Thursday, 14 November 2013

A Dangerous Infection

Sadly disease has struck the shelves of some of the nation's leading magazine retailers, in the shape of the WDDTY bacterium; this is its footprint:

Watch out for it. It's spread by a Lynne Mctaggart, whose rather silly but dangerous views can be sampled here: When 'Science' is a Dirty Word. Note the scare quotes; it's indicative of a schizophrenic approach to the subject. I cannot find details of her scientific qualifications anywhere, but presumably she must have them. She says:
We have been accused of being unscientific, of pedaling [sic] unproven and harmful alternatives, as opposed to the real thing, true ‘scientific’ medicine.
This is true; they have been accused of being unscientific, and they have been peddling unproven and harmful alternatives. She then makes three points, which she says add up "to one indisputable truth: there is nothing remotely scientific about conventional medicine". The points are:

  1. Most of the science behind standard treatments is fiction. This has no supporting reference.
  2. Most treatments haven’t been proven to work. The BMJ are cited here, with no reference. Maybe it's the Clinical Evidence research?
  3. Most treatments cause harm. Again no reference.

Well, these points are not completely off the mark, I don't think. Ben Goldacre says in Bad Pharma that 'Medicine is broken', and goes on to deliver this withering assessment:
Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques which are flawed by design, in such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies don’t like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug’s true effects. Regulators see most of the trial data, but only from early on in a drug’s life, and even then they don’t give this data to doctors or patients, or even to other parts of government. This distorted evidence is then communicated and applied in a distorted fashion. In their forty years of practice after leaving medical school, doctors hear about what works through ad hoc oral traditions, from sales reps, colleagues or journals. But those colleagues can be in the pay of drug companies – often undisclosed – and the journals are too. And so are the patient groups. And finally, academic papers, which everyone thinks of as objective, are often covertly planned and written by people who work directly for the companies, without disclosure. Sometimes whole academic journals are even owned outright by one drug company. Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it’s not in anyone’s financial interest to conduct any trials at all. These are ongoing problems, and although people have claimed to fix many of them, for the most part they have failed; so all these problems persist, but worse than ever, because now people can pretend that everything is fine after all. - Goldacre, Ben (2012-09-25). Bad Pharma: How drug companies mislead doctors and harm patients (Kindle Locations 43-55). HarperCollins Publishers. Kindle Edition. 
Goldacre goes on to document in rather harrowing detail how poor the process is for bringing drugs to market. Unfortunately for Mctaggart, none of that makes her magazine's claims any more believable. Just because medical science has problems does not automatically mean that the alternative does not. For centuries humorism held sway in the medical establishment, with people happily undergoing purges and bloodletting and getting better through regression to the mean. What put an end to it? Science. The only way to progress matters medicinal is to add more science, not to blithely disregard it. But her entire modus operandi is to discredit science in order to promote unscientific alternatives.

Her poor reasoning comes to the fore when she discusses comparative statistics on harm caused by real medicine and alternative 'remedies':
So that risk is: 0.01/1 million for natural substances vs 1000/1 million for drugs.  In other words, the risk of lethal harm from modern medicine is 100,000 higher than that of herbal or nutritional medicine.
This beggars the basic question: which form of medicine is the least scientific?
It should surely be obvious to anyone that a remedy that does nothing is far less likely to cause harm than one that does something. There are, of course, sins of omission, so people are harmed by taking a 'remedy' that does nothing. But her statistics simply highlight that she is peddling treatments that do nothing.
Drugs constitute a one-size-fits-all model, whereas every human being is unique. Drugs that work on me may not work on you and vice versa; most drugs can’t be made smart enough to, say, slot only tab A into slot B without affecting slot C, D and E, because humans are holistic.
Yet, somehow this 'one-size-fits-all model' is fine for the companies that sell Vitamin C, herbal 'remedies' and homeopathy? Of course! By this logic she should have to send a tailored copy of WDDTY to each of her subscribers, lest she is accused of neglecting their uniqueness. She signs off:
True science seeks to drive a stake into science, particularly scientism.
Nevertheless, mainstream science, particularly mainstream medicine, has grown ever more fundamentalist, dominated by a few highly vocal people who believe that our scientific story has largely been written and that the job of science is simply to confirm it.
Thankfully, an enormous body of resistance carries on in defiance of this restricted—highly unscientific—view. May they and all the true scientists like them continue to light our way.
In fact, those who value science and the nation's well-being are trying to organize resistance to this infection; anti-biotics are being developed around the blogosphere! Check out WWDDTYDTY for analyses of WDDTY articles, and Josephine Jones is maintaining a master list of issues relating to this unfortunate publication.

Sadly for Mctaggart, as GP Margaret McCartney said:
I'm astounded that Lynne thinks this is an evidence-based publication. It's anything but. The problem with evidence is that it can tell you things that you'd rather not know. A lot of the time medicine does do harm but that's why doctors and scientists are duty-bound to put their research findings out there and to stop doing things that cause harm. What we shouldn't do is abandon medicine and the scientific method and go straight for alternative medicine with no good evidence that that works either.


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