying to read these journals. The boredom alone may actually make you die.

If your material is particularly hot, it may well feature as a part of a review paper. These are articles that the journals publish in an attempt to summarise the current cutting-edge of a given field for easier reading. “Easier” being very much a relative word. These reviews are only likely to maim the average reader via boredom and an unforgiving learning curve.

If the research has broad appeal to the scientific community as a whole, it may get picked up by the specialist press. Publications such as Focus, Scientific American or New Scientist cater for scientists who like to read news from other fields. The Biologista, for example is a life scientist who also happens to enjoy reading about robots, dinosaurs and jetpacks. New Scientist provides, and it has pictures.

Finally, the very most relevant and exciting research with the broadest appeal possible reaches the mainstream press. Many newspapers have science supplements, many websites carry science news and some papers will go so far as to carry science-oriented stories on their front pages at times. Radio programmes will often do a round-up of the most amusing science of the week.

This system, from peer reviews through the journals and finally to the mainstream is how things would ideally work. What actually happened in the case of our Prof. Delboy is that information was passed from research of unknown quality directly to a credulous newspaper. No peer review or quality control. No vetting for relevance or, most importantly, bias or agenda. This happens a lot in the mainstream press when it comes to science. The source material appears tricky, so information is accepted on the basis of authority, rather than evidence. Newspapers rarely cite anything more than a name as a source, but that’s the starting point for critical reading, as Dr. Goldacre has ably demonstrated for us.

You don’t have to go read those tricky journals. You don’t even need to read the specialist magazines, though it helps. Just do a little digging. Google a name and look for connections to industry or lobby groups. If you want to see if a named source publishes their research much, follow the link on this blog to Google Scholar and put their name in the search box. Ask yourself, did this pass through peer review? Most importantly of all, demand more of your news source. Look for multiple opinions in science articles. Look for evidence and look for data. Demand critical coverage. Above all, be a sceptic, but reasonable. Be a scientist in your own right.