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Use and misuse of scientific information

Medical researchers cannot blame the public for having irrational beliefs about science unless they shun practices that misuse evidence, BVA members were told at their annual conference

Giving the annual Wooldridge memorial lecture in London on 17th November, epidemiology researcher and best-selling author Ben Goldacre argued that public scepticism about the reliability of the information they are given may be entirely reasonable. Unfortunately, it can result in a resistance to accept the benefits of treatments such as the MMR (measles, mumps and rubella) vaccine for children.

Dr Goldacre pointed out that periodic scares about the safety of vaccination have emerged ever since such treatments were first introduced 200 years ago. “There appears to be something in particular about population level interventions that causes public anxiety,” he noted.

The patterns of these events are often quite similar. The previous UK incident occurred only about 15 years before the 1998 MMR panic and was focused on the whooping cough vaccine. The causes of such events are cultural rather than scientific, as shown by the lack of concern in other countries where the same vaccine is being used, he said. In France, for example, there were no worries about the MMR vaccine, but the administration of a hepatitis B treatment generated fears of a link with multiple sclerosis – the only other place where the same panic emerged was in the Francophone community in Canada, he said.

Dr Goldacre put the blame for this phenomenon on the medical establishment, medicines manufacturers and individual scientists for their failure to take steps that would restore their public trust. In his ‘Bad Science’ column that ran for many years in the Guardian newspaper, Dr Goldacre highlighted many examples of incidents where clinical trials had been deliberately designed to provide misleading evidence. He also pointed out that the results of more than half of all clinical trials are “routinely and legally withheld from doctors and patients”.

He cited the WHO programme against polio as an example of when this approach can go disastrously wrong. The programme was on the verge of eliminating this long- standing, global threat to children when campaigners in Kano province in northern Nigeria successfully persuaded the local population that the treatment was a conspiracy by a US drug company to render Muslim males infertile. As a result, children went untreated and the area started exporting polio cases around the world.

“People talk about this incident as though it was a sudden irrational explosion of idiocy in primitive people, in a way I find deeply offensive. The truth is that around three years earlier in the same region, children had been damaged in a trial of a new antibiotic drug, Trovan. When the vaccine campaign began, people were hearing news of the prosecution of those local officials who authorised that first trial and were responsible for dealing with the consequences. Just because people get some of the details wrong doesn’t mean that people are wrong to be suspicious,” he said.

Dr Goldacre outlined the various ways that scientific information is consciously or unconsciously manipulated by policymakers, industry, journalists and campaign groups. These varied from simple manipulation of powerful visual data by truncating the Y axis in a graph, through blurring the lines between causation and correlation, and to the drawing of wilfully inaccurate conclusions from a legitimate study. The Daily Mail was a regular offender in this respect, frequently using its pages to push conclusions that promoted its own political agenda. He noted that publication’s obsession with factors that are supposed either to cause or protect against cancer.

Dr Goldacre’s writings are also noted for their tireless pursuit of charlatans. He made a particular target of the self-styled television nutritionist Gillian McKeith, noting that the qualifications that ‘Dr’ McKeith claims to have earned may be bought on the internet.

To demonstrate the limited value of membership of the American Association of Nutritional Consultants, he mischievously signed up a new member for that body. On receipt of the sum of $60, it provided a certificate of membership to Hetty, who was a cat with no recognised training in nutritional science. Moreover, she had been dead for several years.